Chin Bennett B, Patel Pavni, Cohade Christian, Ewertz Marge, Wahl Richard, Ladenson Paul
Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
J Clin Endocrinol Metab. 2004 Jan;89(1):91-5. doi: 10.1210/jc.2003-031027.
TSH stimulates thyrocyte metabolism, glucose transport, and glycolysis. 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) is a glucose analog used in positron emission tomography (PET) to detect occult well-differentiated thyroid carcinoma. The objective of this study was to examine the effects of recombinant human TSH (rTSH) on FDG PET uptake in patients with residual or recurrent disease. Seven patients with well-differentiated thyroid carcinoma, negative 131-I scintigraphy, and biochemical evidence of residual disease were randomized and prospectively studied with FDG PET both on thyroid hormone suppression and rTSH stimulation within 1 wk. All lesions seen on the TSH suppression scans were seen on the rTSH stimulation studies. rTSH stimulation studies identified four additional lesions not seen on TSH suppression. One patient was positive on rTSH stimulation alone. The mean (2.54 +/- 0.72 vs. 1.79 +/- 0.88) and maximum (2.49 +/- 0.95 vs. 1.74 +/- 0.81) lesion to background ratios were significantly higher with rTSH stimulation, compared with TSH suppression (P = 0.02 for both). rTSH stimulation improves the detectability of occult thyroid metastases with FDG PET, compared with scans performed on TSH suppression.
促甲状腺激素（TSH）可刺激甲状腺细胞代谢、葡萄糖转运及糖酵解。2-脱氧-2-[18F]氟-D-葡萄糖（FDG）是一种葡萄糖类似物，用于正电子发射断层扫描（PET）以检测隐匿性高分化甲状腺癌。本研究的目的是检测重组人促甲状腺激素（rTSH）对残留或复发性疾病患者FDG PET摄取的影响。7例高分化甲状腺癌患者，131-I闪烁扫描阴性且有残留疾病的生化证据，在1周内接受了甲状腺激素抑制和rTSH刺激下的FDG PET随机前瞻性研究。TSH抑制扫描中发现的所有病变在rTSH刺激研究中均可见。rTSH刺激研究发现了TSH抑制时未发现的另外4个病变。1例患者仅在rTSH刺激时呈阳性。与TSH抑制相比，rTSH刺激时病变与背景的平均比值（2.54±0.72对1.79±0.88）和最大比值（2.49±0.95对1.74±0.81）显著更高（两者P均=0.02）。与TSH抑制时进行的扫描相比，rTSH刺激可提高FDG PET对隐匿性甲状腺转移灶的检测能力。
