Skip to main content
Top
Published in: European Radiology 2/2010

01-02-2010 | Nuclear Medicine

Can calcification predict 131I accumulation on metastatic lymph nodes in papillary thyroid carcinoma patients receiving 131I therapy? Comparison of CT, 131I WBS and 18F-FDG PET/CT

Authors: Koichiro Kaneko, Koichiro Abe, Shingo Baba, Yoshitaka Tanabe, Hidetake Yabuuchi, Masamitsu Hatakenaka, Masayuki Sasaki, Hiroshi Honda

Published in: European Radiology | Issue 2/2010

Login to get access

Abstract

Objective

The aim of this study was to clarify the predictive significance of nodal calcification in terms of the therapeutic option of 131I therapy in papillary thyroid carcinoma (PTC) patients.

Methods

We reviewed 19 computed tomography (CT) examinations of PTC patients on receiving 131I therapy for the presence of nodal calcification, and compared the 131I whole-body scintigraphy and 18F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT findings. The metastatic lymph nodes (mLNs) were divided into three groups: A, those with calcification; B, those without calcification but belonging to patients who had calcified mLNs; C, those without calcification and belonging to patients who had no calcified mLNs. The incidences of 131I accumulation and maximum standardised uptake values (SUV max) in the three groups were compared.

Results

A total of 70 mLNs were evaluated. Twelve mLNs belonged to group A, 13 to group B and 45 to group C. The incidences of 131I accumulation were significantly higher in groups A (100%) and B (100%) than in group C (11.1%) (p < 0.0001 for both). The SUVmax was significantly lower in groups A (4.1 ± 1.9) and B (3.9 ± 1.4) than in group C (7.1 ± 4.4) (p = 0.01, p = 0.002, respectively).

Conclusions

Our results indicated that calcification in mLNs related to the ability of 131I accumulation and less dedifferentiation.
Literature
1.
go back to reference Lam AK, Lo CY, Lam KS (2005) Papillary carcinoma of thyroid: a 30-yr clinicopathological review of the histological variants. Endocr Pathol 16:323–330CrossRefPubMed Lam AK, Lo CY, Lam KS (2005) Papillary carcinoma of thyroid: a 30-yr clinicopathological review of the histological variants. Endocr Pathol 16:323–330CrossRefPubMed
2.
go back to reference Wang N, Xu Y, Ge C et al (2006) Association of sonographically detected calcification with thyroid carcinoma. Head Neck 28:1077–1083CrossRefPubMed Wang N, Xu Y, Ge C et al (2006) Association of sonographically detected calcification with thyroid carcinoma. Head Neck 28:1077–1083CrossRefPubMed
3.
go back to reference Hoang JK, Lee WK, Lee M et al (2007) US Features of thyroid malignancy: pearls and pitfalls. Radiographics 27:847–860CrossRefPubMed Hoang JK, Lee WK, Lee M et al (2007) US Features of thyroid malignancy: pearls and pitfalls. Radiographics 27:847–860CrossRefPubMed
4.
go back to reference Fish SA, Langer JE, Mandel SJ (2008) Sonographic imaging of thyroid nodules and cervical lymph nodes. Endocrinol Metab Clin N Am 37:401–417CrossRef Fish SA, Langer JE, Mandel SJ (2008) Sonographic imaging of thyroid nodules and cervical lymph nodes. Endocrinol Metab Clin N Am 37:401–417CrossRef
5.
go back to reference Shetty SK, Maher MM, Hahn PF et al (2006) Significance of incidental thyroid lesions detected on CT: correlation among CT, sonography, and pathology. AJR Am J Roentgenol 187:1349–1356CrossRefPubMed Shetty SK, Maher MM, Hahn PF et al (2006) Significance of incidental thyroid lesions detected on CT: correlation among CT, sonography, and pathology. AJR Am J Roentgenol 187:1349–1356CrossRefPubMed
6.
go back to reference Chan JK (1990) Papillary carcinoma of thyroid: classical and variants. Histol Histopathol 5:241–257PubMed Chan JK (1990) Papillary carcinoma of thyroid: classical and variants. Histol Histopathol 5:241–257PubMed
7.
go back to reference Machens A, Hinze R, Thomusch O et al (2002) Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg 26:22–28CrossRefPubMed Machens A, Hinze R, Thomusch O et al (2002) Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg 26:22–28CrossRefPubMed
8.
go back to reference Mirallié E, Sagan C, Hamy A et al (1999) Predictive factors for node involvement in papillary thyroid carcinoma. Univariate and multivariate analyses. Eur J Cancer 35:420–423CrossRefPubMed Mirallié E, Sagan C, Hamy A et al (1999) Predictive factors for node involvement in papillary thyroid carcinoma. Univariate and multivariate analyses. Eur J Cancer 35:420–423CrossRefPubMed
9.
go back to reference Wada N, Duh QY, Sugino K et al (2003) Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg 237:399–407CrossRefPubMed Wada N, Duh QY, Sugino K et al (2003) Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg 237:399–407CrossRefPubMed
10.
go back to reference Mittendorf EA, Wang X, Perrier ND et al (2007) Follow up of patients with papillary thyroid cancer: in search of the optimal algorithm. J Am Coll Surg 205:239–247CrossRefPubMed Mittendorf EA, Wang X, Perrier ND et al (2007) Follow up of patients with papillary thyroid cancer: in search of the optimal algorithm. J Am Coll Surg 205:239–247CrossRefPubMed
11.
go back to reference Ahuja AT, Chow L, Chick W et al (1995) Metastatic cervical nodes in papillary carcinoma of the thyroid: ultrasound and histological correlation. Clin Radiol 50:229–231CrossRefPubMed Ahuja AT, Chow L, Chick W et al (1995) Metastatic cervical nodes in papillary carcinoma of the thyroid: ultrasound and histological correlation. Clin Radiol 50:229–231CrossRefPubMed
12.
go back to reference Rosário PW, de Faria S, Bicalho L et al (2005) Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma. J Ultrasound Med 24:1385–1389PubMed Rosário PW, de Faria S, Bicalho L et al (2005) Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma. J Ultrasound Med 24:1385–1389PubMed
13.
go back to reference Langer JE, Mandel SJ (2008) Sonographic imaging of cervical lymph nodes in patients with thyroid cancer. Neuroimaging Clin N Am 18:479–489CrossRefPubMed Langer JE, Mandel SJ (2008) Sonographic imaging of cervical lymph nodes in patients with thyroid cancer. Neuroimaging Clin N Am 18:479–489CrossRefPubMed
14.
go back to reference Som PM, Brandwein M, Lidov M et al (1994) The varied presentations of papillary thyroid carcinoma cervical nodal disease: CT and MR findings. Am J Neuroradiol 15:1123–1128PubMed Som PM, Brandwein M, Lidov M et al (1994) The varied presentations of papillary thyroid carcinoma cervical nodal disease: CT and MR findings. Am J Neuroradiol 15:1123–1128PubMed
15.
go back to reference Pacini F, Cetani F, Miccoli P et al (1994) Outcome of 309 patients with metastatic differentiated thyroid carcinoma treated with radioiodine. World J Surg 18:600–604CrossRefPubMed Pacini F, Cetani F, Miccoli P et al (1994) Outcome of 309 patients with metastatic differentiated thyroid carcinoma treated with radioiodine. World J Surg 18:600–604CrossRefPubMed
16.
go back to reference Woodrum DT, Gauger PG (2005) Role of 131I in the treatment of well differentiated thyroid cancer. J Surg Oncol 89:114–121CrossRefPubMed Woodrum DT, Gauger PG (2005) Role of 131I in the treatment of well differentiated thyroid cancer. J Surg Oncol 89:114–121CrossRefPubMed
17.
go back to reference Feine U, Lietzenmayer R, Hanke JP et al (1996) Fluorine-18-FDG and iodine-131-iodide uptake in thyroid cancer. J Nucl Med 37:1468–1472PubMed Feine U, Lietzenmayer R, Hanke JP et al (1996) Fluorine-18-FDG and iodine-131-iodide uptake in thyroid cancer. J Nucl Med 37:1468–1472PubMed
18.
go back to reference Wang W, Macapinlac H, Larson SM et al (1999) [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography localizes residual thyroid cancer in patients with negative diagnostic (131)I whole body scans and elevated serum thyroglobulin levels. J Clin Endocrinol Metab 84:2291–2302CrossRefPubMed Wang W, Macapinlac H, Larson SM et al (1999) [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography localizes residual thyroid cancer in patients with negative diagnostic (131)I whole body scans and elevated serum thyroglobulin levels. J Clin Endocrinol Metab 84:2291–2302CrossRefPubMed
19.
go back to reference Wang W, Larson SM, Tuttle RM et al (2001) Resistance of [18F]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive iodine. Thyroid 11:1169–1175CrossRefPubMed Wang W, Larson SM, Tuttle RM et al (2001) Resistance of [18F]-fluorodeoxyglucose-avid metastatic thyroid cancer lesions to treatment with high-dose radioactive iodine. Thyroid 11:1169–1175CrossRefPubMed
20.
go back to reference van den Brekel MW, Stel HV, Castelijns JA et al (1990) Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 177:379–384PubMed van den Brekel MW, Stel HV, Castelijns JA et al (1990) Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 177:379–384PubMed
21.
go back to reference Khoo ML, Asa SL, Witterick IJ et al (2002) Thyroid calcification and its association with thyroid carcinoma. Head Neck 24:651–655CrossRefPubMed Khoo ML, Asa SL, Witterick IJ et al (2002) Thyroid calcification and its association with thyroid carcinoma. Head Neck 24:651–655CrossRefPubMed
22.
go back to reference Merino MJ, Middleton LP (2001) Pathology of thyroid. In: Pilch BZ (ed) Head and neck surgical pathology. Lippincott and Williams & Wilkins, Philadelphia, pp 358–363 Merino MJ, Middleton LP (2001) Pathology of thyroid. In: Pilch BZ (ed) Head and neck surgical pathology. Lippincott and Williams & Wilkins, Philadelphia, pp 358–363
23.
go back to reference Ellison E, Lapuerta P, Martin SE (1998) Psammoma bodies in fine-needle aspirates of the thyroid: predictive value for papillary carcinoma. Cancer 84:169–175CrossRefPubMed Ellison E, Lapuerta P, Martin SE (1998) Psammoma bodies in fine-needle aspirates of the thyroid: predictive value for papillary carcinoma. Cancer 84:169–175CrossRefPubMed
24.
go back to reference Eisenkraft BL, Som PM (1999) The spectrum of benign and malignant etiologies of cervical node calcification. AJR Am J Roentgenol 172:1433–1437PubMed Eisenkraft BL, Som PM (1999) The spectrum of benign and malignant etiologies of cervical node calcification. AJR Am J Roentgenol 172:1433–1437PubMed
25.
go back to reference Shammas A, Degirmenci B, Mountz JM et al (2007) 18F-FDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer. J Nucl Med 48:221–226PubMed Shammas A, Degirmenci B, Mountz JM et al (2007) 18F-FDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer. J Nucl Med 48:221–226PubMed
26.
go back to reference Moog F, Linke R, Manthey N et al (2000) Influence of thyroid-stimulating hormone levels on uptake of FDG in recurrent and metastatic differentiated thyroid carcinoma. J Nucl Med 41:1989–1995PubMed Moog F, Linke R, Manthey N et al (2000) Influence of thyroid-stimulating hormone levels on uptake of FDG in recurrent and metastatic differentiated thyroid carcinoma. J Nucl Med 41:1989–1995PubMed
27.
go back to reference Chin BB, Patel P, Cohade C et al (2004) Recombinant human thyrotropin stimulation of fluoro-D-glucose positron emission tomography uptake in well-differentiated thyroid carcinoma. J Clin Endocrinol Metab 89:91–95CrossRefPubMed Chin BB, Patel P, Cohade C et al (2004) Recombinant human thyrotropin stimulation of fluoro-D-glucose positron emission tomography uptake in well-differentiated thyroid carcinoma. J Clin Endocrinol Metab 89:91–95CrossRefPubMed
28.
go back to reference Ma C, Kuang A, Xie J, Ma T (2005) Possible explanations for patients with discordant findings of serum thyroglobulin and 131I whole-body scanning. J Nucl Med 46:1473–1480PubMed Ma C, Kuang A, Xie J, Ma T (2005) Possible explanations for patients with discordant findings of serum thyroglobulin and 131I whole-body scanning. J Nucl Med 46:1473–1480PubMed
29.
go back to reference Wang W, Larson SM, Fazzari M et al (2000) Prognostic value of [18F] fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab 85:1107–1113CrossRefPubMed Wang W, Larson SM, Fazzari M et al (2000) Prognostic value of [18F] fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab 85:1107–1113CrossRefPubMed
30.
go back to reference Schoder H, Yeung HW (2004) Positron emission imaging of head and neck cancer, including thyroid carcinoma. Semin Nucl Med 34:180–197CrossRefPubMed Schoder H, Yeung HW (2004) Positron emission imaging of head and neck cancer, including thyroid carcinoma. Semin Nucl Med 34:180–197CrossRefPubMed
Metadata
Title
Can calcification predict 131I accumulation on metastatic lymph nodes in papillary thyroid carcinoma patients receiving 131I therapy? Comparison of CT, 131I WBS and 18F-FDG PET/CT
Authors
Koichiro Kaneko
Koichiro Abe
Shingo Baba
Yoshitaka Tanabe
Hidetake Yabuuchi
Masamitsu Hatakenaka
Masayuki Sasaki
Hiroshi Honda
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 2/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1557-5

Other articles of this Issue 2/2010

European Radiology 2/2010 Go to the issue