131I SPECT/CT provides prognostic information in patients with differentiated thyroid cancer

IF 8.6 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Marieke Heinrich, Elias Blickle, Philipp E. Hartrampf, Natalie Hasenauer, Aleksander Kosmala, Alexander Kerscher, Nicolas Schlegel, Frederik A. Verburg, Andreas K. Buck, Kerstin Michalski
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引用次数: 0

Abstract

Purpose

The aim of this study is to investigate the impact of lymph node metastases (LNM) detected on cervical 131I single photon emission computed tomography/computed tomography (SPECT/CT) after the first radioiodine therapy (RAI) on complete response (CR) and progression-free survival (PFS) in patients with differentiated thyroid cancer (DTC).

Methods

This retrospective study included 942 DTC patients who underwent cervical 131I SPECT/CT after their first RAI. LNM were categorized based on CT (enlarged ≥ 1 cm, small < 1 cm) and 131I uptake. CR and PFS were analysed using Kaplan–Meier curves and Cox regression.

Results

Patients with no LNM had a shorter median time to CR (9.4 months) than those with LNM (44 months, HR 2.2; p < 0.01) and a lower risk of progression (median PFS not reached, HR 0.46; p < 0.01). Among patients with LNM, those with enlarged 131I negative LNM had the longest time to CR (24 months, HR 0.36; p < 0.01). Patients with small LNM had a PFS similar to patients without LNM (median PFS not reached, HR 1.22; p = 0.54). Reoperation after first RAI (13.5 months) led to earlier CR than second RAI (median not reached) in patients with enlarged LNM. For small LNM, second RAI was associated with longer PFS than reoperation (38.4 months vs. not reached, HR 4.0; p = 0.02).

Conclusion

Patients without LNM on post-therapy 131I SPECT/CT have better chances for early CR and longer PFS. Patients with LNM benefit from early reoperations but treatment strategies should be tailored based on LNM characteristics.

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来源期刊
CiteScore
15.60
自引率
9.90%
发文量
392
审稿时长
3 months
期刊介绍: The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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