• Thomas Poisson, Désirée Deandreis, Sophie Leboulleux, François Bidault, Guillaume Bonniaud, Sylvain Baillot, Anne Aupérin, Abir Al Ghuzlan, Jean-Paul Travagli, Jean Lumbroso, Eric Baudin, and Martin Schlumberger.
• Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France. poisson.t@gmail.com
• Eur. J. Nucl. Med. Mol. Imaging. 2010 Dec 1;37(12):2277-85.

PurposeOur aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of 18F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic assessment, therapeutic monitoring and follow-up.MethodsTwenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality.ResultsA total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases. The volume of FDG uptake (≥300 ml) and the intensity of FDG uptake (SUVmax≥18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy, only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients who had persistent FDG uptake during treatment had a clinical recurrence and died.ConclusionFDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation of treatment response and follow-up.

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