Piao Hong Hua, Jeon Subin, Yoo Su Woong, Ryu Young Jae, Kim Dong-Yeon, Pyo Ayoung, Bom Hee-Seung, Min Jung-Joon, Kwon Seong Young
Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun-gun 58128, Korea.
Department of Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun-gun 58128, Korea.
Diagnostics (Basel). 2021 May 6;11(5):836. doi: 10.3390/diagnostics11050836.
We investigated whether an indication for [F]FDG-PET/CT to detect FDG-avid persistent disease (PD) could be identified precisely using the extent of metastatic lymph nodes (MLNs) and serum thyroglobulin (Tg) in papillary thyroid cancer (PTC) patients. This retrospective study included 429 PTC patients who underwent surgery and radioactive iodine (RAI) therapy. [F]FDG-PET/CT and serum Tg were evaluated just before RAI therapy. The MLN ratio (LNR) was defined as the ratio of the number of MLNs to the number of removed LNs. To derive the LNR-combined criteria, different Tg cut-off values for identifying the PET/CT-indicated group for PD detection were applied individually to subgroups initially classified based on LNR cut-off values. The cut-off values for serum Tg, the number of MLNs, and LNR for a PET/CT indication were 6.0 ng/mL, 5, and 0.51, respectively. Compared to a single parameter (serum Tg, total number of MLNs, and LNR), the LNR-combined criteria showed significantly superior diagnostic performance in detecting FDG-avid PD ( < 0.001). The diagnostic performance of PET/CT in detecting FDG-avid PD was significantly improved when the PET/CT-indicated group was identified through the LNR-combined criteria in a stepwise manner; this can contribute to a customized PET/CT indication in PTC patients.
我们研究了在甲状腺乳头状癌（PTC）患者中，能否通过转移淋巴结（MLN）的范围和血清甲状腺球蛋白（Tg）精确确定[F]FDG-PET/CT检测FDG摄取阳性的持续性疾病（PD）的指征。这项回顾性研究纳入了429例接受手术和放射性碘（RAI）治疗的PTC患者。在RAI治疗前评估[F]FDG-PET/CT和血清Tg。MLN比率（LNR）定义为MLN数量与切除淋巴结数量的比值。为得出LNR联合标准，将用于识别PET/CT指示的PD检测组的不同Tg临界值分别应用于最初根据LNR临界值分类的亚组。PET/CT指征的血清Tg、MLN数量和LNR的临界值分别为6.0 ng/mL、5和0.51。与单一参数（血清Tg、MLN总数和LNR）相比，LNR联合标准在检测FDG摄取阳性的PD方面显示出显著优越的诊断性能（<0.001）。当通过LNR联合标准逐步识别PET/CT指示组时，PET/CT检测FDG摄取阳性的PD的诊断性能显著提高；这有助于为PTC患者定制PET/CT指征。
