Masatoyo Nakajo1,2, Megumi Jinguji3, Atsushi Tani3, Yoriko Kajiya4, Tooru Nandate4, Ikumi Kitazano5, Takashi Yoshiura3. 1. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. toyo.nakajo@dolphin.ocn.ne.jp. 2. Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan. toyo.nakajo@dolphin.ocn.ne.jp. 3. Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. 4. Department of Radiology, Nanpuh Hospital, 14-3 Nagata, Kagoshima, 892-8512, Japan. 5. Department of Pathology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
Abstract
PURPOSE: To examine the relationships between 2-deoxy-2-[18F]fluoro-D-glucose ([18F]-FDG) and hypoxia tracer [18F]fluoro-azomycinarabinofuranoside ([18F]-FAZA) and between 131I and [18F]-FAZA uptake in patients with metastatic thyroid cancer and to evaluate imaging features associated with short-term progression after 131I therapy. PROCEDURES: The study population was 20 patients (17 women and 3 men; mean age, 67 years) with metastatic thyroid cancer who underwent both [18F]-FDG- and [18F]-FAZA-positron emission tomography (PET)/X-ray computed tomography (CT) examinations before 131I therapy. Short-term response to radioiodine was assessed (mean follow-up, 19 months ± 9). PET parameters including [18F]-FDG-SUVmax, [18F]-FAZA-SUVmax, and [18F]-FAZA-tumor-to-muscle [T/M] were obtained. Mann-Whitney U, Wilcoxon signed-rank, or χ2 tests were used to assess differences between two quantitative variables or compare categorical data. Predictive factors for short-term progression were investigated with logistic regression analysis. RESULTS: Eleven lymph node metastatic lesions were identified in 9 patients and 46 distant metastatic lesions (lung, 19; bone, 17; and liver, 10) in 14 patients. A total of 24 131I-positive and 33 131I-negative lesions were detected. SUVmax was significantly lower with [18F]-FAZA-PET/CT (1.3 ± 0.6) than with [18F]-FDG-PET/CT (6.4 ± 5.9, p < 0.001). No significant correlation was observed between [18F]-FAZA-PET/CT and 131I imaging concerning visibility (p = 0.36). After 131I therapy, 31 of 57 metastatic lesions displayed short-term progression. Multivariate logistic regression revealed that [18F]-FDG-SUVmax (p = 0.022) and [18F]-FAZA-T/M (p = 0.002) showed significant associations with short-term progression. CONCLUSIONS: Although [18F]-FAZA uptake was low in metastatic thyroid cancers, not only glucose metabolism but also hypoxic conditions may be associated with progression after 131I therapy in patients with metastatic thyroid cancer.
PURPOSE: To examine the relationships between 2-deoxy-2-[18F]fluoro-D-glucose ([18F]-FDG) and hypoxia tracer [18F]fluoro-azomycinarabinofuranoside ([18F]-FAZA) and between 131I and [18F]-FAZA uptake in patients with metastatic thyroid cancer and to evaluate imaging features associated with short-term progression after 131I therapy. PROCEDURES: The study population was 20 patients (17 women and 3 men; mean age, 67 years) with metastatic thyroid cancer who underwent both [18F]-FDG- and [18F]-FAZA-positron emission tomography (PET)/X-ray computed tomography (CT) examinations before 131I therapy. Short-term response to radioiodine was assessed (mean follow-up, 19 months ± 9). PET parameters including [18F]-FDG-SUVmax, [18F]-FAZA-SUVmax, and [18F]-FAZA-tumor-to-muscle [T/M] were obtained. Mann-Whitney U, Wilcoxon signed-rank, or χ2 tests were used to assess differences between two quantitative variables or compare categorical data. Predictive factors for short-term progression were investigated with logistic regression analysis. RESULTS: Eleven lymph node metastatic lesions were identified in 9 patients and 46 distant metastatic lesions (lung, 19; bone, 17; and liver, 10) in 14 patients. A total of 24 131I-positive and 33 131I-negative lesions were detected. SUVmax was significantly lower with [18F]-FAZA-PET/CT (1.3 ± 0.6) than with [18F]-FDG-PET/CT (6.4 ± 5.9, p < 0.001). No significant correlation was observed between [18F]-FAZA-PET/CT and 131I imaging concerning visibility (p = 0.36). After 131I therapy, 31 of 57 metastatic lesions displayed short-term progression. Multivariate logistic regression revealed that [18F]-FDG-SUVmax (p = 0.022) and [18F]-FAZA-T/M (p = 0.002) showed significant associations with short-term progression. CONCLUSIONS: Although [18F]-FAZA uptake was low in metastatic thyroid cancers, not only glucose metabolism but also hypoxic conditions may be associated with progression after 131I therapy in patients with metastatic thyroid cancer.
Authors: R Michael Tuttle; Hernan Tala; Jatin Shah; Rebecca Leboeuf; Ronald Ghossein; Mithat Gonen; Matvey Brokhin; Gal Omry; James A Fagin; Ashok Shaha Journal: Thyroid Date: 2010-10-29 Impact factor: 6.568
Authors: C Durante; N Haddy; E Baudin; S Leboulleux; D Hartl; J P Travagli; B Caillou; M Ricard; J D Lumbroso; F De Vathaire; M Schlumberger Journal: J Clin Endocrinol Metab Date: 2006-05-09 Impact factor: 5.958
Authors: L Hooft; O S Hoekstra; W Devillé; P Lips; G J Teule; M Boers; M W van Tulder Journal: J Clin Endocrinol Metab Date: 2001-08 Impact factor: 5.958
Authors: M Schlumberger; M Tubiana; F De Vathaire; C Hill; P Gardet; J P Travagli; P Fragu; J Lumbroso; B Caillou; C Parmentier Journal: J Clin Endocrinol Metab Date: 1986-10 Impact factor: 5.958