Can [18F]-Fluorodeoxyglucose Standardized Uptake Values of PET Imaging Predict Pathologic Extrathyroid Invasion of Thyroid Papillary Microcarcinomas?

Han

et al. 2015

Nucl Med Mol Imaging

Purpose The BRAF mutation, a potential prognostic factor in papillary thyroid carcinoma (PTC), is associated with a high expression of the glucose transporter gene. We investigated which clinicopathologic factors, including BRAF mutation status, influence 18 F-fluoro-2-deoxyglucose ( 18 F-FDG) avidity. Methods We retrospectively reviewed 55 patients who underwent BRAF analysis from biopsy-confirmed PTC and 18 F-FDG positron emission tomography/computed tomography within 6 months before undergoing thyroid surgery from September 2008 to August 2014. Tumors were considered to be 18 F-FDG avid if the uptake was greater than that of the liver. 18 F-FDG uptake of PTCs was also analyzed semiquantitatively using SUV max . The association between 18 F-FDG avidity and clinicopathologic variables (age, tumor size, perithyroidal extension, cervical lymph node status, and BRAF mutation status) was investigated. Results Twenty-nine (52.7 %) of 55 patients had 18 F-FDGavid PTCs. PTCs with the BRAF mutation showed higher 18 F-FDG avidity (24/38, 63.2 %) than those without (5/17, 29.4 %). The BRAF mutation (p=0.025) and tumor size (p= 0.003) were significantly associated with 18 F-FDG avidity in univariate analysis, and the BRAF mutation status remained significant after adjusting for tumor size in multivariate analysis (p=0.015). In the subgroup of tumor size≥1 cm, the BRAF mutation was the only factor significantly associated with 18 F-FDG avidity (p=0.021). The mean SUV max of PTCs with the BRAF mutation was significantly higher than that of those without (4.89±6.12 vs. 1.96±1.10, p=0.039). Conclusions The BRAF mutation must be one of the most important factors influencing 18 F-FDG avidity in PTCs, especially in those with a tumor size≥1 cm.

Section: Discussioncontrasting

confidence: 69%

“…However, reports regarding the associations of other factors and the 18 F-FDG uptake are inconsistent. Several studies have shown that the 18 F-FDG avidity of PTC is related to known poor prognosis factors [4], such as lymph node metastasis [2,5] and perithyroidal extension [5], although there are conflicting results [1][2][3]6].…”

Section: Introductionmentioning

confidence: 99%

Association Between 18F-FDG Avidity and the BRAF Mutation in Papillary Thyroid Carcinoma

Han

et al. 2015

Nucl Med Mol Imaging

Endocrine-Related Cancer

“…Jeong et al (2006b) reported a strong correlation between SUV and EE of papillary microcarcinoma in a univariate analysis; however, associations between SUV and EE or other aggressive tumor features were not significant in a multivariate analysis. Also, there was no significant difference in the SUV of papillary macrocarcinoma according to the presence or absence of EE (Choi et al 2011b).…”

Section: Preoperative Assessment Of Thyroid Cancer With Fdg Petmentioning

confidence: 99%

“…Jeong et al (2006b) reported that the SUV of thyroid cancer alone is not predictive of the presence of EE, lymphatic metastasis, or the multiplicity of thyroid cancer. Although no studies have evaluated the association between prognosis and FDG uptake, several support the hypothesis that FDG PET before surgery has prognostic value in DTCs.…”

Section: Prediction Of Prognosis By Fdg Pet In Patients With Dtcsmentioning

confidence: 99%

“…Also, there was no significant difference in the SUV of papillary macrocarcinoma according to the presence or absence of EE (Choi et al 2011b). However, US allows the detection of the tumor site attached to the thyroid capsule, which is associated with EE (Jeong et al 2006b). Therefore, preoperative US may be the most appropriate tool for T staging of thyroid cancer.…”

Section: Preoperative Assessment Of Thyroid Cancer With Fdg Petmentioning

confidence: 99%

See 1 more Smart Citation

The role of 18F-fluorodeoxyglucose positron emission tomography in differentiated thyroid cancer before surgery

Pak¹,

Kim²,

Kim³

et al. 2013

The incidence of thyroid cancer in both men and women is increasing faster than that of any other cancer. Although positron emission tomography (PET) using 18 F-fluorodeoxyglucose (FDG) has received much attention, the use of FDG PET for the management of thyroid cancer is limited primarily to postoperative follow-up. However, it might have a role in selected, more aggressive pathologies, and so patients at a high risk of distant metastasis may benefit from PET before surgery. As less FDG-avid thyroid cancers may lower the diagnostic accuracy of PET in preoperative assessment, an understanding of FDG avidity is important for the evaluation of thyroid cancer. FDG avidity has been shown to be associated with tumor size, lymph node metastasis, and glucose transporter expression and differentiation. As PET is commonly used in clinical practice, the detection of incidentalomas by PET is increasing. However, incidentalomas detected by PET have a high risk of malignancy. Clinicians handling cytologically indeterminate nodules face a dilemma regarding a procedure for a definitive diagnosis, usually lobectomy. With 'nondiagnostic (ND)' fine-needle biopsy (FNA), PET has shown a negative predictive value (NPV) of 100%, which indicates that negative uptake in a ND FNA procedure accurately excludes malignancy. With 'atypia of undetermined significance' or 'follicular neoplasm', the sensitivity and NPV of PET are 84 and 88%. PET does not provide additional information for the preoperative assessment of thyroid cancer. However, factors associated with FDG positivity are related to a poor prognosis; therefore, FDG PET scans before surgery may facilitate the prediction of the prognosis of differentiated thyroid cancer.

Preoperative ultrasonographic tumor characteristics as a predictive factor of tumor stage in papillary thyroid carcinoma

Kim

et al. 2011

Head & Neck