Correlation between F18-FDG PET/CT Imaging and BRAF V600E Genetic Mutation for the Early Assessment of Treatment Response in Papillary Thyroid Cancers.

Andra Piciu,Maria-Iulia Larg,Doina Piciu

doi:10.3390/jpm10020052

Abstract

In thyroid neoplastic pathology, the BRAF V600E mutation is shown to be involved in the oncogenesis of papillary thyroid cancer and its subtypes. The purpose of this study is to evaluate the correlation between the mutation of the BRAF V600E oncogene and the pathological standardized uptake values (SUV) at the F18-fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (PET/CT) evaluation, for a group of 20 patients with radically treated (total thyroidectomy and radioiodine therapy) papillary thyroid cancer, with subclinical persistent disease, at 6 months after the initial treatment. We analyzed the correlations between the values of SUV and the presence of the BRAF mutation as well with other prognostic factors such as stage, age, specific tumor markers (thyroglobulin and anti-thyroglobulin), extrathyroid extension, the presence of metastatic lymph nodes or distant metastasis. The value of SUV in the case of BRAF+ (positive) patients was higher than in the negative ones, but without statistical significance, thus, the values of the SUV cannot be a predictable factor for the presence of the genetic mutation. There was a statistically significant correlation in BRAF+ subgroup between the SUV values and the positive resection limit following surgery, showing a higher SUV value in the PET/CT evaluation. No correlation was observed between the aforementioned prognostic factors involved in papillary thyroid cancer and the BRAF V600E mutation.

Highlights

The BRAF mutation is associated with the oncogenesis of several tumors as well as colon cancer, melanoma and thyroid cancer [1]
The purpose of this study is to evaluate the correlation between the mutation of the BRAF V600E oncogene and the pathological standardized uptake values (SUV) at the positron emission tomography/computed tomography (PET/CT) evaluation, for a group of patients with papillary thyroid cancer with persistent subclinical disease at 6 months after the initial radical treatment, consisting of surgery and radioiodine (I-131)
The value of SUVlbm Max for BRAF+ patients was higher, but without a statistically significant difference the value of the SUV cannot be a predictable factor for the presence of the genetic mutation

Summary

Introduction

The BRAF mutation is associated with the oncogenesis of several tumors as well as colon cancer, melanoma and thyroid cancer [1]. The presence of the mutation is associated with aggressive forms of the disease, the presence of an unfavorable prognostic factor and in some cases with the loss of avidity of tumor for the I-131 treatment [3,4]. Taking into account this scenario, the treatment option might be changed. In order to identify the cases with a high degree of aggressiveness and tumor de-differentiation, the correlation between gene mutation and the increased rate of carbohydrate metabolism assessed by positron emission tomography/computed tomography (PET/CT) hybrid imaging using F18-fluorodoxyglucose (F18-FDG) as a tracer, was studied [5,6,7,8,9]

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Discussion

Conclusion