18 F-FDG PET/CT Can Predict Development of Thyroiditis due to Immunotherapy for Lung Cancer
For patients undergoing immunotherapy with nivolumab for lung cancer, determine if increased F-FDG uptake in the thyroid gland predicts development of thyroiditis with subsequent hypothyroidism. Secondarily, determine if F-FDG uptake in the thyroid gland correlates with administered cycles of nivolu...
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| Published in: | Journal of nuclear medicine technology Vol. 46; no. 3; pp. 260 - 264 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
01-09-2018
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | For patients undergoing immunotherapy with nivolumab for lung cancer, determine if increased
F-FDG uptake in the thyroid gland predicts development of thyroiditis with subsequent hypothyroidism. Secondarily, determine if
F-FDG uptake in the thyroid gland correlates with administered cycles of nivolumab.
Retrospective chart review over 2 years found 18 lung cancer patients treated with nivolumab and with
F-FDG PET/CT scans pre- and during therapy. Standardized uptake value (SUV) mean and maximum and total lesion glycolysis (TLG) of the thyroid gland were measured. SUVs were also measured for the pituitary gland, liver and spleen. Patients obtained monthly thyroid testing. PET/CT parameters were analyzed by unpaired t-test for differences between two groups (patients who developed hypothyroidism and those who did not). Correlation between development of thyroiditis and number of cycles of nivolumab received was also tested.
Six of eighteen patients developed hypothyroidism. T-test comparing the two groups (patients who developed hypothyroidism and those who did not) demonstrated significant differences in SUVmean (
= 0.04), SUV
(
= 0.04) and TLG (
= 0.02) of the thyroid gland. Two of four patients who developed thyroiditis and had increased
F-FDG uptake in the thyroid gland, had normal TSH at time of follow-up
F-FDG PET/CT. Patients who developed thyroiditis with subsequent hypothyroidism stayed longer on therapy (10.6 cycles) compared to patients without thyroiditis (7.6 cycles), but the trend was not statistically significant. No significant difference in PET/CT parameters was observed for pituitary gland, liver or spleen.
F-FDG PET/CT can predict the development of thyroiditis with subsequent hypothyroidism before laboratory testing. Further study is required to confirm the positive trend between thyroiditis and duration of therapy. |
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| ISSN: | 0091-4916 1535-5675 |
| DOI: | 10.2967/jnmt.117.204933 |