TY - JOUR
T1 - Fluorodeoxyglucose positron emission tomography/computerized tomography in differentiated thyroid cancer management
T2 - Importance of clinical justification and value in predicting survival
AU - Marcus, Charles
AU - Antoniou, Alexander
AU - Rahmim, Arman
AU - Ladenson, Paul
AU - Subramaniam, Rathan M.
N1 - Publisher Copyright:
© 2015 The Royal Australian and New Zealand College of Radiologists.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Introduction The purpose of this study was to evaluate the added value of follow-up fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to clinical assessment and predicting survival outcome in patients with differentiated thyroid cancers. Methods This is an institutional review board approved, retrospective study of 202 biopsy-proven thyroid cancer patients at a single tertiary centre. A total of 327 follow-up or surveillance PET/CT scans done 6 or more months from initial treatment completion were included in this study. Median follow-up from completion of primary treatment was 94 months (range, 6.17-534.1 months). Overall survival benefit was measured using Kaplan-Meier plots with a Mantel-Cox log-rank test. Multivariate Cox regression model is provided with clinical covariates. Results Of the 327 PET/CT scans from 202 patients, 161 were positive and 166 as negative for recurrence or metastasis. A total of 23 patients died during the study period. Patients with a positive PET/CT scan had shorter overall survival than those who had a negative scan (P < 0.0001, hazard ratio 6.1 (3.0-14.3) ). In the context of clinical assessment, PET/CT identified recurrence in 50% (25/50) of scans without prior clinical suspicion and ruled out recurrence in 36.8% (102/277) of scans with prior clinical suspicion. In a multivariate Cox regression model, factors associated with overall survival were stage (P < 0.0001), time to scan (P = 0.0005) and PET/CT result (P < 0.0001). Conclusion FDG PET/CT performed in follow-up more than 6 months from primary treatment completion adds value to clinical judgment and a prognostic marker of overall survival in thyroid cancer patients.
AB - Introduction The purpose of this study was to evaluate the added value of follow-up fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to clinical assessment and predicting survival outcome in patients with differentiated thyroid cancers. Methods This is an institutional review board approved, retrospective study of 202 biopsy-proven thyroid cancer patients at a single tertiary centre. A total of 327 follow-up or surveillance PET/CT scans done 6 or more months from initial treatment completion were included in this study. Median follow-up from completion of primary treatment was 94 months (range, 6.17-534.1 months). Overall survival benefit was measured using Kaplan-Meier plots with a Mantel-Cox log-rank test. Multivariate Cox regression model is provided with clinical covariates. Results Of the 327 PET/CT scans from 202 patients, 161 were positive and 166 as negative for recurrence or metastasis. A total of 23 patients died during the study period. Patients with a positive PET/CT scan had shorter overall survival than those who had a negative scan (P < 0.0001, hazard ratio 6.1 (3.0-14.3) ). In the context of clinical assessment, PET/CT identified recurrence in 50% (25/50) of scans without prior clinical suspicion and ruled out recurrence in 36.8% (102/277) of scans with prior clinical suspicion. In a multivariate Cox regression model, factors associated with overall survival were stage (P < 0.0001), time to scan (P = 0.0005) and PET/CT result (P < 0.0001). Conclusion FDG PET/CT performed in follow-up more than 6 months from primary treatment completion adds value to clinical judgment and a prognostic marker of overall survival in thyroid cancer patients.
KW - PET/CT
KW - differentiated thyroid cancer
KW - follow-up
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U2 - 10.1111/1754-9485.12286
DO - 10.1111/1754-9485.12286
M3 - Article
C2 - 25676871
AN - SCOPUS:84930473439
SN - 1754-9477
VL - 59
SP - 281
EP - 288
JO - Journal of the College of Radiologists of Australasia
JF - Journal of the College of Radiologists of Australasia
IS - 3
ER -