Review of Fluorine-18-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography (FDG-PET) in the Follow-Up of Medullary and Anaplastic Thyroid Carcinomas

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Abstract
The goal of posttreatment follow-up for medullary and anaplastic thyroid cancer (MTC and ATC) is the early diagnosis of recurrence or metastases. However, routine follow-up protocols, including physical examination and clinically oriented investigations, are not standardized, and their sensitivity in accurately detecting recurrent or metastatic disease is often suboptimal. A valuable addition to posttreatment follow-up of oncology patients is positron emission tomography using fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG-PET). We review the role of FDG-PET imaging in the follow-up of patients previously treated for MTC and ATC. Based on the encouraging literature data, FDG-PET appears to be useful in detecting recurrent or metastatic disease in patients with MTC and ATC, providing a higher sensitivity (66% to 100%) and specificity (79% to 90%) than conventional imaging methods. However, the PET technique is limited by less accurate spatial assignment of small lesions, especially in the lung and liver. Supporting evidence indicates that FDG-PET has a significant role in the follow-up of patients with MTC and ATC.