Research ArticleImaging

18F-FDG PET/CT Can Predict Development of Thyroiditis Due to Immunotherapy for Lung Cancer

Naghmehossadat Eshghi, Linda L. Garland, Emily Nia, Robert Betancourt, Elizabeth Krupinski and Phillip H. Kuo
Journal of Nuclear Medicine Technology September 2018, 46 (3) 260-264; DOI: https://doi.org/10.2967/jnmt.117.204933

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Flow chart showing distribution of patients by development of thyroiditis, 18F-FDG uptake in thyroid gland, and value of TSH at time of PET/CT.

  • FIGURE 2.
    FIGURE 2.

    Patient with increased 18F-FDG uptake in thyroid gland during nivolumab therapy. (A) Coronal CT (top) and 18F-FDG PET (left) images before therapy show normal uptake in thyroid gland, with SUVmax of 1.7. (B) Coronal CT (top) and 18F-FDG PET (bottom) images during therapy show increased thyroid uptake, with SUVmax of 4.3. Region of thyroid gland is encircled.

  • FIGURE 3.
    FIGURE 3.

    Patient with normal 18F-FDG uptake in thyroid gland during nivolumab therapy. (A) Coronal CT (top) and 18F-FDG PET (left) images before therapy show normal uptake in thyroid gland, with SUVmax of 2.2. (B) Coronal CT (top) and 18F-FDG PET (bottom) images during therapy show stable, normal thyroid uptake, with SUVmax of 1.8. Region of thyroid gland is encircled.

Tables

  • TABLE 1

    Overview of Patient Characteristics

    CharacteristicTotal (n = 18)Thyroid irAE (n = 6)No thyroid irAE (n = 12)
    Age (y)
     Mean696572
     Range31–8631–7951–86
    Sex (n)
     Female11 (61%)5 (83%)6 (50%)
     Male7 (39%)1 (17%)6 (50%)
    Therapy cycles (n)
     Mean8.610.67.6
     Range3–206–203–15
  • TABLE 2

    18F-FDG Uptake in Thyroid Gland in Patients Who Developed Thyroiditis

    Before therapyDuring therapyDifference
    Patient no.SUVmeanSUVmaxTLGSUVmeanSUVmaxTLGSUVmeanSUVmaxTLG
    11.51.50.73.34.13.51.82.62.8
    21.72.11.53.74.52.922.41.4
    31.31.70.93.54.32.32.22.61.4
    40.91.10.71.92.41.611.30.9
    52.42.81.91.61.81.6−0.8−1−0.3
    622.20.21.61.80.3−0.4−0.40.1
  • TABLE 3

    Comparison of Thyroid 18F-FDG Uptake During Therapy Between Groups That Did and Did Not Develop Thyroiditis

    ParameterThyroid irAE (n = 6)No thyroid irAE (n = 12)Difference
    SUVmean2.41 (1.04)1.64 (0.44)0.77 (P = 0.04)
    SUVmax2.96 (1.28)2.00 (0.5)0.96 (P = 0.04)
    TLG1.96 (1.05)1.00 (0.47)0.96 (P = 0.02)

    • Data are mean followed by SD in parentheses.

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