Impact of patient age on the iodine/FDG “flip-flop” phenomenon in lung metastasis from thyroid cancer

Objectives Radioiodine therapy is an effective treatment for lung metastasis from thyroid cancer. However, cases of lung metastasis without iodine uptake are often encountered. In such cases, FDG accumulation in lung lesions is often observed. There is a reverse relationship between iodine and FDG a...

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Bibliographic Details
Published in:Annals of nuclear medicine 2016-10, Vol.30 (8), p.518-524
Main Authors: Isoda, Takuro, BaBa, Shingo, Maruoka, Yasuhiro, Kitamura, Yoshiyuki, Tahara, Keiichiro, Sasaki, Masayuki, Honda, Hiroshi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Biological Transport
Female
Fluorodeoxyglucose F18 - metabolism
Humans
Imaging
Iodine Radioisotopes - metabolism
Iodine Radioisotopes - therapeutic use
Lung Neoplasms - secondary
Male
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
Original Article
Positron-Emission Tomography
Radiology
Retrospective Studies
Thyroid Neoplasms - diagnostic imaging
Thyroid Neoplasms - metabolism
Thyroid Neoplasms - pathology
Thyroid Neoplasms - radiotherapy
Young Adult
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Summary:Objectives Radioiodine therapy is an effective treatment for lung metastasis from thyroid cancer. However, cases of lung metastasis without iodine uptake are often encountered. In such cases, FDG accumulation in lung lesions is often observed. There is a reverse relationship between iodine and FDG accumulation in thyroid cancer lesions, the so-called “flip-flop” phenomenon. The aim of this study was to assess the relationship between patient age and the occurrence of the flip-flop phenomenon. Methods Eighty-six patients who underwent radioiodine therapy for lung metastasis were studied retrospectively (age 17–73 years; median 60 years; males:females 22:64). We compared the clinical data and imaging findings (size and FDG uptake of lung nodules) between patients with ( n  = 44) and without ( n  = 42) iodine uptake in lung metastasis. Results Significantly more young patients showed iodine accumulation in lung metastasis than old patients ( p  = 0.0025). Lung metastases with larger size or greater FDG uptake showed no iodine uptake more frequently with significant difference ( p  = 0.015 and
ISSN:0914-7187
1864-6433
DOI:10.1007/s12149-016-1104-9