Visual and Quantitative ¹⁸F-FDG PET Tumor-liver Ratio in Radioiodine Refractory Differentiated Thyroid Cancer: Prognostic and Potential Predictive Value.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Molecular Imaging and Biology Pub Date : 2025-05-20 DOI:10.1007/s11307-025-02017-0

Xian Li, Hanhui Liu, Shenghong Zhang, Han Zhang, Jiajia Zhang, Shanshan Qin, Fei Yu

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引用次数: 0

Abstract

Purpose: The progression rate and course of radioiodine refractory differentiated thyroid cancer (RAIR-DTC) vary significantly, yet there lacks a precise method for predicting its progression. We hypothesized that using the liver as a reference organ can enable selective patient stratification. We aimed to establish fluorine-18 fluorodeoxyglucose positron emission tomography ([¹⁸F] FDG-PET) tumor to-liver ratio (TLR score) to predict outcome for RAIR-DTC.

Procedures: This study included 64 patients with RAIR-DTC undergoing baseline ¹⁸F-FDG PET/CT. Patients were categorized by visual TLR (vTLR) into high (most lesions show higher uptake than the liver) or low (most lesions show lower uptake than the liver) groups using 3D maximum intensity projection (MIP) images. Quantitative TLR (qTLR) scores, including qTLR max (tumor SUVmax/liver SUVmax) and qTLRmean (tumor SUVmean/liver SUVmean), were semiautomatically derived from baseline PET, with high (≥ 1.5) and low (< 1.5) groups defined. Outcome data were progression-free survival (PFS).

Results: Among 64 patients, the distribution of high-TLR versus low-TLR groups varied across scoring methods: vTLR score allocated 36 (56.3%) high vs 28 (43.7%) low, qTLRmax score identified 29 (45.3%) high vs 35 (54.7%) low, and qTLRmean score demonstrated the most divergent pattern with 21 (32.8%) high vs 43 (67.2%) low. Agreement among qTLRmax, vTLR and qTLRmean score was moderate (Fleiss weighted k, 0.579). The median PFS of the high and low groups by vTLR score was 16.0, 29.0 months (P = 0.010) respectively, by qTLRmax score was 14.0, 27.0 months (P = 0.041), respectively, by qTLRmean score was 14.0, 28.0 months (P = 0.004), respectively.

Conclusions: The TLR score was prognostic for PFS of RAIR-DTC. The vTLR score assessed on 3D MIP PET images yielded substantial reproducibility and combining qTLR score provided reliable prognostic value.

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视觉和定量18F-FDG PET在放射性碘难治性分化甲状腺癌中的肿瘤-肝脏比值：预后和潜在的预测价值。

目的：放射性碘难治性分化型甲状腺癌（RAIR-DTC）的进展率和病程差异显著，但缺乏准确预测其进展的方法。我们假设使用肝脏作为参考器官可以实现选择性患者分层。我们的目的是建立氟-18氟脱氧葡萄糖正电子发射断层扫描（[18F] FDG-PET）肿瘤与肝脏的比值（TLR评分）来预测RAIR-DTC的预后。程序：本研究包括64例RAIR-DTC患者，接受基线18F-FDG PET/CT检查。使用3D最大强度投影（MIP）图像，根据视觉TLR （vTLR）将患者分为高（大多数病变显示高于肝脏的摄取）或低（大多数病变显示低于肝脏的摄取）组。定量TLR （qTLR）评分，包括qTLR max（肿瘤SUVmax/肝脏SUVmax）和qTLRmean（肿瘤SUVmean/肝脏SUVmean），由基线PET半自动得出，有高（≥1.5）和低(结果：在64例患者中，高TLR组和低TLR组的分布在不同的评分方法中有所不同：vTLR评分高36分（56.3%），低28分（43.7%），qTLRmax评分高29分（45.3%），低35分（54.7%），qTLRmean评分高21分（32.8%），低43分（67.2%），差异最大。qTLRmax、vTLR和qTLRmean评分之间的一致性中等（Fleiss加权k为0.579）。vTLR评分高、低组的中位PFS分别为16.0、29.0个月（P = 0.010）， qTLRmax评分高、低组的中位PFS分别为14.0、27.0个月（P = 0.041）， qTLRmean评分高、低组的中位PFS分别为14.0、28.0个月（P = 0.004）。结论：TLR评分是RAIR-DTC患者PFS的预后指标。在3D MIP PET图像上评估的qTLR评分具有很高的可重复性，联合qTLR评分提供了可靠的预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.