放射性碘难治性(RAI-R)分化型甲状腺癌(DTC)是一种罕见的疾病,预后差,治疗资源有限。因此,确定预后因素对于选择可以从早期开始治疗中获益的患者至关重要.这项研究的目的是通过集成计算机断层扫描(18F-FDG-PET/CT)参数识别具有18F-氟脱氧葡萄糖的正电子发射断层扫描,以预测RAI-RDTC患者的总体生存率(OS)。在这项单中心回顾性研究中,我们分析了2007年4月至2019年12月期间34例RAI-RDTC患者的18F-FDG-PET/CT参数.收集的参数是MTV,每个转移部位的SUVmax和进展(颈部,纵隔,肺,肝脏,骨)和总部位。ROC曲线,Kaplan-Meier生存分析曲线,单因素和多因素Cox分析确定1年和5年OS的预后因素。纵隔的参数,通过ROC曲线分析和Kaplan-Meier生存分析,肝脏和总部位与较差的1年和5年OS显著相关.单变量Cox分析证实纵隔SUVmax(HR1.08;95%CI[1.02-1.15];p=0.014)和总SUVmax(HR1.06;95%CI[1-1.12];p=0.042)对于更差的1年OS;纵隔SUVmax(HR1.06;95%CI[1.02-1.10];p=0.003),肝脏SUVmax(HR1.04;95%CI[1.01-1.08];p=0.02),肝脏MTV(HR2.56;95%CI[1.13-5.82];p=0.025),总体SUVmax(HR1.05;95%CI[1.02-1.08];p=0.001)和总MTV(HR1.41;95%CI[1.07-1.86];p=0.016)为较差的5年OS。多变量Cox分析证实肝脏MTV(HR1.02;95%CI[1-1.04];p=0.042)与1年OS降低之间存在显着关联。在这项研究中,我们证明在RAI-RDTC中,纵隔的18F-FDG-PET/CT参数,肝脏和总肿瘤负荷是1年和5年OS差的预后因素.确定这些标准可以允许早期治疗干预,以提高患者的生存率。
Radio-iodine refractory (RAI-R) differentiated thyroid cancer (DTC) is a rare disease with a poor prognosis and limited therapeutic resources. Therefore, identifying prognostic factors is essential in order to select patients who could benefit from an early start of treatment. The aim of this study is to identify positron emission tomography with 18F-fluorodeoxyglucose with integrated computed tomography (18F-FDG-PET/CT) parameters to predict overall survival (OS) in patients with RAI-R DTC. In this single-center retrospective study, we analyze the 18F-FDG-PET/CT parameters of 34 patients with RAI-R DTC between April 2007 and December 2019. The parameters collected are MTV, SUVmax and progression for each site of metastasis (neck, mediastinum, lungs, liver, bone) and total sites. ROC curves, Kaplan-Meier survival analysis curves, univariate and multivariate Cox analyses determine prognostic factors for 1-year and 5-year OS. The parameters for mediastinum, liver and total sites are significantly associated with worse 1-year and 5-year OS by both ROC curve analysis and Kaplan-Meier survival analysis. Univariate Cox analysis confirms significance of mediastinum SUVmax (HR 1.08; 95% CI [1.02-1.15]; p = 0.014) and total SUVmax (HR 1.06; 95% CI [1-1.12]; p = 0.042) for worse 1-year OS; of mediastinum SUVmax (HR 1.06; 95% CI [1.02-1.10]; p = 0.003), liver SUVmax (HR 1.04; 95% CI [1.01-1.08]; p = 0.02), liver MTV (HR 2.56; 95% CI [1.13-5.82]; p = 0.025), overall SUVmax (HR 1.05; 95% CI [1.02-1.08]; p = 0.001) and total MTV (HR 1.41; 95% CI [1.07-1.86]; p = 0.016) for worse 5-year OS. Multivariate Cox analysis confirms a significant association between liver MTV (HR 1.02; 95% CI [1-1.04]; p = 0.042) and decrease 1-year OS. In this study, we demonstrate that in RAI-R DTC, 18F-FDG-PET/CT parameters of the mediastinum, liver and overall tumor burden were prognostic factors of poor 1-year and 5-year OS. Identifying these criteria could allow early therapeutic intervention in order to improve patients\' survival.