Cancer Management and Research (Dec 2020)

FDG PET Predicts the Effects of 131I and Prognosis for Patients with Bone Metastases from Differentiated Thyroid Carcinoma

  • Wang D,
  • Bai Y,
  • Huo Y,
  • Ma C

Journal volume & issue
Vol. Volume 12
pp. 13223 – 13232

Abstract

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Danyang Wang,1,* Yongli Bai,2,* Yanlei Huo,3,* Chao Ma1,3 1Department of Nuclear Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China; 2Department of Nuclear Medicine, Shaanxi Provincial People’s Hospital, Xian, People’s Republic of China; 3Department of Nuclear Medicine, Tenth People’s Hospital of Tongji University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chao MaDepartment of Nuclear Medicine, Tenth People’s Hospital of Tongji University, Yanchangzhong Road 301, Shanghai 200072, People’s Republic of ChinaTel +86-21-25078593Email [email protected]: 18F-FDG PET and 131I scans are important in the detection of metastases from differentiated thyroid carcinoma (DTC). The relationship of FDG and radioiodine (RAI) metabolism in bone metastases (BMs) from DTC and its prognostic value on RAI treatment is not clear.Methods: The retrospective study included DTC patients with BMs from two medical centers, who underwent 18F-FDG PET/CT scans and RAI therapy. Therapeutic response was evaluated by serum thyroglobulin (Tg) levels and anatomical imaging changes.Results: The analyses were performed on 30 patients with 72 BMs. Forty-two (42/72, 58%) lesions displayed simultaneous 131I and 18F-FDG uptake. BMs with positive 18F-FDG uptake had a less favorable response to RAI therapy in comparison to those with negative 18F-FDG uptake (p = 0.018), even in 131I-avid lesions (p = 0.033). Sixteen (53%) patients had disease progression with a median PFI of 26 months (range: 3 to 89 months). Compared to those with 131I-avid but non-FDG-avid BMs, patients presenting with 18F-FDG-avid BMs had shorter PFI, whether with 131I uptake (p = 0.002) or without (p = 0.002).Conclusion: More than half of BMs (58%) from DTC show simultaneous 18F-FDG and 131I uptakes which are contrary to the flip-flop phenomenon (131I negative and 18F-FDG positive). Regardless of 131I uptake, 18F-FDG uptake of BMs portends a less favorable therapeutic response and poorer prognosis for patients with DTC.Keywords: bone metastasis, differentiated thyroid carcinoma, FDG, PET, prognosis

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