open access

Vol 25, No 2 (2022)
Research paper
Submitted: 2022-01-03
Accepted: 2022-06-30
Published online: 2022-07-21
Get Citation

Value of diffusion MRI versus [18F]FDG PET/CT in detection of cervical nodal metastases in differentiated thyroid cancer patients

Ahmed M. Shalash1, Mai Amr Elahmadawy2, Samia Y. Heikal1, Ayman A. Amin3, Ayda A. Youssef1
·
Pubmed: 35971948
·
Nucl. Med. Rev 2022;25(2):112-118.
Affiliations
  1. Department of Diagnostic Radiology, National Cancer Institute, Cairo University, Egypt
  2. Nuclear Medicine Unit, National Cancer Institute, Cairo University, Egypt
  3. Department of surgery, National Cancer Institute, Cairo University, Egypt

open access

Vol 25, No 2 (2022)
Original articles
Submitted: 2022-01-03
Accepted: 2022-06-30
Published online: 2022-07-21

Abstract

Background: In differentiated thyroid cancer (DTC) patients, cervical nodal metastasis is a negative prognostic factor. Preoperative imaging plays an important role in treatment planning for nodal metastasis and recurrence. The aim of the study is to compare the diagnostic performance of the diffusion-weighted magnetic resonance imaging (DW-MRI) and the F-18 flurodeoxyglucose positron emission computed tomography ([18F]FDG PET/CT) in detection of cervical nodal deposits in DTC patients. Materal and methods: The study was conducted on 30 patients, each performed both modalities just before the surgery. The gold standard was the pathological specimens with post-operative clinico-radiological follow-up, to assess the diagnostic performance of each modality. Results: Based on pathological and post-operative clinico-radiological follow up data. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were 84%, 80%, 50%, 95% and 83% for PET/CT compared to 84%, 60%, 42.8%, 91.3% and 80% for DW-MRI. On comparing the diagnostic performance of combined DW-MRI and PET/CT to each modality alone, the sensitivity and NPV were improved to 96% and 80% respectively. Conclusions: [18F]FDG PET/CT study is a valuable diagnostic modality for the assessment of cervical nodal deposits in DTC patients, surpassing DW-MRI. Combined PET/CT and DW-MRI techniques seemed to have synergistic performance, mainly in terms of sensitivity and NPV, for detection of nodal metastases.

Abstract

Background: In differentiated thyroid cancer (DTC) patients, cervical nodal metastasis is a negative prognostic factor. Preoperative imaging plays an important role in treatment planning for nodal metastasis and recurrence. The aim of the study is to compare the diagnostic performance of the diffusion-weighted magnetic resonance imaging (DW-MRI) and the F-18 flurodeoxyglucose positron emission computed tomography ([18F]FDG PET/CT) in detection of cervical nodal deposits in DTC patients. Materal and methods: The study was conducted on 30 patients, each performed both modalities just before the surgery. The gold standard was the pathological specimens with post-operative clinico-radiological follow-up, to assess the diagnostic performance of each modality. Results: Based on pathological and post-operative clinico-radiological follow up data. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were 84%, 80%, 50%, 95% and 83% for PET/CT compared to 84%, 60%, 42.8%, 91.3% and 80% for DW-MRI. On comparing the diagnostic performance of combined DW-MRI and PET/CT to each modality alone, the sensitivity and NPV were improved to 96% and 80% respectively. Conclusions: [18F]FDG PET/CT study is a valuable diagnostic modality for the assessment of cervical nodal deposits in DTC patients, surpassing DW-MRI. Combined PET/CT and DW-MRI techniques seemed to have synergistic performance, mainly in terms of sensitivity and NPV, for detection of nodal metastases.

Get Citation

Keywords

DW-MRI; PET/CT; DTC; cervical nodal metastasis

Supp./Additional Files (2)
Supplementary Figure (1)
Download
81KB
Supplementary Table (1)
Download
55KB
About this article
Title

Value of diffusion MRI versus [18F]FDG PET/CT in detection of cervical nodal metastases in differentiated thyroid cancer patients

Journal

Nuclear Medicine Review

Issue

Vol 25, No 2 (2022)

Article type

Research paper

Pages

112-118

Published online

2022-07-21

Page views

4466

Article views/downloads

393

DOI

10.5603/NMR.a2022.0035

Pubmed

35971948

Bibliographic record

Nucl. Med. Rev 2022;25(2):112-118.

Keywords

DW-MRI
PET/CT
DTC
cervical nodal metastasis

Authors

Ahmed M. Shalash
Mai Amr Elahmadawy
Samia Y. Heikal
Ayman A. Amin
Ayda A. Youssef

References (22)
  1. Furuya-Kanamori L, Sedrakyan A, Onitilo AA, et al. Differentiated thyroid cancer: millions spent with no tangible gain? Endocr Relat Cancer. 2018; 25(1): 51–57.
  2. Schmidbauer B, Menhart K, Hellwig D, et al. Differentiated thyroid cancer-treatment: state of the art. Int J Mol Sci. 2017; 18(6).
  3. Shokoohi A, Berthelet E, Gill S, et al. Treatment for recurrent differentiated thyroid cancer: a canadian population based experience. Cureus. 2020; 12(2): e7122.
  4. Hollenbeak CS, Boltz MM, Schaefer EW, et al. Recurrence of differentiated thyroid cancer in the elderly. Eur J Endocrinol. 2013; 168(4): 549–556.
  5. Hempel JM, Kloeckner R, Krick S, et al. Impact of combined FDG-PET/CT and MRI on the detection of local recurrence and nodal metastases in thyroid cancer. Cancer Imaging. 2016; 16(1): 37.
  6. Papaleontiou M, Haymart MR. New insights in risk stratification of differentiated thyroid cancer. Curr Opin Oncol. 2014; 26(1): 1–7.
  7. Chen Q, Raghavan P, Mukherjee S, et al. Accuracy of MRI for the diagnosis of metastatic cervical lymphadenopathy in patients with thyroid cancer. Radiol Med. 2015; 120(10): 959–966.
  8. Treglia G, Muoio B, Giovanella L, et al. The role of positron emission tomography and positron emission tomography/computed tomography in thyroid tumours: an overview. Eur Arch Otorhinolaryngol. 2013; 270(6): 1783–1787.
  9. Platzek I, Beuthien-Baumann B, Schneider M, et al. PET/MRI in head and neck cancer: initial experience. Eur J Nucl Med Mol Imaging. 2013; 40(1): 6–11.
  10. Salem F, Elshafey R, Elmahalawy M, et al. Apparent diffusion coefficient measurements in the differentiation between benign and malignant neck masses. Egyptian J Radiol Nucl Med. 2014; 45(2): 367–375.
  11. Nagamachi S, Wakamatsu H, Kiyohara S, et al. Comparison of diagnostic and prognostic capabilities of ¹⁸F-FDG-PET/CT, ¹³¹I-scintigraphy, and diffusion-weighted magnetic resonance imaging for postoperative thyroid cancer. Jpn J Radiol. 2011; 29(6): 413–422.
  12. Weber T, Ohlhauser D, Hillenbrand A, et al. Impact of FDG-PET computed tomography for surgery of recurrent or persistent differentiated thyroid carcinoma. Horm Metab Res. 2012; 44(12): 904–908.
  13. Kim SJ, Lee SW, Pak K, et al. Diagnostic performance of PET in thyroid cancer with elevated anti-Tg Ab. Endocr Relat Cancer. 2018; 25(6): 643–652.
  14. Caetano R, Bastos C, Oliveira Ide, et al. Accuracy of positron emission tomography and positron emission tomography-CT in the detection of differentiated thyroid cancer recurrence with negative131I whole-body scan results: A meta-analysis. Head & Neck. 2015; 38(2): 316–327.
  15. Rosenkrantz AB, Friedman K, Chandarana H, et al. Current Status of Hybrid PET/MRI in Oncologic Imaging. AJR Am J Roentgenol. 2016; 206(1): 162–172.
  16. Kanmaz L, Karavas E. The role of diffusion-weighted magnetic resonance imaging in the differentiation of head and neck masses. J Clin Med. 2018; 7(6): 130.
  17. Razek AK, Soliman NY, Elkhamary S, et al. Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 2006; 16(7): 1468–1477.
  18. Perrone A, Guerrisi P, Izzo L, et al. Diffusion-weighted MRI in cervical lymph nodes: differentiation between benign and malignant lesions. Eur J Radiol. 2011; 77(2): 281–286.
  19. Chong A, Ha JM, Han YH, et al. Preoperative lymph node staging by FDG PET/CT with contrast enhancement for thyroid cancer: a multicenter study and comparison with neck CT. Clin Exp Otorhinolaryngol. 2017; 10(1): 121–128.
  20. Jeong HS, Baek CH, Son YI, et al. Integrated 18F-FDG PET/CT for the initial evaluation of cervical node level of patients with papillary thyroid carcinoma: comparison with ultrasound and contrast-enhanced CT. Clin Endocrinol (Oxf). 2006; 65(3): 402–407.
  21. Jung Jh, Kim CY, Son SH, et al. Preoperative prediction of cervical lymph node metastasis using primary tumor suvmax on 18F-FDG PET/CT in patients with papillary thyroid carcinoma. PLoS One. 2015; 10(12): e0144152.
  22. Byun BH, Jeong UG, Hong SP, et al. Prediction of central lymph node metastasis from papillary thyroid microcarcinoma by 18F-fluorodeoxyglucose PET/CT and ultrasonography. Ann Nucl Med. 2012; 26(6): 471–477.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

phone: +48 58 320 94 94, fax: +48 58 320 94 60, e-mail: viamedica@viamedica.pl