Is there a role for PET/CT parameters to differentiate thyroid cartilage invasion from penetration?

Ayse Tuba Kendi, Amanda Corey, Kelly R. Magliocca, James R. Galt, Chao Zhang, Zhengjia Chen, Kristin Higgins, Jonathan J. Beitler, J. Trad Wadsworth, Mark W. El-Deiry, David M. Schuster, Nabil F. Saba, Patricia A. Hudgins

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Assessment of thyroid cartilage invasion (tumor extension through inner cortex) and thyroid cartilage penetration (tumor involving both the inner and outer cortices of thyroid cartilage) may be challenging with CT (Computed Tomography) and MR imaging (Magnetic Resonance Imaging). Positron Emission Tomography/Computed Tomography (PET/CT) is a non invasive imaging modality that provides both anatomic and metabolic information. Quantitative data obtained from PET/CT, also known as PET/CT parameters, include maximum, mean or peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized added metabolic activity (SAM) and normalized standardized added metabolic activity (NSAM). Our aim was to examine if FDG PET/CT parameters could differentiate thyroid cartilage invasion from penetration. Methods 50 patients who underwent PET/CT before laryngectomy for squamous cell carcinoma of the larynx, had SUVmax, SUVmean, SUVpeak, TLG, MTV, SAM and NSAM calculated on a dedicated workstation. Univariate and multivariate analysis was performed. ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven thyroid cartilage invasion or penetration. Results Of the 50 patients, 50% (25/50 patients) had history of prior radiation therapy. Among the previously irradiated group, 24% had thyroid cartilage invasion and penetration. 8% of the patients in this group had thyroid cartilage invasion only. Among the non-irradiated group, 76% had thyroid cartilage invasion and penetration, 8% had thyroid cartilage invasion without penetration. ROC analysis revealed that none of the PET/CT parameters had enough power to predict thyroid cartilage penetration, but TLG, MTV and SAM had enough power to predict thyroid cartilage invasion in non-irradiated patients. TLG, MTV, SAM and NSAM had enough power to predict thyroid cartilage invasion and penetration in irradiated group. Conclusion TLG, MTV and SAM have enough power to predict thyroid cartilage invasion and penetration in irradiated patients. PET/CT parameters do not have enough potential to differentiate thyroid cartilage invasion from penetration.

Original languageEnglish (US)
Pages (from-to)319-323
Number of pages5
JournalEuropean Journal of Radiology
Volume85
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

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Thyroid Cartilage
Glycolysis
Tumor Burden
Positron Emission Tomography Computed Tomography
ROC Curve
Magnetic Resonance Imaging
Laryngectomy
Larynx

Keywords

  • Head and neck squamous cell carcinoma
  • Larynx
  • Positron emission tomography
  • Thyroid cartilage

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Is there a role for PET/CT parameters to differentiate thyroid cartilage invasion from penetration? / Tuba Kendi, Ayse; Corey, Amanda; Magliocca, Kelly R.; Galt, James R.; Zhang, Chao; Chen, Zhengjia; Higgins, Kristin; Beitler, Jonathan J.; Wadsworth, J. Trad; El-Deiry, Mark W.; Schuster, David M.; Saba, Nabil F.; Hudgins, Patricia A.

In: European Journal of Radiology, Vol. 85, No. 2, 01.02.2016, p. 319-323.

Research output: Contribution to journalArticle

Tuba Kendi, A, Corey, A, Magliocca, KR, Galt, JR, Zhang, C, Chen, Z, Higgins, K, Beitler, JJ, Wadsworth, JT, El-Deiry, MW, Schuster, DM, Saba, NF & Hudgins, PA 2016, 'Is there a role for PET/CT parameters to differentiate thyroid cartilage invasion from penetration?', European Journal of Radiology, vol. 85, no. 2, pp. 319-323. https://doi.org/10.1016/j.ejrad.2015.11.039
Tuba Kendi, Ayse ; Corey, Amanda ; Magliocca, Kelly R. ; Galt, James R. ; Zhang, Chao ; Chen, Zhengjia ; Higgins, Kristin ; Beitler, Jonathan J. ; Wadsworth, J. Trad ; El-Deiry, Mark W. ; Schuster, David M. ; Saba, Nabil F. ; Hudgins, Patricia A. / Is there a role for PET/CT parameters to differentiate thyroid cartilage invasion from penetration?. In: European Journal of Radiology. 2016 ; Vol. 85, No. 2. pp. 319-323.
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abstract = "Background Assessment of thyroid cartilage invasion (tumor extension through inner cortex) and thyroid cartilage penetration (tumor involving both the inner and outer cortices of thyroid cartilage) may be challenging with CT (Computed Tomography) and MR imaging (Magnetic Resonance Imaging). Positron Emission Tomography/Computed Tomography (PET/CT) is a non invasive imaging modality that provides both anatomic and metabolic information. Quantitative data obtained from PET/CT, also known as PET/CT parameters, include maximum, mean or peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized added metabolic activity (SAM) and normalized standardized added metabolic activity (NSAM). Our aim was to examine if FDG PET/CT parameters could differentiate thyroid cartilage invasion from penetration. Methods 50 patients who underwent PET/CT before laryngectomy for squamous cell carcinoma of the larynx, had SUVmax, SUVmean, SUVpeak, TLG, MTV, SAM and NSAM calculated on a dedicated workstation. Univariate and multivariate analysis was performed. ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven thyroid cartilage invasion or penetration. Results Of the 50 patients, 50{\%} (25/50 patients) had history of prior radiation therapy. Among the previously irradiated group, 24{\%} had thyroid cartilage invasion and penetration. 8{\%} of the patients in this group had thyroid cartilage invasion only. Among the non-irradiated group, 76{\%} had thyroid cartilage invasion and penetration, 8{\%} had thyroid cartilage invasion without penetration. ROC analysis revealed that none of the PET/CT parameters had enough power to predict thyroid cartilage penetration, but TLG, MTV and SAM had enough power to predict thyroid cartilage invasion in non-irradiated patients. TLG, MTV, SAM and NSAM had enough power to predict thyroid cartilage invasion and penetration in irradiated group. Conclusion TLG, MTV and SAM have enough power to predict thyroid cartilage invasion and penetration in irradiated patients. PET/CT parameters do not have enough potential to differentiate thyroid cartilage invasion from penetration.",
keywords = "Head and neck squamous cell carcinoma, Larynx, Positron emission tomography, Thyroid cartilage",
author = "{Tuba Kendi}, Ayse and Amanda Corey and Magliocca, {Kelly R.} and Galt, {James R.} and Chao Zhang and Zhengjia Chen and Kristin Higgins and Beitler, {Jonathan J.} and Wadsworth, {J. Trad} and El-Deiry, {Mark W.} and Schuster, {David M.} and Saba, {Nabil F.} and Hudgins, {Patricia A.}",
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AU - Tuba Kendi, Ayse

AU - Corey, Amanda

AU - Magliocca, Kelly R.

AU - Galt, James R.

AU - Zhang, Chao

AU - Chen, Zhengjia

AU - Higgins, Kristin

AU - Beitler, Jonathan J.

AU - Wadsworth, J. Trad

AU - El-Deiry, Mark W.

AU - Schuster, David M.

AU - Saba, Nabil F.

AU - Hudgins, Patricia A.

PY - 2016/2/1

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N2 - Background Assessment of thyroid cartilage invasion (tumor extension through inner cortex) and thyroid cartilage penetration (tumor involving both the inner and outer cortices of thyroid cartilage) may be challenging with CT (Computed Tomography) and MR imaging (Magnetic Resonance Imaging). Positron Emission Tomography/Computed Tomography (PET/CT) is a non invasive imaging modality that provides both anatomic and metabolic information. Quantitative data obtained from PET/CT, also known as PET/CT parameters, include maximum, mean or peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized added metabolic activity (SAM) and normalized standardized added metabolic activity (NSAM). Our aim was to examine if FDG PET/CT parameters could differentiate thyroid cartilage invasion from penetration. Methods 50 patients who underwent PET/CT before laryngectomy for squamous cell carcinoma of the larynx, had SUVmax, SUVmean, SUVpeak, TLG, MTV, SAM and NSAM calculated on a dedicated workstation. Univariate and multivariate analysis was performed. ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven thyroid cartilage invasion or penetration. Results Of the 50 patients, 50% (25/50 patients) had history of prior radiation therapy. Among the previously irradiated group, 24% had thyroid cartilage invasion and penetration. 8% of the patients in this group had thyroid cartilage invasion only. Among the non-irradiated group, 76% had thyroid cartilage invasion and penetration, 8% had thyroid cartilage invasion without penetration. ROC analysis revealed that none of the PET/CT parameters had enough power to predict thyroid cartilage penetration, but TLG, MTV and SAM had enough power to predict thyroid cartilage invasion in non-irradiated patients. TLG, MTV, SAM and NSAM had enough power to predict thyroid cartilage invasion and penetration in irradiated group. Conclusion TLG, MTV and SAM have enough power to predict thyroid cartilage invasion and penetration in irradiated patients. PET/CT parameters do not have enough potential to differentiate thyroid cartilage invasion from penetration.

AB - Background Assessment of thyroid cartilage invasion (tumor extension through inner cortex) and thyroid cartilage penetration (tumor involving both the inner and outer cortices of thyroid cartilage) may be challenging with CT (Computed Tomography) and MR imaging (Magnetic Resonance Imaging). Positron Emission Tomography/Computed Tomography (PET/CT) is a non invasive imaging modality that provides both anatomic and metabolic information. Quantitative data obtained from PET/CT, also known as PET/CT parameters, include maximum, mean or peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized added metabolic activity (SAM) and normalized standardized added metabolic activity (NSAM). Our aim was to examine if FDG PET/CT parameters could differentiate thyroid cartilage invasion from penetration. Methods 50 patients who underwent PET/CT before laryngectomy for squamous cell carcinoma of the larynx, had SUVmax, SUVmean, SUVpeak, TLG, MTV, SAM and NSAM calculated on a dedicated workstation. Univariate and multivariate analysis was performed. ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven thyroid cartilage invasion or penetration. Results Of the 50 patients, 50% (25/50 patients) had history of prior radiation therapy. Among the previously irradiated group, 24% had thyroid cartilage invasion and penetration. 8% of the patients in this group had thyroid cartilage invasion only. Among the non-irradiated group, 76% had thyroid cartilage invasion and penetration, 8% had thyroid cartilage invasion without penetration. ROC analysis revealed that none of the PET/CT parameters had enough power to predict thyroid cartilage penetration, but TLG, MTV and SAM had enough power to predict thyroid cartilage invasion in non-irradiated patients. TLG, MTV, SAM and NSAM had enough power to predict thyroid cartilage invasion and penetration in irradiated group. Conclusion TLG, MTV and SAM have enough power to predict thyroid cartilage invasion and penetration in irradiated patients. PET/CT parameters do not have enough potential to differentiate thyroid cartilage invasion from penetration.

KW - Head and neck squamous cell carcinoma

KW - Larynx

KW - Positron emission tomography

KW - Thyroid cartilage

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