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Development and validation of a prediction model based on the organ-based metabolic tumor volume on FDG-PET in patients with differentiated thyroid carcinoma

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Ann Nucl Med 35(11) 1223–1231.pdf956.31 kBPDFView/Open
Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/87316

Title: Development and validation of a prediction model based on the organ-based metabolic tumor volume on FDG-PET in patients with differentiated thyroid carcinoma
Authors: Uchiyama, Yuko Browse this author
Hirata, Kenji Browse this author →KAKEN DB
Watanabe, Shiro Browse this author
Okamoto, Shozo Browse this author
Shiga, Tohru Browse this author
Okada, Kazufumi Browse this author
Ito, Yoichi M. Browse this author
Kudo, Kohsuke Browse this author →KAKEN DB
Keywords: Differentiated thyroid carcinoma
Metabolic tumor volume
Organ-based measurement
FDG-PET
Issue Date: 1-Nov-2021
Publisher: Springer
Journal Title: Annals of nuclear medicine
Volume: 35
Issue: 11
Start Page: 1223
End Page: 1231
Publisher DOI: 10.1007/s12149-021-01664-x
Abstract: Background Although patients with differentiated thyroid cancer (DTC) generally have a good prognosis, patients with a large metabolic tumor volume (MTV) on FDG-PET may experience poor clinical courses. We measured organ-based MTVs and tested its prognostic performance in comparison to conventional MTV (cMTV). Methods We retrospectively analyzed the cases of 280 patients who received their first I-131 therapy in 2003-2014 at our hospital and showed an FDG-avid metastatic lesion. We randomly divided the patients into training (n = 190) and validation (n = 90) datasets. We classified the MTVs as MTVneck-node, MTVdistant-node, MTVlung, MTVbone, and MTVother-organs and tested with/without dichotomization vis-a-vis overall survival (OS). Based on the estimated weighting coefficients of the organ-based MTVs, we propose a new index: the adjusted whole-body MTV (aMTV). Using the validation dataset, we compared the aMTV with cMTV for predicting OS. Results In a univariate analysis, MTVdistant-node and MTVother-organs were more strongly correlated with the OS than the dichotomized forms, whereas the dichotomized forms of MTVneck-node, MTVlung, and MTVbone were more strongly correlated with OS than the continuous variables. The aMTV was thus expressed as 0.69 x dic(MTVneck-node) + 0.02 x MTVdistant-node + 1.05 x dic(MTVlung) + 1.58 x dic(MTVbone) + 0.01 x MTVother-organs, where dic(x) represents 0 or 1 based on the optimized cut-off. In the model evaluation using the validation group, aMTV was a significant predictor of OS with a higher c-index (0.7676) than cMTV (0.7218). Conclusion In DTC patients with FDG-avid metastasis before I-131 therapy, all organ-based MTVs were significant predictors of prognosis. As the aMTV outperformed the cMTV for predicting prognoses, we recommend measuring the MTV on an organ basis.
Rights: This is a post-peer-review, pre-copyedit version of an article published in Annals of nuclear medicine. The final authenticated version is available online at: http://dx.doi.org/10.1007/s12149-021-01664-x.
Type: article (author version)
URI: http://hdl.handle.net/2115/87316
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 平田 健司

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