Prognostic role of 18F-FDG PET/CT in the postoperative evaluation of differentiated thyroid cancer patients

Leonardo Pace, Michele Klain, Barbara Salvatore, Emanuele Nicolai, Emilia Zampella, Roberta Assante, Teresa Pellegrino, Giovanni Storto, Rosa Fonti, Marco Salvatore

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

PURPOSE: The aim of this study was to evaluate the role of 18F-FDG PET/CT performed after surgery but before radioiodine therapy in patients with differentiated thyroid cancer. PROCEDURES: FDG PET/CT was performed off l-thyroxine in 60 newly diagnosed differentiated thyroid cancer patients. Clinical and hematological evaluation as well as high-resolution neck ultrasound were performed. All patients underwent a complete follow-up (range, 6-67 months; mean [SD], 31.7 [20.6] months). The date of recurrence or the most recent office visit was recorded. Progression-free survival (PFS) is the primary end point of this study. Analysis was performed by Cox proportional hazards model. Survival curves were generated using Kaplan-Meier estimates, and the log-rank test was used to assess significance. RESULTS: FDG PET/CT was negative in 63% of patients, 20% had FDG thyroid bed uptake, 5% distant metastases, and 12% lymph node FDG uptake. In patients with positive FDG PET/CT scan (ie, those with distant metastases or lymph node uptake), a higher rate of recurrence was observed (50% vs 6%, P <0.05). Thyroglobulin, neck ultrasound, stage, and FDG PET/CT correlated with PFS at univariate analysis. At multivariate analysis, only thyroglobulin and FDG PET/CT continued to be predictors of PFS. Patients with a negative FDG PET/CT scan have a better PFS either in the whole group or in those with elevated thyroglobulin level (both >2 ng/mL and >10 ng/mL). CONCLUSIONS: FDG PET/CT was abnormal in 17% of patients. Moreover, FDG PET/CT has an independent prognostic role, with a better PFS in patients with a negative scan.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
JournalClinical Nuclear Medicine
Volume40
Issue number2
DOIs
Publication statusPublished - Feb 21 2015

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Fluorodeoxyglucose F18
Thyroid Neoplasms
Disease-Free Survival
Lymph Nodes
Neoplasm Metastasis
Office Visits
Recurrence
Kaplan-Meier Estimate
Thyroxine
Proportional Hazards Models
Thyroid Gland
Neck
Survival

Keywords

  • differentiated thyroid cancer
  • FDG PET/CT
  • progression-free survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Prognostic role of 18F-FDG PET/CT in the postoperative evaluation of differentiated thyroid cancer patients. / Pace, Leonardo; Klain, Michele; Salvatore, Barbara; Nicolai, Emanuele; Zampella, Emilia; Assante, Roberta; Pellegrino, Teresa; Storto, Giovanni; Fonti, Rosa; Salvatore, Marco.

In: Clinical Nuclear Medicine, Vol. 40, No. 2, 21.02.2015, p. 111-115.

Research output: Contribution to journalArticle

Pace, Leonardo ; Klain, Michele ; Salvatore, Barbara ; Nicolai, Emanuele ; Zampella, Emilia ; Assante, Roberta ; Pellegrino, Teresa ; Storto, Giovanni ; Fonti, Rosa ; Salvatore, Marco. / Prognostic role of 18F-FDG PET/CT in the postoperative evaluation of differentiated thyroid cancer patients. In: Clinical Nuclear Medicine. 2015 ; Vol. 40, No. 2. pp. 111-115.
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abstract = "PURPOSE: The aim of this study was to evaluate the role of 18F-FDG PET/CT performed after surgery but before radioiodine therapy in patients with differentiated thyroid cancer. PROCEDURES: FDG PET/CT was performed off l-thyroxine in 60 newly diagnosed differentiated thyroid cancer patients. Clinical and hematological evaluation as well as high-resolution neck ultrasound were performed. All patients underwent a complete follow-up (range, 6-67 months; mean [SD], 31.7 [20.6] months). The date of recurrence or the most recent office visit was recorded. Progression-free survival (PFS) is the primary end point of this study. Analysis was performed by Cox proportional hazards model. Survival curves were generated using Kaplan-Meier estimates, and the log-rank test was used to assess significance. RESULTS: FDG PET/CT was negative in 63{\%} of patients, 20{\%} had FDG thyroid bed uptake, 5{\%} distant metastases, and 12{\%} lymph node FDG uptake. In patients with positive FDG PET/CT scan (ie, those with distant metastases or lymph node uptake), a higher rate of recurrence was observed (50{\%} vs 6{\%}, P <0.05). Thyroglobulin, neck ultrasound, stage, and FDG PET/CT correlated with PFS at univariate analysis. At multivariate analysis, only thyroglobulin and FDG PET/CT continued to be predictors of PFS. Patients with a negative FDG PET/CT scan have a better PFS either in the whole group or in those with elevated thyroglobulin level (both >2 ng/mL and >10 ng/mL). CONCLUSIONS: FDG PET/CT was abnormal in 17{\%} of patients. Moreover, FDG PET/CT has an independent prognostic role, with a better PFS in patients with a negative scan.",
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AU - Pace, Leonardo

AU - Klain, Michele

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AU - Nicolai, Emanuele

AU - Zampella, Emilia

AU - Assante, Roberta

AU - Pellegrino, Teresa

AU - Storto, Giovanni

AU - Fonti, Rosa

AU - Salvatore, Marco

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N2 - PURPOSE: The aim of this study was to evaluate the role of 18F-FDG PET/CT performed after surgery but before radioiodine therapy in patients with differentiated thyroid cancer. PROCEDURES: FDG PET/CT was performed off l-thyroxine in 60 newly diagnosed differentiated thyroid cancer patients. Clinical and hematological evaluation as well as high-resolution neck ultrasound were performed. All patients underwent a complete follow-up (range, 6-67 months; mean [SD], 31.7 [20.6] months). The date of recurrence or the most recent office visit was recorded. Progression-free survival (PFS) is the primary end point of this study. Analysis was performed by Cox proportional hazards model. Survival curves were generated using Kaplan-Meier estimates, and the log-rank test was used to assess significance. RESULTS: FDG PET/CT was negative in 63% of patients, 20% had FDG thyroid bed uptake, 5% distant metastases, and 12% lymph node FDG uptake. In patients with positive FDG PET/CT scan (ie, those with distant metastases or lymph node uptake), a higher rate of recurrence was observed (50% vs 6%, P <0.05). Thyroglobulin, neck ultrasound, stage, and FDG PET/CT correlated with PFS at univariate analysis. At multivariate analysis, only thyroglobulin and FDG PET/CT continued to be predictors of PFS. Patients with a negative FDG PET/CT scan have a better PFS either in the whole group or in those with elevated thyroglobulin level (both >2 ng/mL and >10 ng/mL). CONCLUSIONS: FDG PET/CT was abnormal in 17% of patients. Moreover, FDG PET/CT has an independent prognostic role, with a better PFS in patients with a negative scan.

AB - PURPOSE: The aim of this study was to evaluate the role of 18F-FDG PET/CT performed after surgery but before radioiodine therapy in patients with differentiated thyroid cancer. PROCEDURES: FDG PET/CT was performed off l-thyroxine in 60 newly diagnosed differentiated thyroid cancer patients. Clinical and hematological evaluation as well as high-resolution neck ultrasound were performed. All patients underwent a complete follow-up (range, 6-67 months; mean [SD], 31.7 [20.6] months). The date of recurrence or the most recent office visit was recorded. Progression-free survival (PFS) is the primary end point of this study. Analysis was performed by Cox proportional hazards model. Survival curves were generated using Kaplan-Meier estimates, and the log-rank test was used to assess significance. RESULTS: FDG PET/CT was negative in 63% of patients, 20% had FDG thyroid bed uptake, 5% distant metastases, and 12% lymph node FDG uptake. In patients with positive FDG PET/CT scan (ie, those with distant metastases or lymph node uptake), a higher rate of recurrence was observed (50% vs 6%, P <0.05). Thyroglobulin, neck ultrasound, stage, and FDG PET/CT correlated with PFS at univariate analysis. At multivariate analysis, only thyroglobulin and FDG PET/CT continued to be predictors of PFS. Patients with a negative FDG PET/CT scan have a better PFS either in the whole group or in those with elevated thyroglobulin level (both >2 ng/mL and >10 ng/mL). CONCLUSIONS: FDG PET/CT was abnormal in 17% of patients. Moreover, FDG PET/CT has an independent prognostic role, with a better PFS in patients with a negative scan.

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