Department of Nuclear Medicine and PETCT, Amrita Institute of Medical Sciences and Research Center, Cochin, 682041, Kerala, India,
Ann Nucl Med. 2013 Oct;27(8):681-93. doi: 10.1007/s12149-013-0740-6. Epub 2013 Jun 26.
The primary clinical application of (18)F FDG PET/CT ((18)Fluorine labeled flurodeoxyglucose positron emission tomography/computed tomography) in differentiated thyroid carcinoma is in the identification of active disease in thyroglobulin (Tg) positive (>10 ng/ml), whole body iodine scan negative patients. The impact of FDG PET/CT in diagnosis, surveillance, cure, and progression-free survival of differentiated thyroid carcinoma patients remains to be seen. Five main indications of FDG PET/CT in thyroid cancer have been recommended by revised American thyroid association guidelines 2009. This review aims to provide a complete picture of PET imaging in thyroid malignancies and enumerates each indication with literature review. This review also highlights recent advances in targeted molecular imaging. Currently differentiated thyroid cancer is best imaged using conventional single photon emission computed tomography-based radioiodine tracers ((123)I/(131)I). Although the utility of FDG PET in well differentiated thyroid cancer patients who are iodine negative but with raised Tg is well established, evidence is emerging on the advantages of FDG PET/CT in other histological types of thyroid malignancy, such as Hurthle cell, medullary, and the anaplastic malignancies. Novel PET radiotracers, such as (124)Iodine ((124)I), (18)F-DOPA (3,4-dihydroxy-L-phenylalanine), and (68)Ga-DOTA peptides are revolutionizing the way thyroid malignancies are imaged. Newer concepts on targeted molecular imaging and theranostics are ushering in new possibilities for imaging and treating thyroid cancer.
(18)F 氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（(18)F FDG PET/CT）在分化型甲状腺癌中的主要临床应用是在甲状腺球蛋白（Tg）阳性（>10ng/ml）、全身碘扫描阴性的患者中识别活性疾病。FDG PET/CT 在分化型甲状腺癌患者的诊断、监测、治愈和无进展生存中的影响仍有待观察。2009 年修订的美国甲状腺协会指南推荐了 FDG PET/CT 在甲状腺癌中的 5 种主要适应证。本综述旨在全面介绍甲状腺恶性肿瘤的 PET 成像，并通过文献回顾列举每个适应证。本综述还强调了靶向分子成像的最新进展。目前，分化型甲状腺癌最好使用基于传统单光子发射计算机断层扫描的放射性碘示踪剂（(123)I/(131)I）进行成像。尽管 FDG PET 在碘阴性但 Tg 升高的分化型甲状腺癌患者中的应用已得到充分证实，但越来越多的证据表明 FDG PET/CT 在其他组织学类型的甲状腺恶性肿瘤中具有优势，如 Hurthle 细胞癌、髓样癌和间变性癌。新型 PET 放射性示踪剂，如(124)Iodine ((124)I)、(18)F-DOPA（3,4-二羟基-L-苯丙氨酸）和(68)Ga-DOTA 肽，正在彻底改变甲状腺恶性肿瘤的成像方式。靶向分子成像和治疗学的新概念为甲状腺癌的成像和治疗带来了新的可能性。
