Role of 18F-FDG-PET/CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment | Endocrinología, Diabetes y Nutrición (English ed.)

array:24 ["pii" => "S2530018020301256" "issn" => "25300180" "doi" => "10.1016/j.endien.2020.10.002" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "1047" "copyright" => "SEEN and SED" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2020;67:517-24" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2530016420301099" "issn" => "25300164" "doi" => "10.1016/j.endinu.2020.02.007" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "1047" "copyright" => "SEEN y SED" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2020;67:517-24" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Role of 18F-FDG-PET/CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "517" "paginaFinal" => "524" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la tomografía por emisión de positrones con 18F-FDG (18F-FDG PET/TC) en pacientes con carcinoma diferenciado de tiroides con respuesta bioquímica incompleta o indeterminada" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1423 "Ancho" => 2167 "Tamanyo" => 118755 ] ] "descripcion" => array:1 [ "en" => "Standardized uptake value (SUV) as a predictor of structural disease." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Erika Abelleira, María Gabriela García Falcone, Fernanda Bueno, Fabián Pitoia" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Erika" "apellidos" => "Abelleira" ] 1 => array:2 [ "nombre" => "María Gabriela" "apellidos" => "García Falcone" ] 2 => array:2 [ "nombre" => "Fernanda" "apellidos" => "Bueno" ] 3 => array:2 [ "nombre" => "Fabián" "apellidos" => "Pitoia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2530018020301256" "doi" => "10.1016/j.endien.2020.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301256?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016420301099?idApp=UINPBA00004N" "url" => "/25300164/0000006700000008/v2_202012090815/S2530016420301099/v2_202012090815/en/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2530018020301268" "issn" => "25300180" "doi" => "10.1016/j.endien.2020.10.003" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "1007" "copyright" => "SEEN and SED" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2020;67:525-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Serial prolactin sampling as a confirmatory test for true hyperprolactinemia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "525" "paginaFinal" => "529" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Curva de prolactina para la confirmación de hiperprolactinemia real" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carla Francés, Evangelina Boix, Maria Teresa Fajardo, José Manuel Gómez-García" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Carla" "apellidos" => "Francés" ] 1 => array:2 [ "nombre" => "Evangelina" "apellidos" => "Boix" ] 2 => array:2 [ "nombre" => "Maria Teresa" "apellidos" => "Fajardo" ] 3 => array:2 [ "nombre" => "José Manuel" "apellidos" => "Gómez-García" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301268?idApp=UINPBA00004N" "url" => "/25300180/0000006700000008/v1_202011131001/S2530018020301268/v1_202011131001/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2530018020301244" "issn" => "25300180" "doi" => "10.1016/j.endien.2020.03.004" "estado" => "S300" "fechaPublicacion" => "2020-10-01" "aid" => "1051" "copyright" => "SEEN and SED" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Endocrinol Diabetes Nutr. 2020;67:509-16" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Sensitivity of a sequential model based on a questionnaire (STOP-Bang vs Dixon) and nocturnal pulse oximetry for screening obstructive sleep apnea in patients with morbid obesity candidates for bariatric surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "509" "paginaFinal" => "516" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sensibilidad de un modelo secuencial basado en cuestionario (STOP-Bang vs. Dixon) y pulsioximetría nocturna para el screening de apnea obstructiva del sueño en pacientes obesos mórbidos candidatos a cirugía bariátrica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1812 "Ancho" => 3167 "Tamanyo" => 414234 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0075" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Analysis of the sequential model. A) Sequential model with STOP-Bang and pulse oximetry. B) Sequential model with the modified Dixon tool (cut-off point 5) and pulse oximetry. C) Sequential model with the modified Dixon tool (cut-off point 3) and pulse oximetry. D) Analysis of diagnostic tests of the different sequential models." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Lázaro, Paloma Clavería, Carmen Cabrejas, José Fernando, Silvia Segura, José M. Marín" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Lázaro" ] 1 => array:2 [ "nombre" => "Paloma" "apellidos" => "Clavería" ] 2 => array:2 [ "nombre" => "Carmen" "apellidos" => "Cabrejas" ] 3 => array:2 [ "nombre" => "José" "apellidos" => "Fernando" ] 4 => array:2 [ "nombre" => "Silvia" "apellidos" => "Segura" ] 5 => array:2 [ "nombre" => "José M." "apellidos" => "Marín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2530016420301130" "doi" => "10.1016/j.endinu.2020.03.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016420301130?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301244?idApp=UINPBA00004N" "url" => "/25300180/0000006700000008/v1_202011131001/S2530018020301244/v1_202011131001/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Role of 18F-FDG-PET/CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "517" "paginaFinal" => "524" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Erika Abelleira, María Gabriela García Falcone, Fernanda Bueno, Fabián Pitoia" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Erika" "apellidos" => "Abelleira" ] 1 => array:2 [ "nombre" => "María Gabriela" "apellidos" => "García Falcone" ] 2 => array:2 [ "nombre" => "Fernanda" "apellidos" => "Bueno" ] 3 => array:4 [ "nombre" => "Fabián" "apellidos" => "Pitoia" "email" => array:1 [ 0 => "fpitoia@intramed.net" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Division of Endocrinology, University of Buenos Aires, Argentina" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la tomografía por emisión de positrones con 18F-FDG (18F-FDG PET/TC) en pacientes con carcinoma diferenciado de tiroides con respuesta bioquímica incompleta o indeterminada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1423 "Ancho" => 2167 "Tamanyo" => 118755 ] ] "descripcion" => array:1 [ "en" => "Standardized uptake value (SUV) as a predictor of structural disease." ] ] ] "textoCompleto" => "IntroductionDifferentiated thyroid cancer (DTC) is generally characterized by good prognosis and low disease-specific mortality.<a class="elsevierStyleCrossRefs" href="#bib0170">1,2</a> The therapeutic approach and follow-up of patients with DTC is currently individualized according to the risk of recurrence (RR). The presence of a structural incomplete response to therapy (SIR) can be observed in 2–75% of patients with DTC<a class="elsevierStyleCrossRef" href="#bib0180">3</a> and it is usually related to the initial risk of recurrence, and to the dynamic risk assessment performed during the long-term follow-up.<a class="elsevierStyleCrossRefs" href="#bib0185">4–6</a> The frequency of SIR in patients with an initial indeterminate response (IR) has been reported to be around 13–20% over 10 years of follow-up.<a class="elsevierStyleCrossRefs" href="#bib0185">4,5</a> On the other hand, several series have demonstrated that 8–17% of patients with a biochemical incomplete response (BIR) may develop structurally identifiable disease over 5–10 years of follow-up.<a class="elsevierStyleCrossRefs" href="#bib0185">4,7–9</a>In these patients, it is important to characterize the presence of structural lesions with morphologic imaging methodology to plan a strategic therapeutic approach. These studies may include neck ultrasonography (US), systemic computed tomography (CT), magnetic resonance imaging (MRI), nuclear imaging procedures, such as whole-body scan after a diagnostic or therapeutic radioiodine dose, and/or the use of positron emission tomography/computed tomography using fluorine-18 fluorodeoxyglucose (18F-FDG-PET/CT scan).The 18F-FDG-PET/CT scan has been used with high sensitivity and specificity in the diagnosis of local recurrences and distant metastases when other imaging methods were negative in the presence of a BIR.<a class="elsevierStyleCrossRefs" href="#bib0215">10,11</a> Additionally, since the 18F-FDG-PET/CT may reflect disease aggressiveness, it can also provide information about the long-term outcome.<a class="elsevierStyleCrossRefs" href="#bib0225">12,13</a> Therefore, the findings provided by this imaging methodology might modify the therapeutic approach in up to 30% of patients.<a class="elsevierStyleCrossRefs" href="#bib0235">14–16</a>The aims of this study were: to evaluate the usefulness of 18F-FDG-PET/CT to detect recurrent/persistent disease in patients with BIR or IR at some point during the follow-up; and to evaluate the impact of 18F-FDG-PET/CT on patient's management strategies.MethodsData source and study populationWe retrospectively reviewed our database containing 790 files records of patients with DTC who were followed-up from January 2001 to February 2018 in the Division of Endocrinology, Hospital de Clínicas-University of Buenos Aires. We included 60 patients submitted to total thyroidectomy and remnant ablation, who had a biochemical incomplete response at some point during the follow-up, in whom the 18F-FDG-PET/CT was used within the diagnostic algorithm to determine the presence of structural disease. We performed 18F-FDG-PET/CT in patients with conflicting results, that is, patients with biochemical incomplete response with increasing serum Tg or TgAb during the follow-up.We also included in the analysis, those patients with indeterminate response who was referred to our hospital with the 18F-FDG-PET/CT already performed, requested by another physician. To be included, patients had to present a minimum follow-up of 12 months after the evaluation with an 18F-FDG-PET/CT to assess the outcome after the performance of this imaging procedure. All patients with ultrasonographically suspicious lymph nodes were excluded from the study, therefore the total cohort had a cervical ultrasound without findings.Each patient was stratified using the eighth edition of the American Joint Committee on Cancer/International Union against Cancer (AJCC/UICC) staging system and the risk of recurrence was assessed by using the modified 2015 American Thyroid Association risk stratification system (low, intermediate or high).<a class="elsevierStyleCrossRefs" href="#bib0180">3,17</a> The response to therapy was evaluated in the first 12 months and at the end of follow-up, based on serum thyroglobulin determinations, neck ultrasound (US), diagnostic or post radioiodine dose whole body scanning and appropriate additional functional and cross-sectional imaging according to what it is suggested by the ATA guidelines.<a class="elsevierStyleCrossRef" href="#bib0180">3</a> An excellent response to therapy was defined as a suppressed Tg<0.2ng/ml or stimulated Tg<1ng/ml in the absence of anti-thyroglobulin antibodies, with a normal post-operative neck US. The biochemical incomplete response was defined as a suppressed Tg>1ng/ml or stimulated Tg>10ng/ml or increasing TgAb levels in the absence of localizable disease. Indeterminate response was defined as a non-stimulated Tg<1ng/ml or stimulated Tg of 1–10ng/ml or stable or declining TgAb levels with nonspecific structural findings. Patients with persistent or newly identified locoregional or distant metastases with or without abnormal Tg or TgAb were classified as having structural incomplete response.<a class="elsevierStyleCrossRef" href="#bib0180">3</a>Our ablation protocol used fixed radioiodine activities based on the extent of the initial disease. Therapeutic doses of 131I ranged from 3.7 to 7.4GBq (100–200mCi 131I). Even though in our Hospital we began to apply the ATA guidelines from 2008, the group of low risk patients included in this study received radioiodine remnant ablation with high doses in other centers, and then they were referred to our Hospital.A low iodine diet was prescribed from two weeks before radioiodine administration through two days afterwards. In 92% with thyroid hormonal withdrawal (THW) at least 3 weeks, starting from thyroidectomy, and in only 8% after recombinant human thyrotrophin (rhTSH) administration (exogenous stimulation). The election of one or another methodology for preparation for remnant ablation usually was related to the reimbursement that each patient has in Argentina for rhTSH, according to his or her health insurance. Radioiodine was administered following that interval, in all cases with TSH levels above 50mIU/L. A post-therapy scan (WBS) was performed 5–7 days after therapeutic RAI administration.After ablation, all patients were kept on a suppressed thyrotropin (TSH) level until January 2008 when all patients received thyroid hormone therapy according to the Latin American Thyroid Society recommendations for each risk of recurrence group (target TSH: <0.1mIU/L for intermediate risk; 0.4–1mIU/L for low risk; and thyroid hormone replacement for very low risk LATS classification.<a class="elsevierStyleCrossRef" href="#bib0255">18</a> From January 2008 until inclusion all patients received hormonal therapy to keep a TSH level according to the risk of recurrence and response to therapy during the follow up according to what was suggested by the American Thyroid Association guidelines.<a class="elsevierStyleCrossRef" href="#bib0180">3</a>A change of the therapeutic approach was defined as: (i) new surgery/surgeries; (ii) administration of external beam radiotherapy; and/or (iii) initiation of systemic therapy determined by the findings detected by the 18F-FDG-PET/CT.Serum thyroglobulin and anti-thyroglobulin antibodies measurementSerum Tg and TgAb were assessed in one of two reference laboratories using either of two commercial immunometric assays and the same assay was used throughout a patient's follow-up. Serum Tg level was measured by Elecsys Tg Electrochemiluminescence Immunoassay (Roche Diagnostics GmbH, Mannheim, Germany), and the Immulite 2000 Tg Chemiluminiscence Assay (Siemens Corp., Los Angeles, CA, USA). The functional sensitivities of both methods were 0.1ng/ml and 0.3ng/ml, respectively.TgAb assays comprised the Elecsys Anti-Tg Electrochemiluminescence Immunoassay (RSR Ltd., Pentwyn, Cardiff, UK), or the Immulite 2000 Anti-TG Ab chemiluminescent immunometric assay method (Siemens). The serum TgAb level was considered positive when it was 20IU/ml or greater, in accord with the manufacturer's recommendations.Neck ultrasonographyThyroid ultrasonography was performed by experienced sonographers in the outpatient clinic using a 13-MHz linear transducer. Ultrasonographically suspicious nodes >10mm in diameter underwent fine-needle aspiration biopsy (FNAB) for cytology with Tg measurement in the needle washout fluid.Additional conventional imaging proceduresAdditional conventional imaging procedures performed for suspicious lesions regarding metastasis or recurrence included: high resolution computed tomography (n=12, 20%), and bone scintigraphy (n=6, 10%) without positive findings. Twenty-five percent of patients with negative CT had positive findings on 18F-FDG-PET/CT. Only one patient had a negative diagnostic whole-body scan (5mCi 131I).18F-FDG-PET/CT techniquePositron emission tomography combined with computed tomography were obtained with a Gemini Philips scanner with 16 rows of detectors. Each patient fasted for at least 6h before an intravenous administration of fluorine-18 fluorodeoxyglucose (0.11mCi/kg). Blood glucose levels lower than 200mg/dL. Whole-body PET and CT images were performed 60min after marker injection. PET images were obtained from the base of the skull to half of the thighs, with an acquisition time of 3min per bed position. The reconstruction was made in 3 basic planes after correction for attenuation based on CT examination. CT scan was acquired with a Survey of 90kVp and 20mAs. A full-body acquisition with 120kVp, 250mAs and a high-resolution thorax acquisition of 120kVp, 200mAs with images reconstructed every 5 and 1mm, respectively.Maximum standardized uptake value (SUVmax) was the semi-quantitative PET/CT parameter used in the study. It was calculated according to a standard protocol on a dedicated workstation. Maximum standardized uptake value corrected for body weight was computed by standard methods from the activity at the most intense voxel in three-dimensional tumor regions from the transaxial whole-body slices on attenuation-corrected PET/CT images. Transaxial, sagittal, and coronal images were shown on a computer display monitor. A visually abnormal focus of 18F-FDG accumulation was defined as a focal uptake relatively higher than that of the surrounding tissue with no similar activity seen in the contralateral side of the body indicative of metastasis/recurrence reinforced by the related CT findings.Positron emission tomography and neck CT findings were compared with the histopathological examination results if the lesions were surgically removed or biopsied. If those lesions detected by 18F-FDG PET/CT were confirmed by histopathology by surgery or biopsy, the findings provided by the 18F-FDG-PET/CT were classified as true-positive. If recurrence was excluded by histopathological examination in patients with positive lesions on 18F-FDG PET/CT and neck CT, the imaging findings were classified as false-positive results. In the case that recurrence was confirmed by histopathological examinations in patients with negative 18F-FDG PET/CT, the classification of these findings was defined as false-negative results. Finally, negative 18F-FDG PET/CT in patients with negative histopathological examination was classified as true-negative results.In the last 10 years, we performed the 18F-FDG-PET/CT under suppressed TSH, based on evidence of an uncertain clinical benefit of performing 18F-FDG PET/CT under stimulated TSH. Twenty-seven percent (n=16) of 18F-FDG-PET/CT was done under TSH stimulation, in 44% after recombinant human thyrotrophin (rhTSH) administration (exogenous stimulation), whereas in the remaining 56% after THW. Of these 16 patients in whom 18F-FDG PET/CT was performed under stimulated TSH, 5 with an IR referred to our center, and the study was performed before the new methodological approach in 11 patients with a BIR.Statistical analysisEpidemiological data are presented as the mean±SEM, with median and range when appropriate. For categorical variables, the number and percentage of patients and/or scans was calculated within each category. The diagnostic capacity of the 18F-FDG-PET/CT to identify (regional and distant) metastasis was estimated. The crude estimations were adjusted by TSH value (with and without stimulation) and thyroglobulin levels (≥ and <10ng/ml). The categorical variables were compared by Pearson Chi-square and Fisher exact tests. P<0.05 was used to statistical significance. For each instance, the likelihood ratio (ratio between sensitivity and false positive) and their respective 95% confidence intervals were estimated, checking the statistical significance with the overlapping range width. Receiver operating characteristic (ROC) curve analysis was used to define the SUVmax as a predictor of structural disease. The area under the curve (AUC) was mentioned with the best cut-off estimated.ResultsSixty patients (85% women) aged 18–86 years (median 50 years), were enrolled in this retrospective study. Based on the risk of recurrence classification, 17%, 38%, and 40% were low risk, intermediate risk, and high risk, respectively.<a class="elsevierStyleCrossRef" href="#bib0180">3</a> Seventy-five percent of included patients had a BIR and 25% an IR when the 18F-FDG-PET/CT was performed.Baseline characteristics of included patients can be observed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Increased 18FDG uptake suspicious for locoregional lesions was observed in 24 (40%) of the patients, while in the remaining 36 patients had no pathological 18FDG uptake. The distribution of the lesions in the former 24 patients was as follows: cervical and mediastinal lymphatic nodes in 18 patients, thyroid bed in 4 patients and, thyroid bed together with cervical lymph nodes in 2 cases. The median size of the diagnosed lymph nodes was 13mm (range 7–23mm) with a mean SUVmax of 7.18 (± 4.94). In 14 of these 24 patients with positive 18F-FDG-PET/CT results, the final diagnosis was made by histopathological examination and in 5 patients, the diagnosis of locoregional recurrence was determined during clinical follow-up. The remaining 5 patients were considered as false positive (three patients had negative fine-needle aspiration biopsy of cervical lymph nodes and in two patients the cervical lymph nodes disappeared during the follow-up). The therapeutic approach was modified based on 18F-FDG-PET/CT findings in half of the patients with locoregional lesions (in 46% surgical intervention and 4% the use of external beam radiotherapy was indicated).Initially, distant metastases detected by the 18F-FDG-PET/CT were in lungs (n=5) and in bone (n=1). Of the 5 patients with lung metastases, 1 patient had positive 18FDG uptake (SUV max 4.5) and 4 patients had small pulmonary nodules (<1cm) detected by the CT scan procedure without any 18FDG uptake. One patient developed progressive disease, and sorafenib 800mg/day was then prescribed. We inferred that this patient did not have FDG uptake due to the size of the pulmonary nodules which were below the resolution of 18F-FDG-PET/CT. In the remaining 3 patients, the pulmonary nodules disappeared during the follow-up, and they were considered as a false positive result. One patient had a bone uptake, only one focus (L1 vertebrae, SUVmax 3.4), with negative additional images (MRI and bone scintigraphy). Therefore, it was also considered as a false positive result. This patient had had a spinal trauma 5 years before.Finally, the prevalence of distant metastases detected by 18F-FDG-PET/CT was 3.3% (n=2, lung localization). Those two patients had also locoregional lesions.The only variable that was statistically significant when comparing positive and negative 18F-FDG-PET/CT was age at diagnosis of DTC, patients with negative 18F-FDG-PET/CT were younger than those patients with positive (p=0.004). There were no statistically significant differences considering gender (p=0.92), initial lymph node dissection (p=0.574), histology (p=0.05) or PCT histological variant (p 0.694), multicentricity (p=0.141), bilateral disease (p=0.179), presence of thyroiditis (p=0.35), capsular invasion (p=0.189), tumor diameter (p 0.2883), extrathyroidal invasion (p=0.109), BIR and IR (p=0.086).The diagnostic values (sensitivity, specificity, and diagnostic accuracy) of the 18F-FDG-PET/CT to detect locoregional disease were calculated as follows: 95%, 87.5%. and 90%, respectively (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The sensitivity of 18F-FDG-PET/CT carried out under TSH suppression was 93.3%, while when the examination was performed after TSH stimulation, it was 100% (p=0.90). When the 18F-FDG-PET/CT was done after TSH stimulation, its sensitivity did not differ significantly considering the way TSH stimulation was performed (endogenous or exogenous). The specificity was similar independently of the serum TSH levels at the time of the performance of the 18F-FDG-PET/CT. We found no significant differences in the diagnostic performance of 18F-FDG-PET/CT when done with or without TSH stimulation (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Diagnostic accuracy of 18F-FDG-PET/CT and serum thyroglobulin levelsThe cut-off value of serum Tg level that carried to the indication of 18F-FDG-PET/CT influenced its sensitivity. We compared the sensitivity, specificity, and accuracy of 18F-FDG-PET/CT for different thyroglobulin levels under hormonal therapy: (i) 1–10ng/ml and (ii) >10ng/ml. The sensitivity was 83% in patients with Tg levels under thyroid hormone therapy between 1 and 10ng/ml and 100% for those with Tg levels >10ng/ml (p=0.19) (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>On the other hand, the PET/CT was not useful to identify structural disease in patients with indeterminate response defined by thyroglobulin levels (non-stimulated Tg<1ng/mL or stimulated Tg<10ng/mL). The 18F-FDG-PET/CT was negative in 100% of patients with suppressed thyroglobulin levels <1ng/mL, and in 80% with stimulated thyroglobulin levels between 1 and 10ng/ml.The median stimulated Tg levels in patients with and without structural disease were 119ng/ml (range 14–288ng/ml) and 10.2ng/ml (2–53ng/ml), respectively (p=0.03). On the other hand, the median suppressed Tg level was 15ng/mL (range 2.5–788ng/mL) in patients with a structural disease, and 4.05ng/ml (range 0.9–231) in patients without a structural disease (p=0.41).Diagnostic accuracy of 18F-FDG-PET/CT and serum anti-thyroglobulin antibodiesOf the entire cohort, 15 patients had positive anti-thyroglobulin antibodies. Three patients (20%) had positive 18F-FDG-PET/CT findings, with a sensitivity of 100% and a specificity of 91%.Standardized uptake value (SUV) as a predictor of structural diseaseMean SUVmax value was 7.18 (median: 6.3, range: 2–19). The ROC curve for SUVmax can be observed in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>. A cutoff value of 3.2 for SUVmax was able to detect metastasis/recurrence locoregional with a sensitivity of 63% and a specificity of 95%.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Discussion18F-fluorodeoxyglucose is a glucose analog that provides unique information about the glucose metabolism of normal or abnormal tissues.<a class="elsevierStyleCrossRef" href="#bib0260">19</a> Due to the increased glucose metabolism of malignant cells, 18FDG uptake is frequently increased. Thus, positron emission tomography performed with 18FDG is a commonly used imaging methodology for various tumors.<a class="elsevierStyleCrossRef" href="#bib0260">19</a>18F-FDG-PET/CT could be considered as an additional image procedure in patients with DTC and elevated serum Tg level (>10ng/ml) and negative 131I whole-body scans (WBS).<a class="elsevierStyleCrossRefs" href="#bib0180">3,18</a> FDG uptake is a negative predictive factor for therapeutic response to radioactive iodine in metastatic DTC, and it is also an independent prognostic factor for survival.<a class="elsevierStyleCrossRefs" href="#bib0225">12,13</a> Lesions with high 18FDG uptake (standardized uptake value) may be more aggressive and should be targeted for therapy or followed-up closely.<a class="elsevierStyleCrossRefs" href="#bib0225">12,13</a>In our investigation, 18F-FDG-PET/CT had a sensitivity of 95% and a specificity of 87.5% to detect locoregional disease similar to other reported studies<a class="elsevierStyleCrossRefs" href="#bib0265">20,21</a> and changed the therapeutic approach in 50% of our patients. The rate of false positive was 12.5%.There were controversial reports about the need of performing the 18F-FDG-PET/CT after TSH stimulation. Wang et al. did not report any improvement in the detection of DTC foci after TSH stimulation.<a class="elsevierStyleCrossRef" href="#bib0275">22</a> However, Moog et al. suggested to carry out 18F-FDG-PET/CT after TSH stimulation, proposing that glucose uptake by DTC cells would depend on serum TSH concentration.<a class="elsevierStyleCrossRef" href="#bib0280">23</a> Additionally, Leboulleux et al. found that the detection of more DTC foci was observed after rhTSH stimulation.<a class="elsevierStyleCrossRef" href="#bib0285">24</a> However, the clinical benefit of identifying these additional small foci remains to be proven.<a class="elsevierStyleCrossRef" href="#bib0285">24</a> In our study, TSH stimulation did not improve the sensitivity of 18F-FDG-PET/CT.On the other side, there is no consensus on the cut-off value of the Tg level that characterizes sufficient diagnostic accuracy of 18F-FDG-PET/CT to detect recurrences or metastases. Some authors recommend that, to obtain a benefit from this image study, the Tg level should be higher than 10ng/ml, measured under TSH suppression,<a class="elsevierStyleCrossRefs" href="#bib0290">25–26</a> whereas others among them ATA guidelines recommend that a stimulated Tg level higher than 10ng/ml may be sufficient to determine the indication of an 18F-FDG-PET/CT.<a class="elsevierStyleCrossRef" href="#bib0180">3</a> In patients with a stimulated Tg level<10ng/mL, the sensitivity of 18F-FDG-PET/CT is generally low, ranging from <10 to 30%.<a class="elsevierStyleCrossRef" href="#bib0180">3</a> However, some authors showed higher sensitivity rates with Tg levels<10ng/ml.<a class="elsevierStyleCrossRefs" href="#bib0300">27–29</a> Moreover, Giovanella et al. determined that the best Tg threshold for the selection of patients who should undergo 18F-FDG-PET/CT in clinical practice was 4.6ng/ml under thyroid hormone therapy.<a class="elsevierStyleCrossRef" href="#bib0305">28</a> Given these findings, it appears that the cut-off value of the Tg level has not been established yet. We evaluated the cut-off value under TSH suppression, is that in 73% of the cohort the Tg measurement was carried out under hormonal therapy. The sensitivity of 18F-FDG-PET/CT was 83% in patients with non-stimulated Tg levels between 1 and 10ng/ml and 100% with Tg levels higher than 10ng/ml.Furthermore, in our study, the 18F-FDG-PET/CT was not useful to identify structural disease in patients with indeterminate response defined by thyroglobulin levels (non-stimulated Tg<1ng/mL or stimulated Tg<10ng/mL). As mentioned previously we included these patients who were referred to our hospital with the 18F-FDG-PET/CT already performed, requested by another physician.On the other hand, in patients with persistent anti-thyroglobulin antibodies, the level of serum Tg cannot be reliably assessed and 18F-FDG-PET/CT might help to localize structural disease. In our study, 18F-FDG-PET/CT detected recurrence/metastasis in 20% of these patients. We found a sensitivity of 100% and a specificity of 91% like other reports.<a class="elsevierStyleCrossRefs" href="#bib0315">30–33</a>Additionally, we found that the ideal cut-off value for SUVmax to detect structural disease was of 3.2, with a sensitivity of 63% and a specificity of 95%.ConclusionOur study confirmed that 18F-FDG-PET/CT is a useful tool in the detection of recurrences in patients with DTC with conflicting results of standard imaging procedures. The sensitivity of 18F-FDG-PET/CT was high for detecting locoregional lesions and it helped to change the immediate therapeutic approach in half of our patients with locoregional lesions and in 20% of all included patients. Despite this, the location of metastatic tissue by itself is an element to be taken into consideration for individualized follow-up and future therapeutic alternatives. However, this method had a low sensitivity for detecting structural disease in patients with an indeterminate response.Conflict of interestThe authors declare that they have no conflict of interest.Ethical approvalThe study was approved by the Institutional Review Board.Informed consentInformed consent was obtained from all individual participants included in the study." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1413208" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1293353" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1413209" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1293354" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Data source and study population" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Serum thyroglobulin and anti-thyroglobulin antibodies measurement" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Neck ultrasonography" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Additional conventional imaging procedures" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "F-FDG-PET/CT technique" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0045" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0050" "titulo" => "Diagnostic accuracy of F-FDG-PET/CT and serum thyroglobulin levels" ] 1 => array:2 [ "identificador" => "sec0055" "titulo" => "Diagnostic accuracy of F-FDG-PET/CT and serum anti-thyroglobulin antibodies" ] 2 => array:2 [ "identificador" => "sec0060" "titulo" => "Standardized uptake value (SUV) as a predictor of structural disease" ] ] ] 7 => array:2 [ "identificador" => "sec0065" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0075" "titulo" => "Conflict of interest" ] 10 => array:2 [ "identificador" => "sec0080" "titulo" => "Ethical approval" ] 11 => array:2 [ "identificador" => "sec0085" "titulo" => "Informed consent" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-07-04" "fechaAceptado" => "2020-02-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1293353" "palabras" => array:4 [ 0 => "18F-FDG-PET/CT" 1 => "Biochemical incomplete response" 2 => "Indeterminate response" 3 => "Differentiated thyroid cancer" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1293354" "palabras" => array:4 [ 0 => "18F-FDG-PET/TC" 1 => "Respuesta bioquímica incompleta" 2 => "Respuesta indeterminada" 3 => "Carcinoma diferenciado de tiroides" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectivesTo assess the value of 18F-FDG-PET/CT for detecting recurrent/persistent disease in patients with biochemical incomplete (BIR) or indeterminate response (IR) and to assess the impact of 18F-FDG-PET/CT on the therapeutic management of these patients. MethodsThe study included patients with BIR, in whom 18F-FDG PET/CT was used within the diagnostic algorithm from our database. Patients with IR referred to our hospital with the 18F-FDG PET/CT already performed were also enrolled. All patients had neck ultrasonography with no structural changes. A change in therapeutic approach was defined as repeat surgery; administration of external beam radiotherapy; and/or the start of systemic therapy. ResultsSixty patients (85% women) aged 18–86 years were enrolled in this retrospective study. Of these, 75% had BIR and 25% IR. Increased FDG uptake suggesting locoregional lesions was seen in 40% of patients. Sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT to detect local disease were 95%, 87.5% and 90% respectively. The therapeutic approach was modified in 50% of patients with locoregional lesions. ConclusionsOur study confirmed that 18F-FDG-PET/CT is a useful tool for detecting locoregional recurrence in thyroid cancer patients with BIR or IR with conflicting findings in standard diagnostic procedures. In 50% of patients with locoregional lesions, there was an immediate change in the treatment approach." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivosEvaluar la utilidad de la tomografía por emisión de positrones con 18F-FDG (18F-FDG PET/TC) para detectar enfermedad recurrente o persistente en pacientes con respuesta bioquímica incompleta (RBI) o respuesta indeterminada (RI), y evaluar el impacto de los resultados del PET/TC en el manejo terapéutico de estos pacientes. MétodosSe incluyeron pacientes con RBI, en los cuales el PET/TC fue utilizado en el algoritmo diagnóstico durante el seguimiento, y además pacientes con RI referidos a nuestro hospital con el estudio realizado. Todos los pacientes presentaban ecografía de cuello sin evidencia de alteraciones estructurales. Se consideró como cambio en el enfoque terapéutico a: 1) realización de nuevas cirugías, 2) administración de radioterapia externa, y/o 3) inicio de terapia sistémica. ResultadosSesenta pacientes con edad entre 16 a 86 años fueron incluidos retrospectivamente (85% mujeres), el 75% con RBI y el 25% con RI. En el 40% de los pacientes el PET/TC evidenciaron lesiones locorregionales. La sensibilidad, la especificidad y la precisión diagnóstica del PET/TC para detectar enfermedad locorregional fue del 95, 87,5 y 90%, respectivamente. En el 50% de los pacientes con enfermedad locorregional los resultados del PET/TC determinaron un cambio en la conducta terapéutica. ConclusionesNuestro estudio demostró que el PET/TC es una herramienta útil en la detección de enfermedad locorregional recurrente o persistente en pacientes con cáncer de tiroides con RBI o RI durante el seguimiento con hallazgos contradictorios en los métodos diagnósticos estándares. En el 50% de los casos con lesiones locorregionales hubo un cambio inmediato en el enfoque terapéutico." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1423 "Ancho" => 2167 "Tamanyo" => 118755 ] ] "descripcion" => array:1 [ "en" => "Standardized uptake value (SUV) as a predictor of structural disease." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "SD: standard deviation; DTC: differentiated thyroid cancer; Tg: thyroglobulin; TgAb: anti-thyroglobulin antibodies; TSH: thyrotropin; THW: thyroid hormone withdrawal; rhTSH: recombinant human thyrotropin." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (88%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (12%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 (± 15) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Histology and variant (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Classic PTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 (72%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follicular PTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (19%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oncocytic variant PTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tall cell >40% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Follicular thyroid cancer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stage at diagnosis (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (65%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (20%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Initial risk of recurrence (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Low \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (17%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intermediate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (38%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">High \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (40%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cumulative radioiodine dose (mCi)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">304 (± 288) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Response to treatment when the 18F-FDG PET/CT was performed (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Biochemical Incomplete \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (75%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (89%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TgAb \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (11%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Indeterminate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (25%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (33%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TgAb \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (67%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TSH when the 18F-FDG PET/CT was performed (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suppressed TSH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (73%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stimulated TSH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (27%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">THW \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (56%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">rhTSH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (44%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time of follow-up (years)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (range) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (1–13) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2424694.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline characteristics (n=60)." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Locoregional disease \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sensitivity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Specificity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">False positive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">False negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">True positive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">True negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Accuracy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2424695.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT in patients with locoregional disease." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "PPV: positive predictive value; NPV: negative predictive value; NS: not significant." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Stimulated TSH(n=16) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Supressed TSH(n=44) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Positive (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (43%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (39%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.77 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (56%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (61%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.72 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">True positive (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (26%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (32%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.655 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">True negative (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (47%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (59%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.407 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">False positive (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (12.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">False negative (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.68 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sensitivity (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.90 NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Specificity (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.50 NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.55 NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NPV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.55 NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Accuracy (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.69 NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Management change (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.67 NS \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2424692.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Diagnostic yield in relation to TSH levels at the time of 18F-FDG-PET/CT." ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "PPV: positive predictive value; NPV: negative predictive value." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tg 1–10ng/ml(n=15) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tg>10ng/ml(n=9) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Positive (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Negative (n, %) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">True-positive (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (66%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">True-negative (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (60%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">False negative (n) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.42 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sensitivity (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.19 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Specificity (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NPV (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Accuracy (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.41 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2424693.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Diagnostic performance of 18F-FDG PET/CT for different thyroglobulin levels under hormonal therapy." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib0170" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term results and prognostic factors in patients with differentiated thyroid carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Tubiana" 1 => "M. Schlumberger" 2 => "P. Rougier" 3 => "A. Laplanche" 4 => "E. Benhamou" 5 => "P. Gardet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/1097-0142(19850215)55:4<794::aid-cncr2820550418>3.0.co;2-z" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1985" "volumen" => "55" "paginaInicial" => "794" "paginaFinal" => "804" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3967174" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0175" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history, treatment, and course of papillary thyroid carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.J. DeGroot" 1 => "E.L. Kaplan" 2 => "M. Mc Cormick" 3 => "F.H. Straus" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Clin Endocrinol Metabol" "fecha" => "1990" "volumen" => "71" "paginaInicial" => "414" "paginaFinal" => "424" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0180" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.R. Haugen" 1 => "E.K. Alexander" 2 => "K.C. Bible" 3 => "G. Doherty" 4 => "S.J. Mandel" 5 => "Y.E. Nikiforov" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2015.0020" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2016" "volumen" => "26" "paginaInicial" => "1" "paginaFinal" => "133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26462967" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0185" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.M. Tuttle" 1 => "H. Tala" 2 => "J. Shah" 3 => "R. Leboeuf" 4 => "R. Ghossein" 5 => "M. Gonen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2010.0178" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2010" "volumen" => "20" "paginaInicial" => "1341" "paginaFinal" => "1349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21034228" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0190" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delayed risk stratification, to include the response to initial treatment (surgery and radioiodine ablation), has better outcome predictivity in differentiated thyroid cancer patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.G. Castagna" 1 => "F. Maino" 2 => "C. Cipri" 3 => "V. Belardini" 4 => "A. Theodoropoulou" 5 => "G. Cevenini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/EJE-11-0466" "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2011" "volumen" => "165" "paginaInicial" => "441" "paginaFinal" => "446" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21750043" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0195" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementing the modified 2009 American Thyroid Association Risk Stratification System in thyroid cancer patients with low and intermediate risk of recurrence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Pitoia" 1 => "F. Jerkovich" 2 => "C. Urciuoli" 3 => "A. Schmidt" 4 => "E. Abelleira" 5 => "F. Bueno" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2015.0121" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2015" "volumen" => "25" "paginaInicial" => "1235" "paginaFinal" => "1242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26132983" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0200" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous remission in thyroid cancer patients after biochemical incomplete response to initial therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Vaisman" 1 => "D. Momesso" 2 => "D.A. Bulzico" 3 => "C.H. Pessoa" 4 => "F. Dias" 5 => "R. Corbo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Endocrinol (Oxf)" "fecha" => "2012" "volumen" => "77" "paginaInicial" => "132" "paginaFinal" => "138" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0205" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In differentiated thyroid cancer, an incomplete structural response to therapy is associated with significantly worse clinical outcomes than only an incomplete thyroglobulin response" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Vaisman" 1 => "H. Tala" 2 => "R. Grewal" 3 => "R.M. Tuttle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2011.0232" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2011" "volumen" => "21" "paginaInicial" => "1317" "paginaFinal" => "1322" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22136267" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0210" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biochemical persistence in thyroid cancer: is there anything to worry about?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Pitoia" 1 => "E. Abelleira" 2 => "H. Tala" 3 => "F. Bueno" 4 => "C. Urciuoli" 5 => "G. Cross" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12020-013-0097-6" "Revista" => array:7 [ "tituloSerie" => "Endocrine" "fecha" => "2014" "volumen" => "46" "paginaInicial" => "532" "paginaFinal" => "537" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24287799" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1550728916000538" "estado" => "S300" "issn" => "15507289" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0215" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of PET in follow-up of patients treated for differentiated epithelial thyroid cancers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Leboulleux" 1 => "P.R. Schroeder" 2 => "M. Schlumberger" 3 => "P.W. Ladenson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/ncpendmet0402" "Revista" => array:6 [ "tituloSerie" => "Nat Clin Pract Endocrinol Metab" "fecha" => "2007" "volumen" => "3" "paginaInicial" => "112" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17237838" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0220" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "F18-FDG-PET for recurrent differentiated thyroid cancer: a systematic meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "HaslerudT" 1 => "BrauckhoffK" 2 => "L. Reisæter" 3 => "R. Küfner-Lein" 4 => "A. Heinecke" 5 => "J.E. Varhaug" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0284185115594645" "Revista" => array:6 [ "tituloSerie" => "Acta Radiol" "fecha" => "2016" "volumen" => "57" "paginaInicial" => "1193" "paginaFinal" => "1200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26163534" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0225" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F] fluoro-2-deoxy-d-glucose-positron emission tomography scanning" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.J. Robbins" 1 => "Q. Wan" 2 => "R.K. Grewal" 3 => "R. Reibke" 4 => "M. Gonen" 5 => "H.W. Strauss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2005-1534" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2006" "volumen" => "91" "paginaInicial" => "498" "paginaFinal" => "505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16303836" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0230" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Do histological, immunohistochemical, and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Deandreis" 1 => "A. Al Ghuzlan" 2 => "S. Leboulleux" 3 => "L. Lacroix" 4 => "J.P. Garsi" 5 => "M. Talbot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1677/ERC-10-0233" "Revista" => array:6 [ "tituloSerie" => "Endocr Relat Cancer" "fecha" => "2011" "volumen" => "18" "paginaInicial" => "159" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21118976" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0235" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Integrated PET/CT in differentiated thyroid cancer Diagnostic Accuracy and Impact on Patient Management" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Palmedo" 1 => "J. Bucerius" 2 => "A. Joe" 3 => "H. Strunk" 4 => "N. Hortling" 5 => "S. Meyka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "2006" "volumen" => "47" "paginaInicial" => "616" "paginaFinal" => "624" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16595495" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0240" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of positron emission tomography/computed tomography in the management of recurrent papillary thyroid carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z. Nahas" 1 => "D. Goldenberg" 2 => "C. Fakhry" 3 => "M. Ewertz" 4 => "M. Zeiger" 5 => "P.W. Ladenson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.mlg.0000154725.00787.00" "Revista" => array:6 [ "tituloSerie" => "Laryngoscope" "fecha" => "2005" "volumen" => "115" "paginaInicial" => "237" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15689742" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0245" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical impact of (18) F-FDG PET in thyroid carcinoma patients with elevated thyroglobulin levels and negative (131) I scanning results after therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.O. Helal" 1 => "P. Merlet" 2 => "M.E. Toubert" 3 => "B. Franc" 4 => "C. Schvartz" 5 => "H. Gauthier-Koelesnikov" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "2001" "volumen" => "42" "paginaInicial" => "1464" "paginaFinal" => "1469" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11585858" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0250" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "editores" => "M.B.Amin, S.Edge, F.Greene, D.R.Byrd, R.K.Brookland, M.K.Washington" "titulo" => "AJCC cancer staging manual" "edicion" => "8th ed." "serieFecha" => "2017" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0255" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Pitoia" 1 => "L. Ward" 2 => "N. Wohllk" 3 => "C. Friguglietti" 4 => "E. Tomimori" 5 => "A. Gauna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/s0004-27302009000700014" "Revista" => array:6 [ "tituloSerie" => "Arq Bras Endocrinol Metabol" "fecha" => "2009" "volumen" => "53" "paginaInicial" => "884" "paginaFinal" => "887" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19942992" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0260" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "18F-FDG PET/CT imaging in oncology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Almuhaideb" 1 => "N. Papathanasiou" 2 => "J. Bomanji" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0256-4947.75771" "Revista" => array:6 [ "tituloSerie" => "Ann Saudi Med" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "3" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21245592" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0265" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Usefulness of PET/CT in the diagnosis of recurrent or metastasized differentiated thyroid carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.Z. Lu" 1 => "S.S. Cao" 2 => "W. Wang" 3 => "J. Liu" 4 => "N. Fu" 5 => "F. Lu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3892/ol.2016.4229" "Revista" => array:7 [ "tituloSerie" => "Oncol Lett" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "2420" "paginaFinal" => "2423" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27073490" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1550728914003931" "estado" => "S300" "issn" => "15507289" ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0270" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluating positron emission tomography use in differentiated thyroid cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.L. Wiebel" 1 => "N.H. Esfandiari" 2 => "M. Papaleontiou" 3 => "F.P. Worden" 4 => "M.R. Haymart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2015.0062" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2015" "volumen" => "25" "paginaInicial" => "1026" "paginaFinal" => "1032" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26133765" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0275" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[18F]-2-fluoro-2-deoxy-d-glucose positron emission tomography localizes residua thyroid cancer in patients with negative diagnostic (131) I whole body scans and elevated serum thyroglobulin levels" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Wang" 1 => "H. Macapinlac" 2 => "S.M. Larson" 3 => "S.D. Yeh" 4 => "T. Akhurst" 5 => "R.D. Finn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem.84.7.5827" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "1999" "volumen" => "84" "paginaInicial" => "2291" "paginaFinal" => "2302" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10404792" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0280" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of thyroid-stimulating hormone levels on uptake of FDG in recurrent and metastatic differentiated thyroid carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Moog" 1 => "R. Linke" 2 => "N. Manthey" 3 => "R. Tiling" 4 => "P. Knesewitsch" 5 => "K. Tatsch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "2000" "volumen" => "41" "paginaInicial" => "1989" "paginaFinal" => "1995" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11138683" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0285" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of the incremental value of recombinant thyrotropin stimulation before 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography imaging to localize residual differentiated thyroid cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Leboulleux" 1 => "P.R. Schroeder" 2 => "N.L. Busaidy" 3 => "A. Auperin" 4 => "C. Corone" 5 => "H.A. Jacene" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jc.2008-1747" "Revista" => array:6 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2009" "volumen" => "94" "paginaInicial" => "1310" "paginaFinal" => "1316" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19158200" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0290" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postradioiodine treatment whole-body scan in the era of 18-fluorodeoxyglucose positron emission tomography for differentiated thyroid carcinoma with elevated serum thyroglobulin levels" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Leboulleux" 1 => "I. El Bez" 2 => "I. Borget" 3 => "M. Elleuch" 4 => "D. Déandreis" 5 => "A. Al Ghuzlan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2012.0081" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2012" "volumen" => "22" "paginaInicial" => "832" "paginaFinal" => "838" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22853728" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0295" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging in endocrinology: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Salvatori" 1 => "B. Biondi" 2 => "V. Rufini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/EJE-15-0066" "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2015" "volumen" => "173" "paginaInicial" => "R115" "paginaFinal" => "R130" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25947140" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0300" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does recombinant human thyrotropin-stimulated positron emission tomography with [18F]fluoro-2-deoxy-d-glucose improve detection of recurrence of well-differentiated thyroid carcinoma in patients with low serum thyroglobulin?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Vera" 1 => "C. Kuhn-Lansoy" 2 => "A. Edet-Sanson" 3 => "S. Hapdey" 4 => "R. Modzelewski" 5 => "A. Hitzel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/thy.2008.0416" "Revista" => array:6 [ "tituloSerie" => "Thyroid" "fecha" => "2010" "volumen" => "20" "paginaInicial" => "15" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20017617" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0305" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between serum thyroglobulin and 18FDG-PET/CT in 131I-negative differentiated thyroid carcinomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Giovanella" 1 => "L. Ceriani" 2 => "D. De Palma" 3 => "S. Suriano" 4 => "M. Castellani" 5 => "F.A. Verburg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hed.21791" "Revista" => array:6 [ "tituloSerie" => "Head Neck" "fecha" => "2012" "volumen" => "34" "paginaInicial" => "626" "paginaFinal" => "631" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21850699" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0310" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Positron emission tomography-computed tomography with (18)F-fluorodeoxyglucose in patients with recurrent differentiated thyroid carcinoma and negative radioiodine scan. Diagnostic performance and relation with tyroglobulin levels" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Mariscal Labrador" 1 => "A. García Burillo" 2 => "J. Castell-Conesa" 3 => "G. Obiols Alfonso" 4 => "N. Kisiel González" 5 => "M. Barios Profitós" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2012.04.014" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol" "fecha" => "2013" "volumen" => "32" "paginaInicial" => "146" "paginaFinal" => "151" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22726673" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0315" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlation of 18F-FDG PET/CT findings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin antibody levels and negative 131I whole-body scan results" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Ozkan" 1 => "G. Aras" 2 => "N.O. Kucuk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2013" "volumen" => "326" "paginaInicial" => "31" "paginaFinal" => "37" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0320" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic value of 18F-fluorodeoxyglucose-positron emission tomography in patients with differentiated thyroid carcinoma and circulating antithyroglobulin autoantibodies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.V. Bogsrud" 1 => "I.D. Hay" 2 => "D. Karantanis" 3 => "M.A. Nathan" 4 => "B.P. Mullan" 5 => "G.A. Wiseman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MNM.0b013e328343a742" "Revista" => array:6 [ "tituloSerie" => "Nucl Med Commun" "fecha" => "2011" "volumen" => "32" "paginaInicial" => "245" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21278616" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0325" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between circulating anti-thyroglobulin antibodies (TgAb) and tumor metabolism in patients with differentiated thyroid cancer (DTC): prognostic implications" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Morbelli" 1 => "G. Ferrarazzo" 2 => "E. Pomposelli" 3 => "F. Pupo" 4 => "G. Pesce" 5 => "I. Calamia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40618-016-0578-6" "Revista" => array:6 [ "tituloSerie" => "J Endocrinol Invest" "fecha" => "2017" "volumen" => "40" "paginaInicial" => "417" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27844413" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0330" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic performance of 18F-FDG PET/CT in papillary thyroid carcinoma with negative 131I-WBS at first postablation negative Tg and progressively increased TgAb level" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z.L. Qiu" 1 => "W.J. Wei" 2 => "C.T. Shen" 3 => "H.J. Song" 4 => "X.Y. Zhang" 5 => "Z.K. Sun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41598-017-03001-7" "Revista" => array:5 [ "tituloSerie" => "Sci Rep" "fecha" => "2017" "volumen" => "7" "paginaInicial" => "2849" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28588229" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/25300180/0000006700000008/v1_202011131001/S2530018020301256/v1_202011131001/en/main.assets" "Apartado" => array:4 [ "identificador" => "64496" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25300180/0000006700000008/v1_202011131001/S2530018020301256/v1_202011131001/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301256?idApp=UINPBA00004N"]

Statistics

Original article

Role of 18F-FDG-PET/CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment

Utilidad de la tomografía por emisión de positrones con 18F-FDG (18F-FDG PET/TC) en pacientes con carcinoma diferenciado de tiroides con respuesta bioquímica incompleta o indeterminada

Erika Abelleira, María Gabriela García Falcone, Fernanda Bueno, Fabián Pitoia

Corresponding author

fpitoia@intramed.net

Corresponding author.

Division of Endocrinology, University of Buenos Aires, Argentina

Read

2683

Times
was read the article

367

Total PDF

2316

Total HTML

Share statistics

 array:24 [
  "pii" => "S2530018020301256"
  "issn" => "25300180"
  "doi" => "10.1016/j.endien.2020.10.002"
  "estado" => "S300"
  "fechaPublicacion" => "2020-10-01"
  "aid" => "1047"
  "copyright" => "SEEN and SED"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Endocrinol Diabetes Nutr. 2020;67:517-24"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2530016420301099"
      "issn" => "25300164"
      "doi" => "10.1016/j.endinu.2020.02.007"
      "estado" => "S300"
      "fechaPublicacion" => "2020-10-01"
      "aid" => "1047"
      "copyright" => "SEEN y SED"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Endocrinol Diabetes Nutr. 2020;67:517-24"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
        "titulo" => "Role of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "517"
            "paginaFinal" => "524"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Utilidad de la tomograf&#237;a por emisi&#243;n de positrones con <span class="elsevierStyleSup">18</span>F-FDG &#40;<span class="elsevierStyleSup">18</span>F-FDG PET&#47;TC&#41; en pacientes con carcinoma diferenciado de tiroides con respuesta bioqu&#237;mica incompleta o indeterminada"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1423
                "Ancho" => 2167
                "Tamanyo" => 118755
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Standardized uptake value &#40;SUV&#41; as a predictor of structural disease&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Erika Abelleira, Mar&#237;a Gabriela Garc&#237;a Falcone, Fernanda Bueno, Fabi&#225;n Pitoia"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Erika"
                "apellidos" => "Abelleira"
              ]
              1 => array:2 [
                "nombre" => "Mar&#237;a Gabriela"
                "apellidos" => "Garc&#237;a Falcone"
              ]
              2 => array:2 [
                "nombre" => "Fernanda"
                "apellidos" => "Bueno"
              ]
              3 => array:2 [
                "nombre" => "Fabi&#225;n"
                "apellidos" => "Pitoia"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2530018020301256"
          "doi" => "10.1016/j.endien.2020.10.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301256?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016420301099?idApp=UINPBA00004N"
      "url" => "/25300164/0000006700000008/v2_202012090815/S2530016420301099/v2_202012090815/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2530018020301268"
    "issn" => "25300180"
    "doi" => "10.1016/j.endien.2020.10.003"
    "estado" => "S300"
    "fechaPublicacion" => "2020-10-01"
    "aid" => "1007"
    "copyright" => "SEEN and SED"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Endocrinol Diabetes Nutr. 2020;67:525-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Serial prolactin sampling as a confirmatory test for true hyperprolactinemia"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "525"
          "paginaFinal" => "529"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Curva de prolactina para la confirmaci&#243;n de hiperprolactinemia real"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Carla Franc&#233;s, Evangelina Boix, Maria Teresa Fajardo, Jos&#233; Manuel G&#243;mez-Garc&#237;a"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Carla"
              "apellidos" => "Franc&#233;s"
            ]
            1 => array:2 [
              "nombre" => "Evangelina"
              "apellidos" => "Boix"
            ]
            2 => array:2 [
              "nombre" => "Maria Teresa"
              "apellidos" => "Fajardo"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233; Manuel"
              "apellidos" => "G&#243;mez-Garc&#237;a"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301268?idApp=UINPBA00004N"
    "url" => "/25300180/0000006700000008/v1_202011131001/S2530018020301268/v1_202011131001/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2530018020301244"
    "issn" => "25300180"
    "doi" => "10.1016/j.endien.2020.03.004"
    "estado" => "S300"
    "fechaPublicacion" => "2020-10-01"
    "aid" => "1051"
    "copyright" => "SEEN and SED"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Endocrinol Diabetes Nutr. 2020;67:509-16"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Sensitivity of a sequential model based on a questionnaire &#40;STOP-Bang vs Dixon&#41; and nocturnal pulse oximetry for screening obstructive sleep apnea in patients with morbid obesity candidates for bariatric surgery"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "509"
          "paginaFinal" => "516"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sensibilidad de un modelo secuencial basado en cuestionario &#40;STOP-Bang vs&#46; Dixon&#41; y pulsioximetr&#237;a nocturna para el <span class="elsevierStyleItalic">screening</span> de apnea obstructiva del sue&#241;o en pacientes obesos m&#243;rbidos candidatos a cirug&#237;a bari&#225;trica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1812
              "Ancho" => 3167
              "Tamanyo" => 414234
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0075"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Analysis of the sequential model&#46; A&#41; Sequential model with STOP-Bang and pulse oximetry&#46; B&#41; Sequential model with the modified Dixon tool &#40;cut-off point 5&#41; and pulse oximetry&#46; C&#41; Sequential model with the modified Dixon tool &#40;cut-off point 3&#41; and pulse oximetry&#46; D&#41; Analysis of diagnostic tests of the different sequential models&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Javier L&#225;zaro, Paloma Claver&#237;a, Carmen Cabrejas, Jos&#233; Fernando, Silvia Segura, Jos&#233; M&#46; Mar&#237;n"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "L&#225;zaro"
            ]
            1 => array:2 [
              "nombre" => "Paloma"
              "apellidos" => "Claver&#237;a"
            ]
            2 => array:2 [
              "nombre" => "Carmen"
              "apellidos" => "Cabrejas"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Fernando"
            ]
            4 => array:2 [
              "nombre" => "Silvia"
              "apellidos" => "Segura"
            ]
            5 => array:2 [
              "nombre" => "Jos&#233; M&#46;"
              "apellidos" => "Mar&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S2530016420301130"
        "doi" => "10.1016/j.endinu.2020.03.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016420301130?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301244?idApp=UINPBA00004N"
    "url" => "/25300180/0000006700000008/v1_202011131001/S2530018020301244/v1_202011131001/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Role of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "517"
        "paginaFinal" => "524"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Erika Abelleira, Mar&#237;a Gabriela Garc&#237;a Falcone, Fernanda Bueno, Fabi&#225;n Pitoia"
        "autores" => array:4 [
          0 => array:2 [
            "nombre" => "Erika"
            "apellidos" => "Abelleira"
          ]
          1 => array:2 [
            "nombre" => "Mar&#237;a Gabriela"
            "apellidos" => "Garc&#237;a Falcone"
          ]
          2 => array:2 [
            "nombre" => "Fernanda"
            "apellidos" => "Bueno"
          ]
          3 => array:4 [
            "nombre" => "Fabi&#225;n"
            "apellidos" => "Pitoia"
            "email" => array:1 [
              0 => "fpitoia@intramed.net"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Division of Endocrinology&#44; University of Buenos Aires&#44; Argentina"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Utilidad de la tomograf&#237;a por emisi&#243;n de positrones con <span class="elsevierStyleSup">18</span>F-FDG &#40;<span class="elsevierStyleSup">18</span>F-FDG PET&#47;TC&#41; en pacientes con carcinoma diferenciado de tiroides con respuesta bioqu&#237;mica incompleta o indeterminada"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1423
            "Ancho" => 2167
            "Tamanyo" => 118755
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Standardized uptake value &#40;SUV&#41; as a predictor of structural disease&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Differentiated thyroid cancer &#40;DTC&#41; is generally characterized by good prognosis and low disease-specific mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">1&#44;2</span></a> The therapeutic approach and follow-up of patients with DTC is currently individualized according to the risk of recurrence &#40;RR&#41;&#46; The presence of a structural incomplete response to therapy &#40;SIR&#41; can be observed in 2&#8211;75&#37; of patients with DTC<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a> and it is usually related to the initial risk of recurrence&#44; and to the dynamic risk assessment performed during the long-term follow-up&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#8211;6</span></a> The frequency of SIR in patients with an initial indeterminate response &#40;IR&#41; has been reported to be around 13&#8211;20&#37; over 10 years of follow-up&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#44;5</span></a> On the other hand&#44; several series have demonstrated that 8&#8211;17&#37; of patients with a biochemical incomplete response &#40;BIR&#41; may develop structurally identifiable disease over 5&#8211;10 years of follow-up&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#44;7&#8211;9</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In these patients&#44; it is important to characterize the presence of structural lesions with morphologic imaging methodology to plan a strategic therapeutic approach&#46; These studies may include neck ultrasonography &#40;US&#41;&#44; systemic computed tomography &#40;CT&#41;&#44; magnetic resonance imaging &#40;MRI&#41;&#44; nuclear imaging procedures&#44; such as whole-body scan after a diagnostic or therapeutic radioiodine dose&#44; and&#47;or the use of positron emission tomography&#47;computed tomography using fluorine-18 fluorodeoxyglucose &#40;<span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT scan&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT scan has been used with high sensitivity and specificity in the diagnosis of local recurrences and distant metastases when other imaging methods were negative in the presence of a BIR&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">10&#44;11</span></a> Additionally&#44; since the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT may reflect disease aggressiveness&#44; it can also provide information about the long-term outcome&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">12&#44;13</span></a> Therefore&#44; the findings provided by this imaging methodology might modify the therapeutic approach in up to 30&#37; of patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">14&#8211;16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aims of this study were&#58; to evaluate the usefulness of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT to detect recurrent&#47;persistent disease in patients with BIR or IR at some point during the follow-up&#59; and to evaluate the impact of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT on patient&#39;s management strategies&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Data source and study population</span><p id="par0025" class="elsevierStylePara elsevierViewall">We retrospectively reviewed our database containing 790 files records of patients with DTC who were followed-up from January 2001 to February 2018 in the Division of Endocrinology&#44; Hospital de Cl&#237;nicas-University of Buenos Aires&#46; We included 60 patients submitted to total thyroidectomy and remnant ablation&#44; who had a biochemical incomplete response at some point during the follow-up&#44; in whom the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was used within the diagnostic algorithm to determine the presence of structural disease&#46; We performed <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT in patients with conflicting results&#44; that is&#44; patients with biochemical incomplete response with increasing serum Tg or TgAb during the follow-up&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We also included in the analysis&#44; those patients with indeterminate response who was referred to our hospital with the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT already performed&#44; requested by another physician&#46; To be included&#44; patients had to present a minimum follow-up of 12 months after the evaluation with an <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT to assess the outcome after the performance of this imaging procedure&#46; All patients with ultrasonographically suspicious lymph nodes were excluded from the study&#44; therefore the total cohort had a cervical ultrasound without findings&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Each patient was stratified using the eighth edition of the American Joint Committee on Cancer&#47;International Union against Cancer &#40;AJCC&#47;UICC&#41; staging system and the risk of recurrence was assessed by using the modified 2015 American Thyroid Association risk stratification system &#40;low&#44; intermediate or high&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">3&#44;17</span></a> The response to therapy was evaluated in the first 12 months and at the end of follow-up&#44; based on serum thyroglobulin determinations&#44; neck ultrasound &#40;US&#41;&#44; diagnostic or post radioiodine dose whole body scanning and appropriate additional functional and cross-sectional imaging according to what it is suggested by the ATA guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a> An excellent response to therapy was defined as a suppressed Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml or stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml in the absence of anti-thyroglobulin antibodies&#44; with a normal post-operative neck US&#46; The biochemical incomplete response was defined as a suppressed Tg<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml or stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml or increasing TgAb levels in the absence of localizable disease&#46; Indeterminate response was defined as a non-stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml or stimulated Tg of 1&#8211;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml or stable or declining TgAb levels with nonspecific structural findings&#46; Patients with persistent or newly identified locoregional or distant metastases with or without abnormal Tg or TgAb were classified as having structural incomplete response&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Our ablation protocol used fixed radioiodine activities based on the extent of the initial disease&#46; Therapeutic doses of <span class="elsevierStyleSup">131</span>I ranged from 3&#46;7 to 7&#46;4<span class="elsevierStyleHsp" style=""></span>GBq &#40;100&#8211;200<span class="elsevierStyleHsp" style=""></span>mCi <span class="elsevierStyleSup">131</span>I&#41;&#46; Even though in our Hospital we began to apply the ATA guidelines from 2008&#44; the group of low risk patients included in this study received radioiodine remnant ablation with high doses in other centers&#44; and then they were referred to our Hospital&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A low iodine diet was prescribed from two weeks before radioiodine administration through two days afterwards&#46; In 92&#37; with thyroid hormonal withdrawal &#40;THW&#41; at least 3 weeks&#44; starting from thyroidectomy&#44; and in only 8&#37; after recombinant human thyrotrophin &#40;rhTSH&#41; administration &#40;exogenous stimulation&#41;&#46; The election of one or another methodology for preparation for remnant ablation usually was related to the reimbursement that each patient has in Argentina for rhTSH&#44; according to his or her health insurance&#46; Radioiodine was administered following that interval&#44; in all cases with TSH levels above 50<span class="elsevierStyleHsp" style=""></span>mIU&#47;L&#46; A post-therapy scan &#40;WBS&#41; was performed 5&#8211;7 days after therapeutic RAI administration&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">After ablation&#44; all patients were kept on a suppressed thyrotropin &#40;TSH&#41; level until January 2008 when all patients received thyroid hormone therapy according to the Latin American Thyroid Society recommendations for each risk of recurrence group &#40;target TSH&#58; &#60;0&#46;1<span class="elsevierStyleHsp" style=""></span>mIU&#47;L for intermediate risk&#59; 0&#46;4&#8211;1<span class="elsevierStyleHsp" style=""></span>mIU&#47;L for low risk&#59; and thyroid hormone replacement for very low risk LATS classification&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a> From January 2008 until inclusion all patients received hormonal therapy to keep a TSH level according to the risk of recurrence and response to therapy during the follow up according to what was suggested by the American Thyroid Association guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">A change of the therapeutic approach was defined as&#58; &#40;i&#41; new surgery&#47;surgeries&#59; &#40;ii&#41; administration of external beam radiotherapy&#59; and&#47;or &#40;iii&#41; initiation of systemic therapy determined by the findings detected by the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Serum thyroglobulin and anti-thyroglobulin antibodies measurement</span><p id="par0060" class="elsevierStylePara elsevierViewall">Serum Tg and TgAb were assessed in one of two reference laboratories using either of two commercial immunometric assays and the same assay was used throughout a patient&#39;s follow-up&#46; Serum Tg level was measured by Elecsys Tg Electrochemiluminescence Immunoassay &#40;Roche Diagnostics GmbH&#44; Mannheim&#44; Germany&#41;&#44; and the Immulite 2000 Tg Chemiluminiscence Assay &#40;Siemens Corp&#46;&#44; Los Angeles&#44; CA&#44; USA&#41;&#46; The functional sensitivities of both methods were 0&#46;1<span class="elsevierStyleHsp" style=""></span>ng&#47;ml and 0&#46;3<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#44; respectively&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">TgAb assays comprised the Elecsys Anti-Tg Electrochemiluminescence Immunoassay &#40;RSR Ltd&#46;&#44; Pentwyn&#44; Cardiff&#44; UK&#41;&#44; or the Immulite 2000 Anti-TG Ab chemiluminescent immunometric assay method &#40;Siemens&#41;&#46; The serum TgAb level was considered positive when it was 20<span class="elsevierStyleHsp" style=""></span>IU&#47;ml or greater&#44; in accord with the manufacturer&#39;s recommendations&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Neck ultrasonography</span><p id="par0070" class="elsevierStylePara elsevierViewall">Thyroid ultrasonography was performed by experienced sonographers in the outpatient clinic using a 13-MHz linear transducer&#46; Ultrasonographically suspicious nodes &#62;10<span class="elsevierStyleHsp" style=""></span>mm in diameter underwent fine-needle aspiration biopsy &#40;FNAB&#41; for cytology with Tg measurement in the needle washout fluid&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Additional conventional imaging procedures</span><p id="par0075" class="elsevierStylePara elsevierViewall">Additional conventional imaging procedures performed for suspicious lesions regarding metastasis or recurrence included&#58; high resolution computed tomography &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#44; 20&#37;&#41;&#44; and bone scintigraphy &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 10&#37;&#41; without positive findings&#46; Twenty-five percent of patients with negative CT had positive findings on <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46; Only one patient had a negative diagnostic whole-body scan &#40;5mCi <span class="elsevierStyleSup">131</span>I&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095"><span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT technique</span><p id="par0080" class="elsevierStylePara elsevierViewall">Positron emission tomography combined with computed tomography were obtained with a Gemini Philips scanner with 16 rows of detectors&#46; Each patient fasted for at least 6<span class="elsevierStyleHsp" style=""></span>h before an intravenous administration of fluorine-18 fluorodeoxyglucose &#40;0&#46;11<span class="elsevierStyleHsp" style=""></span>mCi&#47;kg&#41;&#46; Blood glucose levels lower than 200<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#46; Whole-body PET and CT images were performed 60<span class="elsevierStyleHsp" style=""></span>min after marker injection&#46; PET images were obtained from the base of the skull to half of the thighs&#44; with an acquisition time of 3<span class="elsevierStyleHsp" style=""></span>min per bed position&#46; The reconstruction was made in 3 basic planes after correction for attenuation based on CT examination&#46; CT scan was acquired with a Survey of 90<span class="elsevierStyleHsp" style=""></span>kVp and 20<span class="elsevierStyleHsp" style=""></span>mAs&#46; A full-body acquisition with 120<span class="elsevierStyleHsp" style=""></span>kVp&#44; 250<span class="elsevierStyleHsp" style=""></span>mAs and a high-resolution thorax acquisition of 120<span class="elsevierStyleHsp" style=""></span>kVp&#44; 200<span class="elsevierStyleHsp" style=""></span>mAs with images reconstructed every 5 and 1<span class="elsevierStyleHsp" style=""></span>mm&#44; respectively&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Maximum standardized uptake value &#40;SUVmax&#41; was the semi-quantitative PET&#47;CT parameter used in the study&#46; It was calculated according to a standard protocol on a dedicated workstation&#46; Maximum standardized uptake value corrected for body weight was computed by standard methods from the activity at the most intense voxel in three-dimensional tumor regions from the transaxial whole-body slices on attenuation-corrected PET&#47;CT images&#46; Transaxial&#44; sagittal&#44; and coronal images were shown on a computer display monitor&#46; A visually abnormal focus of <span class="elsevierStyleSup">18</span>F-FDG accumulation was defined as a focal uptake relatively higher than that of the surrounding tissue with no similar activity seen in the contralateral side of the body indicative of metastasis&#47;recurrence reinforced by the related CT findings&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Positron emission tomography and neck CT findings were compared with the histopathological examination results if the lesions were surgically removed or biopsied&#46; If those lesions detected by <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT were confirmed by histopathology by surgery or biopsy&#44; the findings provided by the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT were classified as true-positive&#46; If recurrence was excluded by histopathological examination in patients with positive lesions on <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT and neck CT&#44; the imaging findings were classified as false-positive results&#46; In the case that recurrence was confirmed by histopathological examinations in patients with negative <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT&#44; the classification of these findings was defined as false-negative results&#46; Finally&#44; negative <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT in patients with negative histopathological examination was classified as true-negative results&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In the last 10 years&#44; we performed the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT under suppressed TSH&#44; based on evidence of an uncertain clinical benefit of performing <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT under stimulated TSH&#46; Twenty-seven percent &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#41; of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was done under TSH stimulation&#44; in 44&#37; after recombinant human thyrotrophin &#40;rhTSH&#41; administration &#40;exogenous stimulation&#41;&#44; whereas in the remaining 56&#37; after THW&#46; Of these 16 patients in whom <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT was performed under stimulated TSH&#44; 5 with an IR referred to our center&#44; and the study was performed before the new methodological approach in 11 patients with a BIR&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0100" class="elsevierStylePara elsevierViewall">Epidemiological data are presented as the mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SEM&#44; with median and range when appropriate&#46; For categorical variables&#44; the number and percentage of patients and&#47;or scans was calculated within each category&#46; The diagnostic capacity of the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT to identify &#40;regional and distant&#41; metastasis was estimated&#46; The crude estimations were adjusted by TSH value &#40;with and without stimulation&#41; and thyroglobulin levels &#40;&#8805; and &#60;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46; The categorical variables were compared by Pearson Chi-square and Fisher exact tests&#46; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was used to statistical significance&#46; For each instance&#44; the likelihood ratio &#40;ratio between sensitivity and false positive&#41; and their respective 95&#37; confidence intervals were estimated&#44; checking the statistical significance with the overlapping range width&#46; Receiver operating characteristic &#40;ROC&#41; curve analysis was used to define the SUVmax as a predictor of structural disease&#46; The area under the curve &#40;AUC&#41; was mentioned with the best cut-off estimated&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">Sixty patients &#40;85&#37; women&#41; aged 18&#8211;86 years &#40;median 50 years&#41;&#44; were enrolled in this retrospective study&#46; Based on the risk of recurrence classification&#44; 17&#37;&#44; 38&#37;&#44; and 40&#37; were low risk&#44; intermediate risk&#44; and high risk&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a> Seventy-five percent of included patients had a BIR and 25&#37; an IR when the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was performed&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Baseline characteristics of included patients can be observed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Increased <span class="elsevierStyleSup">18</span>FDG uptake suspicious for locoregional lesions was observed in 24 &#40;40&#37;&#41; of the patients&#44; while in the remaining 36 patients had no pathological <span class="elsevierStyleSup">18</span>FDG uptake&#46; The distribution of the lesions in the former 24 patients was as follows&#58; cervical and mediastinal lymphatic nodes in 18 patients&#44; thyroid bed in 4 patients and&#44; thyroid bed together with cervical lymph nodes in 2 cases&#46; The median size of the diagnosed lymph nodes was 13<span class="elsevierStyleHsp" style=""></span>mm &#40;range 7&#8211;23<span class="elsevierStyleHsp" style=""></span>mm&#41; with a mean SUVmax of 7&#46;18 &#40;&#177; 4&#46;94&#41;&#46; In 14 of these 24 patients with positive <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT results&#44; the final diagnosis was made by histopathological examination and in 5 patients&#44; the diagnosis of locoregional recurrence was determined during clinical follow-up&#46; The remaining 5 patients were considered as false positive &#40;three patients had negative fine-needle aspiration biopsy of cervical lymph nodes and in two patients the cervical lymph nodes disappeared during the follow-up&#41;&#46; The therapeutic approach was modified based on <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT findings in half of the patients with locoregional lesions &#40;in 46&#37; surgical intervention and 4&#37; the use of external beam radiotherapy was indicated&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Initially&#44; distant metastases detected by the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT were in lungs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; and in bone &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; Of the 5 patients with lung metastases&#44; 1 patient had positive <span class="elsevierStyleSup">18</span>FDG uptake &#40;SUV max 4&#46;5&#41; and 4 patients had small pulmonary nodules &#40;&#60;1<span class="elsevierStyleHsp" style=""></span>cm&#41; detected by the CT scan procedure without any <span class="elsevierStyleSup">18</span>FDG uptake&#46; One patient developed progressive disease&#44; and sorafenib 800<span class="elsevierStyleHsp" style=""></span>mg&#47;day was then prescribed&#46; We inferred that this patient did not have FDG uptake due to the size of the pulmonary nodules which were below the resolution of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46; In the remaining 3 patients&#44; the pulmonary nodules disappeared during the follow-up&#44; and they were considered as a false positive result&#46; One patient had a bone uptake&#44; only one focus &#40;L1 vertebrae&#44; SUVmax 3&#46;4&#41;&#44; with negative additional images &#40;MRI and bone scintigraphy&#41;&#46; Therefore&#44; it was also considered as a false positive result&#46; This patient had had a spinal trauma 5 years before&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Finally&#44; the prevalence of distant metastases detected by <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was 3&#46;3&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44; lung localization&#41;&#46; Those two patients had also locoregional lesions&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The only variable that was statistically significant when comparing positive and negative <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was age at diagnosis of DTC&#44; patients with negative <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT were younger than those patients with positive &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; There were no statistically significant differences considering gender &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;92&#41;&#44; initial lymph node dissection &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;574&#41;&#44; histology &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; or PCT histological variant &#40;p 0&#46;694&#41;&#44; multicentricity &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;141&#41;&#44; bilateral disease &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;179&#41;&#44; presence of thyroiditis &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;35&#41;&#44; capsular invasion &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;189&#41;&#44; tumor diameter &#40;p 0&#46;2883&#41;&#44; extrathyroidal invasion &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;109&#41;&#44; BIR and IR &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;086&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The diagnostic values &#40;sensitivity&#44; specificity&#44; and diagnostic accuracy&#41; of the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT to detect locoregional disease were calculated as follows&#58; 95&#37;&#44; 87&#46;5&#37;&#46; and 90&#37;&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">The sensitivity of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT carried out under TSH suppression was 93&#46;3&#37;&#44; while when the examination was performed after TSH stimulation&#44; it was 100&#37; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;90&#41;&#46; When the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was done after TSH stimulation&#44; its sensitivity did not differ significantly considering the way TSH stimulation was performed &#40;endogenous or exogenous&#41;&#46; The specificity was similar independently of the serum TSH levels at the time of the performance of the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46; We found no significant differences in the diagnostic performance of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT when done with or without TSH stimulation &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Diagnostic accuracy of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT and serum thyroglobulin levels</span><p id="par0145" class="elsevierStylePara elsevierViewall">The cut-off value of serum Tg level that carried to the indication of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT influenced its sensitivity&#46; We compared the sensitivity&#44; specificity&#44; and accuracy of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT for different thyroglobulin levels under hormonal therapy&#58; &#40;i&#41; 1&#8211;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml and &#40;ii&#41; &#62;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46; The sensitivity was 83&#37; in patients with Tg levels under thyroid hormone therapy between 1 and 10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml and 100&#37; for those with Tg levels &#62;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;19&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">On the other hand&#44; the PET&#47;CT was not useful to identify structural disease in patients with indeterminate response defined by thyroglobulin levels &#40;non-stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>ng&#47;mL or stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#46; The <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was negative in 100&#37; of patients with suppressed thyroglobulin levels &#60;1<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; and in 80&#37; with stimulated thyroglobulin levels between 1 and 10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The median stimulated Tg levels in patients with and without structural disease were 119<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;range 14&#8211;288<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; and 10&#46;2<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;2&#8211;53<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#44; respectively &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#46; On the other hand&#44; the median suppressed Tg level was 15<span class="elsevierStyleHsp" style=""></span>ng&#47;mL &#40;range 2&#46;5&#8211;788<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41; in patients with a structural disease&#44; and 4&#46;05<span class="elsevierStyleHsp" style=""></span>ng&#47;ml &#40;range 0&#46;9&#8211;231&#41; in patients without a structural disease &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;41&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Diagnostic accuracy of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT and serum anti-thyroglobulin antibodies</span><p id="par0160" class="elsevierStylePara elsevierViewall">Of the entire cohort&#44; 15 patients had positive anti-thyroglobulin antibodies&#46; Three patients &#40;20&#37;&#41; had positive <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT findings&#44; with a sensitivity of 100&#37; and a specificity of 91&#37;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Standardized uptake value &#40;SUV&#41; as a predictor of structural disease</span><p id="par0165" class="elsevierStylePara elsevierViewall">Mean SUVmax value was 7&#46;18 &#40;median&#58; 6&#46;3&#44; range&#58; 2&#8211;19&#41;&#46; The ROC curve for SUVmax can be observed in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; A cutoff value of 3&#46;2 for SUVmax was able to detect metastasis&#47;recurrence locoregional with a sensitivity of 63&#37; and a specificity of 95&#37;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0170" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose is a glucose analog that provides unique information about the glucose metabolism of normal or abnormal tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> Due to the increased glucose metabolism of malignant cells&#44; <span class="elsevierStyleSup">18</span>FDG uptake is frequently increased&#46; Thus&#44; positron emission tomography performed with <span class="elsevierStyleSup">18</span>FDG is a commonly used imaging methodology for various tumors&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a><span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT could be considered as an additional image procedure in patients with DTC and elevated serum Tg level &#40;&#62;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41; and negative <span class="elsevierStyleSup">131</span>I whole-body scans &#40;WBS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">3&#44;18</span></a> FDG uptake is a negative predictive factor for therapeutic response to radioactive iodine in metastatic DTC&#44; and it is also an independent prognostic factor for survival&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">12&#44;13</span></a> Lesions with high <span class="elsevierStyleSup">18</span>FDG uptake &#40;standardized uptake value&#41; may be more aggressive and should be targeted for therapy or followed-up closely&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">12&#44;13</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">In our investigation&#44; <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT had a sensitivity of 95&#37; and a specificity of 87&#46;5&#37; to detect locoregional disease similar to other reported studies<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">20&#44;21</span></a> and changed the therapeutic approach in 50&#37; of our patients&#46; The rate of false positive was 12&#46;5&#37;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">There were controversial reports about the need of performing the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT after TSH stimulation&#46; Wang et al&#46; did not report any improvement in the detection of DTC foci after TSH stimulation&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">22</span></a> However&#44; Moog et al&#46; suggested to carry out <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT after TSH stimulation&#44; proposing that glucose uptake by DTC cells would depend on serum TSH concentration&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> Additionally&#44; Leboulleux et al&#46; found that the detection of more DTC foci was observed after rhTSH stimulation&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> However&#44; the clinical benefit of identifying these additional small foci remains to be proven&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> In our study&#44; TSH stimulation did not improve the sensitivity of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">On the other side&#44; there is no consensus on the cut-off value of the Tg level that characterizes sufficient diagnostic accuracy of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT to detect recurrences or metastases&#46; Some authors recommend that&#44; to obtain a benefit from this image study&#44; the Tg level should be higher than 10ng&#47;ml&#44; measured under TSH suppression&#44;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">25&#8211;26</span></a> whereas others among them ATA guidelines recommend that a stimulated Tg level higher than 10ng&#47;ml may be sufficient to determine the indication of an <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a> In patients with a stimulated Tg level<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#44; the sensitivity of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT is generally low&#44; ranging from &#60;10 to 30&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a> However&#44; some authors showed higher sensitivity rates with Tg levels<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">27&#8211;29</span></a> Moreover&#44; Giovanella et al&#46; determined that the best Tg threshold for the selection of patients who should undergo <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT in clinical practice was 4&#46;6<span class="elsevierStyleHsp" style=""></span>ng&#47;ml under thyroid hormone therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> Given these findings&#44; it appears that the cut-off value of the Tg level has not been established yet&#46; We evaluated the cut-off value under TSH suppression&#44; is that in 73&#37; of the cohort the Tg measurement was carried out under hormonal therapy&#46; The sensitivity of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was 83&#37; in patients with non-stimulated Tg levels between 1 and 10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml and 100&#37; with Tg levels higher than 10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Furthermore&#44; in our study&#44; the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was not useful to identify structural disease in patients with indeterminate response defined by thyroglobulin levels &#40;non-stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>ng&#47;mL or stimulated Tg<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#41;&#46; As mentioned previously we included these patients who were referred to our hospital with the <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT already performed&#44; requested by another physician&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">On the other hand&#44; in patients with persistent anti-thyroglobulin antibodies&#44; the level of serum Tg cannot be reliably assessed and <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT might help to localize structural disease&#46; In our study&#44; <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT detected recurrence&#47;metastasis in 20&#37; of these patients&#46; We found a sensitivity of 100&#37; and a specificity of 91&#37; like other reports&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">30&#8211;33</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">Additionally&#44; we found that the ideal cut-off value for SUVmax to detect structural disease was of 3&#46;2&#44; with a sensitivity of 63&#37; and a specificity of 95&#37;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusion</span><p id="par0205" class="elsevierStylePara elsevierViewall">Our study confirmed that <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT is a useful tool in the detection of recurrences in patients with DTC with conflicting results of standard imaging procedures&#46; The sensitivity of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT was high for detecting locoregional lesions and it helped to change the immediate therapeutic approach in half of our patients with locoregional lesions and in 20&#37; of all included patients&#46; Despite this&#44; the location of metastatic tissue by itself is an element to be taken into consideration for individualized follow-up and future therapeutic alternatives&#46; However&#44; this method had a low sensitivity for detecting structural disease in patients with an indeterminate response&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflict of interest</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Ethical approval</span><p id="par0215" class="elsevierStylePara elsevierViewall">The study was approved by the Institutional Review Board&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Informed consent</span><p id="par0220" class="elsevierStylePara elsevierViewall">Informed consent was obtained from all individual participants included in the study&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres1413208"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1293353"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1413209"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1293354"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Data source and study population"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Serum thyroglobulin and anti-thyroglobulin antibodies measurement"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Neck ultrasonography"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Additional conventional imaging procedures"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "F-FDG-PET&#47;CT technique"
            ]
            5 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0045"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Diagnostic accuracy of F-FDG-PET&#47;CT and serum thyroglobulin levels"
            ]
            1 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Diagnostic accuracy of F-FDG-PET&#47;CT and serum anti-thyroglobulin antibodies"
            ]
            2 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Standardized uptake value &#40;SUV&#41; as a predictor of structural disease"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflict of interest"
        ]
        10 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Ethical approval"
        ]
        11 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Informed consent"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-07-04"
    "fechaAceptado" => "2020-02-02"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1293353"
          "palabras" => array:4 [
            0 => "<span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT"
            1 => "Biochemical incomplete response"
            2 => "Indeterminate response"
            3 => "Differentiated thyroid cancer"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1293354"
          "palabras" => array:4 [
            0 => "<span class="elsevierStyleSup">18</span>F-FDG-PET&#47;TC"
            1 => "Respuesta bioqu&#237;mica incompleta"
            2 => "Respuesta indeterminada"
            3 => "Carcinoma diferenciado de tiroides"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess the value of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT for detecting recurrent&#47;persistent disease in patients with biochemical incomplete &#40;BIR&#41; or indeterminate response &#40;IR&#41; and to assess the impact of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT on the therapeutic management of these patients&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The study included patients with BIR&#44; in whom <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT was used within the diagnostic algorithm from our database&#46; Patients with IR referred to our hospital with the <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT already performed were also enrolled&#46; All patients had neck ultrasonography with no structural changes&#46; A change in therapeutic approach was defined as repeat surgery&#59; administration of external beam radiotherapy&#59; and&#47;or the start of systemic therapy&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Sixty patients &#40;85&#37; women&#41; aged 18&#8211;86 years were enrolled in this retrospective study&#46; Of these&#44; 75&#37; had BIR and 25&#37; IR&#46; Increased FDG uptake suggesting locoregional lesions was seen in 40&#37; of patients&#46; Sensitivity&#44; specificity&#44; and diagnostic accuracy of <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT to detect local disease were 95&#37;&#44; 87&#46;5&#37; and 90&#37; respectively&#46; The therapeutic approach was modified in 50&#37; of patients with locoregional lesions&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our study confirmed that <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT is a useful tool for detecting locoregional recurrence in thyroid cancer patients with BIR or IR with conflicting findings in standard diagnostic procedures&#46; In 50&#37; of patients with locoregional lesions&#44; there was an immediate change in the treatment approach&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Evaluar la utilidad de la tomograf&#237;a por emisi&#243;n de positrones con <span class="elsevierStyleSup">18</span>F-FDG &#40;<span class="elsevierStyleSup">18</span>F-FDG PET&#47;TC&#41; para detectar enfermedad recurrente o persistente en pacientes con respuesta bioqu&#237;mica incompleta &#40;RBI&#41; o respuesta indeterminada &#40;RI&#41;&#44; y evaluar el impacto de los resultados del PET&#47;TC en el manejo terap&#233;utico de estos pacientes&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron pacientes con RBI&#44; en los cuales el PET&#47;TC fue utilizado en el algoritmo diagn&#243;stico durante el seguimiento&#44; y adem&#225;s pacientes con RI referidos a nuestro hospital con el estudio realizado&#46; Todos los pacientes presentaban ecograf&#237;a de cuello sin evidencia de alteraciones estructurales&#46; Se consider&#243; como cambio en el enfoque terap&#233;utico a&#58; 1&#41; realizaci&#243;n de nuevas cirug&#237;as&#44; 2&#41; administraci&#243;n de radioterapia externa&#44; y&#47;o 3&#41; inicio de terapia sist&#233;mica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Sesenta pacientes con edad entre 16 a 86 a&#241;os fueron incluidos retrospectivamente &#40;85&#37; mujeres&#41;&#44; el 75&#37; con RBI y el 25&#37; con RI&#46; En el 40&#37; de los pacientes el PET&#47;TC evidenciaron lesiones locorregionales&#46; La sensibilidad&#44; la especificidad y la precisi&#243;n diagn&#243;stica del PET&#47;TC para detectar enfermedad locorregional fue del 95&#44; 87&#44;5 y 90&#37;&#44; respectivamente&#46; En el 50&#37; de los pacientes con enfermedad locorregional los resultados del PET&#47;TC determinaron un cambio en la conducta terap&#233;utica&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio demostr&#243; que el PET&#47;TC es una herramienta &#250;til en la detecci&#243;n de enfermedad locorregional recurrente o persistente en pacientes con c&#225;ncer de tiroides con RBI o RI durante el seguimiento con hallazgos contradictorios en los m&#233;todos diagn&#243;sticos est&#225;ndares&#46; En el 50&#37; de los casos con lesiones locorregionales hubo un cambio inmediato en el enfoque terap&#233;utico&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1423
            "Ancho" => 2167
            "Tamanyo" => 118755
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Standardized uptake value &#40;SUV&#41; as a predictor of structural disease&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#59; DTC&#58; differentiated thyroid cancer&#59; Tg&#58; thyroglobulin&#59; TgAb&#58; anti-thyroglobulin antibodies&#59; TSH&#58; thyrotropin&#59; THW&#58; thyroid hormone withdrawal&#59; rhTSH&#58; recombinant human thyrotropin&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sex &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;88&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;years&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;&#177; 15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Histology and variant &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Classic PTC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Follicular PTC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;19&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oncocytic variant PTC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tall cell &#62;40&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Follicular thyroid cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Stage at diagnosis &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Initial risk of recurrence &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intermediate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;38&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;40&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cumulative radioiodine dose &#40;mCi&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">304 &#40;&#177; 288&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Response to treatment when the 18F-FDG PET&#47;CT was performed &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Biochemical Incomplete&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;75&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;89&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TgAb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Indeterminate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TgAb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;67&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">TSH when the 18F-FDG PET&#47;CT was performed &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Suppressed TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;73&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stimulated TSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>THW&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;56&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>rhTSH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;44&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Time of follow-up &#40;years&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Median &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#8211;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2424694.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>60&#41;&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Locoregional disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sensitivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specificity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">False positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">False negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">True positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">True negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Accuracy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2424695.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Sensitivity&#44; specificity&#44; and diagnostic accuracy of <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT in patients with locoregional disease&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">PPV&#58; positive predictive value&#59; NPV&#58; negative predictive value&#59; NS&#58; not significant&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Stimulated TSH&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Supressed TSH&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Positive &#40;<span class="elsevierStyleItalic">n&#44;</span> &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;43&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Negative &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;56&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;61&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">True positive &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;655&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">True negative &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;47&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;59&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;407&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">False positive &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;12&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">False negative &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sensitivity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;90 NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specificity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;50 NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PPV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;55 NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NPV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;55 NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Accuracy &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;69 NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Management change &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67 NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2424692.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Diagnostic yield in relation to TSH levels at the time of <span class="elsevierStyleSup">18</span>F-FDG-PET&#47;CT&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">PPV&#58; positive predictive value&#59; NPV&#58; negative predictive value&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tg 1&#8211;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tg<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Positive &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;66&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Negative &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;66&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">True-positive &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;66&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">True-negative &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;33&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">False negative &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sensitivity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specificity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PPV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NPV &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Accuracy &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2424693.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Diagnostic performance of <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT for different thyroglobulin levels under hormonal therapy&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:33 [
            0 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term results and prognostic factors in patients with differentiated thyroid carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Tubiana"
                            1 => "M&#46; Schlumberger"
                            2 => "P&#46; Rougier"
                            3 => "A&#46; Laplanche"
                            4 => "E&#46; Benhamou"
                            5 => "P&#46; Gardet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/1097-0142(19850215)55:4<794::aid-cncr2820550418>3.0.co;2-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1985"
                        "volumen" => "55"
                        "paginaInicial" => "794"
                        "paginaFinal" => "804"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3967174"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Natural history&#44; treatment&#44; and course of papillary thyroid carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;J&#46; DeGroot"
                            1 => "E&#46;L&#46; Kaplan"
                            2 => "M&#46; Mc Cormick"
                            3 => "F&#46;H&#46; Straus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Endocrinol Metabol"
                        "fecha" => "1990"
                        "volumen" => "71"
                        "paginaInicial" => "414"
                        "paginaFinal" => "424"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer&#58; The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;R&#46; Haugen"
                            1 => "E&#46;K&#46; Alexander"
                            2 => "K&#46;C&#46; Bible"
                            3 => "G&#46; Doherty"
                            4 => "S&#46;J&#46; Mandel"
                            5 => "Y&#46;E&#46; Nikiforov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2015.0020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2016"
                        "volumen" => "26"
                        "paginaInicial" => "1"
                        "paginaFinal" => "133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26462967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation&#58; using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Tuttle"
                            1 => "H&#46; Tala"
                            2 => "J&#46; Shah"
                            3 => "R&#46; Leboeuf"
                            4 => "R&#46; Ghossein"
                            5 => "M&#46; Gonen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2010.0178"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "1341"
                        "paginaFinal" => "1349"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21034228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delayed risk stratification&#44; to include the response to initial treatment &#40;surgery and radioiodine ablation&#41;&#44; has better outcome predictivity in differentiated thyroid cancer patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;G&#46; Castagna"
                            1 => "F&#46; Maino"
                            2 => "C&#46; Cipri"
                            3 => "V&#46; Belardini"
                            4 => "A&#46; Theodoropoulou"
                            5 => "G&#46; Cevenini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-11-0466"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2011"
                        "volumen" => "165"
                        "paginaInicial" => "441"
                        "paginaFinal" => "446"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21750043"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Implementing the modified 2009 American Thyroid Association Risk Stratification System in thyroid cancer patients with low and intermediate risk of recurrence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Pitoia"
                            1 => "F&#46; Jerkovich"
                            2 => "C&#46; Urciuoli"
                            3 => "A&#46; Schmidt"
                            4 => "E&#46; Abelleira"
                            5 => "F&#46; Bueno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2015.0121"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2015"
                        "volumen" => "25"
                        "paginaInicial" => "1235"
                        "paginaFinal" => "1242"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26132983"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous remission in thyroid cancer patients after biochemical incomplete response to initial therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Vaisman"
                            1 => "D&#46; Momesso"
                            2 => "D&#46;A&#46; Bulzico"
                            3 => "C&#46;H&#46; Pessoa"
                            4 => "F&#46; Dias"
                            5 => "R&#46; Corbo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Endocrinol &#40;Oxf&#41;"
                        "fecha" => "2012"
                        "volumen" => "77"
                        "paginaInicial" => "132"
                        "paginaFinal" => "138"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In differentiated thyroid cancer&#44; an incomplete structural response to therapy is associated with significantly worse clinical outcomes than only an incomplete thyroglobulin response"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46; Vaisman"
                            1 => "H&#46; Tala"
                            2 => "R&#46; Grewal"
                            3 => "R&#46;M&#46; Tuttle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2011.0232"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2011"
                        "volumen" => "21"
                        "paginaInicial" => "1317"
                        "paginaFinal" => "1322"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22136267"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biochemical persistence in thyroid cancer&#58; is there anything to worry about&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Pitoia"
                            1 => "E&#46; Abelleira"
                            2 => "H&#46; Tala"
                            3 => "F&#46; Bueno"
                            4 => "C&#46; Urciuoli"
                            5 => "G&#46; Cross"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12020-013-0097-6"
                      "Revista" => array:7 [
                        "tituloSerie" => "Endocrine"
                        "fecha" => "2014"
                        "volumen" => "46"
                        "paginaInicial" => "532"
                        "paginaFinal" => "537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24287799"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1550728916000538"
                          "estado" => "S300"
                          "issn" => "15507289"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of PET in follow-up of patients treated for differentiated epithelial thyroid cancers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Leboulleux"
                            1 => "P&#46;R&#46; Schroeder"
                            2 => "M&#46; Schlumberger"
                            3 => "P&#46;W&#46; Ladenson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ncpendmet0402"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Clin Pract Endocrinol Metab"
                        "fecha" => "2007"
                        "volumen" => "3"
                        "paginaInicial" => "112"
                        "paginaFinal" => "121"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17237838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "F18-FDG-PET for recurrent differentiated thyroid cancer&#58; a systematic meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "HaslerudT"
                            1 => "BrauckhoffK"
                            2 => "L&#46; Reis&#230;ter"
                            3 => "R&#46; K&#252;fner-Lein"
                            4 => "A&#46; Heinecke"
                            5 => "J&#46;E&#46; Varhaug"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0284185115594645"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Radiol"
                        "fecha" => "2016"
                        "volumen" => "57"
                        "paginaInicial" => "1193"
                        "paginaFinal" => "1200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26163534"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real-time prognosis for metastatic thyroid carcinoma based on 2-&#91;18F&#93; fluoro-2-deoxy-<span class="elsevierStyleSmallCaps">d</span>-glucose-positron emission tomography scanning"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;J&#46; Robbins"
                            1 => "Q&#46; Wan"
                            2 => "R&#46;K&#46; Grewal"
                            3 => "R&#46; Reibke"
                            4 => "M&#46; Gonen"
                            5 => "H&#46;W&#46; Strauss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2005-1534"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2006"
                        "volumen" => "91"
                        "paginaInicial" => "498"
                        "paginaFinal" => "505"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16303836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Do histological&#44; immunohistochemical&#44; and metabolic &#40;radioiodine and fluorodeoxyglucose uptakes&#41; patterns of metastatic thyroid cancer correlate with patient outcome&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Deandreis"
                            1 => "A&#46; Al Ghuzlan"
                            2 => "S&#46; Leboulleux"
                            3 => "L&#46; Lacroix"
                            4 => "J&#46;P&#46; Garsi"
                            5 => "M&#46; Talbot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1677/ERC-10-0233"
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr Relat Cancer"
                        "fecha" => "2011"
                        "volumen" => "18"
                        "paginaInicial" => "159"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21118976"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Integrated PET&#47;CT in differentiated thyroid cancer Diagnostic Accuracy and Impact on Patient Management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Palmedo"
                            1 => "J&#46; Bucerius"
                            2 => "A&#46; Joe"
                            3 => "H&#46; Strunk"
                            4 => "N&#46; Hortling"
                            5 => "S&#46; Meyka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nucl Med"
                        "fecha" => "2006"
                        "volumen" => "47"
                        "paginaInicial" => "616"
                        "paginaFinal" => "624"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16595495"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of positron emission tomography&#47;computed tomography in the management of recurrent papillary thyroid carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46; Nahas"
                            1 => "D&#46; Goldenberg"
                            2 => "C&#46; Fakhry"
                            3 => "M&#46; Ewertz"
                            4 => "M&#46; Zeiger"
                            5 => "P&#46;W&#46; Ladenson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.mlg.0000154725.00787.00"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2005"
                        "volumen" => "115"
                        "paginaInicial" => "237"
                        "paginaFinal" => "243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15689742"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical impact of &#40;18&#41; F-FDG PET in thyroid carcinoma patients with elevated thyroglobulin levels and negative &#40;131&#41; I scanning results after therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;O&#46; Helal"
                            1 => "P&#46; Merlet"
                            2 => "M&#46;E&#46; Toubert"
                            3 => "B&#46; Franc"
                            4 => "C&#46; Schvartz"
                            5 => "H&#46; Gauthier-Koelesnikov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nucl Med"
                        "fecha" => "2001"
                        "volumen" => "42"
                        "paginaInicial" => "1464"
                        "paginaFinal" => "1469"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11585858"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:1 [
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "editores" => "M&#46;B&#46;Amin, S&#46;Edge, F&#46;Greene, D&#46;R&#46;Byrd, R&#46;K&#46;Brookland, M&#46;K&#46;Washington"
                        "titulo" => "AJCC cancer staging manual"
                        "edicion" => "8th ed&#46;"
                        "serieFecha" => "2017"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Pitoia"
                            1 => "L&#46; Ward"
                            2 => "N&#46; Wohllk"
                            3 => "C&#46; Friguglietti"
                            4 => "E&#46; Tomimori"
                            5 => "A&#46; Gauna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/s0004-27302009000700014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arq Bras Endocrinol Metabol"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "884"
                        "paginaFinal" => "887"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19942992"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "18F-FDG PET&#47;CT imaging in oncology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Almuhaideb"
                            1 => "N&#46; Papathanasiou"
                            2 => "J&#46; Bomanji"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/0256-4947.75771"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Saudi Med"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "3"
                        "paginaFinal" => "13"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21245592"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of PET&#47;CT in the diagnosis of recurrent or metastasized differentiated thyroid carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;Z&#46; Lu"
                            1 => "S&#46;S&#46; Cao"
                            2 => "W&#46; Wang"
                            3 => "J&#46; Liu"
                            4 => "N&#46; Fu"
                            5 => "F&#46; Lu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3892/ol.2016.4229"
                      "Revista" => array:7 [
                        "tituloSerie" => "Oncol Lett"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "2420"
                        "paginaFinal" => "2423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27073490"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1550728914003931"
                          "estado" => "S300"
                          "issn" => "15507289"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluating positron emission tomography use in differentiated thyroid cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;L&#46; Wiebel"
                            1 => "N&#46;H&#46; Esfandiari"
                            2 => "M&#46; Papaleontiou"
                            3 => "F&#46;P&#46; Worden"
                            4 => "M&#46;R&#46; Haymart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2015.0062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2015"
                        "volumen" => "25"
                        "paginaInicial" => "1026"
                        "paginaFinal" => "1032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26133765"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;18F&#93;-2-fluoro-2-deoxy-<span class="elsevierStyleSmallCaps">d</span>-glucose positron emission tomography localizes residua thyroid cancer in patients with negative diagnostic &#40;131&#41; I whole body scans and elevated serum thyroglobulin levels"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Wang"
                            1 => "H&#46; Macapinlac"
                            2 => "S&#46;M&#46; Larson"
                            3 => "S&#46;D&#46; Yeh"
                            4 => "T&#46; Akhurst"
                            5 => "R&#46;D&#46; Finn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jcem.84.7.5827"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1999"
                        "volumen" => "84"
                        "paginaInicial" => "2291"
                        "paginaFinal" => "2302"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10404792"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of thyroid-stimulating hormone levels on uptake of FDG in recurrent and metastatic differentiated thyroid carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Moog"
                            1 => "R&#46; Linke"
                            2 => "N&#46; Manthey"
                            3 => "R&#46; Tiling"
                            4 => "P&#46; Knesewitsch"
                            5 => "K&#46; Tatsch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nucl Med"
                        "fecha" => "2000"
                        "volumen" => "41"
                        "paginaInicial" => "1989"
                        "paginaFinal" => "1995"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11138683"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of the incremental value of recombinant thyrotropin stimulation before 2-&#91;18F&#93;-fluoro-2-deoxy-<span class="elsevierStyleSmallCaps">d</span>-glucose positron emission tomography&#47;computed tomography imaging to localize residual differentiated thyroid cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Leboulleux"
                            1 => "P&#46;R&#46; Schroeder"
                            2 => "N&#46;L&#46; Busaidy"
                            3 => "A&#46; Auperin"
                            4 => "C&#46; Corone"
                            5 => "H&#46;A&#46; Jacene"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2008-1747"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2009"
                        "volumen" => "94"
                        "paginaInicial" => "1310"
                        "paginaFinal" => "1316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19158200"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postradioiodine treatment whole-body scan in the era of 18-fluorodeoxyglucose positron emission tomography for differentiated thyroid carcinoma with elevated serum thyroglobulin levels"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Leboulleux"
                            1 => "I&#46; El Bez"
                            2 => "I&#46; Borget"
                            3 => "M&#46; Elleuch"
                            4 => "D&#46; D&#233;andreis"
                            5 => "A&#46; Al Ghuzlan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2012.0081"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2012"
                        "volumen" => "22"
                        "paginaInicial" => "832"
                        "paginaFinal" => "838"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22853728"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging in endocrinology&#58; 2-&#91;18F&#93;-fluoro-2-deoxy-<span class="elsevierStyleSmallCaps">d</span>-glucose positron emission tomography&#47;computed tomography in differentiated thyroid carcinoma&#58; clinical indications and controversies in diagnosis and follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Salvatori"
                            1 => "B&#46; Biondi"
                            2 => "V&#46; Rufini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-15-0066"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2015"
                        "volumen" => "173"
                        "paginaInicial" => "R115"
                        "paginaFinal" => "R130"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25947140"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does recombinant human thyrotropin-stimulated positron emission tomography with &#91;18F&#93;fluoro-2-deoxy-<span class="elsevierStyleSmallCaps">d</span>-glucose improve detection of recurrence of well-differentiated thyroid carcinoma in patients with low serum thyroglobulin&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Vera"
                            1 => "C&#46; Kuhn-Lansoy"
                            2 => "A&#46; Edet-Sanson"
                            3 => "S&#46; Hapdey"
                            4 => "R&#46; Modzelewski"
                            5 => "A&#46; Hitzel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/thy.2008.0416"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thyroid"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "15"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20017617"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between serum thyroglobulin and <span class="elsevierStyleSup">18</span>FDG-PET&#47;CT in <span class="elsevierStyleSup">131</span>I-negative differentiated thyroid carcinomas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Giovanella"
                            1 => "L&#46; Ceriani"
                            2 => "D&#46; De Palma"
                            3 => "S&#46; Suriano"
                            4 => "M&#46; Castellani"
                            5 => "F&#46;A&#46; Verburg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hed.21791"
                      "Revista" => array:6 [
                        "tituloSerie" => "Head Neck"
                        "fecha" => "2012"
                        "volumen" => "34"
                        "paginaInicial" => "626"
                        "paginaFinal" => "631"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21850699"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Positron emission tomography-computed tomography with &#40;18&#41;F-fluorodeoxyglucose in patients with recurrent differentiated thyroid carcinoma and negative radioiodine scan&#46; Diagnostic performance and relation with tyroglobulin levels"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Mariscal Labrador"
                            1 => "A&#46; Garc&#237;a Burillo"
                            2 => "J&#46; Castell-Conesa"
                            3 => "G&#46; Obiols Alfonso"
                            4 => "N&#46; Kisiel Gonz&#225;lez"
                            5 => "M&#46; Barios Profit&#243;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.remn.2012.04.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Med Nucl Imagen Mol"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "146"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22726673"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlation of <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT findings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin antibody levels and negative <span class="elsevierStyleSup">131</span>I whole-body scan results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Ozkan"
                            1 => "G&#46; Aras"
                            2 => "N&#46;O&#46; Kucuk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Nucl Med"
                        "fecha" => "2013"
                        "volumen" => "326"
                        "paginaInicial" => "31"
                        "paginaFinal" => "37"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic value of <span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose-positron emission tomography in patients with differentiated thyroid carcinoma and circulating antithyroglobulin autoantibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;V&#46; Bogsrud"
                            1 => "I&#46;D&#46; Hay"
                            2 => "D&#46; Karantanis"
                            3 => "M&#46;A&#46; Nathan"
                            4 => "B&#46;P&#46; Mullan"
                            5 => "G&#46;A&#46; Wiseman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MNM.0b013e328343a742"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nucl Med Commun"
                        "fecha" => "2011"
                        "volumen" => "32"
                        "paginaInicial" => "245"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21278616"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between circulating anti-thyroglobulin antibodies &#40;TgAb&#41; and tumor metabolism in patients with differentiated thyroid cancer &#40;DTC&#41;&#58; prognostic implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Morbelli"
                            1 => "G&#46; Ferrarazzo"
                            2 => "E&#46; Pomposelli"
                            3 => "F&#46; Pupo"
                            4 => "G&#46; Pesce"
                            5 => "I&#46; Calamia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40618-016-0578-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Endocrinol Invest"
                        "fecha" => "2017"
                        "volumen" => "40"
                        "paginaInicial" => "417"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27844413"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic performance of <span class="elsevierStyleSup">18</span>F-FDG PET&#47;CT in papillary thyroid carcinoma with negative <span class="elsevierStyleSup">131</span>I-WBS at first postablation negative Tg and progressively increased TgAb level"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46;L&#46; Qiu"
                            1 => "W&#46;J&#46; Wei"
                            2 => "C&#46;T&#46; Shen"
                            3 => "H&#46;J&#46; Song"
                            4 => "X&#46;Y&#46; Zhang"
                            5 => "Z&#46;K&#46; Sun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-017-03001-7"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep"
                        "fecha" => "2017"
                        "volumen" => "7"
                        "paginaInicial" => "2849"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28588229"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/25300180/0000006700000008/v1_202011131001/S2530018020301256/v1_202011131001/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64496"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/25300180/0000006700000008/v1_202011131001/S2530018020301256/v1_202011131001/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530018020301256?idApp=UINPBA00004N"
]

Article information

ISSN: 25300180
Original language: English

DOI:10.1016/j.endien.2020.10.002

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	6	0	6
2024 October	58	12	70
2024 September	43	6	49
2024 August	47	6	53
2024 July	48	11	59
2024 June	40	7	47
2024 May	48	4	52
2024 April	31	7	38
2024 March	45	7	52
2024 February	50	2	52
2024 January	84	1	85
2023 December	85	9	94
2023 November	79	10	89
2023 October	86	5	91
2023 September	71	10	81
2023 August	63	7	70
2023 July	70	8	78
2023 June	87	7	94
2023 May	115	15	130
2023 April	54	1	55
2023 March	80	3	83
2023 February	69	9	78
2023 January	58	4	62
2022 December	66	7	73
2022 November	94	15	109
2022 October	60	12	72
2022 September	60	8	68
2022 August	38	10	48
2022 July	65	24	89
2022 June	74	7	81
2022 May	54	12	66
2022 April	56	22	78
2022 March	35	10	45
2022 February	28	6	34
2022 January	51	7	58
2021 December	16	10	26
2021 November	19	12	31
2021 October	16	9	25
2021 September	17	11	28
2021 August	40	3	43
2021 July	8	2	10
2021 June	25	10	35
2021 May	46	14	60
2021 April	30	5	35
2021 March	1	0	1

Show all

Indexed in:

Follow us:

Subscribe:

Statistics

Indexed in:

Follow us:

Subscribe:

Statistics

Subscribe to our newsletter