Authors' objectives:

This report aims to assess the available evidence on the use of positron emission tomography (PET) in the diagnosis of previously treated thyroid cancer suspected to be metastatic, for which standard imaging modalities have failed to localize metastatic disease.

Authors' recommendations: Only two studies were sufficiently powered to provide potentially reliable estimates of PET sensitivity and specificity for diagnosing metastatic disease in patients with treated differentiated thyroid cancer, elevated thyroglobulin, and negative (131)scintigraphy. However, the poor quality and small size of these studies limit the reliability of the test performance estimates. Smaller studies reported wide ranges of sensitivity and specifity. Insufficient data exist to estimate the test performance of PET for treated medullary thyroid cancer or other rarer forms of thyroid cancer. Limited data suggest that PET may affect management of patients with differentiated cancer and may result in cure of at least on-third of such patients. However, study quality was too poor and follow-up duration was too short (or not reported) to allow a definitive conclusion. Insufficient data exist to estimate the effect of PET on treatment management of patients with medullary or other rarer forms of thyroid cancer. Overall study quality was poor and study sample sizes were small. Future well-designed, clearly reported studies that focus on patients with treated thyroid cancer, elevated biochemical markers of metastasis and negative standard imaging tests are needed to define best performance and effect on clinical management and outcome of PET.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)