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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 Health-Related Quality of Life in Survivors of Head and Neck Cancer [Original Article] Archives of Otolaryngology Head & Neck Surgery: January 16, 2012, 12:00 pm Objective To examine health-related quality of life (HRQOL) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores. Design Prospective, observational outcomes study. Setting Tertiary care institution. Patients A total Sequential Bilateral Cochlear Implantation in Children: Quality of Life [Original Article] Archives of Otolaryngology Head & Neck Surgery: January 16, 2012, 12:00 pm Objective To assess the effect of sequential bilateral cochlear implantation in children on their quality of life (QoL). Design Prospective cohort-control study. Setting Tertiary academic referral center. Patients Thirty children with prelingual deafness underwent sequential Disinfection of Flexible Fiberoptic Laryngoscopes After In Vitro Contamination With Staphylococcus aureus and Candida albicans [Original Article] Archives of Otolaryngology Head & Neck Surgery: January 16, 2012, 12:00 pm Objective To determine the efficacy of various cleaning and disinfective methods in reducing bacterial and fungal load on flexible fiberoptic laryngoscopes (FFLs). Design In vitro model. Subjects Flexible fiberoptic laryngoscopes contaminated with Staphylococcus aureus Winter scene, Pittsburgh, Pennsylvania [About the Cover] Archives of Otolaryngology Head & Neck Surgery: January 1, 2012, 12:00 pm About This Journal [About This Journal] Archives of Otolaryngology Head & Neck Surgery: January 1, 2012, 12:00 pm
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