Relationship among 201T1 uptake, nuclear DNA content and clinical behavior in metastatic thyroid carcinoma.
A prospective study of 201TI uptake was performed to compare 201TI uptake with nuclear deoxyribonucleic acid (DNA) content and clinical behavior of tumors in metastatic thyroid carcinoma and to assess the significance of 201TI uptake in evaluating clinical characteristics of thyroid carcinoma.


METHODS
Fifty-six patients with metastases of differentiated thyroid carcinoma had 201TI scintigraphy. Grade of 201TI uptake was semiquantitatively assessed according to tumor-to-background ratio on 2-h late scan. Nuclear DNA content was analyzed within 3 wk of 201TI study by flow cytometry using biopsy material and was classified as diploidy or aneuploidy. Patients were followed up to examine incidence of tumor growth and/or anaplastic transformation.


RESULTS
DNA content was diploidy in 48 patients and aneuploidy in 8 patients. 201TI uptake in the DNA-aneuploid group (2.61 +/- 0.29) was significantly higher than that in the DNA-diploid group (1.82 +/- 0.35, P < 0.01 for both groups). Tumor growth was observed in all patients with DNA aneuploidy but in only 5 of 48 patients with DNA diploidy (P < 0.01). Anaplastic transformation was observed in 3 patients in the DNA-aneuploid group but in none of the patients in the DNA-diploid group.


CONCLUSIONS
High 201TI uptake indicates greater incidence of abnormal DNA content with aggressive clinical behavior of metastatic tumors. Thus, 201TI scintigraphy may be useful in characterizing metastatic thyroid carcinoma and in identifying those patients with poorer prognoses.
Nakada
K
K
Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Katoh
C
C
Morita
K
K
Kanegae
K
K
Tsukamoto
E
E
Shiga
T
T
Mochizuki
T
T
Tamaki
N
N
D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000782:Aneuploidy; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D016009:Chi-Square Distribution; D004273:DNA, Neoplasm / Q000032:analysis*; D004171:Diploidy; D005260:Female; D005434:Flow Cytometry; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D013965:Thyroidectomy
D004273:DNA, Neoplasm; D007457:Iodine Radioisotopes; D013794:Thallium Radioisotopes