Open AccessPredicting 131I-avidity of metastases from differentiated thyroid cancer using 18F-FDG PET/CT in postoperative patients with elevated thyroglobulin
Author(s) -
Min Liu,
Le Cheng,
Yuchen Jin,
Min Ruan,
Shiwei Sheng,
Libo Chen
Publication year - 2018
Publication title -
scientific reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.24
H-Index - 213
ISSN - 2045-2322
DOI - 10.1038/s41598-018-22656-4
Subject(s) - avidity , medicine , thyroglobulin , thyroid cancer , receiver operating characteristic , pet ct , radioiodine therapy , prospective cohort study , nuclear medicine , standardized uptake value , positron emission tomography , cancer , thyroid , antibody , immunology
The quantitative relationship between iodine and glucose metabolism in metastases from differentiated thyroid cancer (DTC) remains unknown. Aim of the prospective study was to establish the value of 18 F-FDG PET/CT in predicting 131 I-avidity of metastases from DTC before the first radioiodine therapy. A total of 121 postoperative DTC patients with elevated stimulated serum thyroglobulin (ssTg) who underwent 131 I adjuvant therapy or therapy after 18 F-FDG PET/CT scan were enrolled. The Receiver operating characteristic curve was established to create an optimal cut-off point and evaluate the value of SUVmax for predicting 131 I-avidity. In our study, the median SUVmax in 131 I-nonavid metastatic target lesions was also significantly higher than that in 131 I-avid metastatic target lesions (5.37 vs. 3.30; P = 0.000). At a cut-off value of 4.0 in SUVmax, the area under curve was 0.62 with the sensitivity, specificity, positive predictive value and negative predictive value of 75.3%, 56.7%, 76.1%, and 54.8%, respectively. These results suggest that 18 F-FDG PET/CT may be of great value in identifying metastases in postoperative DTC patients with elevated ssTg before 131 I administration, leading to an improved management of disease. 18 F-FDG positive metastatic DTC with SUVmax of greater than 4.0 possesses higher probability of non-avidity to radioiodine.