Prediction of treatment response to 131 I therapy by diffuse hepatic uptake intensity on post-therapy whole-body scan in
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ORIGINAL ARTICLE
Prediction of treatment response to 131I therapy by diffuse hepatic uptake intensity on post-therapy whole-body scan in patients with distant metastases of differentiated thyroid cancer Sungmin Jun1 • Jong Jin Lee2 • Seol Hoon Park3 • Tae Yong Kim4 Won Bae Kim4 • Young Kee Shong4 • Jin-Sook Ryu2
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Received: 27 January 2015 / Accepted: 8 May 2015 Ó The Japanese Society of Nuclear Medicine 2015
Abstract Objective A diffuse hepatic uptake (DHU) on radioiodine whole-body scans (WBS) after 131I therapy is caused by 131 I-labeled iodoproteins, particularly 131I-labeled thyroglobulin (Tg). We hypothesized that the DHU intensity after 131I therapy might correlate with subsequent serum Tg reduction, suggesting that DHU reflects destruction of functioning thyroid tissue as measured by serum Tg.
& Jong Jin Lee [email protected]; [email protected] Sungmin Jun [email protected] Seol Hoon Park [email protected] Tae Yong Kim [email protected] Won Bae Kim [email protected] Young Kee Shong [email protected] Jin-Sook Ryu [email protected] 1
Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
2
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea
3
Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
4
Department of Endocrinology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Materials and methods We retrospectively reviewed the medical records and 131I WBSs of 47 patients treated with 131 I therapy for distant metastasis from differentiated thyroid cancer (M:F = 15:32, median age 45 years, range 11–74 years). All patients received post-ablative 131I scans (PAWBS) at first 131I ablation after total thyroidectomy and post-therapy 131I scan (PTWBS) at second 131I therapy. The DHU intensities of the PAWBS and PTWBS were classified into 3 grades: 1, faint; 2, modest; and 3, intense. Serum thyroid-stimulating hormone-stimulated Tg (sTg) levels were measured at the time of each therapy and 1 year after the second 131I therapy. Results One year after the second 131I therapy, 10 patients (21.3 %) were in remission and 37 (78.7 %) had persistent disease. The DHU intensity on PAWBS correlated with the percentage sTg reduction at the next follow-up point (r = 0.466, p = 0.0016). The patients with intense DHU on PTWBS tended to have a higher percentage sTg reduction than the other patients, although statistical significances were marginal (Spearman’s rank correlation: r = 0.304, p = 0.054; Kruskal– Wallis test: p = 0.067). In univariate analysis, the DHU grades on PAWBS and the initial sTg levels were significantly different between patients in remission and those with persistent disease (PAWBS: p = 0.022; initial sTg: p = 0.0059). In multivariate logistic regression analysis, after adjusting for initial sTg levels, a DHU grade of 3 on PAWBS was an independen
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