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[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 (1355008X); May2024, Vol. 84 Issue 2, p656-662, 7p
Publication Year :
2024

Abstract

Background: In patients with iodine-negative thyroid cancer (TC), current guidelines endorse an [<superscript>18</superscript>F]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 [<superscript>131</superscript>I] whole body scan were scheduled for [<superscript>18</superscript>F]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 [<superscript>18</superscript>F]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, [<superscript>18</superscript>F]FDG PET/CT triggered relevant management changes along with disease control in the vast majority of patients. As such, in dedifferentiated TC, [<superscript>18</superscript>F]FDG PET/CT may serve as a relevant management tool and therapeutic decision-aid in the clinic. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
1355008X
Volume :
84
Issue :
2
Database :
Complementary Index
Journal :
Endocrine (1355008X)
Publication Type :
Academic Journal
Accession number :
178047497
Full Text :
https://doi.org/10.1007/s12020-023-03645-8