Int J Thyroidol.  2020 May;13(1):37-42. 10.11106/ijt.2020.13.1.37.

Diagnostic Value of SUV in 18F-FDG PET/CT for Papillary Thyroid Cancer

• Gim H
• Lee DK
• Park HS
• Jeong YJ

• KMID: 2502258
• DOI: http://doi.org/10.11106/ijt.2020.13.1.37

Abstract

Background and Objectives
PET/CT is widely used to determine whether metastasis or recurrence will occur following initial treatment of thyroid cancer. However, there are not much research on diagnostic usefulness of preoperative PET/CT imaging for papillary thyroid cancer (PTC). We analyzed the correlation between the preoperative maximum standard uptake value (SUVmax) of PET/CT and prognostic factors of PTC to evaluate the diagnostic usefulness of PET/CT.
Materials and Methods
Of the 133 patients who underwent surgery for PTC, 88 patients who had an increased uptake in thyroid mass in preoperative PET/CT were enrolled. They were divided into two groups according to B-RAF gene mutation, extrathyroidal extension (ETE), lymph node metastasis, and recurrence. The average of the SUVmax for each group was analyzed through multiple regression analysis. Correlation analysis were performed on changes in SUVmax according to the size of the thyroid tumor. Statistical analysis was performed to determine whether there were stage differences between the 47 patients who had no increased uptake in PET/CT and the others who had.
Results
There were no statistical correlation between recurrence, the presence of central/lateral lymph node metastasis, ETE, stage and the SUVmax in PET/CT (p=0.513, p=0.8, p=0.73, p=0.01, p=0.9). There were statistical correlations between the size of tumor (p=0.001), the presence of the B-RAF mutation (p=0.024) and SUVmax. Statistical correlations between the presence of the hypermetabolic uptake and high stage were found by the chi-square test (p=0.012).
Conclusion
The size of tumor, B-RAF are major factors in determining prognosis of PTC. There is a possibility that there is a correlation between preoperative SUVmax and prognosis of PTC.

Keyword

Papillary thyroid carcinoma; 18F-FDG PET/CT; Standardized uptake value

Figure

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  Fig. 1 Positron emission tomography/computed tomography (PET/CT) images of a patient with papillary thyroid cancer. (A) A typical Torso 18F-fluorodeoxy-glucose (FDG)-PET image of a patient with papillary thyroid cancer. (B) A 62-year-old woman with Left papillary thyroid cancer. 18F-FDG-PET/CT image clearly shows an increased focal 18F-FDG accumulation (SUVmax=16.86) in the tumor (arrow).

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  Fig. 2 SUVmax according to tumor size of papillary thyroid cancer.

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  Fig. 3 ROC curves of ETE and SUVmax. The ROC curves of ETE and SUVmax were analyzed, AUC=0.576, and were not statistically significant (p=0.118). The cut-off value was 4.52, and it can be predicted that there is ETE when it is 4.52 or more. ETE: Extrathyroidal extension, SUVmax: the maximum standardized uptake value

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