18F-FDG uptake as a prognostic variable in primary differentiated thyroid cancer incidentally detected by PET/CT: a multicentre study

Piccardo, Arnoldo; Puntoni, Matteo; Bertagna, Francesco; Treglia, Giorgio; Foppiani, Luca; Arecco, Federico; Giubbini, Raffaele; Naseri, Mehrdad; Cistaro, Angelina; Cabria, Manlio; Bardesono, Francesca; Ceriani, Luca; Orlandi, Fabio; Giovanella, Luca

doi:10.1007/s00259-014-2774-y

Cited by 33 publications

(16 citation statements)

References 31 publications

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“…Fourthly, considering the connection between BRAF V600E mutation and mortality (34) and the inverse correlation between survival and FDG uptake in DTC patients (35,36), we tested the association between primary thyroid tumour uptake (expressed in terms of SUV ratio) and BRAF V600E mutation in vivo; to our knowledge, this was the first such test. Although this association has recently been reported in patients with DTC metastases (37), we did (38); in such cases, a low number of BRAF V600E mutations should be expected a priori, as indeed we found (22%).…”

Section: F-fdg Pet/ct Mpus and 99mmentioning

confidence: 99%

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Piccardo

Puntoni

Treglia

et al. 2016

European Journal of Endocrinology

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Purpose: To evaluate the role of 18 F-flurodeoxiglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in predicting malignancy of thyroid nodules with indeterminate cytology. Patients and methods:We analysed 87 patients who have been scheduled to undergo surgery for thyroid nodule with indeterminate cytology. All patients underwent 18 F-FDG-PET/CT, multiparametric neck ultrasonography (MPUS), and 99m Tc-methoxyisobutylisonitrile scintigraphy ( 99m Tc-MIBI-scan). Histopathology was the standard of reference.We compared the sensitivity (SE), specificity (SP), accuracy (AC), positive (PPV) and negative predictive (

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Section: F-fdg Pet/ct Mpus and 99mmentioning

confidence: 99%

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Piccardo

Puntoni

Treglia

et al. 2016

European Journal of Endocrinology

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“…reported on 54 FDG‐avid primary differentiated thyroid carcinoma patients incidentally detected on FDG‐PET/CT. The authors reported that the FDG avidity of the primary differentiated thyroid carcinoma was associated with the persistence or progression of the disease, although, on multivariate analysis, the FDG avidity did not add further prognostic information . Unlike the report of Piccardo et al., our study enrolled both FDG‐avid and non‐FDG‐avid tumors, and we evaluated only PTCs in a larger number of patients, thus enhancing the integrity of our study.…”

Section: Discussionmentioning

confidence: 95%

Analysis of predictability of F‐18 fluorodeoxyglucose‐PET/CT in the recurrence of papillary thyroid carcinoma

Kim

Chung

et al. 2016

Cancer Medicine

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Whether preoperative F‐18 fluorodeoxyglucose (FDG)‐positron emission tomography/computed tomography (PET/CT) can predict recurrence of papillary thyroid carcinoma (PTC) remains unclear. Herein, we evaluated the potential of primary tumor FDG avidity for the prediction of tumor recurrence in PTC patients. A total of 412 PTC patients (72 males, 340 females; age: 47.2 ± 12.2 years; range: 17–84 years) who underwent FDG‐PET/CT prior to total thyroidectomy (n = 350), subtotal thyroidectomy (n = 2), or lobectomy (n = 60) from 2007 to 2011 were analyzed. The predictive ability for recurrence was investigated among various clinicopathological factors, BRAFV 600E mutation, and preoperative FDG avidity of the primary tumor using Kaplan–Meier (univariate) and Cox proportional hazards regression (multivariate) analyses. Of the 412 patients, 19 (4.6%) experienced recurrence, which was confirmed either by pathology (n = 17) or high serum thyroglobulin level (n = 2), during a mean follow‐up period of 43.9 ± 16.6 months. Of the 412 patients, 237 (57.5%) had FDG‐avid tumors (maximum standardized uptake value, 7.1 ± 7.0; range: 1.6–50.5). Kaplan–Meier analysis revealed that tumor size (P = 0.0054), FDG avidity of the tumor (P = 0.0049), extrathyroidal extension (P = 0.0212), and lymph node (LN) stage (P < 0.0001) were significant predictors for recurrence. However, only LN stage remained a significant predictor in the multivariate analysis (P < 0.0001). Patients with FDG‐avid tumors had higher LN stage (P < 0.0001), larger tumor size (P < 0.0001), and more frequent extrathyroidal extension (P < 0.0001). In conclusion, FDG avidity of the primary tumor in preoperative FDG‐PET/CT could not predict the recurrence of PTC. LN stage was the only identified predictor of PTC recurrence.

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“…Yun et al [10] reported that visual FDG positivity was associated with central lymph node metastasis, but the SUV of PTMC was not. Recent studies have concluded that FDG uptake did not add further prognostic information [21,22]. Study limitations included that there were a small number of PTC patients and some of them included only PTMC, not large PTC.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of FDG-PET/CT for the initial diagnosis of papillary thyroid cancer

Kim

Choi

et al. 2015

Eur Arch Otorhinolaryngol

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To assess the role of [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) as a preoperative diagnostic tool in papillary thyroid carcinoma (PTC). From 2011 to 2014, 197 patients with PTC (246 tumor foci in all) underwent FDG-PET. Among these patients, 46 underwent neck dissection for lateral neck metastasis. According to the FDG avidity of the tumor foci or lateral neck metastasis, factors associated with the prognostic value were evaluated by univariate and multivariate logistic regression analyses. Among the 197 patients, 7 (3.6 %) were incidentally found to have non-thyroid origin malignancy. Additionally, 63.0 % (155/246) of PTC foci showed FDG uptake on PET/CT. Univariate analysis showed that the tumor size, the presence of extrathyroidal extension, BRAF mutation, and Hashimoto thyroiditis were associated with FDG avidity. However, except for pathological extrathyroidal extension, the other factors showed statistically significant correlations with FDG avidity (p < 0.001, p = 0.008, and p = 0.009, respectively). FDG uptake in lateral neck node metastasis showed high specificity and negative predictive value (NPV). In four cases of nonspecific findings on ultrasonography (USG)/CT, FDG avidity was helpful to diagnose the presence of lateral neck metastasis. The maximum standardized uptake value (SUVmax) of PET/CT was correlated with the maximum diameter of the involved lateral node. FDG avidity did not show any significance in the recurrence-free survival of both the thyroid tumor and lateral neck metastasis. The FDG avidity of PTC did not show prognostic predictive meaning. However, in the case of lateral neck metastasis, FDG avidity showed high sensitivity and NPV, and could provide better information in cases of nonspecific findings on USG and CT.

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18F-FDG uptake as a prognostic variable in primary differentiated thyroid cancer incidentally detected by PET/CT: a multicentre study

Abstract: An intense (18)F-FDG uptake of the primary DTC is associated with persistence/progression of disease. However, when all other prognostic factors have been taken into account, (18)F-FDG uptake does not add further prognostic information.

Cited by 33 publications

References 31 publications

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Thyroid nodules with indeterminate cytology: prospective comparison between 18F-FDG-PET/CT, multiparametric neck ultrasonography, 99mTc-MIBI scintigraphy and histology

Analysis of predictability of F‐18 fluorodeoxyglucose‐PET/CT in the recurrence of papillary thyroid carcinoma

Feasibility of FDG-PET/CT for the initial diagnosis of papillary thyroid cancer

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