Early prediction of treatment outcome for lenvatinib using 18F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study

EJNMMI Research

Original Research

Kenji Hirata¹  Satoshi Takeuchi²  Takurou Noguchi²  Hirotoshi Dosaka-Akita²  Yoshihito Ohhara²  Yasushi Shimizu²  Shin Ariga²  Tomohiro Goda²  Jun Taguchi²  Rika Moku²  Akihiko Shiiya²  Ichiro Kinoshita²  Yasushi Tsuji³  Rio Honma³  Shiro Watanabe⁴  Akihiro Homma⁵  Keiichi Magota⁶ 

[1] Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Sapporo, Japan;Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan;Department of Medical Oncology, Tonan Hospital, Sapporo, Japan;Department of Nuclear Medicine, Hokkaido University Hospital, Sapporo, Japan;Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan;Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo, Japan;

关键词: Lenvatinib;    Early prediction;    Treatment outcome;    F-FDG PET/CT;    Differentiated thyroid carcinoma;   

DOI  :  10.1186/s13550-023-01019-9

 received in 2023-05-15, accepted in 2023-07-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLenvatinib is widely used to treat unresectable and advanced thyroid carcinomas. We aimed to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) performed 1 week after lenvatinib treatment initiation could predict treatment outcomes.ResultsThis was a prospective, nonrandomised, multicentre study. Patients with pathologically confirmed differentiated thyroid carcinoma (DTC) and lesions refractory to radioiodine treatment were eligible for inclusion. Patients were treated with 24 mg lenvatinib as the initial dose and underwent PET/CT examination 1 week after treatment initiation. Contrast-enhanced CT was scheduled at least 4 weeks later as the gold standard for evaluation. The primary endpoint was to evaluate the discrimination power of maximum standardised uptake value (SUVmax) obtained by PET/CT compared to that obtained by contrast-enhanced CT. Evaluation was performed using the area under the receiver operating characteristic (ROC-AUC) curve. Twenty-one patients were included in this analysis. Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.714 for SUVmax after 1 week of lenvatinib treatment. The best cut-off value for the treatment response for SUVmax was 15.211. The sensitivity and specificity of this cut-off value were 0.583 and 0.857, respectively. The median progression-free survival was 26.3 months in patients with an under-cut-off value and 19.7 months in patients with an over-cut-off value (P = 0.078).ConclusionsThe therapeutic effects of lenvatinib were detected earlier than those of CT because of decreased FDG uptake on PET/CT. PET/CT examination 1 week after the initiation of lenvatinib treatment may predict treatment outcomes in patients with DTC.Trial registration: This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (number UMIN000022592) on 6 June, 2016.

【 授权许可】

CC BY   
© The Author(s) 2023

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