Thyroglobulin (Tg) and radioiodine whole body scan (WBS) have been commonly used in follow-up of patients with differentiated thyroid carcinoma (DTC). Tg is associated with radioiodine uptake in local or distant metastases. In minority of patients, the follow-up scan shows no functioning thyroid tissue, but the serum thyroglobulin is still elevated. Therefore, we review recent developments of diagnosis and treatment of those patients with differentiated thyroid cancer and with thyroglobulin elevation but negative iodine scintigraphy.
The main purpose of this study is to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) metabolism imaging in accurate staging and prognosis prediction before treatment of cervical cancer. 18F-FDG single photon emission computed tomography (SPECT/CT) was performed before treatment on 27 patients with cervical cancer and was analyzed retrospectively. All the images were analyzed by image fusion software. Meanwhile, primary tumor size and T/B, lymph nodes size and T/B were measured by software. Comparison of the relationship between primary tumor T/B of cervix and clinic pathological factors was performed using SPSS17.0. The diagnosis was established according to pathology results of surgery or/and multi-modalities of imaging and clinical following up. The results showed that the primary tumor T/B value of cervix was 5.9 (3.2). With the increased clinical stage, T/B of primary tumor value was significantly increased (P<0.05). The T/B value in patients ≥Ⅱa stage was significantly higher than those of ≤Ⅰb stage. There were no significant correlations between T/B value and primary tumor size, lymph-node metastasis, and histological type (P>0.05). Thirteen lymph nodes were detected by 18F-FDG imaging in 27 patients with cervical cancer. For diagnosing lymph nodes metastasis, the sensitivity, specificity, accuracy, positive and negative predictive value by 18F-FDG imaging were 75.0%, 78.9%, 77.8%, 60.0% and 88.2%, respectively. The T/B value of all lymph nodes was 6.3 (3.5), in which T/B value of distant metastasis was significantly higher than that of the pelvic metastasis (P<0.05). There were no significant correlations between T/B value and the size of lymph nodes (P>0.05). Uterine body uptaking FDG were discovered in 17 patients and 15 cases were then pathologically proved. Two of 15 cases were cancerous invasion of uterine body, and the other 13 cases were physiological changes of endometrial, and the T/B value of the former was significantly higher than that of the latter (P<0.05). There were positive correlation between invasion of uterine body and lymph nodes metastasis (P<0.05). In conclusion, 18F-FDG imaging has an obvious value for the diagnosis of outside pelvic and distant lymph node metastasis, uterine body infiltrated, and accurate staging. Primary focal T/B value of cervical cancer associates with the clinical stage, which can reflect the risk of patients, and were useful to preliminarily predict the prognosis of cervical cancer.
Lung metastases are more common in metastatic disease in differentiated thyroid carcinoma (DTC). Because of its insidious onset and slow development, clinical diagnosis is relatively difficult. Some possible diagnostic methods for detecting the lung metastasis of DTC including serological examination, radionuclide imaging and other medical imaging patterns are discussed in this paper. The progress and the current situation about investigation of those modalities which are in the early diagnosis, recurrent and clinical evaluation for the lung metastasis of DTC are briefly reviewed. Therefore, it is expected to promote DTC with lung metastasis to a higher diagnostic level.