Unexpected 99m Tc-pertechnetate avidity of lymph node metastases predicts better response to radioiodine therapy in differentiated thyroid cancer patients with lymph node metastases
To investigate the value of Tc-pertechnetate scan in postoperative differentiated thyroid cancer (DTC) patients with lymph node (LN) metastases (LNM) uptake Tc-pertechnetate, especially the predictive value to their response to radioiodine-131 ( I) therapy. This retrospective study collected 752 pat...
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Veröffentlicht in: | American journal of nuclear medicine and molecular imaging 2024, Vol.14 (1), p.63 |
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Sprache: | eng |
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Zusammenfassung: | To investigate the value of
Tc-pertechnetate scan in postoperative differentiated thyroid cancer (DTC) patients with lymph node (LN) metastases (LNM) uptake
Tc-pertechnetate, especially the predictive value to their response to radioiodine-131 (
I) therapy.
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
Tc-pertechnetate, the patients were grouped as the
Tc-pertechnetate-avid (n=88) vs.
Tc-pertechnetate-non-avid (n=664) groups. And Propensity score matching (PSM) was performed at a 1:4 ratio to reduce confounding bias.
In the PSM analysis, the 1:4 matched cohort comprised 752 patients (88 with
Tc-pertechnetate-avid LNM, 664 with
Tc-pertechnetate-non-avid LNM). Patients' age, initial
I activity and frequency of iodine therapy were included as covariates. After PSM analysis, 363 patients (
Tc-pertechnetate-avid group, n=83;
Tc-pertechnetate-non-avid group, n=280) were successfully matched. Among the 363 PSM-matched patients, 48/83 (57.8%) in the
Tc-pertechnetate-avid group and 158/280 (56.4%) in the
Tc-pertechnetate-non-avid group had two or more
I treatments. The nsTg and the percentage of changes in ssTg between the
Tc-pertechnetate-avid and
Tc-pertechnetate-non-avid groups were significantly different ([0.05 (0.04 to 0.90) vs. 0.40 (0.04 to 4.92),
=0.018] and [-88% (-98%, -50%) vs. -66% (-86%, -30%),
< 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
I treatment activity, and
I treatment frequency) after PSM (all
> 0.05).
In patients with DTC and LNM, LNM uptake of
Tc-pertechnetate is a rare phenomenon. Patients with
Tc-pertechnetate-avid LNMs were more likely to benefit from
I therapy, even after adjustment for age,
I treatment frequency, and initial
I activity. |
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ISSN: | 2160-8407 2160-8407 |
DOI: | 10.62347/PBCV5827 |