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

B. Salvatore, M. Klain, E. Nicolai, D. D'Amico, G. De Matteis, M. Raddi, R. Fonti, T. Pellegrino, G. Storto, A. Cuocolo, L. Pace

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Abstract

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.
Original languageEnglish
JournalMedicine (United States)
Volume96
Issue number42
DOIs
Publication statusPublished - Oct 2017

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Keywords

  • 18F-FDG-PET/CT
  • differentiated thyroid carcinoma
  • empiric therapy
  • prognosis
  • thyroglobulin
  • fluorodeoxyglucose f 18
  • iodine 131
  • radioactive iodine
  • radiopharmaceutical agent
  • adult
  • Article
  • cancer diagnosis
  • cancer patient
  • cancer prognosis
  • cancer survival
  • clinical article
  • differentiated thyroid cancer
  • disease free survival
  • female
  • follow up
  • histopathology
  • human
  • male
  • medical record review
  • middle aged
  • overall survival
  • positron emission tomography-computed tomography
  • priority journal
  • retrospective study
  • thyroglobulin blood level
  • thyroid follicular carcinoma
  • thyroid papillary carcinoma
  • whole body scintiscanning
  • aged
  • biosynthesis
  • diagnostic imaging
  • mortality
  • pathology
  • Thyroid Neoplasms
  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Iodine Radioisotopes
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Radiopharmaceuticals
  • Retrospective Studies
  • Thyroglobulin

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