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：

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[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。