THE COMBINED USE OF CALCITONIN DOUBLING TIME AND F-18-FDG PET/CT IMPROVES PROGNOSTIC VALUES IN MEDULLARY THYROID CARCINOMA: THE CLINICAL UTILITY OF F-18-FDG PET/CT

THE COMBINED USE OF CALCITONIN DOUBLING TIME AND F-18-FDG PET/CT IMPROVES PROGNOSTIC VALUES IN MEDULLARY THYROID CARCINOMA: THE CLINICAL UTILITY OF F-18-FDG PET/CT

Author Yang, Ji H. Autor UNIFESP Google Scholar
Camacho, Cleber P. Autor UNIFESP Google Scholar
Lindsey, Susan C. Autor UNIFESP Google Scholar
Valente, Flavia O. F. Autor UNIFESP Google Scholar
Andreoni, Danielle M. Autor UNIFESP Google Scholar
Yamaga, Lilian Y. Google Scholar
Wagner, Jairo Google Scholar
Biscolla, Rosa Paula M. Autor UNIFESP Google Scholar
Maciel, Rui M. B. Autor UNIFESP Google Scholar
Abstract Objective: Calcitonin and carcinoembryonic antigen (CEA) doubling times are established prognostic markers in medullary thyroid cancer (MTC). On the other hand, F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) shows an increased rate of detection with high blood tumor marker levels in several cancers. This study aimed to analyze the ability of F-18-FDG PET/CT to determine prognosis in the follow-up of patients with MTC. Methods: Medical records of 17 patients with MTC who underwent F-18-FDG PET/CT were analyzed retrospectively. All patients were classified into two groups: stable disease or progressive disease. Results: Eight patients presented with progressive disease, and all of them showed F-18-FDG uptake (100%), compared to only 3 of 9 patients who presented in stable condition (33%). F-18-FDG PET/CT results were able to distinguish progressive from stable disease (P = .009). Calcitonin levels >4,020 pg/mL (P = .0004), CEA levels >26.8 ng/mL (P = .04), and a calcitonin doubling time <24.1 months (P = .015) were associated with progressive disease in our cohort. The proportion of variance explained that predicted progressive disease was 32% for F-18-FDG uptake, 27.1% for a calcitonin doubling time of 24.1 months, and 41.2% for doubling time plus F-18-FDG PET/CT. Conclusion: F-18-FDG uptake was able to distinguish progressive from stable disease. However, this tool should not replace the validated calcitonin doubling time, but rather the combination of information could improve the clinical re-assessment and better identify high-risk patients who require more careful surveillance.
Language English
Sponsor São Paulo State Research Foundation (FAPESP)
Fleury Group
Brazilian Ministry of Health
CAPES-Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Grant number FAPESP: [2006/60402-1
FAPESP: 2010/51547-1
FAPESP: 2009/50575-4
Fleury Group: 12518
Brazilian Ministry of Health: 25000.168513/2008-11
Date 2017
Published in Endocrine Practice. Jacksonville, v. 23, n. 8, p. 942-948, 2017.
ISSN 1530-891X (Sherpa/Romeo, impact factor)
Publisher Amer Assoc Clinical Endocrinologists
Extent 942-948
Origin http://dx.doi.org/10.4158/EP171806.OR
Access rights Closed access
Type Article
Web of Science ID WOS:000411114800006
URI http://repositorio.unifesp.br/handle/11600/51422

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