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Predictive value of FDG-PET in patients with advanced medullary thyroid cancer undergoing vandetanib treatment

Please always quote using this URN: urn:nbn:de:bvb:20-opus-161147
  • Introduction: The prognosis of medullary thyroid carcinoma (MTC) is poor using common chemotherapeutic approaches. However, during the last years encouraging results of recently introduced tyrosine kinase inhibitors (TKI) such as vandetanib have been published. In this study we aimed to correlate the results of \(^{18}\)F-fluorodeoxyglucose ([\(^{18}\)F]FDG) positron emission tomography (PET) imaging with treatment outcome. Methods: Eighteen patients after thyroidectomy with recurrent/advanced MTC lesions receiving vandetanib (300 mgIntroduction: The prognosis of medullary thyroid carcinoma (MTC) is poor using common chemotherapeutic approaches. However, during the last years encouraging results of recently introduced tyrosine kinase inhibitors (TKI) such as vandetanib have been published. In this study we aimed to correlate the results of \(^{18}\)F-fluorodeoxyglucose ([\(^{18}\)F]FDG) positron emission tomography (PET) imaging with treatment outcome. Methods: Eighteen patients after thyroidectomy with recurrent/advanced MTC lesions receiving vandetanib (300 mg orally/day) could be analysed. A baseline \(^{18}\)F-FDG PET prior to and a follow-up \(^{18}\)F-FDG PET 3 months after TKI initiation were performed. During follow-up, tumor progression was assessed every 3 months including computed tomography according to RECIST. Progression-free survival (PFS) was correlated with the maximum standardized uptake value of \(^{18}\)F-FDG in lymph nodes (SUV(LN)max) or visceral metastases (SUV(MTS)max) as well as with clinical parameters using ROC analysis. Results: Within median 3.6 years of follow-up, 9 patients showed disease progression at median 8.5 months after TKI initiation. An elevated glucose consumption assessed by baseline \(^{18}\)F-FDG PET (SUV(LN)max > 7.25) could predict a shorter PFS (2 y) with an accuracy of 76.5% (SUV(LN)max <7.25, 4.3 y; p=0.03). Accordingly, preserved tumor metabolism in the follow-up PET (SUV(MTS)max >2.7) also demonstrated an unfavorable prognosis (accuracy, 85.7%). On the other hand, none of the clinical parameters reached significance in response prediction. Conclusions: In patients with advanced and progressive MTC, tumors with higher metabolic activity at baseline are more aggressive and more prone to progression as reflected by a shorter PFS; they should be monitored more closely. Preserved glucose consumption 3 months after treatment initiation was also related to poorer prognosis.show moreshow less
Metadaten
Author: Rudolf Werner, Takahiro Higuchi, Dirk Muegge, Mehrbod S. Javadi, Bruno Märkl, Christoph Aulmann, Andreas K. Buck, Martin Fassnacht, Constantin Lapa, Michael C. Kreissl
URN:urn:nbn:de:bvb:20-opus-161147
Document Type:Conference Proceeding
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Nuklearmedizin
Medizinische Fakultät / Medizinische Klinik und Poliklinik I
Language:English
Parent Title (English):Journal of Nuclear Medicine
ISSN:0161-5505
Year of Completion:2017
Volume:58
Issue:no. supplement 1
Pagenumber:169
Source:Journal of Nuclear Medicine May 1, 2017 vol. 58 no. supplement 1 169
URL:http://jnm.snmjournals.org/content/58/supplement_1/169
Sonstige beteiligte Institutionen:Johns Hopkins School of Medicine, Baltimore, MD, U.S.
Sonstige beteiligte Institutionen:Hospital Augsburg, Augsburg, Germany
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:18F-FDG; PET; TKI; positron emission tomography; vandetanib
Release Date:2018/05/05
Note:
This  research  was  originally  published  in  JNM. 
Rudolf  A.  Werner,  Takahiro  Higuchi, Dirk O. Muegge, Mehrbod S. Javadi, B. Märkl, C. Aulmann, Andreas K. Buck, Martin Fassnacht,  Constantin  Lapa, Michael  C.  Kreissl. 
Predictive  value  of  FDG-PET  in patients with advanced medullary thyroid cancer undergoing vandetanib treatment. J Nucl Med. May 1, 2017; vol. 58 no. supplement 1:169. © SNMMI.
EU-Project number / Contract (GA) number:701983
OpenAIRE:OpenAIRE
Licence (German):License LogoDeutsches Urheberrecht