Unexpected 99mTc-pertechnetate avidity of lymph node metastases predicts better response to radioiodine therapy in differentiated thyroid cancer patients with lymph node metastases.

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
American journal of nuclear medicine and molecular imaging Pub Date : 2024-02-20 eCollection Date: 2024-01-01
Jie Liu, Xin Li, Linfa Li, Yuhua Yin, Hu Cai, Heqing Yi
{"title":"Unexpected <sup>99m</sup>Tc-pertechnetate avidity of lymph node metastases predicts better response to radioiodine therapy in differentiated thyroid cancer patients with lymph node metastases.","authors":"Jie Liu, Xin Li, Linfa Li, Yuhua Yin, Hu Cai, Heqing Yi","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the value of <sup>99m</sup>Tc-pertechnetate scan in postoperative differentiated thyroid cancer (DTC) patients with lymph node (LN) metastases (LNM) uptake <sup>99m</sup>Tc-pertechnetate, especially the predictive value to their response to radioiodine-131 (<sup>131</sup>I) therapy.</p><p><strong>Methods: </strong>This retrospective study collected 752 patients with DTC and LNM treated at Zhejiang Cancer Hospital between May 2012 and December 2017. Depending on the ability of LNM uptake <sup>99m</sup>Tc-pertechnetate, the patients were grouped as the <sup>99m</sup>Tc-pertechnetate-avid (n=88) vs. <sup>99m</sup>Tc-pertechnetate-non-avid (n=664) groups. And Propensity score matching (PSM) was performed at a 1:4 ratio to reduce confounding bias.</p><p><strong>Results: </strong>In the PSM analysis, the 1:4 matched cohort comprised 752 patients (88 with <sup>99m</sup>Tc-pertechnetate-avid LNM, 664 with <sup>99m</sup>Tc-pertechnetate-non-avid LNM). Patients' age, initial <sup>131</sup>I activity and frequency of iodine therapy were included as covariates. After PSM analysis, 363 patients (<sup>99m</sup>Tc-pertechnetate-avid group, n=83; <sup>99m</sup>Tc-pertechnetate-non-avid group, n=280) were successfully matched. Among the 363 PSM-matched patients, 48/83 (57.8%) in the <sup>99m</sup>Tc-pertechnetate-avid group and 158/280 (56.4%) in the <sup>99m</sup>Tc-pertechnetate-non-avid group had two or more <sup>131</sup>I treatments. The nsTg and the percentage of changes in ssTg between the <sup>99m</sup>Tc-pertechnetate-avid and <sup>99m</sup>Tc-pertechnetate-non-avid groups were significantly different ([0.05 (0.04 to 0.90) vs. 0.40 (0.04 to 4.92), <i>p</i>=0.018] and [-88% (-98%, -50%) vs. -66% (-86%, -30%), <i>p</i> < 0.001], respectively). No significant differences were observed between the two groups in the other parameters (age, pathological type, distant metastasis, follow-up time, AJCC TNM stage, initial <sup>131</sup>I treatment activity, and <sup>131</sup>I treatment frequency) after PSM (all <i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>In patients with DTC and LNM, LNM uptake of <sup>99m</sup>Tc-pertechnetate is a rare phenomenon. Patients with <sup>99m</sup>Tc-pertechnetate-avid LNMs were more likely to benefit from <sup>131</sup>I therapy, even after adjustment for age, <sup>131</sup>I treatment frequency, and initial <sup>131</sup>I activity.</p>","PeriodicalId":7572,"journal":{"name":"American journal of nuclear medicine and molecular imaging","volume":"14 1","pages":"63-71"},"PeriodicalIF":2.0000,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944372/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of nuclear medicine and molecular imaging","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To investigate the value of 99mTc-pertechnetate scan in postoperative differentiated thyroid cancer (DTC) patients with lymph node (LN) metastases (LNM) uptake 99mTc-pertechnetate, especially the predictive value to their response to radioiodine-131 (131I) therapy.

Methods: This retrospective study collected 752 patients with DTC and LNM treated at Zhejiang Cancer Hospital between May 2012 and December 2017. Depending on the ability of LNM uptake 99mTc-pertechnetate, the patients were grouped as the 99mTc-pertechnetate-avid (n=88) vs. 99mTc-pertechnetate-non-avid (n=664) groups. And Propensity score matching (PSM) was performed at a 1:4 ratio to reduce confounding bias.

Results: In the PSM analysis, the 1:4 matched cohort comprised 752 patients (88 with 99mTc-pertechnetate-avid LNM, 664 with 99mTc-pertechnetate-non-avid LNM). Patients' age, initial 131I activity and frequency of iodine therapy were included as covariates. After PSM analysis, 363 patients (99mTc-pertechnetate-avid group, n=83; 99mTc-pertechnetate-non-avid group, n=280) were successfully matched. Among the 363 PSM-matched patients, 48/83 (57.8%) in the 99mTc-pertechnetate-avid group and 158/280 (56.4%) in the 99mTc-pertechnetate-non-avid group had two or more 131I treatments. The nsTg and the percentage of changes in ssTg between the 99mTc-pertechnetate-avid and 99mTc-pertechnetate-non-avid groups were significantly different ([0.05 (0.04 to 0.90) vs. 0.40 (0.04 to 4.92), p=0.018] and [-88% (-98%, -50%) vs. -66% (-86%, -30%), p < 0.001], respectively). No significant differences were observed between the two groups in the other parameters (age, pathological type, distant metastasis, follow-up time, AJCC TNM stage, initial 131I treatment activity, and 131I treatment frequency) after PSM (all p > 0.05).

Conclusion: In patients with DTC and LNM, LNM uptake of 99mTc-pertechnetate is a rare phenomenon. Patients with 99mTc-pertechnetate-avid LNMs were more likely to benefit from 131I therapy, even after adjustment for age, 131I treatment frequency, and initial 131I activity.

有淋巴结转移的分化型甲状腺癌患者淋巴结转移灶的99m锝-过硫酸盐嗜性可预示对放射性碘治疗的更好反应。
目的探讨99m锝-过硫酸盐扫描在术后分化型甲状腺癌(DTC)淋巴结(LNM)转移(LNM)患者摄取99m锝-过硫酸盐的价值,尤其是对其放射性碘-131(131I)治疗反应的预测价值:这项回顾性研究收集了2012年5月至2017年12月期间在浙江省肿瘤医院接受治疗的752例DTC和LNM患者。根据LNM摄取99m锝-pertechnetate的能力,将患者分为99m锝-pertechnetate-avid组(n=88)和99m锝-pertechnetate-non-avid组(n=664)。并按1:4的比例进行倾向评分匹配(PSM),以减少混杂偏差:在PSM分析中,1:4配对队列由752名患者组成(88名99m锝-过硫酸盐-亲和性LNM患者,664名99m锝-过硫酸盐-非亲和性LNM患者)。患者的年龄、初始 131I 活性和碘治疗频率被列为协变量。经过 PSM 分析,363 名患者(99m锝-过硫酸盐-亲和组,n=83;99m锝-过硫酸盐-非亲和组,n=280)成功配对。在363名PSM匹配患者中,99m锝-过硫酸盐-avid组48/83(57.8%)人和99m锝-过硫酸盐-non-avid组158/280(56.4%)人接受过两次或两次以上的131I治疗。99mTc-pertechnetate-avid 组和 99mTc-pertechnetate-non-avid 组的 nsTg 和 ssTg 变化百分比有显著差异(分别为 [0.05 (0.04 to 0.90) vs. 0.40 (0.04 to 4.92), p=0.018] 和 [-88% (-98%, -50%) vs. -66% (-86%, -30%), p < 0.001])。PSM 后,两组患者在其他参数(年龄、病理类型、远处转移、随访时间、AJCC TNM 分期、初始 131I 治疗活性和 131I 治疗频率)方面无明显差异(均 p > 0.05):结论:在 DTC 和 LNM 患者中,LNM 摄取 99mTc-pertechnetate 是一种罕见现象。即使对年龄、131I 治疗频率和初始 131I 活性进行了调整,具有 99mTc-pertechnetate-avid LNM 的患者也更有可能从 131I 治疗中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
American journal of nuclear medicine and molecular imaging
American journal of nuclear medicine and molecular imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
4.00%
发文量
4
期刊介绍: The scope of AJNMMI encompasses all areas of molecular imaging, including but not limited to: positron emission tomography (PET), single-photon emission computed tomography (SPECT), molecular magnetic resonance imaging, magnetic resonance spectroscopy, optical bioluminescence, optical fluorescence, targeted ultrasound, photoacoustic imaging, etc. AJNMMI welcomes original and review articles on both clinical investigation and preclinical research. Occasionally, special topic issues, short communications, editorials, and invited perspectives will also be published. Manuscripts, including figures and tables, must be original and not under consideration by another journal.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信