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

TY - JOUR

T1 - Prognostic role of FDG PET/CT in patients with differentiated thyroid cancer treated with 131-iodine empiric therapy

AU - Salvatore, B.

AU - Klain, M.

AU - Nicolai, E.

AU - D'Amico, D.

AU - De Matteis, G.

AU - Raddi, M.

AU - Fonti, R.

AU - Pellegrino, T.

AU - Storto, G.

AU - Cuocolo, A.

AU - Pace, L.

N1 - Export Date: 5 March 2018 CODEN: MEDIA Correspondence Address: Salvatore, B.; Istituto di Biostrutture e Bioimmagini, CNRFrance; email: barbara.salvatore@cnr.it Chemicals/CAS: fluorodeoxyglucose f 18, 63503-12-8; iodine 131, 10043-66-0, 15124-39-7; thyroglobulin, 9010-34-8; Fluorodeoxyglucose F18; Iodine Radioisotopes; Radiopharmaceuticals; Thyroglobulin References: Tuttle, R.M., Tala, H., Shah, J., 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 (2010) Thyroid, 20, pp. 1341-1349; Haugen, B.R., Alexander, E.K., Bible, K.C., 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer (2016) Thyroid, 26, pp. 1-33; Feldt-Rasmussen, U., Schlumberger, M., European interlaboratory comparison of serum thyroglobulin measurement (1998) J Endocrinol Invest, 11, pp. 175-181; Salvatori, M., Biondi, B., Rufini, V., 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 (2015) Eur J Endocrinol, 173, pp. R115-R130; Asa, S., Aksoy, S.Y., Vatankulu, B., The role of FDG-PET/CT in differentiated thyroid cancer patients with negative iodine-131 wholebody scan and elevated anti-Tg level (2014) Ann Nucl Med, 28, pp. 970-979; Salvatore, B., Paone, G., Klain, M., Fluorodeoxyglucose PET/CT in patients with differentiated thyroid cancer and elevated thyroglobulin after total thyroidectomy and (131)I ablation (2008) Q J Nucl Med Mol Imaging, 52, pp. 2-8; Wang, W., Larson, S.M., Tuttle, R.M., Resistance of [18f]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive iodine (2001) Thyroid, 11, pp. 1169-1175; Rosario, P.W., Mouraõ, G.F., Dos Santos, J.B., Is empirical radioactive iodine therapy still a valid approach to patients with thyroid cancer and elevated thyroglobulin (2014) Thyroid, 24, pp. 533-536; Kloos, R.T., Approach to the patient with a positive serum thyroglobulin and a negative radioiodine scan after initial therapy for differentiated thyroid cancer (2008) J Clin Endocrinol Metab, 93, pp. 1519-1525; Rivera, M., Ghossein, R.A., Schoder, H., Histopathologic characterization of radioactive iodine-refractory fluorodeoxyglucose-positron emission tomography-positive thyroid carcinoma (2008) Cancer, 113, pp. 48-56; Pace, L., Klain, M., Salvatore, B., Prognostic role of 18F-FDG PET/CT in the postoperative evaluation of differentiated thyroid cancer patients (2015) Clin Nucl Med, 40, pp. 111-115; Wang, W., Larson, S.M., Fazzari, M., Prognostic value of [18F] fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer (2000) J Clin Endocrinol Metab, 85, pp. 1107-1113; Robbins, R.J., Wan, Q., Grewal, R.K., Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F] fluoro-2-deoxy-Dglucose-positron emission tomography scanning (2006) J Clin Endocrinol Metab, 91, pp. 498-505; Creach, K.M., Nussenbaum, B., Siegel, B.A., Thyroid carcinoma uptake of 18F-Fluorodeoxyglucose in patients with elevated serum thyroglobulin and negative 131I scintigraphy (2013) Am J Otolaryngol, 34, pp. 51-56; Deandreis, D., Al Ghuzlan, A., Leboulleux, S., Do histological immunohistochemical and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome (2011) Endocr Relat Cancer, 18, pp. 159-169; Tomoda, C., Ogimi, Y., Saito, F., Outcome and characteristics of patients with malignant pleural effusion from differentiated thyroid carcinoma (2016) Endocr J, 63, pp. 257-261; Durante, C., Haddy, N., Baudin, E., Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: Benefits and limits of radioiodine therapy (2006) JClin Endocrinol Metab, 91, pp. 2892-2899; Dong, M.J., Liu, Z.F., Zhao, K., Value of 18F-FDG-PET/PET-CT in differentiated thyroid carcinoma with radioiodine-negative whole-body scan: A meta-analysis (2013) Nucl Med Commun, 30, pp. 639-650; Podoloff, D.A., Ball, D.W., Ben-Josef, E., NCCN task force report: Clinical utility of PET in a variety of tumor types (2009) J Natl Compr Canc Netw, 5, pp. 1-26; Lamartina, L., Deandreis, D., Durante, C., ENDOCRINE TUMOURS: Imaging in the follow up of differentiated thyroid cancer: Current evidence and future perspectives for a risk-adapted approach (2016) Eur J Endocrinol, 175, pp. R185-202; Treglia, G., Giovanella, L., Prognostic role of FDG-PET/CT in differentiated thyroid carcinoma Where are we now (2015) J Med Imaging Radiat Oncol, 59, pp. 278-280; Vural, G.U., Akkas, B.E., Ercakmak, N., Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative 131I whole-body scan and elevated thyroglobulin levels: Correlation with clinical and histopathologic characteristics and long-termfollow-up data (2012) Clin Nucl Med, 37, pp. 953-959; Schreinemakers, J.M.J., Vriens, M.R., Munoz-Perez, N., Fluorodeoxyglucose-positron emission tomography scan-positive recurrent papillary thyroid cancer and the prognosis and implications for surgical management (2012) World J Surg Oncol, 10, p. 192; Marcus, C., Antoniou, A., Rahmim, A., Fluorodeoxyglucose positron emission tomography/computerized tomography in differentiated thyroid cancer management: Importance of clinical justification and value in predicting survival (2015) J Med Imaging Radiat Oncol, 59, pp. 281-288; Ibanez, E.M., Muros, M.A., Torres Vela, E., The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma (2016) Endocrine, 51, pp. 490-498

PY - 2017/10

Y1 - 2017/10

N2 - Background: To assess the long-term prognostic value of 18F-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 (x2=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 (x2=26.3, P<.0001), while Tg normalization was the only variable associated with overall survival x2=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.. © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

AB - Background: To assess the long-term prognostic value of 18F-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 (x2=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 (x2=26.3, P<.0001), while Tg normalization was the only variable associated with overall survival x2=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.. © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

KW - 18F-FDG-PET/CT

KW - differentiated thyroid carcinoma

KW - empiric therapy

KW - prognosis

KW - thyroglobulin

KW - fluorodeoxyglucose f 18

KW - iodine 131

KW - radioactive iodine

KW - radiopharmaceutical agent

KW - adult

KW - Article

KW - cancer diagnosis

KW - cancer patient

KW - cancer prognosis

KW - cancer survival

KW - clinical article

KW - differentiated thyroid cancer

KW - disease free survival

KW - female

KW - follow up

KW - histopathology

KW - human

KW - male

KW - medical record review

KW - middle aged

KW - overall survival

KW - positron emission tomography-computed tomography

KW - priority journal

KW - retrospective study

KW - thyroglobulin blood level

KW - thyroid follicular carcinoma

KW - thyroid papillary carcinoma

KW - whole body scintiscanning

KW - aged

KW - biosynthesis

KW - diagnostic imaging

KW - mortality

KW - pathology

KW - Thyroid Neoplasms

KW - Adult

KW - Aged

KW - Disease-Free Survival

KW - Female

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Iodine Radioisotopes

KW - Male

KW - Middle Aged

KW - Positron Emission Tomography Computed Tomography

KW - Prognosis

KW - Radiopharmaceuticals

KW - Retrospective Studies

KW - Thyroglobulin

U2 - 10.1097/MD.0000000000008344

DO - 10.1097/MD.0000000000008344

M3 - Article

VL - 96

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 42

ER -