Importance of combined use of preoperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection in recurrent papillary thyroid cancer.

Radio-guided surgery using an intra-operative positron emission tomography (PET) probe in recurrent thyroid cancer (RTC) can be a useful method for tumor localization, verification of complete excision and to decrease operation time. We describe a case of RTC whose serum thyroglobulin (Tg) level was 5.6ng/mL. Preoperative fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) revealed two focal abnormalities in the anterior tracheal and right upper mediastinal regions and a handheld gamma probe was used intraoperatively to identify the hot areas seen on PET scan. Postoperative 18F-FDG PET/CT imaging after tumor excision was normal. This case shows that recurrent tumor can be localized correctly using 18F-FDG PET/CT and a surgical gamma probe.