Positron emission tomography (PET) is a highly sensitive and low invasive technology for cancer biological imaging. Integrated PET/computed tomography (PET/CT) cameras combine functional and anatomical information in a synergistic manner that improves diagnostic interpretation. The role of 18F FDG PET/CT in differentiated thyroid cancer (DTC) is well established, particularly in patients presenting with elevated thyroglobulin (Tg) levels and negative radioactive iodine scan. This review presents the evidence supporting the use of 18F FDG PET/CT throughout the diagnosis and management of thyroid cancer, and provides suggestions for its clinical uses.
The aim of this study is to analyze the concordance between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO in patients with myocardial infarction. Sixty-four patients with coronary artery disease (CAD) and myocardial infarction were enrolled in the study.. Each patient underwent at least two of the above mentioned studies within 2 weeks. LVEF、 EDV and ESV values were analyzed with dedicated software. Statistical evaluation of correlation and agreement was carried out EDV was overestimated by 18F-FDG PET compared with GSPECT [(137.98±61.71) mL and (125.35±59.34) mL]; ESV was overestimated by 18F-FDG PET (85.89±55.21) mL and GSPECT (82.39±55.56) mL compared with ECHO (68.22±41.37) mL; EF was overestimated by 18F-FDG PET (41.96%±15.08%) and ECHO (52.18%±13.87%) compared with GSPECT (39.75%±15.64%), and EF was also overestimated by 18F-FDG PET compared with GSPECT. The results of linear regression analysis showed good correlation between EDV, ESV and LVEF values derived from 18F-FDG PET, GSPECT and ECHO (r=0.643-0.873, P=0.000). Bland-Altman analysis indicated that 18F-FDG PET correlated well with ECHO in the Left ventricular function parameters. While GSPECT correlated well with 18F-FDG PET in ESV, GSPECT had good correlation with Echo in respect of EDV and EF; whereas GSPECT had poor correlation with PET/ECHO in the remaining left ventricular function parameters. Therefore, the clinical physicians should decide whether they would use the method according to the patients' situation and diagnostic requirements.
ObjectiveTo evaluate whether thyroglobin (Tg) value by radioimmunoassay (Tg-RIA) can be used as a complementary marker in differentiated thyroid cancer (DTC) patients, as serum Tg value is the key marker for the follow-up of patients with DTC, and endogenous antithyroglobulin (TgAb) interferes with serum Tg value by immunometric assay (Tg-IMA). MethodsFifty-five in-hospital patients with DTC after total thyroidectomy and 131I ablation during September and December 2012 were enrolled. Tg-IMA tests and Tg-RIA tests were performed separately. Diagnostic criteria about relapse, metastasis or disease-free status of thyroid carcinoma were established by serum Tg, diagnostic whole body scan (D-WBS), neck ultrasonography, chest CT and patients' history. ResultsTwo DTC patients showed false negative Tg-IMA and true positive Tg-RIA. Five patients had false negative Tg-RIA because of low sensitivity of RIA. Four patients with weak positive Tg-IMA (1.07-4.09 μg/L) required follow-up. Among the 11 DTC patients with strong TgAb positivity (>115 kU/L), two patients with positive Tg-IMA and positive Tg-RIA received second operation or radioiodine therapy, seven patients had positive Tg-RIA and negative Tg-IMA. Five of the seven patients with strong positive TgAb needed further follow-up, and two of them received radioiodine therapy. ConclusionTg value with radioimmunoassay is a complementary marker to find false negative Tg-IMA in follow-up patients with DTC.
ObjectiveTo compare the diagnostic efficacy of serum thyroglobulin (Tg), diagnostic 131I whole-body scan (D-WBS), neck ultrasound for diagnosing metastasis and recurrence of differentiated thyroid carcinoma (DTC). MethodsFrom May to June 2011, fifty follow-up DTC patients were collected retrospectively 6 months or more after 131I ablation therapy following total-thyroidectomy or near-total thyroidectomy. The diagnostic standard for DTC metastasis and relapse were based on serum Tg, D-WBS, neck ultrasound and chest CT. Diagnostic 2 by 2 table was employed for calculating the sensitivity, specificity, accuracy of the methods. ResultsThe sensitivity, specificity, accuracy, positive predictive value, negative predictive value of TgIMA and D-WBS parallel experiments were 100.0%, 92.9%, 96.0%, 91.7%, and 100.0% respectively. ConclusionTgIMA combined with D-WBS parallel test in diagnosis of DTC metastasis and recurrence has the highest accuracy.
ObjectiveTo compare the citations of Chinese literature in the 2015 and 2025 editions of the American Thyroid Association (ATA) guidelines, aiming to evaluate the progress in the field of differentiated thyroid cancer (DTC) research in China. MethodsChinese literature cited in the 2015 and 2025 ATA guidelines was collected and cataloged. A comparison was conducted between the two editions regarding the number of publications, source journals, affiliated institutions and their regional distribution, research types, and research foci of the cited literature. Results ① Changes in the quantity and regional distribution of Chinese citations: in the 2025 ATA guideline, the proportion of Chinese literature cited increased by nearly two times compared to the 2015 ATA guideline [8.8% (128/1 458) vs. 3.3% (36/1 078), P＜0.001]. The number of source journals increased by nearly three times (74 vs. 21), the number of contributing cities nearly doubled (29 vs. 13), and the number of involved healthcare institutions increased by nearly three times (65 vs. 18). In terms of regional distribution, compared to the 2015 ATA guideline, where institutions producing cited literature were mainly located in the Taiwan region (11 publications), the Hong Kong region (11 publications), and coastal and Beijing-Tianjin-Hebei rigions of the Chinese mainland (12 publications), the 2025 ATA guideline showed a expansion of distribution to medical centers in regions such as Beijing-Tianjin-Hebei, Yangtze River Delta, Pearl River Delta, Chengdu, and Changchun. Among these, West China Hospital of Sichuan University had the highest number of cited publications nationwide (20 publications). The proportion of cited literature from institutions in the Chinese mainland increased significantly compared to that from the Taiwan and Hong Kong regions [69.2% (45/65) vs. 16.9% (11/65) and 13.8% (9/65)]. ② Changes in research types of cited literature: clinical research constituted the majority [100% (36/36) and 97.7% (125/128), respectively] of the cited Chinese literature in both the 2015 and 2025 ATA guidelines. However, three basic research studies appeared in the 2025 ATA guideline. Cited literature in both editions was predominantly single-center studies [86.7% (26/30) and 93.8% (90/96), respectively]. ③ Changes in research foci of cited literature: the number of research foci involved in the 2025 ATA guideline (19 foci) increased by nearly doubled compared to the 2015 ATA guideline (11 foci). Among them, iodine-131 therapy was the most cited research focus in both editions. Among research foci with ≥5 citations, besides traditional areas such as tumor staging and prognosis, and surgical methods and extent which remained top-ranked, the ranking of recurrent laryngeal nerve protection rose. The ranking of some traditional research foci, such as molecular markers, imaging, preoperative diagnosis, declined. Notable newly prominent or significantly changed foci included ablation therapy (12 publications, ranked 2nd), comprehensive treatment (11 publications), lymph node metastasis (10 publications), parathyroid protection (7 publications), thyroid cancer and pregnancy risks (5 publications), and active surveillance (5 publications). ConclusionsCompared to the 2015 ATA guideline, the 2025 ATA guideline cites a higher proportion of Chinese literature, demonstrates a wider geographical distribution of publication origins (expanding from Taiwan region, Hong Kong region, and coastal developed area to major regional centers across China), and covered broader and more in-depth research foci. This suggests that the field of DTC in China has undergone robust development in recent years, with a gradual shift from traditional focuses such as cure rate and recurrence rate towards improving long-term quality of life, developing individualized, and precise comprehensive management models. China is playing an increasingly important role in establishing global DTC diagnostic and treatment standards. However, high-quality prospective, multicenter, randomized controlled trials remain to be strengthened.