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[18F]FDG PET/CT can trigger relevant oncological management changes leading to favorable outcome in iodine-negative thyroid cancer patients

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Title: [18F]FDG PET/CT can trigger relevant oncological management changes leading to favorable outcome in iodine-negative thyroid cancer patients
Authors: Zhi, Yingjun, Higuchi, Takahiro, Hackenberg, Stephan, Hagen, Rudolf, Stöth, Manuel, Scherzad, Agmal, Buck, Andreas K., Werner, Rudolf A., Serfling, Sebastian E.
Source: Endocrine
Publisher Information: Springer Science and Business Media LLC, 2023.
Publication Year: 2023
Subject Terms: Male, Adult, 0301 basic medicine, ddc:610, Middle Aged, Iodine Radioisotopes, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Iodine Radioisotopes/therapeutic use [MeSH], Female [MeSH], Aged [MeSH], Adult [MeSH], Humans [MeSH], Treatment Outcome [MeSH], Tyrosine kinase inhibitor, Radiopharmaceuticals [MeSH], Thyroid cancer, Middle Aged [MeSH], Thyroid Neoplasms/radiotherapy [MeSH], Fluorodeoxyglucose F18 [MeSH], Original Article, Management change, Thyroid Neoplasms/diagnostic imaging [MeSH], Thyroid Neoplasms/therapy [MeSH], Male [MeSH], Positron Emission Tomography Computed Tomography/methods [MeSH], [, Humans, Female, Thyroid Neoplasms, Radiopharmaceuticals, Aged
Description: Background In patients with iodine-negative thyroid cancer (TC), current guidelines endorse an [18F]FDG PET/CT to identify dedifferentiated sites of disease. We aimed to determine the rate of oncological management changes triggered by such a molecular imaging approach, along with the impact on outcome. Methods 42 consecutive patients with negative findings on [131I] whole body scan were scheduled for [18F]FDG PET/CT and treatment based on PET results were initiated. To determine the impact on oncological management, we compared the therapeutic plan prior to and after molecular imaging. Based on imaging follow-up, the rate of controlled disease (CD, defined as stable disease, complete or partial response) was also recorded, thereby allowing to assess whether [18F]FDG-triggered management changes can also lead to favorable outcome. Results We observed no alterations of the treatment plan in 9/42 (21.4%) subjects (active surveillance in 9/9 [100%]). Oncological management was changed in the remaining 33/42 (78.6%; systemic treatment in 9/33 [27.3%] and non-systemic treatment in 24/33 [72.7%]). Among patients receiving non-systemic therapy, the following changes were noted: surgery in 20/24 (83.3%) and radiation therapy in 4/24 (16.7%). In the systemic group, tyrosine kinase inhibitor (TKI) was prescribed in 8/9 (88.9%), while radioiodine therapy based on a TKI-mediated redifferentiation approach was conducted in 1/9 (11.1%). In 26 subjects with available follow-up, rate of CD was 22/26 (84.6%) and among those, 15/22 (68.1%) had experienced previous management changes based on PET/CT findings. Conclusions In subjects with iodine-negative TC, [18F]FDG PET/CT triggered relevant management changes along with disease control in the vast majority of patients. As such, in dedifferentiated TC, [18F]FDG PET/CT may serve as a relevant management tool and therapeutic decision-aid in the clinic.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1559-0100
DOI: 10.1007/s12020-023-03645-8
Access URL: https://pubmed.ncbi.nlm.nih.gov/38133766
https://repository.publisso.de/resource/frl:6519819
https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-382267
https://opus.bibliothek.uni-wuerzburg.de/files/38226/s12020-023-03645-8.pdf
https://doi.org/10.1007/s12020-023-03645-8
https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/38226
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Accession Number: edsair.doi.dedup.....907bb1d6ed2d0a5f6904a7b467be4cdf
Database: OpenAIRE
Description
Abstract:Background In patients with iodine-negative thyroid cancer (TC), current guidelines endorse an [18F]FDG PET/CT to identify dedifferentiated sites of disease. We aimed to determine the rate of oncological management changes triggered by such a molecular imaging approach, along with the impact on outcome. Methods 42 consecutive patients with negative findings on [131I] whole body scan were scheduled for [18F]FDG PET/CT and treatment based on PET results were initiated. To determine the impact on oncological management, we compared the therapeutic plan prior to and after molecular imaging. Based on imaging follow-up, the rate of controlled disease (CD, defined as stable disease, complete or partial response) was also recorded, thereby allowing to assess whether [18F]FDG-triggered management changes can also lead to favorable outcome. Results We observed no alterations of the treatment plan in 9/42 (21.4%) subjects (active surveillance in 9/9 [100%]). Oncological management was changed in the remaining 33/42 (78.6%; systemic treatment in 9/33 [27.3%] and non-systemic treatment in 24/33 [72.7%]). Among patients receiving non-systemic therapy, the following changes were noted: surgery in 20/24 (83.3%) and radiation therapy in 4/24 (16.7%). In the systemic group, tyrosine kinase inhibitor (TKI) was prescribed in 8/9 (88.9%), while radioiodine therapy based on a TKI-mediated redifferentiation approach was conducted in 1/9 (11.1%). In 26 subjects with available follow-up, rate of CD was 22/26 (84.6%) and among those, 15/22 (68.1%) had experienced previous management changes based on PET/CT findings. Conclusions In subjects with iodine-negative TC, [18F]FDG PET/CT triggered relevant management changes along with disease control in the vast majority of patients. As such, in dedifferentiated TC, [18F]FDG PET/CT may serve as a relevant management tool and therapeutic decision-aid in the clinic.
ISSN:15590100
DOI:10.1007/s12020-023-03645-8