Sat, 26 Jul 2008 00:11:23 BST CiteULike: omalbams pet http://www.citeulike.org/user/omalbam/tag/pet CiteULike.org en-gb Copyright © 2004-2008 citeulike.org http://www.citeulike.org/user/omalbam/article/2776524 <i>J Clin Endocrinol Metab, Vol. 93, No. 5. (1 May 2008), pp. 1519-1525.</i><br /><br />The 10-yr survival of differentiated thyroid cancer is about 76-93%, and at least 10% of patients manifest tumor persistence or recurrence, depending on their disease stage, after initial therapy, which typically includes total thyroidectomy and 131I ablation. Previously the realization of their residual/recurrent cancer often presented simultaneously with the additional surprise that they lacked pathological uptake on their diagnostic whole-body radioiodine image despite their elevated stimulated serum thyroglobulin (Tg) level, a scenario referred to as the scan-negative, Tg-positive patient. Now that serum Tg and neck ultrasonography have supplanted the diagnostic whole-body scan because of its inferior sensitivity, patients are often recognized to harbor residual disease without radioiodine imaging, and a new challenging scenario has emerged: the ultrasonography-negative, Tg-positive patient. Similarities and differences of these two patient populations aside, these Tg-positive patients are frequently encountered, and some are considered for additional 131I therapy, although now typically after negative anatomic +/- 18F-fluorodeoxyglucose positron emission tomography imaging or in the setting of known or suspected distant metastases already localized by anatomic imaging. Thus, the scan-negative, Tg-positive patient of today differs from those of the past, but the term still has relevance to current practice. The optimal evaluation and treatment of these patients remain controversial, partly because many of these patients will not die from thyroid cancer, and there are no randomized trials to demonstrate that intervention could have prevented the deaths that do occur. Here a case is presented that adds the complexity of advanced age, and one approach to these challenging patients is offered. 10.1210/jc.2007-2357 Approach to the Patient with a Positive Serum Thyroglobulin and a Negative Radioiodine Scan after Initial Therapy for Differentiated Thyroid Cancer Richard Kloos doi:10.1210/jc.2007-2357 J Clin Endocrinol Metab, Vol. 93, No. 5. (1 May 2008), pp. 1519-1525. 2008-05-09T19:55:08-00:00 2008 J Clin Endocrinol Metab 93 5 1519 1525 diagnosis pet thyroid-ca http://www.citeulike.org/user/omalbam/article/2223123 <i>J Clin Endocrinol Metab, Vol. 92, No. 12. (1 December 2007), pp. 4512-4513.</i><br /><br />10.1210/jc.2007-1337 A Pulmonary Adrenocorticotropin-Secreting Carcinoid Tumor Localized by 6-Fluoro-[18F]L-Dihydroxyphenylalanine Positron Emission/Computed Tomography Imaging in a Patient with Cushing's Syndrome S Dubois O Morel P Rodien F Illouz S Girault A Cahouet F Lacoeuille M Brousseau J Picquet V Rohmer doi:10.1210/jc.2007-1337 J Clin Endocrinol Metab, Vol. 92, No. 12. (1 December 2007), pp. 4512-4513. 2008-01-12T18:39:31-00:00 2007 J Clin Endocrinol Metab 92 12 4512 4513 cushing diagnosis pet http://www.citeulike.org/user/omalbam/article/2223120 <i>J Clin Endocrinol Metab, Vol. 92, No. 12. (1 December 2007), pp. 4706-4711.</i><br /><br />Objectives: Focal lesions in infants with congenital hyperinsulinism (HI) represent areas of adenomatosis that express a paternally derived ATP-sensitive potassium channel mutation due to embryonic loss of heterozygosity for the maternal 11p region. This study evaluated the accuracy of 18F-fluoro-L-dihydroxyphenylalanine ([18F]DOPA) positron emission tomography (PET) scans in diagnosing focal vs. diffuse disease and identifying the location of focal lesions. Design: A total of 50 infants with HI unresponsive to medical therapy were studied. Patients were injected iv with [18F]DOPA, and PET scans were obtained for 5060 min. Images were coregistered with abdominal computed tomography scans. PET scan interpretations were compared with histological diagnoses. Results: The diagnosis of focal or diffuse HI was correct in 44 of the 50 cases (88%). [18F]DOPA PET identified focal areas of high uptake of radiopharmaceutical in 18 of 24 patients with focal disease. The locations of these lesions matched the areas of increased [18F]DOPA uptake on the PET scans in all of the cases. PET scan correctly located five lesions that could not be visualized at surgery. The positive predictive value of [18F]DOPA in diagnosing focal adenomatosis was 100%, and the negative predictive value was 81%. Conclusions: [18F]DOPA PET scans correctly diagnosed 75% of focal cases and were 100% accurate in identifying the location of the lesion. These results suggest that [18F]DOPA PET imaging provides a useful guide to surgical resection of focal adenomatosis and should be considered as a guide to surgery in all infants with congenital HI who have medically uncontrollable disease. 10.1210/jc.2007-1637 Accuracy of [18F]Fluorodopa Positron Emission Tomography for Diagnosing and Localizing Focal Congenital Hyperinsulinism Olga Hardy Miguel Hernandez-Pampaloni Janet Saffer Joshua Scheuermann Linda Ernst Richard Freifelder Hongming Zhuang Courtney Macmullen Susan Becker Scott Adzick Chaitanya Divgi Abass Alavi Charles Stanley doi:10.1210/jc.2007-1637 J Clin Endocrinol Metab, Vol. 92, No. 12. (1 December 2007), pp. 4706-4711. 2008-01-12T18:37:49-00:00 2007 J Clin Endocrinol Metab 92 12 4706 4711 diagnosis hypoglycemia pet