Usefulness of partial volume effect-corrected F-18 FDG PET/CT for predicting I-131 accumulation in the metastatic lymph nodes of patients with thyroid carcinoma

Purpose: The purpose of this study was to evaluate the clinical usefulness of partial volume effect (PVE)-corrected F-18 FDG PET/CT for predicting I-131 accumulation in metastatic lymph nodes (mLNs) during I-131 therapy for papillary thyroid carcinoma (PTC). Methods: Sixty-five mLNs in 31 PTC patients who underwent F-18 FDG PET/CT in an initial radioiodine therapy (RIT) were retrospectively evaluated. Of these, 25 mLNs were I-131-positive and 40 were I-131-negative. SUVmax and SUVmax with PVE correction (cSUVmax) were measured for each mLN, where PVE correction was performed utilizing a simple table lookup correction method. Then, SUVmax/cSUVmax was compared between I-131-positive and I-131-negative mLNs, including the analyses for the mLNs with small-sized (<1 cm) and weak FDG accumulation (SUVmax <3.5). The predictability for I-131 accumulation with SUVmax/cSUVmax was also compared. Results: For all 65 mLNs, SUVmax/cSUVmax was significantly higher in I-131-negative than I-131-positive mLNs (p < 0.0001). Only in cSUVmax, I-131-negative mLNs were significantly higher than I-131-positive, in terms of the 30 small-sized mLNs (p = 0.0001) and 14 mLNs with weak FDG uptake (p = 0.007). The highest accuracy in predictability for I-131 accumulation was significantly better with cSUVmax (92 %) than SUVmax (62 %) (p < 0.0001). Conclusion: PVE-corrected F-18 FDG PET/CT is a valuable predictor of I-131 accumulation in mLNs during RIT.