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

Choi, Joon Ho; Byun, Byung Hyun; Lim, Ilhan; Moon, Hansol; Park, Jihyun; Chang, Kyoung Jin; Kim, Byung Il; Choi, Chang Woon; Lim, Sang Moo

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저자정보: Choi, Joon Ho (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Byun, Byung Hyun (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Lim, Ilhan (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Moon, Hansol (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Park, Jihyun (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Chang, Kyoung Jin (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Kim, Byung Il (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KIRAMS]) Choi, Chang Woon (Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences [KI) Lim, Sang Moo

저널정보: 대한핵의학회 Nuclear medicine and molecular imaging : NMMI Nuclear medicine and molecular imaging : NMMI 제52권 제2호

발행연도: 2018.1

수록면: 135 - 143 (9page)

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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 ${\geq}1.0cm$ 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.

#Differentiated thyroid carcinoma #Lung metastasis #F-18 FDG avidity #I-131 avidity #Micronodular #Macronodular

참고문헌 (24)

참고문헌 신청

Lang BH / 2013 / Evaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasis / Ann Surg Oncol 20:1329~1335

Casara D / 1993 / Different features of pulmonary metastases in differentiated thyroid cancer: natural history and multivariate statistical analysis of prognostic variables / J Nucl Med 34:1626~1631

Chopra S / 2015 / Lung metastases from differentiated thyroid carcinoma: prognostic factors related to remission and disease-free survival / Clin Endocrinol 82:445~452

Durante C / 2006 / Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy / J Clin Endocrinol Metab 91:2892~2899

Cho SW / 2014 / Long-term prognosis of differentiated thyroid cancer with lung metastasis in Korea and its prognostic factors / Thyroid 24:277~286

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