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Difference of Clinical and Radiological Characteristics According to Radioiodine Avidity in Pulmonary Metastases of Differentiated Thyroid Cancer

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Abstract

Purpose

To evaluate differences in clinical, radiological and laboratory findings between pulmonary metastasis with and without radioiodine avidity in thyroidectomized differentiated thyroid cancer (DTC) patients with pulmonary metastasis who underwent high-dose I-131 treatment.

Methods

A total of 105 DTC patients with pulmonary metastasis (age, 48.7 ± 16.8 years; women/men, 78/27) were included. Clinical characteristics, chest computed tomography (CT), F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET)/CT and thyroid-stimulating hormone (TSH)-stimulated serum thyroglobulin (s-Tg) level were compared between patients with and without radioiodine uptake in metastatic lung lesions. The response to I-131 treatment was evaluated with follow-up study.

Results

Eighty-nine patients (84.8 %, whole-body scan positive [WBSP] group) showed radioiodine uptake at pulmonary metastasis on post I-131 treatment whole-body scan (WBS) and 16 patients (15.2 %, WBS negative [WBSN] group) did not show uptake at pulmonary lesions on the WBS. Ninety percent and 87 % of the WBSP group had visible metastatic lesions on CT and F-18 FDG PET/CT; however, all of the patients in the WBSN group showed lesions on CT and F-18 FDG PET/CT. In seven (6.7 %) of 105 patients, CT and F-18 FDG PET/CT could not detect pulmonary lesions, which were diagnosed by post I-131 treatment WBS. Complete disease remission was achieved in six (5.7 %) patients and all of them were in the WBSP group.

Conclusions

Metastatic lesion was not visualized on chest CT or F-18 FDG PET/CT in 6.7 % of DTC patients with pulmonary metastasis and the lesion was visualized only on post I-131 treatment WBS. Complete remission was achieved in 5.7 % of DTC patients with pulmonary metastasis and the cured metastases were non-visualizing or micronodular lesions on chest CT and demonstrated radioiodine avidity on post I-131 treatment WBS.

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Acknowledgments

This work was supported by a Grant (A111345) from the Korea Health Technology R&D Project, Ministry of Health & Welfare, Republic of KOREA; a Grant from the National Nuclear R&D Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (No. 2012M2A2A7014020); a Grant from the National Research Foundation of Korea (NRF); a Grant funded by the Korea government (MEST) (No. 2009-0078222, 2009-0078234); a Grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A091224).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea

    Do-Hoon Kim, Ji-hoon Jung, Seung Hyun Son, Choon-Young Kim, Chae Moon Hong, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee & Byeong-Cheol Ahn

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  1. Do-Hoon Kim
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  2. Ji-hoon Jung
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  4. Choon-Young Kim
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  7. Sang-Woo Lee
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Correspondence to Byeong-Cheol Ahn.

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Kim, DH., Jung, Jh., Son, S.H. et al. Difference of Clinical and Radiological Characteristics According to Radioiodine Avidity in Pulmonary Metastases of Differentiated Thyroid Cancer. Nucl Med Mol Imaging 48, 55–62 (2014). https://doi.org/10.1007/s13139-013-0239-z

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  • DOI: https://doi.org/10.1007/s13139-013-0239-z

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