Prognostic Role of 18F-FDG PET/CT in the Postoperative Evaluation of Differentiated Thyroid Cancer Patients
Prognostic Role of 18F-FDG PET/CT in the Postoperative Evaluation of Differentiated Thyroid Cancer Patients
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DOI：
10.1097/rlu.0000000000000621
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发表时间：
2015-02-01
影响因子：
10.6
通讯作者：
Salvatore, Marco
中科院分区：
文献类型：
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作者：
Pace, Leonardo;Klain, Michele;Salvatore, Marco
目的：本研究的目的是评估的作用，F-18-FDG PET/CT进行手术后，但在放射性碘治疗的分化型甲状腺cancer.Procedures患者：FDG PET/CT进行关闭L-甲状腺素在60例新诊断的分化型甲状腺癌患者。进行临床和血液学评估以及高分辨率颈部超声检查。所有患者均接受了完整随访（范围：6-67个月;平均[SD]：31.7 [20.6]个月）。记录复发日期或最近一次门诊访视。无进展生存期（PFS）是本研究的主要终点。采用考克斯比例风险模型进行分析。生存曲线生成使用Kaplan-Meier估计，和对数秩检验被用来评估significant.Results：FDG PET/CT是阴性的63%的患者，20%的FDG甲状腺床摄取，5%的远处转移，和12%的淋巴结FDG摄取。FDGPET/CT阳性（即有远处转移或淋巴结转移）的患者复发率较高（50% vs6%，P < 0.05）。在单变量分析中，甲状腺球蛋白、颈部超声、分期和FDGPET/CT与PFS相关。在多变量分析中，只有甲状腺球蛋白和FDG PET/CT仍然是PFS的预测因子。FDG PET/CT扫描阴性的患者无论是在整个组中还是在甲状腺球蛋白水平升高的患者中（均>2 ng/mL和>10 ng/mL）都有更好的PFS。此外，FDG PET/CT具有独立的预后作用，扫描阴性患者的PFS更好。
Purpose: The aim of this study was to evaluate the role of F-18-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 FDGPET/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/CTwas abnormal in 17% of patients. Moreover, FDG PET/CT has an independent prognostic role, with a better PFS in patients with a negative scan.