Y. Zeki ÇELEN, Ebuzer KALENDER, Hasan Deniz DEMİR, Hüseyin KARAOĞLAN, Umut ELBOĞA, Ertan ŞAHİN

MEDÜLLER TİROİD KARSİNOMALI HASTALARIN TAKİBİNDE FDG PET

Amaç: Çalışmanın amacı cerrahi sonrası yüksek kalsitonin seviyelerine sahip medüller tiroid karsinomlu (MTK)hastaların takibinde florodeoksiglikoz pozitron emisyon tomografisinin (FDG PET) etkinliğini değerlendirmektedir.Gereç ve Yöntemler: Çalışmaya yüksek kalsitonin seviyeleri nedeniyle kliniğimize FDG PET görüntüleme içinyönlendirilen MTK tanılı 6 hasta dahil edildi. Bütün hastalar erkekti. Yaş ortalaması 52±8 idi.Bulgular: Kalsitonin seviyeleri sırasıyla75 pg/ml, 90pg/ml, 94 pg/ml ve 127 pg/ml olan 4 hastada FDG PETgörüntülemede MTKnın rekürrens ya da metastazını düşündürecek bulgu izlenmedi. Kalsitonin seviyeleri1300 pg/ml ve 2110 pg/ml olan 2 hastada ise FDG PET bulguları pozitifti. Bu hastalarda lenf nodu ve kemikmetastazları saptandı.Tartışma: Öyle görünüyor ki MTKnın rutin görüntülemesinde FDG PETe yer yoktur. Ancak burada kalsitoninseviyeleri önem arz etmektedir. Kalsitonin seviyeleri 1000 pg/mlden yüksek hastalarda FDG PET oldukça faydalıolabilmekte ve birçok lezyon odağını tespit edebilmektedir. Ayrıca tüm vücut görüntülemeye olanak sağlamasıda önemli bir avantajıdır.

FDG PET in the Follow-up of Medullary Thyroid Carcinoma Patients

Objective: The aim of study is to evaluate the impact of fluorodeoxyglucose positron emission tomography(FDG PET) in the follow-up of medullary thyroid carcionma (MTC) patients who had elevated calcitonin levelsafter surgery.Materials and Methods: Six patients diagnosed with MTC who referred to our clinic for FDG PET imagingbecause of the elevated calcitonin levels were included. All were male. Mean age was 52±8 years.Results: In 4 patients whose calcitonin levels were 75 pg/ml, 90pg/ml, 94 pg/ml and 127 pg/ml respectively,there was no evidence for recurrence or metastasis of MTC on FDG PET. FDG PET findings were positive in 2patients whose calcitonin levels were 1300 pg/ml and 2110 pg/ml respectively. In these patients lymph nodemetastases and bone metastases were detected.Conclusion: It seems that there is no place to FDG PET for routine imaging of MTC. But here calcitonin levels areimportant. In patients who have calcitonin levels higher than 1000 pg/ml FDG PET can be very useful and detecta lot of lesion foci. Also allowing to whole body imaging is a significant advantage of it.

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