Patterns of radioiodine uptake combined with pulmonary nodule size in predicting long-term clinical outcomes of differentiated thyroid carcinoma patients with lung metastasis alone

Objective(s): This study aimed to evaluate the role of radioiodine uptake patterns and pulmonary nodule size in predicting progression-free survival (PFS) and overall survival (OS) in DTC patients with lung metastases only.Methods: A retrospective study was conducted on ۱۸۹ DTC patients with pulmonary metastasis alone who were treated and monitored at the Department of Nuclear Medicine, Hospital ۱۰۸, Viet Nam from January ۲۰۰۴ to December ۲۰۱۸. They were categorized based on radioiodine uptake patterns on post-therapy whole-body scans (WBS) and CT-based pulmonary nodule sizes. Prognostic factors were identified by Kaplan-Meier survival and Cox regression.Results: The ۵-year and ۱۰-year OS rates were ۹۶.۸۳ % and ۹۴.۷۱ %. DTC-LM patients with diffuse radioiodine uptake and miliary metastases demonstrated significantly higher survival rates, with ۵-year and ۱۰-year PFS rates of ۱۰۰% and ۹۸.۸%, respectively. In contrast, patients with non-avid metastases exhibited a markedly lower prognosis, with ۵-year and ۱۰-year PFS rates of ۵۸.۸% and ۲۵.۲%, respectively (p<۰.۰۰۱). Patients with nodules <۵ mm had ۵-year and ۱۰-year PFS rates of ۸۸.۸% and ۷۳.۸%, respectively, while those with nodules ۵–۱۰ mm had rates of ۷۹.۸% and ۵۲.۷%. Patients with nodules ≥۱۰ mm experienced the worst outcomes, with ۵-year and ۱۰-year PFS rates of ۷۰.۶% and ۲۹.۳% (p<۰.۰۰۱). Multivariate analysis confirmed that non-avid metastases, nodule size ≥۱۰ mm, and age ≥۵۵ were independent predictors of poor prognosis (HR: ۲۴.۹۹, ۵.۹۶, and ۶.۵۸; p<۰.۰۰۱).Conclusions: Patterns of radioiodine uptake and pulmonary nodule sizes on CT imaging are crucial predictors of long-term clinical outcomes in DTC-LM. Diffuse iodine uptake and miliary pulmonary metastases are associated with favorable outcomes, while non-avid lung nodules and larger nodule sizes predict poorer survival.

کلیدواژه ها:

Differentiated Thyroid Carcinoma ، lung metastasis ، patterns of lung radioiodine uptake ، pulmonary nodule size ، Prognosis