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[18F]-FDG-PET/CT and [18F]-FAZA-PET/CT Hypoxia Imaging of Metastatic Thyroid Cancer: Association with Short-Term Progression After Radioiodine Therapy.
Molecular Imaging and Biology ( IF 3.0 ) Pub Date : 2020-08-03 , DOI: 10.1007/s11307-020-01516-6
Masatoyo Nakajo 1, 2 , Megumi Jinguji 1 , Atsushi Tani 1 , Yoriko Kajiya 2 , Tooru Nandate 2 , Ikumi Kitazano 3 , Takashi Yoshiura 1
Affiliation  

Purpose

To examine the relationships between 2-deoxy-2-[18F]fluoro-d-glucose ([18F]-FDG) and hypoxia tracer [18F]fluoro-azomycinarabinofuranoside ([18F]-FAZA) and between 131I and [18F]-FAZA uptake in patients with metastatic thyroid cancer and to evaluate imaging features associated with short-term progression after 131I therapy.

Procedures

The study population was 20 patients (17 women and 3 men; mean age, 67 years) with metastatic thyroid cancer who underwent both [18F]-FDG- and [18F]-FAZA-positron emission tomography (PET)/X-ray computed tomography (CT) examinations before 131I therapy. Short-term response to radioiodine was assessed (mean follow-up, 19 months ± 9). PET parameters including [18F]-FDG-SUVmax, [18F]-FAZA-SUVmax, and [18F]-FAZA-tumor-to-muscle [T/M] were obtained. Mann-Whitney U, Wilcoxon signed-rank, or χ2 tests were used to assess differences between two quantitative variables or compare categorical data. Predictive factors for short-term progression were investigated with logistic regression analysis.

Results

Eleven lymph node metastatic lesions were identified in 9 patients and 46 distant metastatic lesions (lung, 19; bone, 17; and liver, 10) in 14 patients. A total of 24 131I-positive and 33 131I-negative lesions were detected. SUVmax was significantly lower with [18F]-FAZA-PET/CT (1.3 ± 0.6) than with [18F]-FDG-PET/CT (6.4 ± 5.9, p < 0.001). No significant correlation was observed between [18F]-FAZA-PET/CT and 131I imaging concerning visibility (p = 0.36). After 131I therapy, 31 of 57 metastatic lesions displayed short-term progression. Multivariate logistic regression revealed that [18F]-FDG-SUVmax (p = 0.022) and [18F]-FAZA-T/M (p = 0.002) showed significant associations with short-term progression.

Conclusions

Although [18F]-FAZA uptake was low in metastatic thyroid cancers, not only glucose metabolism but also hypoxic conditions may be associated with progression after 131I therapy in patients with metastatic thyroid cancer.



中文翻译:

[18F]-FDG-PET/CT 和 [18F]-FAZA-PET/CT 转移性甲状腺癌的缺氧成像:与放射性碘治疗后短期进展的关联。

目的

为了检查之间的关系2-脱氧-2- [ 18 F]氟- d -葡萄糖([ 18 F] -FDG)和缺氧示踪物〔18 F]氟- azomycinarabinofuranoside([ 18 F] -FAZA)和间131我和[ 18 F]-FAZA 在转移性甲状腺癌患者中的摄取,并评估与131 I 治疗后短期进展相关的影像学特征。

程序

研究人群为 20 名转移性甲状腺癌患者(17 名女性和 3 名男性;平均年龄 67 岁),他们接受了 [ 18 F]-FDG- 和 [ 18 F]-FAZA-正电子发射断层扫描 (PET)/X-在131 I 治疗前进行射线计算机断层扫描 (CT) 检查。评估了对放射性碘的短期反应(平均随访时间,19 个月 ± 9 个月)。获得了PET参数,包括[ 18 F]-FDG-SUVmax、[ 18 F]-FAZA-SUVmax和[ 18 F]-FAZA-肿瘤-肌肉[T/M]。Mann-Whitney U、Wilcoxon 符号秩或χ 2测试用于评估两个定量变量之间的差异或比较分类数据。使用逻辑回归分析研究短期进展的预测因素。

结果

在 9 名患者中发现了 11 个淋巴结转移病灶,在 14 名患者中发现了 46 个远处转移病灶(肺,19;骨,17;肝,10)。共检测到 24 131 个I 阳性和 33 131 个I 阴性病变。SUVmax值被显著与[降低18 F] -FAZA-PET / CT(1.3±0.6)比使用[ 18 F] -FDG-PET / CT(6.4±5.9,p  <0.001)。[ 18 F]-FAZA-PET/CT 和131 I 成像之间没有观察到显着相关性(p  = 0.36)。在131 I 治疗后,57 个转移病灶中有 31 个显示出短期进展。多元逻辑回归表明 [ 18F]-FDG-SUVmax ( p  = 0.022) 和 [ 18 F]-FAZA-T/M ( p  = 0.002) 显示出与短期进展的显着关联。

结论

尽管[ 18 F]-FAZA 摄取在转移性甲状腺癌中较低,但在转移性甲状腺癌患者中,131 I 治疗后,不仅葡萄糖代谢而且缺氧条件可能与进展相关。

更新日期:2020-08-04
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