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Preoperative PET-CT in papillary thyroid cancer

Preoperative PET-CT in papillary thyroid cancer. Chung- Ang University, Korea Department of Surgery. Byung Seup Kim, Ju Won Seok , Han suk Ryu , Kyung Ho Kang, Sung Jun Park, Bo Youn Cho. Introduction. FDG. PET – CT. 2-[fluorine-18] f luoro-2- d eoxy- glucose. Introduction.

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Preoperative PET-CT in papillary thyroid cancer

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  1. Preoperative PET-CT in papillary thyroid cancer Chung-Ang University, Korea Department of Surgery ByungSeup Kim, Ju Won Seok, Han sukRyu, Kyung Ho Kang, Sung Jun Park, Bo Youn Cho

  2. Introduction FDG PET – CT 2-[fluorine-18]fluoro-2-deoxy- glucose

  3. Introduction Meaning of FDG -uptake Rate of uptake of FDG is proportional to metabolic activity Metabolic activity Uptake of FDG An introduction to PET-CT imaging. Radigraphics 2004; 523-543

  4. Flip – flop phenomenon PTC

  5. Introduction We evaluated the FDG uptake of papillary thyroid cancer in preoperative PET CT. About Primary lesion

  6. Method Operation Preoperative PET-CT FNAB : Papillary thyroid cancer Period : 2011.3.1 ~ 2012. 2. 29 PTC was preoperatively confirmed by FANB CND was routinely performed. Preoperative PET CT was performed when patient argeed it Enrolled patients : 194

  7. Method Divided into PET negative(-) and positive(+) group VS. Postive ; Presence of FDG uptake Negative ; Absence of FDG uptatke Backgroud : surrounding thyroid tissue

  8. Method 1. Analyze the cliniopathologic factors related to PET (+) 2. .Analyze quantity of SUVmax value according to clinicopathologic factors SUVmax : maximal standardized uptake value SUVmax of PET negative patient = SUV of surrounding thyroid tissue

  9. Results PET sensitivity ① Primary tumor : 71.7% (138/194 patients) ③ Lateral lymph node metz. : 62.5% (15/24 patients) False positive : 1.1% ② Central lymph node metz. : 4.3% (3/70 patients)

  10. Results Table 1-1. PET-CT and clinicopathologic parameters

  11. Table 1-2. PET-CT and clinicopathologic parameters

  12. Results Table 2. PET positivity and cliniocopathologic parameters by logistic regression PTCa Papillary thyroid cancer

  13. 2. Analysis for quantity of FDG uptake

  14. SUVmax Kolmogorov-Smirnove goodness P < 0.001 Non normally distributed data

  15. Table 3. SUVmax by clinicopathologic parameters d The number of case was only one so that quartile was not available

  16. Analysis for quantity of FDG uptake Relationship between extrathyroidal extension and SUVmax ROC curve P value < 0.001 SUVmax 2.6 sensitivity 70.3% specificity 60.0% 1-specificity

  17. Results Cliniopathologic factors and Extrathyroidalexntesion by univariate analysis

  18. Extrathyroidal extension and clinicopathologic factors by mulivariate analysis → SUVmax was not related to extrathyroidal extension

  19. Results Cliniopathologic factors and lymph node metastasis by univariate analysis

  20. Lymph node metastasis and clinicopathologic factors by mulivariate analysis → SUVmax was not related to lymph node metastasis

  21. Subtype Relationship between Non-follicular subtype and SUVmax ROC curve P value < 0.001 FDG 2.0 sensitivity 70.9% specificity 69.0 % 1-specificity

  22. Results Cliniopathologic factors and subtype of PTC by univariate analysis

  23. Non-follicular variant and clinicopathologic factors by mulivariate analysis

  24. Conclusion The usefulness of preoperative PET-CT for PTC was not yet certain. PET positive results and SUVmax had no relation to significant clinical factors such as extrathyroidal extension and lymph node metastasis. PET negative results or low SUVmax indicate the possibility of follicular variant subtype in papillarthyroid cancer.

  25. Thank you for your attention

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