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Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To investigate clinical implications of FDG uptake in the thyroid glands in patients with advanced breast carcinoma by comparing metabolic and morphologic patterns on positron emission tomography (PET)/computed tomography (CT).

Methods

The institutional review board waived the requirement for informed consent. A retrospective analysis was performed in 146 women (mean age 54 years) with advanced breast carcinoma who received systemic treatment. All patients underwent PET-CT before and after treatment. All PET-CT studies were reviewed in consensus by two reviewers. Morphologic changes including volume and mean parenchymal density of the thyroid glands were evaluated. Maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG) were determined to evaluate metabolic changes. These parameters were compared between patients with chronic thyroiditis who received thyroid hormone replacement therapy and those who did not.

Results

Of the 146 patients, 29 (20%) showed bilaterally diffuse uptake in the thyroid glands on the baseline PET-CT scan. The SUVmax showed a linear relationship with volume (r = 0.428, p = 0.021) and the mean parenchymal density (r = −0.385, p = 0.039) of the thyroid glands. In 21 of the 29 patients (72%) with hypothyroidism who received thyroid hormone replacement therapy, the volume, mean parenchymal density, SUVmax, and TLG of the thyroid glands showed no significant changes. In contrast, 8 of the 29 patients (28%) who did not receive thyroid hormone replacement therapy showed marked decreases in SUVmax and TLG.

Conclusion

Diffuse thyroid uptake on PET-CT represents active inflammation caused by chronic thyroiditis in patients with advanced breast carcinoma. Diffuse thyroid uptake may also address the concern about subclinical hypothyroidism which develops into overt disease during follow-up.

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Acknowledgments

This work was supported in part by grants from the Scientific Research Expenses for Health and Welfare Programs and the Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Ukihide Tateishi, Cristina Gamez, Henry W. D. Yeung & Homer A. Macapinlac

  2. Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Ukihide Tateishi & Tomio Inoue

  3. Division of Breast Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA

    Shaheenah Dawood & Massimo Cristofanilli

  4. Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Unit 1263, 1515 Holcombe Blvd., Houston, TX, USA

    Ukihide Tateishi

Authors
  1. Ukihide Tateishi
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  2. Cristina Gamez
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  3. Shaheenah Dawood
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  4. Henry W. D. Yeung
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  5. Massimo Cristofanilli
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  6. Tomio Inoue
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  7. Homer A. Macapinlac
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Correspondence to Ukihide Tateishi.

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Tateishi, U., Gamez, C., Dawood, S. et al. Chronic thyroiditis in patients with advanced breast carcinoma: metabolic and morphologic changes on PET-CT. Eur J Nucl Med Mol Imaging 36, 894–902 (2009). https://doi.org/10.1007/s00259-008-1048-y

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  • DOI: https://doi.org/10.1007/s00259-008-1048-y

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