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THE RELATIONSHIP OF BRAF (V600E) MUTATION STATUS TO FDG PET/CT AVIDITY IN THYROID CANCER: A REVIEW AND META-ANALYSIS.

THE RELATIONSHIP OF BRAF (V600E) MUTATION STATUS TO FDG PET/CT AVIDITY IN THYROID CANCER: A REVIEW AND META-ANALYSIS.
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Santhanam P, Khthir R, Solnes LB, Ladenson PW,


Santhanam P, Khthir R, Solnes LB, Ladenson PW, (click to view)

Santhanam P, Khthir R, Solnes LB, Ladenson PW,

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Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2017 11 16() doi 10.4158/EP-2017-0080

Abstract
OBJECTIVES
Papillary thyroid cancers harboring BRAF (V600E) gene mutation have been shown to exhibit aggressive tumor behaviors and higher risks of recurrence and disease-specific death. In this systematic review and meta-analysis, we examine and report published evidence related to the accuracy of FDG-PET-CT in detection of residual disease in patients’ with BRAF (V600E) mutated thyroid cancer.

METHODS
We extracted data from PUBMED/MEDLINE and EMBASE from January, 1995 to March, 2017. Studies that compared FDG PET SUV (Standardized Uptake Values) between BRAF (V600E) positive and BRAF (V600E) negative subjects as well as those that evaluated the odds of having FDG avidity between BRAF (V600E) positive and negative patients with thyroid cancer were included.

RESULTS
There were a total of 12 studies in the systematic review. There were 7 studies that qualified for the analysis for calculating the pooled odds ratio. The pooled cohort with binary data had 1144 patients out of which 843 were BRAF (V600E)positive and 301 were BRAF (V600E) negative. The patients with BRAF (V600E) mutation had significantly greater likelihood of having 18F-FDG avid lesions. The pooled odds ratio was 2.12 (CI 1.53-3.00, p value <0.01). The pooled mean SUV (cohort of 315 patients) was significantly higher in BRAF (V600E) positive compared to BRAF (V600E) negative patients with a pooled mean difference of 5.1 (CI 4.3 -5.8). CONCLUSION
Our meta-analysis shows that presence of BRAF (V600E) mutation in PTC confers a higher likelihood of 18-F FDG PET avidity as well as overall higher SUV uptake values compared to BRAF (V600E) mutation negative status.

ABBREVIATIONS
BRAF= B-Raf proto-oncogene, serine/threonine kinase; FDG = Fluorodeoxyglucose; PET = Positron Emission Tomography; CT = Computerized Tomography; SUV = Standardized Uptake Values; GLUT = Glucose Transporter.

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