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Andreas Bockisch

Publications and source records attributed to Andreas Bockisch.

At least 19 recordsLinked to original sources
PubMed2007

Segmentation of PET volumes by iterative image thresholding.

UNLABELLED: The segmentation of metastatic volumes in PET is usually performed by thresholding methods. In a clinical application, the optimum threshold obtained from the adaptive thresholding method requires a priori estimation of the lesion volume from anatomic images such as CT. We describe an iterative thresholding method (ITM) used to estimate the PET volumes without anatomic a priori knowledge and its application to clinical images. METHODS: The ITM is based on threshold-volume curves at varying source-to-background (S/B) ratio acquired from a body phantom. The spheres and background were filled either with (18)F-FDG or Na(124)I ((124)I). These calibrated S/B-threshold-volume curves were used in estimating the volume by applying an iterative procedure. The ITM was validated with a PET phantom containing spheres and with 39 PET tumors that were discernable on CT by using whole-body (18)F-FDG (15 patients) and (124)I PET/CT (9 patients): The measured S/B ratios of the lesions were estimated from PET images, and their volumes were iteratively calculated using the calibrated S/B-threshold-volume curves. The resulting PET volumes were then compared with the known sphere inner volume and CT volumes of tumors that served as gold standards. RESULTS: Phantom data analysis showed that the S/B-threshold-volume curves of (18)F-FDG and (124)I were similar. The average absolute deviation (expressed as a percentage of the expected volume) obtained in the PET validation phantom was 10% for volumes larger than 1.0 mL; sphere volumes of 0.5 mL showed a significantly larger deviation. For patients, the average absolute deviation for volumes between 0.8 and 7.5 mL was about 9% (31 lesions), whereas volumes larger than 7.5 mL showed an average volume mismatch of 15% (8 lesions). CONCLUSION: The ITM sufficiently estimated the clinical volumes in the range of 0.8-7.5 mL; volumes larger than 7.5 mL showed greater deviations that were still acceptable. These findings are associated with the limitation of the ITM. The ITM is especially useful for lesions that are only visible on PET. As a consequence, the lesion dosimetry is feasible with sufficient accuracy using PET images only.

Calibration↗
PubMed2007

Can PET/CT replace separate diagnostic CT for cancer imaging? Optimizing CT protocols for imaging cancers of the chest and abdomen.

Stage-adapted treatment in oncology relies on correct tumor staging for patients with malignant diseases. To ensure accurate assessment of the tumor stage in thoracic and abdominal diseases by PET/CT, both CT and PET need to be optimized. In this setting, different malignant diseases require customized imaging protocols. Although in the clinical setting of therapy assessment, PET/CT with integration of low-dose, nonenhanced CT may be sufficient, tumor staging may require a more sophisticated CT protocol. This review focuses on potential CT protocols for imaging cancers of the chest and abdomen. Examples of CT protocols are presented and discussed for non-small cell lung cancer, breast cancer, colorectal cancer, gastrointestinal stromal tumors, and interventional liver therapy.

Abdominal Neoplasms↗
PubMed2006

Diagnostic accuracy of colorectal cancer staging with whole-body PET/CT colonography.

CONTEXT: Staging of patients with colorectal cancer often requires a multimodality, multistep imaging approach. Colonography composed of a combined modality of positron emission tomography (PET) and computed tomography (CT) provides whole-body tumor staging in a single session. OBJECTIVES: To determine the staging accuracy of whole-body PET/CT colonography compared with the staging accuracies of CT followed by PET (CT + PET) and CT alone and to evaluate the effect of PET/CT colonography on therapy planning compared with conventional staging (CT of the abdomen and thorax and optical colonoscopy). DESIGN, SETTING, AND PATIENTS: Prospective study of 47 patients enrolled between May 2004 and June 2006 with clinical findings and optical colonoscopy that suggested primary colorectal cancer (mean [SD] age, 71 [11] years; range, 47-92 years). Patients underwent whole-body PET/CT colonography 1 day after colonoscopy. The study was conducted at a university hospital with a mean (SD) follow-up of 447 (140) days (range, 232-653 days). MAIN OUTCOME MEASURES: Correct classification of overall TNM stage using PET/CT colonography compared with CT + PET and CT alone. Secondary outcome measures were the accurate assessment of T-stage, N-stage, and M-stage by PET/CT colonography compared with CT + PET and CT alone and the effect of PET/CT colonography on therapy planning. RESULTS: Of the 47 patients with a total of 50 lesions, the overall TNM stage was correctly determined for 37 lesions with PET/CT colonography (74%; 95% confidence interval [CI], 60%-85%), 32 lesions with CT + PET (64%; 95% CI, 49%-77%), and 26 lesions with CT alone with a 0.7-cm node threshold (52%; 95% CI, 37%-66%). Compared with optimized abdominal CT staging alone, PET/CT colonography was significantly more accurate in defining TNM stage (difference, 22%; 95% CI, 9%-36%; P=.003), which was mainly based on a more accurate definition of the T-stage. Differences were not detected for defining N-stage between PET/CT colonography and CT alone with a threshold of 0.7 cm for malignant nodes but were detected with a threshold of 1 cm. Differences were not detected in defining M-stage separately or when comparing the accuracies of PET/CT colonography with CT + PET. PET/CT colonography affected consecutive therapy decisions in 4 patients (9%; 95% CI, 2.4%-20.4%) compared with conventional staging (CT alone and colonoscopy). CONCLUSIONS: In this preliminary study, PET/CT colonography is at least equivalent to CT + PET for tumor staging in patients with colorectal cancer. Thus, PET/CT colonography in conjunction with optical colonoscopy may be a suitable concept of tumor staging for patients with colorectal cancer.

Aged↗
PubMed2006

Accuracy of combined PET/CT in image-guided interventions of liver lesions: an ex-vivo study.

AIM: Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies. METHODS: Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of (18)F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square (RMS) was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS: In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions. CONCLUSION: Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

Animals↗
PubMed2006

Lymph node staging with dual-modality PET/CT: enhancing the diagnostic accuracy in oncology.

Lymph node staging according to the TNM criteria is an essential part of tumor evaluation. Several morphological and functional imaging procedures are used complementarily in this setting. Dual-modality PET/CT scanners are able to provide anatomical and functional data sets in a single session with accurate image co-registration. Comparative studies between morphological imaging procedures, such as MRI and CT, with co-registered PET/CT demonstrated significantly better lymph node staging with PET/CT than with anatomical procedures alone, regardless of the staged body compartment (head and neck, thorax or abdominal area). Based on more accurate staging results, PET/CT was able to alter the patients' therapy in a significant number of studies. Functional imaging with FDG-PET ([(18)F]-2-fluoro-2-desoxy-D-glucose-positron emission tomography) demonstrated outstanding results in lymph node staging of different tumor diseases. By adding anatomical information to PET, PET/CT outperforms PET alone when assessing the TNM-stage of different malignant diseases. This paper provides an overview concerning the performance of PET/CT in staging lymph nodes for malignant spread and points out benefits and limitations of this new imaging modality.

Contrast Media↗
PubMed2006

Value of 18F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography in non-small-cell lung cancer for prediction of pathologic response and times to relapse after neoadjuvant chemoradiotherapy.

PURPOSE: To determine the value of combined positron emission tomography/computed tomography (PET/CT) during induction chemotherapy (CTx) followed by chemoradiotherapy (CTx/RTx) for non-small-cell lung cancer to predict histopathologic response in primary tumor and mediastinum and prognosis of the patient. EXPERIMENTAL DESIGN: Fifty consecutive patients with locally advanced non-small-cell lung cancer received induction therapy and, if considered resectable, proceeded to surgery (37 of 50 patients). Patients had at least two repeated 18F-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT scans either before treatment (t0) or after induction CTx (t1) or CTx/RTx (t2). Variables from the PET/CT studies [e.g., lesion volume and corrected maximum standardized glucose uptake values (SUV(max,corr))] were correlated with histopathologic response (graded as 3, 2b, or 2a: 0%, >0-10%, or >10% residual tumor cells) and times to failure. RESULTS: Primary tumors showed a percentage decrease in SUV(max,corr) during induction significantly larger in grade 2b/3 than in grade 2a responding tumors (67% versus 34% at t(1), 73% versus 49% at t(2); both P < 0.005). SUV(max,corr) at t(2) was significantly correlated with histopathologic response in tumors smaller than the median volume (7.5 cm(3); r = -0.54, P = 0.02). In the mediastinal lymph nodes, SUV(max,corr) values at t2 predicted an ypN0 status with a sensitivity and specificity of 73% and 89%, respectively (SUV(max,corr) threshold of 4.1, r = -0.54, P = 0.0005). Freedom from extracerebral relapse was significantly better in grade 2b/3 patients (86% at 16 months versus 20% in 2a responders; P = 0.003) and in patients with a greater percentage decrease in SUV(max,corr) in the primary tumor at t2 in relation to t0 than in patients with lesser response (83% at 16 months versus 43%; P = 0.03 for cutoff points between 0.45 and 0.55). CONCLUSIONS: SUV(max,corr) values from two serial PET/CT scans, before and after three chemotherapy cycles or later, allow prediction of histopathologic response in the primary tumor and mediastinal lymph nodes and have prognostic value.

Adult↗
PubMed2006

Liver transplantation for patients with metastatic endocrine tumors: single-center experience with 15 patients.

In contrast to other secondary liver malignancy, orthotopic liver transplantation (OLT) is considered as a treatment modality for nonresectable endocrine liver metastases in selected patients. However, only few series have assessed patient selection criteria and long-term results, and no reports have focused on the impact of new technologies in this regard. Between 1992 and 2004, 28 patients with malignant endocrine tumors underwent evaluation for OLT according to our protocol. Data were entered into a prospective database. During pretransplant evaluation, somatostatin receptor scintigraphy detected extrahepatic metastases not diagnosed in standard imaging in 10 patients. Of them, 3 showed aberrant Ki67 labeling results. One patient was excluded from further evaluation due to severe carcinoid heart. Thus far, 15 patients, 10 men and 5 women, aged 37 to 67 years, were subjected to the transplant procedure (11 deceased donor OLT, 3 living donor liver transplantations, and 1 cluster transplantation). Four patients died during the hospital treatment. The median follow-up of the discharged patients was 60.8 months. The actuarial patient survival was 78.3% at 1 year and 67.2% at 5 years. The actuarial 1-, 2-, and 5-year tumor-free survival amounted to 69.4%, 48.3%, and 48.3%, respectively. Two patients underwent surgery for isolated tumor recurrence. In 2 patients, peptide receptor radiotherapy was carried out because of multilocular recurrent disease. In conclusion, liver transplantation is a realistic therapeutic option for highly selected patients with hepatic metastases of endocrine tumors. Our strategy, which implements strict pretransplant selection and aggressive surgical approach, in case of disease recurrence, in addition to systemic radiopeptide treatment, led to an excellent long-term survival cure, however, is unlikely to be achieved.

Adult↗
PubMed2006

Health-related Quality of Life, depression and anxiety in thyroid cancer patients.

OBJECTIVES: We examined the relationships among physical complaints, health-related quality of life (HRQL), anxiety and depression in differentiated thyroid cancer (DTC) patients under short-term hypothyroidism. METHODS: We conducted a cross-sectional study in 136 patients hypothyroid on thyroid hormone withdrawal (THW) hospitalized for radioiodine administration. Patients were assessed using Short Form SF-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Profile of Mood States (POMS), Beck Depression Inventory (BDI), and physical complaints. RESULTS: Compared to the German general population, hypothyroid patients had significantly impaired HRQL. Surprisingly, the prevalence of anxiety (62.5%), but not depression (17.9%) was much higher in hypothyroid DTC patients than in the general population. In multivariate analysis, depression and age were independently associated with the physical health score (R(2) = 0.21), but only psychological variables (depression, mood disturbance, and anxiety) were associated with the mental health score (R(2) = 0.43), on the SF-36 HRQL instrument. CONCLUSIONS: HRQL is severely impaired in DTC patients under short-term hypothyroidism. As potential predictors of generic HRQL impairment, depression, anxiety, and mood disturbance could be used to preselect the patients most needing psychiatric care. The high frequency of anxiety should be considered in the aftercare of thyroid cancer patients.

Adult↗
PubMed2006

Treatment with (90)Y- and (177)Lu-DOTATOC in patients with metastatic neuroendocrine tumors.

BACKGROUND: Treatment with (90)Y- or (177)Lu-DOTATOC has recently been introduced in the palliative treatment of somatostatin receptor-expressing neuroendocrine tumors (NETs). The aim of the study was to present clinical experience with (90)Y- and (177)Lu-DOTATOC therapy in the management of NET. METHODS: To prove suitability for treatment each patient underwent scanning with (111)In-DTPAOC or (68)Ga-DOTATOC positron emission tomography/computed tomography. All patients received [(90)Y-DOTATOC] as initial treatment. In case of disease relapse the treatment was repeated. To avoid side effects of repeated [(90)Y] applications, a switch to [(177)Lu-DOTATOC] was carried out. Clinical, biochemical, and radioimaging responses were documented. RESULTS: Twenty patients with metastatic nonresectable NETs (15 pancreas NETs, 2 midgut NETs, 1 gastrinoma, 1 paraganglioma, 1 NET of unknown primary origin) were included. In 8 patients the treatment was repeated more than once (mean, 3 times; range, 2-5 times). After [(90)Y] treatment moderate toxicity was observed in 8 patients. No serious adverse events were documentable. After restaging, a partial remission was found in 5 patients, stable disease in 11 patients, and tumor progression in 4 patients. CONCLUSIONS: Peptide receptor-targeted radionuclide therapy is a promising, safe, and feasible approach in the palliative therapy of patients with NET.

Adult↗
PubMed2006

Relationship between cumulative radiation dose and salivary gland uptake associated with radioiodine therapy of thyroid cancer.

AIM: To estimate the individual absorbed dose to the parotid and submandibular salivary glands in radioiodine therapy and its dependence from the previous cumulative therapy. METHODS: Fifty-five patients with differentiated thyroid carcinoma after thyroidectomy received 1-21 GBq (131)I using single activities of 1-6 GBq. The patients were stratified according to the cumulative activities into low-activity (1-2 GBq), middle-activity (3-7 GBq), and high-activity groups (9-21 GBq). The time-activity curves over the respective salivary glands were derived from multiple static calibrated images measured for each patient up to 48 h after ingestion of the radioiodine therapy capsule with a gamma camera. Manually drawn regions of interests were used to determine the background activities and the activities arising from the salivary glands. The gland volumes were determined by ultrasonography using appropriate volume models. RESULTS: The median absorbed dose per administered activity of each single parotid and submandibular gland was about 0.15 Gy.GBq (range, 0.1-0.3 Gy.GBq(-1)) and 0.48 Gy.GBq(-1) (range, 0.2-1.2 Gy.GBq(-1)), respectively. The maximum uptake of both gland types was significantly lower for the high-activity than for the low-activity groups and correlated with the mean cumulative administered activity of the activity groups. CONCLUSION: The iodine uptake of salivary glands is significantly reduced, whereas the absorbed dose per administered (131)I activity was not significantly decreased during the course of therapy. Comparing the well-known dose-effect relationships in external radiation therapy, the absorbed dose per administered (131)I activity is too low to induce comparable radiation damage, suggesting an inhomogeneous distribution of (131)I in human salivary glands.

Adult↗
PubMed2006

Whole-body 18F-FDG PET/CT in the presence of truncation artifacts.

UNLABELLED: We investigated the effect of CT truncation in whole-body (WB) PET/CT imaging of large patients, and we evaluated the efficacy of an extended field-of-view (eFOV) correction technique. METHODS: Two uniform phantoms simulating a "torso" and an "arms-up" setup were filled with (18)F-FDG/water. A third, nonuniform "body phantom was prepared with hot and cold lesions. All 3 phantoms were positioned in the center of the PET/CT gantry with >or=10% of their volume extending beyond the maximum CT FOV. An eFOV algorithm was used to estimate complete CT projections from nonlinear extrapolation of the truncated projections. CT-based attenuation correction (CT AC) of the phantom data was performed using CT images reconstructed from truncated and extended projections. For clinical validation, we processed truncated datasets from 10 PET/CT patients with and without eFOV correction. RESULTS: When using truncated CT images for CT AC, PET tracer distribution was suppressed outside the transverse CT FOV in phantom and patient studies. PET activity concentration in the truncated regions was only 10%-32% of the true value but increased to 84%-100% when using the extended CT images for CT AC. At the same time, the contour of phantoms and patients was recovered to the anatomically correct shape from the uncorrected emission images, and the apparent distortion of lesions near the maximum CT FOV was reduced. CONCLUSION: Truncation artifacts in WB PET/CT led to visual and quantitative distortions of the CT and attenuation-corrected PET images in the area of truncation. These artifacts can be corrected to improve the accuracy of PET/CT for diagnosis and therapy response evaluation.

Algorithms↗
PubMed2005

False-positive FDG PET uptake--the role of PET/CT.

Positron emission tomography (PET) is a powerful molecular imaging technique for the human body-imaging applications currently available. As altered glucose metabolism is characteristic for many malignancies, FDG-PET is mostly used in oncology for staging and therapy control. Although PET is a sensitive tool for detecting malignancy, FDG uptake is not tumor specific. It can also be seen in healthy tissue or in benign disease as inflammation or posttraumatic repair and could be mistaken for cancer. The experienced nuclear medicine physician mostly manages to differentiate malignant from non-malignant FDG uptake, but some findings may remain ambiguous. In these cases, the difficulties in differentiating physiologic variants or benign causes of FDG uptake from tumor tissue can often be overcome by combined PET and CT (PET/CT) as anatomic information is added to the metabolic data. Thus, PET/CT improves the diagnostic accuracy compared to PET alone and helps to avoid unnecessary surgery/therapy. However, PET/CT involves other sources of artifacts that may occur when using CT for attenuation correction of PET or by patient motion caused by respiration or bowel movements.

Artifacts↗
PubMed2005

Respiration artifacts in whole-body (18)F-FDG PET/CT studies with combined PET/CT tomographs employing spiral CT technology with 1 to 16 detector rows.

PURPOSE: Co-registration accuracy in combined whole-body (WB) PET/CT imaging is impaired by respiration-induced mismatches between the CT and the PET. Furthermore, PET/CT misregistration may bias the PET tracer distribution following CT-based attenuation correction (CT-AC). With the introduction of multi-row CT technology of up to 16 detector rows into PET/CT designs, we investigated the incidence of respiration artifacts in WB PET/CT examinations of patients who were unable to follow any breath-hold instructions. METHODS: A total of 80 WB studies from six international sites operating PET/CT tomographs with 1-, 2-, 4-, 6-, 8-, and 16-row spiral CT were included. PET/CT examinations were acquired with the patients breathing normally during both the CT and the PET scan, and CT-AC was performed routinely. All studies were anonymized and reviewed independently by three radiologists and three nuclear medicine specialists. We report the frequency and severity of artifacts on CT and PET for the thorax and the abdomen. RESULTS: In WB PET/CT imaging of normally breathing patients, significant gains in diagnostic image quality can be expected from employing CT technology with six or more detector rows. In our study, fewer PET images appear distorted than corresponding CT images, which is due to the limited propagation of only mild CT image artifacts after the resampling of the CT-based attenuation map during CT-AC. CONCLUSION: In whole-body PET/CT imaging of normally breathing patients, respiration-induced artifacts are reduced in both magnitude and prominence for PET/CT systems employing CT components of six or more detector rows.

Adolescent↗
PubMed2005

Detection of residual tumor after radiofrequency ablation of liver metastasis with dual-modality PET/CT: initial results.

The aim of this study was to determine the accuracy of dual-modality positron emission tomography(PET)/computed tomography (CT) in the detection of residual tumor after radiofrequency ablation (RFA) of liver metastasis of colorectal cancer. Eleven patients with 16 hepatic metastases (mean size 2.9 cm) from colorectal cancer were enrolled in this study, and 19 RFA procedures and 32 PET/CT examinations were performed. The patients had PET/CT before and after RFA using [18F]-2-fluoro-2-deoxy-D: -glucose. CT images alone were read by two radiologists, PET images alone were evaluated by two nuclear physicians. Fused images were read by one physician of each speciality in consensus. The accuracy for detection of residual tumor by the different imaging modalities following RFA was assessed. Eleven patients with a mean age of 63 (range 55-71) years were evaluated. The mean follow-up period was 393 days. The overall procedure-based sensitivity for detection of residual tumor was 65% for PET and PET/CT and 44% for CT alone. The accuracies were 68% and 47%, respectively. Four patients had residual tumor after RFA, six patients total developed local recurrence. PET/CT therefore possibly proved superior to CT alone when assessing the liver for residual tumor after RFA.

Aged↗
PubMed2005

Positron emission tomography/computed tomography improves diagnostics of inflammatory arteritis.

Based on the unique property of fluorine-18 fluorodeoxyglucose, localization and follow-up of hypermetabolic processes is possible with positron emission tomography (PET). The dual-modality PET/computed tomography (CT) systems provide intrinsically fused morphologic and functional data in a single examination. We report on two patients with inflammatory aortitis and positive PET/CT findings. A 57-year-old woman with an inflammatory process involving the thoracolumbal aorta with an aneurysm and a 48-year-old woman with an aneurysm of the thoracic aorta and pronounced fluorodeoxyglucose-uptake. The advantages in differentiation of vessel wall structures compared with PET or CT alone are pointed out.

Aortic Aneurysm↗
PubMed2005

Evaluation of integrated whole-body PET/CT in the detection of recurrent ovarian cancer.

PURPOSE: To assess the usefulness and reliability of integrated whole-body positron emission tomography/computed tomography (PET/CT) in patients in whom recurrent ovarian cancer is suspected. METHODS: Integrated whole-body PET/CT imaging was performed in 19 patients with suspected ovarian cancer recurrence. CT, PET and fused PET/CT images were evaluated separately and imaging results were compared with pathological findings and clinical follow-up after 6 months. RESULTS: Of the 19 patients studied, 11 were found to have recurrent cancer. In 8 of these 11 patients, recurrence was diagnosed by CT, PET and fused PET/CT. In the remaining three patients, only PET and PET/CT showed a recurrent tumour, while CT was negative. Twelve localisations of ovarian cancer recurrence could be detected by CT, 17 by PET and 18 by PET/CT. In one patient with pulmonary metastases in CT and in the CT component of PET/CT, PET was negative. In the case of three metastases in the diaphragm, the spleen and the thoracic wall, respectively, the determination of the exact localisation was only possible by fused PET/CT. CONCLUSION: In patients with recurrent ovarian cancer, PET/CT detects more lesions than PET or CT alone. PET/CT permits the exact anatomical localisation of pathologic tracer uptake and can thus direct further treatment to the precise site of tumour recurrence. Hence, PET/CT should be considered for follow-up of patients with ovarian cancer.

Aged↗
PubMed2005

Health-related quality of life, anxiety and depression in thyroid cancer patients under short-term hypothyroidism and TSH-suppressive levothyroxine treatment.

OBJECTIVE: Very few previous studies have compared the degree of health-related quality of life (HRQL), depression and anxiety of differentiated thyroid cancer patients (DTC) under short-term hypothyroid-ism and levothyroxine treatment. METHODS: Using patient-completed instruments, we examined the frequency of physical complaints, HRQL, anxiety and depression in 130 DTC patients hospitalized for radioiodine therapy or whole-body diagnostics (age 52 years, female 71%) under short-term hypothyroidism (4 weeks of levothyroxine withdrawal; DTC-H) and in 100 DTC out-patients under TSH-suppressive doses of levothyroxine subsequent to radioiodine therapy (DTC-L; age 49 years, female 81%). RESULTS: Compared with the German general population, DTC-H as well as DTC-L patients had significantly impaired HRQL. Notably, the decrease in HRQL was significantly higher in DTC-H than in DTC-L patients. Surprisingly, the prevalence of anxiety (44.6%) but not depression (17.7%) was much higher in the DTC-H patients than in the general population. In contrast to expectations, similar results for anxiety (44.0%) and depression (17.6%) were observed in the DTC-L patients. CONCLUSIONS: This mounting evidence suggests that a consistent pattern of HRQL impairment is experienced by patients with DTC. The high frequency of anxiety and the significantly reduced HRQL should be considered in the aftercare of DTC patients.

Adult↗