Unexpected 99mTc-pertechnetate avidity of lymph node metastases predicts better response to radioiodine therapy in differentiated thyroid cancer patients with lymph node metastases.

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING American journal of nuclear medicine and molecular imaging Pub Date : 2024-02-20 eCollection Date: 2024-01-01
Jie Liu, Xin Li, Linfa Li, Yuhua Yin, Hu Cai, Heqing Yi
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Abstract

Objective: To investigate the value of 99mTc-pertechnetate scan in postoperative differentiated thyroid cancer (DTC) patients with lymph node (LN) metastases (LNM) uptake 99mTc-pertechnetate, especially the predictive value to their response to radioiodine-131 (131I) therapy.

Methods: This retrospective study collected 752 patients with DTC and LNM treated at Zhejiang Cancer Hospital between May 2012 and December 2017. Depending on the ability of LNM uptake 99mTc-pertechnetate, the patients were grouped as the 99mTc-pertechnetate-avid (n=88) vs. 99mTc-pertechnetate-non-avid (n=664) groups. And Propensity score matching (PSM) was performed at a 1:4 ratio to reduce confounding bias.

Results: In the PSM analysis, the 1:4 matched cohort comprised 752 patients (88 with 99mTc-pertechnetate-avid LNM, 664 with 99mTc-pertechnetate-non-avid LNM). Patients' age, initial 131I activity and frequency of iodine therapy were included as covariates. After PSM analysis, 363 patients (99mTc-pertechnetate-avid group, n=83; 99mTc-pertechnetate-non-avid group, n=280) were successfully matched. Among the 363 PSM-matched patients, 48/83 (57.8%) in the 99mTc-pertechnetate-avid group and 158/280 (56.4%) in the 99mTc-pertechnetate-non-avid group had two or more 131I treatments. The nsTg and the percentage of changes in ssTg between the 99mTc-pertechnetate-avid and 99mTc-pertechnetate-non-avid groups were significantly different ([0.05 (0.04 to 0.90) vs. 0.40 (0.04 to 4.92), p=0.018] and [-88% (-98%, -50%) vs. -66% (-86%, -30%), p < 0.001], respectively). No significant differences were observed between the two groups in the other parameters (age, pathological type, distant metastasis, follow-up time, AJCC TNM stage, initial 131I treatment activity, and 131I treatment frequency) after PSM (all p > 0.05).

Conclusion: In patients with DTC and LNM, LNM uptake of 99mTc-pertechnetate is a rare phenomenon. Patients with 99mTc-pertechnetate-avid LNMs were more likely to benefit from 131I therapy, even after adjustment for age, 131I treatment frequency, and initial 131I activity.

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有淋巴结转移的分化型甲状腺癌患者淋巴结转移灶的99m锝-过硫酸盐嗜性可预示对放射性碘治疗的更好反应。
目的探讨99m锝-过硫酸盐扫描在术后分化型甲状腺癌(DTC)淋巴结(LNM)转移(LNM)患者摄取99m锝-过硫酸盐的价值,尤其是对其放射性碘-131(131I)治疗反应的预测价值:这项回顾性研究收集了2012年5月至2017年12月期间在浙江省肿瘤医院接受治疗的752例DTC和LNM患者。根据LNM摄取99m锝-pertechnetate的能力,将患者分为99m锝-pertechnetate-avid组(n=88)和99m锝-pertechnetate-non-avid组(n=664)。并按1:4的比例进行倾向评分匹配(PSM),以减少混杂偏差:在PSM分析中,1:4配对队列由752名患者组成(88名99m锝-过硫酸盐-亲和性LNM患者,664名99m锝-过硫酸盐-非亲和性LNM患者)。患者的年龄、初始 131I 活性和碘治疗频率被列为协变量。经过 PSM 分析,363 名患者(99m锝-过硫酸盐-亲和组,n=83;99m锝-过硫酸盐-非亲和组,n=280)成功配对。在363名PSM匹配患者中,99m锝-过硫酸盐-avid组48/83(57.8%)人和99m锝-过硫酸盐-non-avid组158/280(56.4%)人接受过两次或两次以上的131I治疗。99mTc-pertechnetate-avid 组和 99mTc-pertechnetate-non-avid 组的 nsTg 和 ssTg 变化百分比有显著差异(分别为 [0.05 (0.04 to 0.90) vs. 0.40 (0.04 to 4.92), p=0.018] 和 [-88% (-98%, -50%) vs. -66% (-86%, -30%), p < 0.001])。PSM 后,两组患者在其他参数(年龄、病理类型、远处转移、随访时间、AJCC TNM 分期、初始 131I 治疗活性和 131I 治疗频率)方面无明显差异(均 p > 0.05):结论:在 DTC 和 LNM 患者中,LNM 摄取 99mTc-pertechnetate 是一种罕见现象。即使对年龄、131I 治疗频率和初始 131I 活性进行了调整,具有 99mTc-pertechnetate-avid LNM 的患者也更有可能从 131I 治疗中获益。
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来源期刊
American journal of nuclear medicine and molecular imaging
American journal of nuclear medicine and molecular imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
4.00%
发文量
4
期刊介绍: The scope of AJNMMI encompasses all areas of molecular imaging, including but not limited to: positron emission tomography (PET), single-photon emission computed tomography (SPECT), molecular magnetic resonance imaging, magnetic resonance spectroscopy, optical bioluminescence, optical fluorescence, targeted ultrasound, photoacoustic imaging, etc. AJNMMI welcomes original and review articles on both clinical investigation and preclinical research. Occasionally, special topic issues, short communications, editorials, and invited perspectives will also be published. Manuscripts, including figures and tables, must be original and not under consideration by another journal.
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