Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy

Barbara Salvatore, Michele Klain, Emanuele Nicolai, Domenico D'Amico, Gianluca De Matteis, Marco Raddi, Rosa Fonti, Teresa Pellegrino, Giovanni Storto, Alberto Cuocolo, Leonardo Pace

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Abstract

BACKGROUND: To assess the long-term prognostic value of F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with differentiated thyroid carcinoma (DTC) undergoing empiric radioiodine (RAI) therapy due to raising values of thyroglobulin (Tg).

METHODS: Forty-nine patients with histological diagnosis of DTC (31 with papillary and 18 with follicular carcinoma) follow-up for a mean period of 7.9 ± 5 years after empiric RAI therapy were retrospectively analyzed.

RESULTS: FDG-PET/CT was negative in 15 (30.6%) patients and positive in 34 (69.4%), whereas postradioiodine therapy whole body scan (t-WBS) was negative in 16 (32.7%) and positive in 33 (67.3%) patients. FDG-PET/CT and t-WBS were in agreement in 32 patients (7 both negative and 25 both positive); on the contrary, in 17 patients there was disagreement between FDG-PET/CT and t-WBS (P =ns). At short-term follow-up, Tg normalized in 19 (38.8%) patients and was unchanged or increased in 30 (61.2%). Of the 15 patients with negative FDG-PET/CT, 11 (73.3%) showed Tg normalization, whereas of the 34 patients with positive FDG-PET/CT, only 8 (23.5%) had Tg normalization (χ =8.9, P < .005). At multivariate analysis, FDG-PET/CT and Tg normalization at short-term follow-up were independent predictors of disease-free survival (χ =26.3, P < .0001), while Tg normalization was the only variable associated with overall survival χ =7.2, P < .01).

CONCLUSION: FDG-PET/CT in association with Tg normalization at short-term follow-up may be useful for long-term prognostic stratification in DTC patients.

Original languageEnglish
Pages (from-to)e8344
JournalMedicine
Volume96
Issue number42
DOIs
Publication statusPublished - Oct 1 2017

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Thyroid Neoplasms
Iodine
Thyroglobulin
Whole Body Imaging
Therapeutics
Positron Emission Tomography Computed Tomography
Disease-Free Survival
Multivariate Analysis
Carcinoma
Survival

ASJC Scopus subject areas

  • Medicine(all)

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Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy. / Salvatore, Barbara; Klain, Michele; Nicolai, Emanuele; D'Amico, Domenico; De Matteis, Gianluca; Raddi, Marco; Fonti, Rosa; Pellegrino, Teresa; Storto, Giovanni; Cuocolo, Alberto; Pace, Leonardo.

In: Medicine, Vol. 96, No. 42, 01.10.2017, p. e8344.

Research output: Contribution to journalArticle

Salvatore, B, Klain, M, Nicolai, E, D'Amico, D, De Matteis, G, Raddi, M, Fonti, R, Pellegrino, T, Storto, G, Cuocolo, A & Pace, L 2017, 'Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy', Medicine, vol. 96, no. 42, pp. e8344. https://doi.org/10.1097/MD.0000000000008344
Salvatore, Barbara ; Klain, Michele ; Nicolai, Emanuele ; D'Amico, Domenico ; De Matteis, Gianluca ; Raddi, Marco ; Fonti, Rosa ; Pellegrino, Teresa ; Storto, Giovanni ; Cuocolo, Alberto ; Pace, Leonardo. / Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy. In: Medicine. 2017 ; Vol. 96, No. 42. pp. e8344.
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title = "Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy",
abstract = "BACKGROUND: To assess the long-term prognostic value of F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with differentiated thyroid carcinoma (DTC) undergoing empiric radioiodine (RAI) therapy due to raising values of thyroglobulin (Tg).METHODS: Forty-nine patients with histological diagnosis of DTC (31 with papillary and 18 with follicular carcinoma) follow-up for a mean period of 7.9 ± 5 years after empiric RAI therapy were retrospectively analyzed.RESULTS: FDG-PET/CT was negative in 15 (30.6{\%}) patients and positive in 34 (69.4{\%}), whereas postradioiodine therapy whole body scan (t-WBS) was negative in 16 (32.7{\%}) and positive in 33 (67.3{\%}) patients. FDG-PET/CT and t-WBS were in agreement in 32 patients (7 both negative and 25 both positive); on the contrary, in 17 patients there was disagreement between FDG-PET/CT and t-WBS (P =ns). At short-term follow-up, Tg normalized in 19 (38.8{\%}) patients and was unchanged or increased in 30 (61.2{\%}). Of the 15 patients with negative FDG-PET/CT, 11 (73.3{\%}) showed Tg normalization, whereas of the 34 patients with positive FDG-PET/CT, only 8 (23.5{\%}) had Tg normalization (χ =8.9, P < .005). At multivariate analysis, FDG-PET/CT and Tg normalization at short-term follow-up were independent predictors of disease-free survival (χ =26.3, P < .0001), while Tg normalization was the only variable associated with overall survival χ =7.2, P < .01).CONCLUSION: FDG-PET/CT in association with Tg normalization at short-term follow-up may be useful for long-term prognostic stratification in DTC patients.",
author = "Barbara Salvatore and Michele Klain and Emanuele Nicolai and Domenico D'Amico and {De Matteis}, Gianluca and Marco Raddi and Rosa Fonti and Teresa Pellegrino and Giovanni Storto and Alberto Cuocolo and Leonardo Pace",
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T1 - Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy

AU - Salvatore, Barbara

AU - Klain, Michele

AU - Nicolai, Emanuele

AU - D'Amico, Domenico

AU - De Matteis, Gianluca

AU - Raddi, Marco

AU - Fonti, Rosa

AU - Pellegrino, Teresa

AU - Storto, Giovanni

AU - Cuocolo, Alberto

AU - Pace, Leonardo

PY - 2017/10/1

Y1 - 2017/10/1

N2 - BACKGROUND: To assess the long-term prognostic value of F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with differentiated thyroid carcinoma (DTC) undergoing empiric radioiodine (RAI) therapy due to raising values of thyroglobulin (Tg).METHODS: Forty-nine patients with histological diagnosis of DTC (31 with papillary and 18 with follicular carcinoma) follow-up for a mean period of 7.9 ± 5 years after empiric RAI therapy were retrospectively analyzed.RESULTS: FDG-PET/CT was negative in 15 (30.6%) patients and positive in 34 (69.4%), whereas postradioiodine therapy whole body scan (t-WBS) was negative in 16 (32.7%) and positive in 33 (67.3%) patients. FDG-PET/CT and t-WBS were in agreement in 32 patients (7 both negative and 25 both positive); on the contrary, in 17 patients there was disagreement between FDG-PET/CT and t-WBS (P =ns). At short-term follow-up, Tg normalized in 19 (38.8%) patients and was unchanged or increased in 30 (61.2%). Of the 15 patients with negative FDG-PET/CT, 11 (73.3%) showed Tg normalization, whereas of the 34 patients with positive FDG-PET/CT, only 8 (23.5%) had Tg normalization (χ =8.9, P < .005). At multivariate analysis, FDG-PET/CT and Tg normalization at short-term follow-up were independent predictors of disease-free survival (χ =26.3, P < .0001), while Tg normalization was the only variable associated with overall survival χ =7.2, P < .01).CONCLUSION: FDG-PET/CT in association with Tg normalization at short-term follow-up may be useful for long-term prognostic stratification in DTC patients.

AB - BACKGROUND: To assess the long-term prognostic value of F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with differentiated thyroid carcinoma (DTC) undergoing empiric radioiodine (RAI) therapy due to raising values of thyroglobulin (Tg).METHODS: Forty-nine patients with histological diagnosis of DTC (31 with papillary and 18 with follicular carcinoma) follow-up for a mean period of 7.9 ± 5 years after empiric RAI therapy were retrospectively analyzed.RESULTS: FDG-PET/CT was negative in 15 (30.6%) patients and positive in 34 (69.4%), whereas postradioiodine therapy whole body scan (t-WBS) was negative in 16 (32.7%) and positive in 33 (67.3%) patients. FDG-PET/CT and t-WBS were in agreement in 32 patients (7 both negative and 25 both positive); on the contrary, in 17 patients there was disagreement between FDG-PET/CT and t-WBS (P =ns). At short-term follow-up, Tg normalized in 19 (38.8%) patients and was unchanged or increased in 30 (61.2%). Of the 15 patients with negative FDG-PET/CT, 11 (73.3%) showed Tg normalization, whereas of the 34 patients with positive FDG-PET/CT, only 8 (23.5%) had Tg normalization (χ =8.9, P < .005). At multivariate analysis, FDG-PET/CT and Tg normalization at short-term follow-up were independent predictors of disease-free survival (χ =26.3, P < .0001), while Tg normalization was the only variable associated with overall survival χ =7.2, P < .01).CONCLUSION: FDG-PET/CT in association with Tg normalization at short-term follow-up may be useful for long-term prognostic stratification in DTC patients.

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