PET/CT is approved by Medicare for use in non-iodine avid thyroid cancer with elevated or rising thyroid globulin.
Research has shown that the sensitivity of PET/CT can be increased significantly by giving thyroid stimulating hormone prior to the PET/CT scan (1). In this study, additional lesions were found in 30% of the patients and administration of TSH.
1.Moog et al. Influence of TSH levels on uptake of FDG in recurrent and metastatic differentiated thyroid carcinoma. J Nuc Med 2000; 41:1989-1995
Patient: 65yo male with history of thyroid cancer. Elevated TG. Negative iodine studies. PET/CT was ordered to restage.
Results: PET/CT revealed two hypermetabolic foci in the neck, one on the right and one on the left (only one is shown above). The patient was sent to surgery with the aid of PET/CT and two metastatic lymph nodes were removed.