Daniel Pryma MD, Presenter: Nothing to Disclose

Heiko Schoder MD, Abstract Co-Author: Nothing to Disclose

Richard J Robbins MD, Abstract Co-Author: Nothing to Disclose

Steven Mark Larson MD, Abstract Co-Author: Nothing to Disclose

Henry Yeung, Abstract Co-Author: Nothing to Disclose

Hürthle cell carcinoma presents diagnostic and therapeutic challenges because it is often characterized by an aggressive course and poor avidity for radioactive iodine. It has been suggested that 18F-FDG PET may improve diagnostic accuracy and disease management. We reviewed our experience with 18F-FDG PET in patients with Hürthle cell carcinoma to determine the accuracy of PET compared to other imaging modalities and laboratory tests.

Patients with Hürthle cell carcinoma status post surgical resection of primary disease who underwent an initial 18F-FDG PET scan at our institution between May, 1996 and February, 2003 were retrospectively reviewed. All available imaging (including CT, ultrasound, radioiodine scintigraphy and MRI), laboratory and clinical follow up of up to one year were reviewed for presence of disease and used as gold standard.

52 patients were identified as meeting study criteria. Eight patients were lost to follow up and were excluded. There were 23 positive and 21 negative PET scans, with sensitivity and specificity of 95.7% and 95.2%, respectively. Most patients had very striking uptake of radiotracer with mean maximum standardized uptake value (SUV) of 17.3±14.7 (range 2.1 – 53). In 4 patients (9%) with negative conventional imaging modalities, PET identified disease subsequently confirmed on follow up. Furthermore, there were 3 patients (7%) with positive conventional imaging modalities who were correctly identified by negative PET as not having disease on subsequent follow up.

18F-FDG PET scanning in patients with Hürthle cell carcinoma demonstrates excellent sensitivity and specificity and improves identification of metastatic disease over other available imaging modalities. Furthermore, Hürthle cell carcinoma tends to be very 18F-FDG avid. Therefore, 18F-FDG PET should be used in all patients who have undergone surgical resection of Hürthle cell carcinoma.

Pryma, D, Schoder, H, Robbins, R, Larson, S, Yeung, H, 18F-FDG PET Improves Diagnostic Accuracy in Patients with Hürthle Cell Carcinoma.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4408688.html