ISSN: 1859 - 2872
The value of 18F-FDG PET/CT metabolic parameters in predicting overall survival in patients with radioiodine-refractory differentiated thyroid cancer
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Abstract
Objective: The aim of this study was to investigate whether metabolic parameters of 18F-FDG PET/CT might be prognostic markers of overall survival (OS) in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC). Subject and method: This prospective study included 122 patients with RR-DTC who had lesions visible on 18F-FDG PET/CT imaging. ROC curves were used to determine the mortality prediction threshold of metabolic parameters, and Kaplan-Meier estimates were employed to calculate OS. Univariate and multivariate Cox regression analyses were performed to assess the impact of clinical factors, histopathological features, and quantitative metabolic parameters of 18F-FDG PET/CT on OS in patients with RR-DTC. Result: The quantitative metabolic parameters of 18F-FDG PET/CT showed significant predictive value for mortality with high sensitivity and specificity (p<0.001). Patients with log-SUVmax (g/ml) < 0.9; log-TLG (g/ml x cm3) < 0.76, log-tMTV (cm3) < 0.51 had significantly higher overall survival rates compared to others (p<0.05). In univariate Cox regression analysis, OS was associated with factors such as stimulated Tg, Tg-DT, cumulative RAI activities administrated, bone metastasis, number of lession, SUVmax, SUVmean, SULpeak, TLG, and tMTV. However, only Tg-DT ≤ 1 year and log-tMTV were identified as independent prognostic factors for OS in multivariate analysis. Conclusion: The quantitative metabolic parameters of 18F-FDG PET/CT play a significant role in predicting mortality in patients with RR-DTC. Among these, log-tMTV, along with Tg-DT ≤ 1 year are independent prognostic factors for OS in patients with RR-DTC.
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References
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