both f-18 fdg-avidity and malignant shape of cervical lymph nodes on pet/ct after total thyroidectomy predict resistance to high-dose i-131 therapy in patients with papillary thyroid cancer
نویسندگان
چکیده
objective: resistance of metastatic lymph nodes (lns) to high dose i-131 therapy is associated with high morbidity in patients with differentiated thyroid cancer. we evaluated the role of f-18 fdg pet/ct in the prediction of resistance to high dose i-131 therapy in patients with papillary thyroid cancer. methods: the subjects were 307 patients who underwent total or near total thyroidectomy followed by high dose (5.55-6.66 gbq) i-131 therapy. we divided the patients into three subgroups by visual assessment of regional lns: fdg-avid lns with a malignant shape on ct (pet/ct-positive group), fdg-avid lns with a benign shape on ct (pet/ct-intermediate group) and no fdg-avid lesion (pet/ct-negative group). we measured the maximum suv (suvmax) of fdg-avid lns in each patient. the presence or absence of focal increased uptake of i-131 was evaluated by whole body scan (wbs), and was denoted as wbs-positive group or wbs-negative group, respectively. resistance to therapy was defined as presence of thyroglobulin (tg) in serum (tg ≥1.0 ng/ml) 3-6 months after i-131 therapy. univariate and multivariate analyses were performed to determine the relationship between resistance to i-131 therapy and various clinico-pathologic variables. results: pet/ct-positive, intermediate, and negative groups included 20 (6.5%), 44 (14.3%) and 243 (79.2%) patients, respectively. the mean suvmax was significantly higher in the pet/ct-positive group than that of the pet/ct-intermediate group (4.6 vs. 2.7, p <0.001). univariate analysis revealed that the pet/ct-positive group (p <0.001), t2-4 stage (p <0.001), n1b stage (p = 0.001), lower dose (5.55 gbq) of i-131 (p <0.001), and the wbs-positive group (p = 0.029) were associated with resistance to therapy. in multivariate analysis, the pet/ct-positive group, lower dose of i-131, n1b stage, and t2-4 stage remained significant with odds ratios of 10.07 (p <0.001), 3.82 (p <0.001), 3.58 (p = 0.001), and 2.53 (p = 0.009), respectively. conclusion: fdg-avidity and malignant shape of cervical lns on pre-therapy fdg pet/ct were a strong risk factors predicting resistance to high dose i-131 therapy. a lower dose of administered i-131 (5.55 gbq) and more extensive tumors (t2-4 and n1b) were also associated with resistance to high dose i-131 therapy.
منابع مشابه
Both F-18 FDG-avidity and Malignant Shape of Cervical Lymph Nodes on PET/CT after Total Thyroidectomy Predict Resistance to High-dose I-131 Therapy in Patients with Papillary Thyroid Cancer
Objective: Resistance of metastatic lymph nodes (LNs) to high dose I-131 therapy is associated with high morbidity in patients with differentiated thyroid cancer. We evaluated the role of F-18 FDG PET/CT in the prediction of resistance to high dose I-131 therapy in patients with papillary thyroid cancer. Methods: The subjects were 307 patients who underwent total or near total thyroidectomy fol...
متن کاملAsia Oceania Journal of Nuclear Medicine and Biology
keyword: F-18 FDG PET/CT, resistance to I-131 therapy, cervical lymph node, papillary thyroid cancer Objective: Resistance of metastatic lymph nodes (LNs) to high dose I-131 therapy is associated with high morbidity in patients with differentiated thyroid cancer. We evaluated the role of F-18 FDG PET/CT in the prediction of resistance to high dose I-131 therapy in patients with papillary thyroi...
متن کاملSuspicious cervical lymph nodes detected after thyroidectomy for papillary thyroid cancer usually remain stable over years in properly selected patients.
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Normalization of lymphocyte count after high ablative dose of I-131 in a patient with chronic lymphoid leukemia and secondary papillary carcinoma of the thyroid. Case report
The authors report the case of a 70-year-old male patient with chronic lymphoid leukemia who presented subsequently a papillary carcinoma of the thyroid with metastases to regional lymph nodes. The patient was treated with surgical thyroidectomy with regional and cervical lymph node excision and radioiodine therapy (I-131). The protocolar control scintigraphy 4 days after the radioactive dose s...
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عنوان ژورنال:
asia oceania journal of nuclear medicine and biologyجلد ۱، شماره ۱، صفحات ۶-۱۳
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