ObjectivesThe aim of the current study was to evaluate the value of preoperative 18F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC).MethodsOne hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were analyzed for prediction of LN metastasis. Detectability by ultrasonography (US) and FDG PET/CT for cervical LN metastasis were also assessed and compared with the pSUVmax.ResultsThe FDG avidity of the primary tumor was identified in 118 patients (FDG avid group: 61.0%, M: F = 16:102, age 47.0 ± 12.7 years) and pSUVmax ranged from 1.3 to 35.6 (median 4.6) in the FDG avid group. The tumor size in the FDG avid group was bigger and there was a higher incidence of LN metastasis compared to the FDG non-avid group (0.93 vs. 0.59 cm, p <0.001 and 49.2 vs. 33.3%, p <0.05). In the FDG avid group, patients with LN metastasis had higher pSUVmax than patients without LN metastasis (8.7 ± 8.3 vs. 5.7 ± 5.1, p <0.001). The incidence of central LN metastasis in patients with a pSUVmax >4.6 was 54%; however, the detectability of central LN metastasis by US and FDG PET/CT were 10.3% and 3.6%, respectively.ConclusionA high FDG avidity of the primary tumor was related to LN metastasis in PTC patients. Therefore, patients with a high pSUVmax should be cautiously assessed for LN metastasis and might need a more comprehensive surgical approach.

BACKGROUND Standard allogeneic bone marrow transplantation (BMT) offers only a small chance of cure for most adult patients with advanced hematologic malignancies. The authors postulated that allogeneic peripheral blood stem cell transplantation (PBSCT) followed by prophylactic growth factor‐primed donor lymphocyte infusion (DLI) with cells reserved at harvest would maximize the graft‐versus‐tumor effects in patients with hematologic malignancies who had a high risk of recurrence. METHODS Seventeen patients with hematologic malignancies who had a high risk of recurrence were allocated on an intent‐to‐treat basis to allogeneic PBSCT from human leukocyte antigen‐matched sibling donors followed by prophylactic growth factor‐primed DLI of cells reserved at harvest for transplantation. RESULTS The median age was 37 years (range, 19–56 years). All donors underwent two or more apheresis procedures. The median numbers of mononuclear cells (MNCs), CD34 positive (CD34+) cells, and CD3+ cells, respectively, that were collected for 17 donors were 9.0 × 108 MNCs/kg (range, 4.9–14.4 × 108 MNCs/kg), 13.0 × 106 CD34+ cells/kg (range, 2.4–75.2 × 106 CD34+ cells/kg), and 5.8 × 108 CD3+ cells/kg (range, 3.3–9.9 × 108 CD3+ cells/kg) for a mean number of 2.35 apheresis procedures (range, 2.0–4.0 procedures). The median numbers of MNCs and CD3+ cells that were cryopreserved were 2.1 × 108 MNCs/kg (range, 0.0–4.4 × 108 MNCs/kg) and 1.4 × 108 CD3+ cells/kg (range, 0.0–3.5 × 108 CD3+ cells/kg). Seven of 17 patients received additional PBSCs, with a median of 5.0 × 107 CD3+ cells/kg (range, 3.0–9.9 CD3+ cells/kg) between Day 41 and Day 120. The reasons for inability to administer additional PBSCs in 10 patients included early death (n = 4 patients), severe graft‐versus‐host disease (GVHD) (n = 3 patients), disease recurrence (n = 2 patients), and harvest failure (n = 1 patient). Of seven patients, two patients died of recurrence, and one died of cytomegalovirus pneumonitis. The surviving four patients were free of disease when last assessed (median follow‐up, 597 days) but were suffering from chronic GVHD (one patient had limited GVHD, and three patients had extensive GVHD). CONCLUSIONS The authors suggest that allogeneic PBSCT with prophylactic growth factor‐primed DLI may be a potentially curative strategy for the treatment of hematologic malignancies in patients with a high risk of recurrence. Their approach may offer the additional advantage of collecting enough cells at harvest for the potential use of DLI, which is easy, convenient for donors, and cost effective. Cancer 2002;94:18–24. © 2002 American Cancer Society.

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Purpose To evaluate the preventive effect of parotid gland (PG) massage for PG damage during the 131I therapy, we prospectively investigated the serum amylase value and salivary gland scintigraphy (SGS) after 131I therapy. Materials and Methods One hundred patients with thyroidectomized differentiated thyroid cancer who underwent high-dose 131I therapy were enrolled in the clinical trial and randomized into 2 groups (PG massage group and nonmassage group). The serum amylase value was obtained before and 24 hours after 131I therapy, and the SGSs were also taken just before and at 8 months after the 131I therapy. Change in serum amylase value and SGS was compared between PG massage and nonmassage groups. Results The difference value of serum amylase was significantly lower in PG massage group than in nonmassage group (P = 0.0052). Worsening of PG function on SGS was observed in 43 (45.3%) of the 95 patients. The incidence rate of PG abnormality on F/U SGS was significantly lower in PG massage group than in nonmassage group (odds ratio, 0.3704; P = 0.0195). In the multiple regression analysis, PG massage significantly affected the abnormality on the 8-month F/U SGS (r partial = −0.2741, P = 0.0090) after adjusting for clinical variables (age, sex, TNM stage, TSH preparation methods for the 131I therapy, and 131I dose). Conclusions PG gland massage significantly reduced the incidence rates of salivary gland dysfunction on the 8-month F/U SGS and the level of the serological marker of salivary gland destruction after 131I therapy. Therefore, PG gland massage could alleviate salivary gland damage related to 131I therapy.