Correlation between diffuse hepatic ¹³¹I uptake and functional status of ¹³¹I uptake in lung metastases during post-operative ablation therapy for papillary thyroid carcinom

doi:10.16150/j.1671-2870.2025.05.006

Abstract

Abstract:

Objective To investigate the auxiliary value of diffuse hepatic ¹³¹I uptake (DHU) levels on post-therapy whole-body scan (Rx-WBS) images in assessing metastatic tumor burden in patients with papillary thyroid cancer (PTC) accompanied by lung metastases who underwent total thyroidectomy followed by radioiodine remnant ablation (RRA) and subsequently received ¹³¹I therapy for non-resectable distant or regional metastases. Methods A total of 22 PTC patients with lung metastases scheduled for ¹³¹I metastatic ablation therapy were retrospectively enrolled from the Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, between June 2020 and February 2025. The patients met the following three criteria: (1) total thyroidectomy; (2) completion of ¹³¹I RRA; (3) multiple pulmonary nodules detected on ¹³¹I RRA-period whole-body scan or chest CT, with stimulated thyroglobulin (sTg) >10 ng/mL. Bivariate correlation and multiple linear regression models were used to analyze the correlations of target-to-background ratios (TBR) of liver (TBR_liver) and lung metastases (TBR_lung) for ¹³¹I uptake with clinical parameters including sTg, thyroglobulin antibody (TgAb), and administered ¹³¹I dose. Results TBR_liver showed a significant positive correlation with TBR_lung (r=0.510, P<0.05). No significant correlations were found between TBR_liver and sTg (r=0.218, P=0.331) or administered dose (r=0.334, P=0.128). Multiple linear regression analysis identified TBR_lung as an independent influencing factor of TBR_liver (β=0.511, 95% CI: 0.053-0.453, P<0.05). Conclusion In PTC patients with lung metastases after thyroidectomy and RRA, TBR_liver demonstrates a significant correlation with the functional status of ¹³¹I uptake in lung metastases. Particularly when ¹³¹I scanning shows negative pulmonary nodules, elevated TBR_liver may serve as an indicator of the presence of lung metastases.

Key words: Papillary thyroid cancer, Diffuse hepatic uptake, Lung metastasis, Post-therapy whole-body scan

CLC Number:

WANG Yang, WANG Chao, FU Fan, ZHANG Min, LI Biao, WANG Jin. Correlation between diffuse hepatic ¹³¹I uptake and functional status of ¹³¹I uptake in lung metastases during post-operative ablation therapy for papillary thyroid carcinom[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(05): 512-517.

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Indice	N=22
Gender[case（%）]
Male	3（13.6）
Female	19（86.4）
Age[year（mean±standard）]	36.45±15.193
TSH[μIU/mL，M（Q₁，Q₃）]	69.809（54.108，100.00）
sTg[μg/L，M（Q₁，Q₃）]	46.170（15.253，467.975）
Dose[mCi，M（Q₁，Q₃）]	163（150，179）
TBR_lung[M（Q₁，Q₃）]	2.000（1.554，6.920）
TBR_liver[M（Q₁，Q₃）]	3.567（2.705，5.451）
CLNM[case（%）]
Negative	14（63.6）
Positive	8（36.4）

Indice	r	P value
Gender	-0.031	0.890
Age	-0.078	0.729
TSH	0.118	0.602
sTg	0.218	0.331
Dose	0.334	0.128
TBR_lung	0.510	0.015
CLNM	0.052	0.818

Indice	B	Standard error	β value	t value	P value	95% CI
sTg	-0.002	0.002	-0.277	-1.333	0.198	-0.006~0.002
Dose	0.041	0.024	0.479	1.712	0.104	-0.009~0.091
TBR_lung	0.253	0.095	0.511	2.657	0.015	0.053~0.453

CT imaging features	Iodine uptake positive: 15 cases (68.2%)	Iodine uptake negative: 7 cases (31.8%)	Total cases: 22
Bilateral multiple nodules	4（26.7%）	4（57.1%）	8 （36.4%）
Solitary pulmonary nodule	3（20.0%）	1（14.3%）	4 （18.2%）
No definitive nodules in both lungs	8（53.3%）	2（28.6%）	10（45.4%）