Prognostic value of volume-based metabolic parameters of [18F]FDG PET/CT in anaplastic thyroid carcinoma

Abstract Introduction Anaplastic thyroid carcinoma (ATC) is a rare and aggressive malignancy with a median overall survival (OS) of approximately 2 months. The prognostic value of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ([ 18 F]FDG PET/CT) in ATC remains unclear. This study aims to evaluate the prognostic significance of [ 18 F]FDG PET/CT parameters in ATC patients. Methods This retrospective study analyzed 34 patients diagnosed with ATC between January 2010 and October 2024 who underwent initial staging with [ 18 F]FDG PET/CT. Data collected included standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), along with patient and tumor characteristics. The relationships between these parameters and survival were assessed. Results OS was 48 days (IQR: 27–134). In univariate analysis, MTV (HR = 1.44, p = 0.009) was significantly associated with poorer OS. Surgery was associated with a significantly decreased hazard of mortality (HR, 0.418; 95% CI, 0.188–0.929; P = 0.032), as was radiotherapy (HR, 0.423; 95% CI, 0.220–0.977; P = 0.026). Conclusion This study identifies MTV as a significant prognostic markers in univariate analysis for patients with ATC, highlighting the utility of [ 18 F]FDG PET/CT in predicting patient outcomes.