Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer

Weiping Wang, Steven M. Larson, Melissa Fazzari, Satish K. Tickoo, Katherine Kolbert, George Sgouros, Henry Yeung, Homer Macapinlac, Juan Rosai, Richard J. Robbins

Research output: Contribution to journalArticle

284 Citations (Scopus)

Abstract

Poorly differentiated thyroid cancer lesions often lose the ability to concentrate radioactive [131I]iodine (RAI) and exhibit increased metabolic activity, as evidenced by enhanced glucose uptake. We incorporated [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning into the routine follow-up of a cohort of thyroid cancer patients undergoing annual evaluations. One hundred and twenty-five patients who had previous thyroidectomies were included. They had diagnostic RAI whole body scans, serum thyroglobulin measurements, and additional imaging studies as clinically indicated. During 41 months of follow-up, 14 patients died. Univariate analysis demonstrated that survival was reduced in those with age over 45 yr, distant metastases, PET positivity, high rates of FDG uptake, and high volume of the FDG-avid disease (>125 mL). Survival did not correlate with gender, RAI uptake, initial histology, or grade. Multivariate analysis demonstrated that the single strongest predictor of survival was the volume of FDG-avid disease. The 3-yr survival probability of patients with FDG volumes of 125 mL or less was 0.96 (95% confidence interval, 0.91, 1.0) compared with 0.18 (95% confidence interval, 0.04, 0.85) in patients with FDG volume greater than 125 mL. Only 1 death (of leukemia) occurred in the PET-negative group (n = 66). Of the 10 patients with distant metastases and negative PET scans, all were alive and well. Patients over 45 yr with distant metastases that concentrate FDG are at the highest risk. Once distant metastases are discovered in patients with differentiated thyroid carcinoma, FDG-PET can identify high and low risk subsets. Subjects with a FDG volume greater than 125 mL have significantly reduced short term survival.

Original languageEnglish (US)
Pages (from-to)1107-1113
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume85
Issue number3
DOIs
StatePublished - Dec 1 2000
Externally publishedYes

Fingerprint

Positron emission tomography
Fluorodeoxyglucose F18
Positrons
Thyroid Neoplasms
Electrons
Scanning
Positron-Emission Tomography
Neoplasm Metastasis
Survival
Histology
Thyroglobulin
Set theory
Iodine
Confidence Intervals
Whole Body Imaging
Thyroidectomy
Imaging techniques
Survival Analysis
Glucose
Leukemia

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. / Wang, Weiping; Larson, Steven M.; Fazzari, Melissa; Tickoo, Satish K.; Kolbert, Katherine; Sgouros, George; Yeung, Henry; Macapinlac, Homer; Rosai, Juan; Robbins, Richard J.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 85, No. 3, 01.12.2000, p. 1107-1113.

Research output: Contribution to journalArticle

Wang, W, Larson, SM, Fazzari, M, Tickoo, SK, Kolbert, K, Sgouros, G, Yeung, H, Macapinlac, H, Rosai, J & Robbins, RJ 2000, 'Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer', Journal of Clinical Endocrinology and Metabolism, vol. 85, no. 3, pp. 1107-1113. https://doi.org/10.1210/jc.85.3.1107
Wang, Weiping ; Larson, Steven M. ; Fazzari, Melissa ; Tickoo, Satish K. ; Kolbert, Katherine ; Sgouros, George ; Yeung, Henry ; Macapinlac, Homer ; Rosai, Juan ; Robbins, Richard J. / Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. In: Journal of Clinical Endocrinology and Metabolism. 2000 ; Vol. 85, No. 3. pp. 1107-1113.
@article{9b2eb0786b924735bc689bd15d06ba22,
title = "Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer",
abstract = "Poorly differentiated thyroid cancer lesions often lose the ability to concentrate radioactive [131I]iodine (RAI) and exhibit increased metabolic activity, as evidenced by enhanced glucose uptake. We incorporated [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning into the routine follow-up of a cohort of thyroid cancer patients undergoing annual evaluations. One hundred and twenty-five patients who had previous thyroidectomies were included. They had diagnostic RAI whole body scans, serum thyroglobulin measurements, and additional imaging studies as clinically indicated. During 41 months of follow-up, 14 patients died. Univariate analysis demonstrated that survival was reduced in those with age over 45 yr, distant metastases, PET positivity, high rates of FDG uptake, and high volume of the FDG-avid disease (>125 mL). Survival did not correlate with gender, RAI uptake, initial histology, or grade. Multivariate analysis demonstrated that the single strongest predictor of survival was the volume of FDG-avid disease. The 3-yr survival probability of patients with FDG volumes of 125 mL or less was 0.96 (95{\%} confidence interval, 0.91, 1.0) compared with 0.18 (95{\%} confidence interval, 0.04, 0.85) in patients with FDG volume greater than 125 mL. Only 1 death (of leukemia) occurred in the PET-negative group (n = 66). Of the 10 patients with distant metastases and negative PET scans, all were alive and well. Patients over 45 yr with distant metastases that concentrate FDG are at the highest risk. Once distant metastases are discovered in patients with differentiated thyroid carcinoma, FDG-PET can identify high and low risk subsets. Subjects with a FDG volume greater than 125 mL have significantly reduced short term survival.",
author = "Weiping Wang and Larson, {Steven M.} and Melissa Fazzari and Tickoo, {Satish K.} and Katherine Kolbert and George Sgouros and Henry Yeung and Homer Macapinlac and Juan Rosai and Robbins, {Richard J.}",
year = "2000",
month = "12",
day = "1",
doi = "10.1210/jc.85.3.1107",
language = "English (US)",
volume = "85",
pages = "1107--1113",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "3",

}

TY - JOUR

T1 - Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer

AU - Wang, Weiping

AU - Larson, Steven M.

AU - Fazzari, Melissa

AU - Tickoo, Satish K.

AU - Kolbert, Katherine

AU - Sgouros, George

AU - Yeung, Henry

AU - Macapinlac, Homer

AU - Rosai, Juan

AU - Robbins, Richard J.

PY - 2000/12/1

Y1 - 2000/12/1

N2 - Poorly differentiated thyroid cancer lesions often lose the ability to concentrate radioactive [131I]iodine (RAI) and exhibit increased metabolic activity, as evidenced by enhanced glucose uptake. We incorporated [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning into the routine follow-up of a cohort of thyroid cancer patients undergoing annual evaluations. One hundred and twenty-five patients who had previous thyroidectomies were included. They had diagnostic RAI whole body scans, serum thyroglobulin measurements, and additional imaging studies as clinically indicated. During 41 months of follow-up, 14 patients died. Univariate analysis demonstrated that survival was reduced in those with age over 45 yr, distant metastases, PET positivity, high rates of FDG uptake, and high volume of the FDG-avid disease (>125 mL). Survival did not correlate with gender, RAI uptake, initial histology, or grade. Multivariate analysis demonstrated that the single strongest predictor of survival was the volume of FDG-avid disease. The 3-yr survival probability of patients with FDG volumes of 125 mL or less was 0.96 (95% confidence interval, 0.91, 1.0) compared with 0.18 (95% confidence interval, 0.04, 0.85) in patients with FDG volume greater than 125 mL. Only 1 death (of leukemia) occurred in the PET-negative group (n = 66). Of the 10 patients with distant metastases and negative PET scans, all were alive and well. Patients over 45 yr with distant metastases that concentrate FDG are at the highest risk. Once distant metastases are discovered in patients with differentiated thyroid carcinoma, FDG-PET can identify high and low risk subsets. Subjects with a FDG volume greater than 125 mL have significantly reduced short term survival.

AB - Poorly differentiated thyroid cancer lesions often lose the ability to concentrate radioactive [131I]iodine (RAI) and exhibit increased metabolic activity, as evidenced by enhanced glucose uptake. We incorporated [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scanning into the routine follow-up of a cohort of thyroid cancer patients undergoing annual evaluations. One hundred and twenty-five patients who had previous thyroidectomies were included. They had diagnostic RAI whole body scans, serum thyroglobulin measurements, and additional imaging studies as clinically indicated. During 41 months of follow-up, 14 patients died. Univariate analysis demonstrated that survival was reduced in those with age over 45 yr, distant metastases, PET positivity, high rates of FDG uptake, and high volume of the FDG-avid disease (>125 mL). Survival did not correlate with gender, RAI uptake, initial histology, or grade. Multivariate analysis demonstrated that the single strongest predictor of survival was the volume of FDG-avid disease. The 3-yr survival probability of patients with FDG volumes of 125 mL or less was 0.96 (95% confidence interval, 0.91, 1.0) compared with 0.18 (95% confidence interval, 0.04, 0.85) in patients with FDG volume greater than 125 mL. Only 1 death (of leukemia) occurred in the PET-negative group (n = 66). Of the 10 patients with distant metastases and negative PET scans, all were alive and well. Patients over 45 yr with distant metastases that concentrate FDG are at the highest risk. Once distant metastases are discovered in patients with differentiated thyroid carcinoma, FDG-PET can identify high and low risk subsets. Subjects with a FDG volume greater than 125 mL have significantly reduced short term survival.

UR - http://www.scopus.com/inward/record.url?scp=0034335410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034335410&partnerID=8YFLogxK

U2 - 10.1210/jc.85.3.1107

DO - 10.1210/jc.85.3.1107

M3 - Article

C2 - 10720047

AN - SCOPUS:0034335410

VL - 85

SP - 1107

EP - 1113

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 3

ER -