Unexpected 99mTc-pertechnetate avidity of lymph node metastases predicts better response to radioiodine therapy in differentiated thyroid cancer patients with lymph node metastases.
Jie Liu, Xin Li, Linfa Li, Yuhua Yin, Hu Cai, Heqing Yi
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引用次数: 0
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.
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.