From the *Service de Médecine Nucléaire, Institut Jean Godinot, Reims; †Unité thyroïde, Institut Jean Godinot, Reims; ‡Unité de Biostatistiques et Qualité de vie, Centre Georges-François Leclerc, Dijon; and §Service de Radiophysique, Institut Jean Godinot, Reims, France.
Clin Nucl Med. 2015 Jun;40(6):469-75. doi: 10.1097/RLU.0000000000000780.
To evaluate the prognostic value of F-fluorodeoxyglucose positron emission tomography (FDG PET) with quantitative analysis using metabolic parameters in metastatic differentiated thyroid cancer (DTC).
The FDG-PET scans of 37 patients with metastatic DTC were studied retrospectively. The number of FDG-avid lesions, the SUVmax, the SULpeak of the lesion with the highest FDG uptake, the overall metabolic tumor volume (MTV), and the total lesion glycolysis (TLG) were measured. Curves of progression-free survival (Kaplan-Meier) and Cox univariate and multivariate analyses determined the prognostic factors for survival.
Progression-free survival was better in patients with less than 10 FDG-avid lesions (P = 0.0089), the SUVmax less than 10 (P = 0.0026), the SULpeak less than 5 (P = 0.0004), and the TLG less than 154 (P = 0.0110).Cox analyses showed that only the result of the PET scan was predictive of survival (age, TNM stage, histology, and the I whole body radioiodine scan were not associated with prognosis). In the univariate analysis, prognostic factors for progression-free survival and overall survival were the SUVmax (P = 0.004; P = 0.018), the SULpeak (P = 0.001; P = 0.017), and the TLG (P = 0.014; P = 0.012). The number of FDG-avid lesions was significantly associated with progression-free survival (P = 0.012), but not the MTV. In the multivariate analysis, the number of FDG-avid lesions and the SULpeak were independent prognostic factors.
FDG PET using metabolic parameters is a prognostic factor in metastatic DTC. It could improve the therapeutic management and follow-up of patients.
评估 F-氟脱氧葡萄糖正电子发射断层扫描（FDG PET）结合代谢参数对分化型甲状腺癌（DTC）转移患者的预后价值。
回顾性分析 37 例转移性 DTC 患者的 FDG-PET 扫描结果。测量 FDG 摄取最高的病灶的病灶数量、SUVmax、病灶摄取最高的 SULpeak、总体代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）。通过无进展生存（Kaplan-Meier）曲线和 Cox 单因素和多因素分析确定生存的预后因素。
转移灶少于 10 个（P = 0.0089）、SUVmax 小于 10（P = 0.0026）、SULpeak 小于 5（P = 0.0004）、TLG 小于 154（P = 0.0110）的患者无进展生存率更好。Cox 分析表明，只有 PET 扫描结果对生存有预测作用（年龄、TNM 分期、组织学和 I 全身放射性碘扫描与预后无关）。在单因素分析中，无进展生存和总生存的预后因素是 SUVmax（P = 0.004；P = 0.018）、SULpeak（P = 0.001；P = 0.017）和 TLG（P = 0.014；P = 0.012）。病灶数量与无进展生存显著相关（P = 0.012），但 MTV 无显著相关性。在多因素分析中，病灶数量和 SULpeak 是独立的预后因素。
FDG PET 代谢参数是转移性 DTC 的预后因素。它可以改善患者的治疗管理和随访。
