1
|
Chandekar KR, Satapathy S, Bal C. Positron Emission Tomography/Computed Tomography in Thyroid Cancer: An Updated Review. PET Clin 2024; 19:131-145. [PMID: 38212213 DOI: 10.1016/j.cpet.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
PET/computed tomography (CT) is a valuable hybrid imaging modality for the evaluation of thyroid cancer, potentially impacting management decisions. 18F-fluorodeoxyglucose (FDG) PET/CT has proven utility for recurrence evaluation in differentiated thyroid cancer (DTC) patients having thyroglobulin elevation with negative iodine scintigraphy. Aggressive histologic subtypes such as anaplastic thyroid cancer shower higher FDG uptake. 18F-FDOPA is the preferred PET tracer for medullary thyroid cancer. Fibroblast activation protein inhibitor and arginylglycylaspartic acid -based radiotracers have emerged as promising PET agents for radioiodine refractory DTC patients with the potential for theranostic application.
Collapse
|
2
|
Dondi F, Gatta R, Treglia G, Piccardo A, Albano D, Camoni L, Gatta E, Cavadini M, Cappelli C, Bertagna F. Application of radiomics and machine learning to thyroid diseases in nuclear medicine: a systematic review. Rev Endocr Metab Disord 2024; 25:175-186. [PMID: 37434097 PMCID: PMC10808150 DOI: 10.1007/s11154-023-09822-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND In the last years growing evidences on the role of radiomics and machine learning (ML) applied to different nuclear medicine imaging modalities for the assessment of thyroid diseases are starting to emerge. The aim of this systematic review was therefore to analyze the diagnostic performances of these technologies in this setting. METHODS A wide literature search of the PubMed/MEDLINE, Scopus and Web of Science databases was made in order to find relevant published articles about the role of radiomics or ML on nuclear medicine imaging for the evaluation of different thyroid diseases. RESULTS Seventeen studies were included in the systematic review. Radiomics and ML were applied for assessment of thyroid incidentalomas at 18 F-FDG PET, evaluation of cytologically indeterminate thyroid nodules, assessment of thyroid cancer and classification of thyroid diseases using nuclear medicine techniques. CONCLUSION Despite some intrinsic limitations of radiomics and ML may have affect the results of this review, these technologies seem to have a promising role in the assessment of thyroid diseases. Validation of preliminary findings in multicentric studies is needed to translate radiomics and ML approaches in the clinical setting.
Collapse
Affiliation(s)
- Francesco Dondi
- Nuclear Medicine, ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, Brescia, 25123, Italy
| | - Roberto Gatta
- Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | | | - Domenico Albano
- Nuclear Medicine, ASST Spedali Civili di Brescia and Università degli Studi di Brescia, Brescia, Italy
| | - Luca Camoni
- Nuclear Medicine, ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, Brescia, 25123, Italy
| | - Elisa Gatta
- Unit of Endocrinology and Metabolism, ASST Spedali Civili di Brescia and Università degli Studi di Brescia, Brescia, Italy
| | - Maria Cavadini
- Unit of Endocrinology and Metabolism, ASST Spedali Civili di Brescia and Università degli Studi di Brescia, Brescia, Italy
| | - Carlo Cappelli
- Unit of Endocrinology and Metabolism, ASST Spedali Civili di Brescia and Università degli Studi di Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, ASST Spedali Civili di Brescia, P.le Spedali Civili, 1, Brescia, 25123, Italy.
- Nuclear Medicine, ASST Spedali Civili di Brescia and Università degli Studi di Brescia, Brescia, Italy.
| |
Collapse
|
3
|
Bang JI, Park S, Kim K, Seo Y, Chong A, Hong CM, Choi M, Lee SW, Oh SW. The Diagnostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Differentiated Thyroid Cancer Patients with Elevated Thyroglobulin/Thyroglobulin Antibody Levels and Negative Iodine Scintigraphy: A Systematic Review and Meta-Analysis. Thyroid 2023; 33:1224-1236. [PMID: 37597200 DOI: 10.1089/thy.2023.0264] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
Background: The objective of this study is to evaluate the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in detecting recurrence in patients with differentiated thyroid cancer (DTC) who have negative whole-body scans (WBSs) but elevated serum thyroglobulin (Tg) or thyroglobulin antibody (TgAb) levels. Methods: This systematic review/meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Diagnostic Test Accuracy criteria (International Prospective Register of Systematic Reviews registration number: CRD42022340924). A comprehensive search of the MEDLINE, EMBASE, and Cochrane databases identified articles reporting the diagnostic accuracy of FDG PET/CT for the detection of recurrence in patients with DTC with negative WBS and elevated serum Tg or TgAb levels published between January 2012 and June 2023. Meta-analyses were performed to determine the diagnostic accuracy of FDG PET/CT on the total target population as well as on subgroups stratified by serum Tg or TgAb, and thyrotropin (TSH) stimulation status at the time of FDG PET/CT. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was applied to evaluate the quality of evidence and the strength of recommendations to facilitate translation of the meta-analysis results into practical recommendations for clinical guidelines. Results: A total of 24 studies involving 1988 patients were included for analysis. The overall pooled sensitivity and specificity values were 0.87 (95% confidence interval [CI] = 0.83-0.92; I2 = 75%) and 0.84 (CI = 0.80-0.89; I2 = 44%), respectively. Subgroup analyses revealed no significant differences in the diagnostic accuracy of FDG PET/CT in patients stratified by serum Tg or TgAb levels, and TSH stimulation status at the time of PET/CT. Treatment plans were changed following FDG PET/CT imaging in 40% (CI = 34-47%; I2 = 39%) of cases. The quality level of evidence for using FDG PET/CT was moderate in both sensitivity and specificity according to the GRADE system. Conclusion: There is moderate quality evidence demonstrating the high diagnostic accuracy of FDG PET/CT in detecting recurrence in patients with DTC with negative WBS and elevated serum Tg or TgAb levels. This evidence corroborates the current guidelines' endorsement of FDG PET/CT as a diagnostic tool in such patients.
Collapse
Affiliation(s)
- Ji-In Bang
- Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Republic of Korea
| | - Sohyun Park
- Department of Nuclear Medicine, National Cancer Center Hospital, Gyeonggi-do, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital and School of Medicine, Pusan National University, Pusan, Republic of Korea
| | - Youngduk Seo
- Department of Nuclear Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ari Chong
- Department of Nuclear Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - Chae Moon Hong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Miyoung Choi
- Division for Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University, School of Medicine and Chilgok Hospital, Daegu, Republic of Korea
| | - So Won Oh
- Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| |
Collapse
|
4
|
Giovanella L, Garo ML, Albano D, Görges R, Ceriani L. The role of thyroglobulin doubling time in differentiated thyroid cancer: a meta-analysis. Endocr Connect 2022; 11:e210648. [PMID: 35245206 PMCID: PMC9066573 DOI: 10.1530/ec-21-0648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/04/2022] [Indexed: 12/02/2022]
Abstract
OBJECTIVE In patients with differentiated thyroid cancer (DTC), recurrences may occur in up to 20% and may have a fatal outcome in 10% of cases. Thyroglobulin doubling time (Tg-DT) values may contribute to predict response to treatment and disease recurrence in DTC patients. This study aimed to address the following questions: (1) Are Tg-DT values indicative of response to treatments in patients with DTC (i.e. 'treatment monitoring')?; (2) Is Tg-DT predictive of 2-[18F]fluoro-2-deoxy-d-glucose (2-[18F]FDG) PET/CT in patients with DTC?; (3) Are Tg-DT values predictive of DTC prognosis (i.e. 'prediction')? DESIGN Systematic review and meta-analysis. METHODS Methodology was registered in the PROSPERO database (CRD42021257947). A systematic search was carried out in PubMed, Web Of Science, and Scopus from June to August 2021 without time and language restrictions. RESULTS Eleven studies were included for a total of 1421 patients. Positive association between Tg-DT < 1 year and recurrence or disease progression was observed. Tg-DT was found to be related with (2-[18F]FDG) PET/CT results in patients with DTC. The area under the curve was 0.86 (95% CI: 0.83-0.89), sensitivity was 0.84 (0.64;0.94), specificity was 0.71 (0.35; 0.92), DOR was 13.1 (3.1; 55.0), LR+ was 2.9 (1.0; 8.1), LR- was 0.22 (0.1; 0.5). For patients with Tg-DT < 1 year (n = 247), the survival risk ratio was 2.09 (95% CI: 1.49; 2.94). CONCLUSIONS Tg-DT values are valuable in predicting response to treatment and disease recurrence in patients with DTC, as well as their overall survival. In addition, Tg-DT significantly increases the detection rate of 2-[18F]-FDG PET/CT.
Collapse
Affiliation(s)
- Luca Giovanella
- Clinic for Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Clinic for Nuclear Medicine, University Hospital of Zürich, Zürich, Switzerland
| | | | - Domenico Albano
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Rainer Görges
- Department of Nuclear Medicine, University Hospital of Essen, Essen, Germany
| | - Luca Ceriani
- Clinic for Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| |
Collapse
|
5
|
Wang Y, Wu J, Jiang L, Zhang X, Liu B. Prognostic value of post-ablation stimulated thyroglobulin in differentiated thyroid cancer patients with biochemical incomplete response: a bi-center observational study. Endocrine 2022; 76:109-115. [PMID: 35094313 DOI: 10.1007/s12020-021-02976-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/23/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Little is known regarding parameters predicting persistence/recurrence for differentiated thyroid cancer (DTC) patients exhibiting biochemical incomplete response (BIR) to initial therapy. High post-ablation stimulated thyroglobulin (ps-Tg) levels have undetermined prognostic significance in DTC patients with BIR. The goal of this bi-center study was to systemically assess the prognosis of DTC patients with BIR in relation to ps-Tg levels and to establish the determinants of clinical outcomes. DESIGN AND METHODS The retrospective study of consecutive 81 DTC patients from two tertiary centers who were classified as BIR after total thyroidectomy and radioiodine ablation between January 2010 to December 2019 were analyzed. BIR was defined as ps-Tg > 10 ng/mL measured under thyroid hormone withdrawal at 9-12 months followed by radioiodine ablation, negative anti-Tg antibodies, and no structural evidence of disease. Multivariable regression models were used to evaluate potential risk factors associated with clinical outcomes. RESULTS With a median follow-up of 5.4 years, 28 patients (34.6%) showed no evidence of disease and 50 patients (61.7%) were of a biochemical persistent status at the time of final follow-up. Conversely, 3 patients (3.7%) developed structural evidence of disease. Ps-Tg of 20.2 ng/mL or greater displayed the high positive predictive value (81%) for disease persistence/recurrence. Multivariate analysis revealed that only a high ps-Tg level (>20.2 ng/mL) was an independent risk factor for persistent/recurrent disease (odds ratio = 5.6; p < 0.001). CONCLUSION The ps-Tg (>20.2 ng/mL) was a valuable predictor of disease persistence/recurrence in DTC patients with BIR.
Collapse
Affiliation(s)
- Yu Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jie Wu
- Department of Nuclear Medicine, Panzhihua Central Hospital, Panzhihua University, Panzhihua, 617067, China
| | - Lisha Jiang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xinyue Zhang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Bin Liu
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
6
|
Albano D, Dondi F, Mazzoletti A, Bellini P, Rodella C, Bertagna F. Prognostic Role of 2-[ 18F]FDG PET/CT Metabolic Volume Parameters in Patients Affected by Differentiated Thyroid Carcinoma with High Thyroglobulin Level, Negative 131I WBS and Positive 2-[ 18F]-FDG PET/CT. Diagnostics (Basel) 2021; 11:diagnostics11122189. [PMID: 34943426 PMCID: PMC8700137 DOI: 10.3390/diagnostics11122189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022] Open
Abstract
The clinical and prognostic role of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) in the study of patients affected by differentiated thyroid carcinoma (DTC) with positive serum thyroglobulin (Tg) level and negative [131I] whole-body scan ([131I]WBS) has already been demonstrated. However, the potential prognostic role of semi-quantitative PET metabolic volume features, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), has not yet been clearly investigated. The aim of this retrospective study was to investigate whether the main metabolic PET/CT parameters may predict the prognosis. We retrospectively included 122 patients with a positive 2-[18F]FDG PET/CT for DTC disease after a negative [131I]WBS with Tg > 10 ng/mL. The maximum and mean standardized uptake value (SUVmax and SUVmean), MTV and TLG of the hypermetabolic lesion, total MTV (tMTV) and total TLG (tTLG) were measured for each scan. Progression-free survival (PFS) and overall survival (OS) curves were plotted according to the Kaplan-Meier analysis. After a median follow up of 53 months, relapse/progression of disease occurred in 87 patients and death in 42. The median PFS and OS were 19 months (range 1-132 months) and 46 months (range 1-145 months). tMTV and tTLG were the only independent prognostic factors for OS. No variables were significantly correlated with PFS. The best thresholds derived in our sample were 6.6 cm3 for MTV and 119.4 for TLG. In patients with negative WBS and Tg > 10 ng/mL, 2-[18F]FDG PET/CT metabolic volume parameters (tMTV and tTLG) may help to predict OS.
Collapse
Affiliation(s)
- Domenico Albano
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.M.); (P.B.); (F.B.)
- Correspondence:
| | - Francesco Dondi
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.M.); (P.B.); (F.B.)
| | - Angelica Mazzoletti
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.M.); (P.B.); (F.B.)
| | - Pietro Bellini
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.M.); (P.B.); (F.B.)
| | - Carlo Rodella
- Health Physics Department, ASST-Spedali Civili, 25123 Brescia, Italy;
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (F.D.); (A.M.); (P.B.); (F.B.)
| |
Collapse
|