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PET imaging for thyroid cancers: Current status and future directions.

Positron emission tomography-computed tomography (PET/CT) combines both functional and anatomic information and provides in vivo molecular information on biological processes that can be useful at different steps of evolution of thyroid cancers. 18 Fluorodeoxyglucose being highly trapped in rapidly dividing cells makes 18 F-FDG-PET recommended in the staging, prognostic evaluation and follow-up of metastatic and/or of poorly differentiated thyroid carcinomas. 18 F-FDG PET/CT can help in the localization of persistent/recurrent disease. However, its sensitivity depends widely on tumor burden and histology. Iodine 124 (124 I) is currently under evaluation for diagnosis and pretherapeutic dosimetry planning. PET/CT using 18 F-FDOPA is the most sensitive radiopharmaceutical for localizing persistent/recurrent medullary thyroid carcinoma (MTC). However, its sensitivity depends on calcitonin levels, with a threshold value of around 150pg/mL. 18 F-FDG PET/CT can also be used in MTC with short calcitonin or CEA doubling time.

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