Meyer Patrick
Service d'endocrinologie, diabétologie et nutrition, HUG, 1211 Genève 14.
Rev Med Suisse. 2010 Jan 13;6(231):18-22.
The use of 18FDG-PET has become standard in the management of various malignancies but its application to thyroid nodules and carcinomas is not yet well defined. For the evaluation of thyroid nodules, 18FDG-PET can not consistently predict the nature of the lesions although there are some trends to higher uptakes in malignant tumours. On the other hand, it helps to detect and localize persistent diseases when progressive dedifferentiation of thyroid tumour tissue leads to a loss of iodine uptake. In addition, the more metabolically active lesions are associated with a poor prognosis. For the treatment of advanced thyroid carcinomas, recent clinical studies have now evidenced the promising results of tyrosine kinases inhibitors which can lead to partial responses in patients with progressive differentiated thyroid cancer.
18氟脱氧葡萄糖正电子发射断层扫描（18FDG-PET）的应用已成为各种恶性肿瘤管理的标准，但它在甲状腺结节和癌中的应用尚未明确界定。对于甲状腺结节的评估，尽管恶性肿瘤有摄取增加的趋势，但18FDG-PET不能始终如一地预测病变的性质。另一方面，当甲状腺肿瘤组织逐渐去分化导致碘摄取丧失时，它有助于检测和定位持续性疾病。此外，代谢活性越高的病变预后越差。对于晚期甲状腺癌的治疗，最近的临床研究已证实酪氨酸激酶抑制剂取得了有前景的结果，可使进展性分化型甲状腺癌患者产生部分缓解。
