{"title":"[18F]FDG PET/CT对分化型甲状腺癌1311例肺转移避免过度治疗的价值","authors":"Zhongyun Xu, Chao Li, Fang Feng, Shuqi Wu, Hui Wang, Hongliang Fu","doi":"10.5603/EP.a2023.0048","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>We usually use 131I-whole body scan (131I-WBS) and serum thyroglobulin (Tg) values to determine whether differentiated thyroid cancer (DTC) patients need to receive 131I treatment, but not all ¹³¹I-avid (functioning) patients have a good response to ¹³¹I therapy. Our study aims to assess the data of [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography ([¹⁸F] FDG PET/CT) to research the status of 131I-avid pulmonary metastases (PMs) and the prognosis of the patients.</p><p><strong>Material and methods: </strong>The 131I-avid PMs of DTC patients who underwent [18F]FDG PET/CT scans were included. The maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were used to estimate [¹⁸F]FDG uptake. The mean follow-up period was 34.14 ± 18.64 months. Progression-free survival (PFS) was estimated by the Kaplan-Meier method. The study was based on per-patient and per-lesion analyses.</p><p><strong>Results: </strong>Among the 42 included patients, 34 (34/42, 81%) showed [¹⁸F]FDG uptake, which was defined as abnormal foci (SUVmax > 1.0) in the lungs. SUVmax, MTV, TLG, and tumour size were the factors that influenced the outcome of 131I treatment based on Tg levels (p = 0.000, 0.016, 0.000, 0.000) in per-lesion analysis. The only independent factor was the size of the lesion. There was a significant difference in response to ¹³¹I therapy between PMs with F-I+ and F+/I+ according to both Tg levels and Response Evaluation Criteria in Solid Tumours (RECIST) (version 1.1) (p = 0.044, 0.001), in the per-lesion analysis. When the changes in size or metabolism of some lesions are inconsistent the prognosis of these patients is poor (p = 0.003).</p><p><strong>Conclusions: </strong>We concluded that higher [18F]FDG uptake and larger tumour size predict poor therapeutic effects and a high risk of disease progression in ¹³¹I-avid PMs of DTC. For evaluating the efficiency of ¹³¹I treatment, per-lesion analyses and assessing the data of [¹⁸F] FDG PET/CT would be more reliable than per-patient evaluation only. And early focal treatment modalities may improve their life span.</p>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The value of [18F]FDG PET/CT in avoiding overtreatment of 131l avidity pulmonary metastasis of differentiated thyroid cancer.\",\"authors\":\"Zhongyun Xu, Chao Li, Fang Feng, Shuqi Wu, Hui Wang, Hongliang Fu\",\"doi\":\"10.5603/EP.a2023.0048\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>We usually use 131I-whole body scan (131I-WBS) and serum thyroglobulin (Tg) values to determine whether differentiated thyroid cancer (DTC) patients need to receive 131I treatment, but not all ¹³¹I-avid (functioning) patients have a good response to ¹³¹I therapy. Our study aims to assess the data of [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography ([¹⁸F] FDG PET/CT) to research the status of 131I-avid pulmonary metastases (PMs) and the prognosis of the patients.</p><p><strong>Material and methods: </strong>The 131I-avid PMs of DTC patients who underwent [18F]FDG PET/CT scans were included. The maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were used to estimate [¹⁸F]FDG uptake. The mean follow-up period was 34.14 ± 18.64 months. Progression-free survival (PFS) was estimated by the Kaplan-Meier method. The study was based on per-patient and per-lesion analyses.</p><p><strong>Results: </strong>Among the 42 included patients, 34 (34/42, 81%) showed [¹⁸F]FDG uptake, which was defined as abnormal foci (SUVmax > 1.0) in the lungs. SUVmax, MTV, TLG, and tumour size were the factors that influenced the outcome of 131I treatment based on Tg levels (p = 0.000, 0.016, 0.000, 0.000) in per-lesion analysis. The only independent factor was the size of the lesion. There was a significant difference in response to ¹³¹I therapy between PMs with F-I+ and F+/I+ according to both Tg levels and Response Evaluation Criteria in Solid Tumours (RECIST) (version 1.1) (p = 0.044, 0.001), in the per-lesion analysis. When the changes in size or metabolism of some lesions are inconsistent the prognosis of these patients is poor (p = 0.003).</p><p><strong>Conclusions: </strong>We concluded that higher [18F]FDG uptake and larger tumour size predict poor therapeutic effects and a high risk of disease progression in ¹³¹I-avid PMs of DTC. For evaluating the efficiency of ¹³¹I treatment, per-lesion analyses and assessing the data of [¹⁸F] FDG PET/CT would be more reliable than per-patient evaluation only. And early focal treatment modalities may improve their life span.</p>\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2023-08-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5603/EP.a2023.0048\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5603/EP.a2023.0048","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
The value of [18F]FDG PET/CT in avoiding overtreatment of 131l avidity pulmonary metastasis of differentiated thyroid cancer.
Introduction: We usually use 131I-whole body scan (131I-WBS) and serum thyroglobulin (Tg) values to determine whether differentiated thyroid cancer (DTC) patients need to receive 131I treatment, but not all ¹³¹I-avid (functioning) patients have a good response to ¹³¹I therapy. Our study aims to assess the data of [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography ([¹⁸F] FDG PET/CT) to research the status of 131I-avid pulmonary metastases (PMs) and the prognosis of the patients.
Material and methods: The 131I-avid PMs of DTC patients who underwent [18F]FDG PET/CT scans were included. The maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were used to estimate [¹⁸F]FDG uptake. The mean follow-up period was 34.14 ± 18.64 months. Progression-free survival (PFS) was estimated by the Kaplan-Meier method. The study was based on per-patient and per-lesion analyses.
Results: Among the 42 included patients, 34 (34/42, 81%) showed [¹⁸F]FDG uptake, which was defined as abnormal foci (SUVmax > 1.0) in the lungs. SUVmax, MTV, TLG, and tumour size were the factors that influenced the outcome of 131I treatment based on Tg levels (p = 0.000, 0.016, 0.000, 0.000) in per-lesion analysis. The only independent factor was the size of the lesion. There was a significant difference in response to ¹³¹I therapy between PMs with F-I+ and F+/I+ according to both Tg levels and Response Evaluation Criteria in Solid Tumours (RECIST) (version 1.1) (p = 0.044, 0.001), in the per-lesion analysis. When the changes in size or metabolism of some lesions are inconsistent the prognosis of these patients is poor (p = 0.003).
Conclusions: We concluded that higher [18F]FDG uptake and larger tumour size predict poor therapeutic effects and a high risk of disease progression in ¹³¹I-avid PMs of DTC. For evaluating the efficiency of ¹³¹I treatment, per-lesion analyses and assessing the data of [¹⁸F] FDG PET/CT would be more reliable than per-patient evaluation only. And early focal treatment modalities may improve their life span.
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