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Otolaryngology, ENT & Sinus News Provided by the California Sinus CentersClinical Usefulness of Positron Emission Tomography-Computed Tomography in Recurrent Thyroid Carcinoma [Original Article]February 1, 2010, 12:00 pm by Archives of Otolaryngology Head & Neck SurgeryObjectives To determine the efficacy of combined positron emission tomography–computed tomography (PET-CT) in identifying recurrent thyroid cancer and to elucidate its role in the clinical management of thyroid carcinoma. Design Retrospective study. Setting Tertiary care referral academic center. Patients One hundred twenty-four patients with previously treated thyroid carcinoma who underwent PET-CT. Main Outcome Measures PET-CT images were correlated with clinicopathologic information. The influence of PET-CT findings on disease status determination and the treatment plan was evaluated. Results Among 121 patients undergoing iodine I 131 (131I) imaging (an 131I image was unavailable for 3 patients), 80.6% had negative findings on 131I imaging before undergoing PET-CT. Among 75 patients who had positive findings on PET-CT, 71 were true positive results. Among 49 patients who had negative findings on PET-CT, 32 were true negative results. Therefore, PET-CT demonstrated a sensitivity of 80.7%, specificity of 88.9%, positive predictive value of 94.7%, and negative predictive value of 65.3%. A significant difference was noted in the mean serum thyroglobulin levels between patients with positive vs negative PET-CT findings (192.1 vs 15.0 ng/mL, P = .01) (to convert thyroglobulin level to micrograms per liter, multiply by 1.0). Overall, distant metastases were detected in 20.2% of patients using PET-CT. There was an alteration of the treatment plan in 28.2% of patients as a result of added PET-CT information, and 21.0% of patients underwent additional surgery. Conclusions PET-CT is usually performed in patients with thyroid cancer having elevated thyroglobulin levels but non-131I–avid tumors and has high diagnostic accuracy for identifying local, regional, and distant metastases. Additional information from PET-CT in patients with 131I-negative and thyroglobulin-positive tumors frequently guides the clinical management of recurrent thyroid carcinoma.
More from Archives of Otolaryngology Head & Neck Surgery Long-term Results of Radiofrequency Turbinoplasty for Allergic Rhinitis Refractory to Medical Therapy [Original Article] Archives of Otolaryngology Head & Neck Surgery: July 19, 2010, 12:00 pm Objective To study the long-term outcomes of radiofrequency (RF) turbinate surgery for the treatment of allergic rhinitis refractory to medical therapy.Design A retrospective review of a prospective data set.Setting Tertiary referral center.Patients Sea view at Palma de Mallorca [About the Cover] Archives of Otolaryngology Head & Neck Surgery: July 1, 2010, 12:00 pm About This Journal [About This Journal] Archives of Otolaryngology Head & Neck Surgery: July 1, 2010, 12:00 pm Lack of Financial Barriers to Pediatric Cochlear Implantation: Impact of Socioeconomic Status on Access and Outcomes [Original Article] Archives of Otolaryngology Head & Neck Surgery: July 1, 2010, 12:00 pm Objectives (1) To analyze if socioeconomic status influences access to cochlear implantation in an environment with adequate Medicaid reimbursement. (2) To determine the impact of socioeconomic status on outcomes after unilateral cochlear Propranolol in the Management of Airway Infantile Hemangiomas [Original Article] Archives of Otolaryngology Head & Neck Surgery: July 1, 2010, 12:00 pm Objective To report our experience with propranolol in managing airway infantile hemangiomas. Design Case series of 3 consecutive patients who had extensive, symptomatic airway infantile hemangiomas treated with propranolol. Setting Tertiary academic medical center. Patients
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