The Predictive Values of Lesion Size, F-18 FDG Avidity and I-131 Avidity for the Clinical Outcome of I-131 Treatment in Patients with Metastatic Differentiated Thyroid Carcinoma Only in the Lung
10.1007/s13139-017-0502-9
- Author:
Joon Ho CHOI
1
;
Byung Hyun BYUN
;
Ilhan LIM
;
Hansol MOON
;
Jihyun PARK
;
Kyoung Jin CHANG
;
Byung Il KIM
;
Chang Woon CHOI
;
Sang Moo LIM
Author Information
1. Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea. smlim328@kcch.re.kr
- Publication Type:Original Article
- Keywords:
Differentiated thyroid carcinoma;
Lung metastasis;
F-18 FDGavidity;
I-131 avidity;
Micronodular;
Macronodular
- MeSH:
Disease Progression;
Disease-Free Survival;
Follow-Up Studies;
Humans;
Kaplan-Meier Estimate;
Lung;
Neoplasm Metastasis;
Prognosis;
Radiography;
Thyroid Gland;
Thyroid Neoplasms;
Whole Body Imaging
- From:Nuclear Medicine and Molecular Imaging
2018;52(2):135-143
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We aimed to evaluate the prognostic values of radiography, F-18 FDG PET, and I-131 whole body scans in patients with lung-only metastasis from differentiated thyroid carcinoma (DTC).METHODS: Between 1998 and 2013, we included 31 patients (F: 26, M: 5) with lung-only metastasis from DTC who had been treated with I-131 and underwent PET. Lung metastasis was categorized according to the size (macronodular ≥1.0 cm vs. micronodular <1.0 cm), FDG avidity (avid vs. non-avid), and I-131 avidity (avid vs. non-avid). Progression-free survival (PFS) was evaluated for each patient.RESULTS: Among 31 patients, seven (23%) had macronodular lung metastasis, 26 (84%) had FDG avid lung metastasis, and 16 (52%) had I-131 avid lung metastasis. During the median follow-up period of 9.4 y, median PFS was 6.1 y. Based on Kaplan-Meier analysis, macronodular lung metastasis (p = 0.017) and I-131 non-avid lung metastasis (p = 0.059) were significantly associated with worse outcomes, but FDG avid lung metastasis was not (p = 0.135). Patients with FDG non-avid lung metastasis did not experience disease progression during follow-up, while 11 of 26 patients (42%) experienced disease progression. Based on univariate analysis, the hazard ratio for a poor prognosis was 3.78 (p = 0.029) for macronodular lung metastasis and 3.29 (p = 0.079) for I-131 non-avid lung metastasis.CONCLUSIONS: Macronodular and I-131 non-avid lung metastasis were associated with a poor prognosis in lung-only metastasis from DTC. Although FDG avid lung metastasis may be associated with a poor prognosis, a larger-scale study is needed.
