The role of [18F]F-DOPA PET/CT in diagnostic and prognostic assessment of medullary thyroid cancer: a 15-year experience with 109 patients.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2024-07-13 Print Date: 2024-08-01 DOI:10.1530/ETJ-24-0089

Zhaoqi Zhang, Josef Yu, Eva Rainer, Lindsay Hargitai, Zewen Jiang, Georgios Karanikas, Tatjana Traub-Weidinger, Richard Crevenna, Marcus Hacker, Shuren Li

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引用次数: 0

Abstract

Objective: Correct diagnosis and prognostic evaluation of medullary thyroid cancer (MTC) are crucial to treat patients. The purpose of this study was to evaluate the diagnostic and prognostic value of [18F]F-DOPA PET/CT in patients with MTC.

Methods: We reviewed MTC patients who underwent [18F]F-DOPA PET/CT from June 2008 to November 2023. Clinical characteristics, follow-up data, and the following [18F]F-DOPA PET/CT parameters were recorded: maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and SUVmean of multiple organs. The diagnostic value of PET/CT for the detection of tumor lesions was calculated. Serum basal calcitonin (bCt) and stimulated calcitonin (sCt) were determined. Receiver operating characteristics, Kaplan-Meier, and Cox regression analyses were performed.

Results: In total, 109 patients (50 women, 59 men; average age, 55 ± 14 years) were included in the analysis. The patient-related sensitivity, specificity, and accuracy of [18F]F-DOPA PET/CT were 95%, 93%, and 94%, respectively. The lesion-related sensitivity, specificity, and accuracy were 65%, 99%, and 72%, respectively. The optimal cutoff values of bCt, sCt, and CEA to obtain positive [18F]F-DOPA PET/CT results were 64 pg/mL, 1808 pg/mL, and 4 µg/L, respectively. Patients with negative [18F]F-DOPA PET/CT had longer overall survival than patients with positive [18F]F-DOPA PET/CT results (P = 0.017). Significant positive correlations were found between bCt, sCt, and CEA with SUVmax, SUVmean, and MTV of [18F]F-DOPA PET/CT (P < 0.001). [18F]F-DOPA PET/CT results and MTV may be useful for the evaluation of the prognosis of patients with recurrent MTC, while age and MTV were independent prognostic factors in patients with primary MTC. For all patients, SUVmean of the left kidney, liver, aorta, and pancreas might be used to independently predict OS.

Conclusion: [18F]F-DOPA PET/CT had great value for diagnosis and prognostic assessment in patients with MTC. The DOPA PET/CT parameter SUVmean and MTV showed significant association with OS.

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18F]F-DOPA PET/CT 在甲状腺髓样癌诊断和预后评估中的作用：109例患者的15年经验

目的：正确诊断和评估甲状腺髓样癌（MTC）的预后对于MTC的治疗至关重要。本研究旨在评估[18F]F-DOPA PET/CT 在 MTC 患者中的诊断和预后价值：我们回顾了 2008 年 6 月至 2023 年 11 月期间接受[18F]F-DOPA PET/CT 检查的 MTC 患者。记录了临床特征、随访数据和以下[18F]F-DOPA PET/CT参数：最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）、代谢肿瘤体积（MTV）和多器官的SUVmean。计算了 PET/CT 对检测肿瘤病灶的诊断价值。测定了血清基础降钙素（bCt）和刺激降钙素（sCt）。进行了接收器操作特征（ROC）、Kaplan-Meier和Cox回归分析：109名患者（50名女性，59名男性；平均年龄（55 ± 14）岁）被纳入分析。患者相关的[18F]F-DOPA PET/CT敏感性、特异性和准确性分别为95%、93%和94%。与病灶相关的敏感性、特异性和准确性分别为 65%、99% 和 72%。获得[18F]F-DOPA PET/CT阳性结果的最佳bCt、sCt和CEA临界值分别为64 pg/mL、1808 pg/mL和4 µg/L。与[18F]F-DOPA PET/CT结果为阳性的患者相比，[18F]F-DOPA PET/CT结果为阴性的患者总生存期（OS）更长（P=0.017）。在 bCt、sCt 和 CEA 与 [18F]F-DOPA PET/CT 的 SUVmax、SUVmean 和 MTV 之间发现了显著的正相关（PConclusions：[18F]F-DOPA PET/CT 对 MTC 患者的诊断和预后评估具有重要价值。DOPA PET/CT参数SUVmean和MTV与OS有显著相关性。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.