title: Analysis of predictability of F-18 fluorodeoxyglucose-PET/CT in the recurrence of papillary thyroid carcinoma.
abstract: Whether preoperative F-18 fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) can predict recurrence of papillary thyroid carcinoma (PTC) remains unclear. Herein, we evaluated the potential of primary tumor FDG avidity for the prediction of tumor recurrence in PTC patients. A total of 412 PTC patients (72 males, 340 females; age: 47.2 ± 12.2 years; range: 17-84 years) who underwent FDG-PET/CT prior to total thyroidectomy (n = 350), subtotal thyroidectomy (n = 2), or lobectomy (n = 60) from 2007 to 2011 were analyzed. The predictive ability for recurrence was investigated among various clinicopathological factors, BRAFV600Emutation, and preoperative FDG avidity of the primary tumor using Kaplan-Meier (univariate) and Cox proportional hazards regression (multivariate) analyses. Of the 412 patients, 19 (4.6%) experienced recurrence, which was confirmed either by pathology (n = 17) or high serum thyroglobulin level (n = 2), during a mean follow-up period of 43.9 ± 16.6 months. Of the 412 patients, 237 (57.5%) had FDG-avid tumors (maximum standardized uptake value, 7.1 ± 7.0; range: 1.6-50.5). Kaplan-Meier analysis revealed that tumor size (P = 0.0054), FDG avidity of the tumor (P = 0.0049), extrathyroidal extension (P = 0.0212), and lymph node (LN) stage (P < 0.0001) were significant predictors for recurrence. However, only LN stage remained a significant predictor in the multivariate analysis (P < 0.0001). Patients with FDG-avid tumors had higher LN stage (P < 0.0001), larger tumor size (P < 0.0001), and more frequent extrathyroidal extension (P < 0.0001). In conclusion, FDG avidity of the primary tumor in preoperative FDG-PET/CT could not predict the recurrence of PTC. LN stage was the only identified predictor of PTC recurrence.
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Suk Kyeong
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Korea. youngso@kuh.ac.kr.|Bioimaging Translational Open Innovation Center, Konkuk University School of Medicine, Seoul, Korea. youngso@kuh.ac.kr.
authors.forename: Young
authors.initials: Y
authors.lastname: So
authors.affiliation: Department of Nuclear Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Chung
authors.affiliation: Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Young Bum
authors.initials: YB
authors.lastname: Yoo
authors.affiliation: Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Tae Sook
authors.initials: TS
authors.lastname: Hwang
authors.affiliation: Bioimaging Translational Open Innovation Center, Konkuk University School of Medicine, Seoul, Korea.|Department of Physiology, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Bokyung
authors.initials: B
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Won Woo
authors.initials: WW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000378:metabolism*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: F-18 fluorodeoxyglucose-positron emission tomography/computed tomography; lymph node metastasis; papillary thyroid carcinoma; prognosis; recurrence