Clin Nucl Med. 2018 Mar;43(3):162-167. doi: 10.1097/RLU.0000000000001977.
Recently, [F]tetrafluoroborate ([F]TFB) has been introduced as a versatile PET probe for imaging the human sodium/iodide symporter activity. This pilot study aimed to compare [F]TFB-PET/CT with [I]NaI-PET/CT imaging in thyroid cancer patients.
Nine patients with newly diagnosed differentiated thyroid cancer underwent both [F]TFB- and [I]NaI-PET/CT after total thyroidectomy. PET/CT scans were visually analyzed for the presence of remnant thyroid tissue and for metastatic lesions on a patient and lesion basis. For semiquantitative analysis, thyroid remnant/tumor to blood pool ratios were calculated.
All patients presented with positive [F]TFB and [I]NaI-PET/CT scans. Retention of I in remnant thyroid tissue was significantly higher as compared with [F]TFB (P < 0.01). In a lesion-based analysis, both tracers identified an almost equal number of foci with [F]TFB depicting a total of 41 foci and I a total of 40 foci, respectively. In 6 of 9 patients, both radiopharmaceuticals returned an identical number of foci. Two I-positive benign thyroid remnants were missed by [F]TFB-PET/CT in a single patient. In another case, both tracers identified different thyroid remnant tissues in the cervical region. Notably, [F]TFB demonstrated additional (I-negative) cervical lymph node metastases in 2 patients, leading to an overall agreement between the radiotracers of 91% (74/81 foci).
In this pilot study, [F]TFB-PET was not inferior to [I]NaI-PET for detecting thyroid cancer and its metastases and was able to detect [I]NaI-PET-negative viable differentiated thyroid cancer metastases. Further clinical evaluation as a PET tracer for imaging thyroid pathophysiology and human sodium/iodide symporter expressing neoplasms is highly warranted.
最近，[四氟硼酸根（F]TFB）已被引入作为一种多功能的 PET 探针，用于成像人类钠/碘同向转运体的活性。本研究旨在比较[F]TFB-PET/CT 与[I]NaI-PET/CT 在甲状腺癌患者中的成像效果。
9 例新诊断的分化型甲状腺癌患者在甲状腺全切除术后行[F]TFB 和[I]NaI-PET/CT 检查。对 PET/CT 扫描进行视觉分析，以确定残余甲状腺组织和转移病灶的存在情况，并对患者和病灶进行基于病灶的分析。对于半定量分析，计算甲状腺残余/肿瘤与血池的比值。
所有患者的[F]TFB 和[I]NaI-PET/CT 扫描均呈阳性。与[F]TFB 相比，残余甲状腺组织中 I 的摄取明显更高（P<0.01）。基于病灶的分析，两种示踪剂均发现了几乎相同数量的病灶，[F]TFB 共显示 41 个病灶，I 共显示 40 个病灶。在 9 例患者中有 6 例患者两种放射性药物显示的病灶数量相同。1 例患者中，[F]TFB-PET/CT 漏诊了 2 个 I 阳性的良性甲状腺残余组织。在另一个病例中，两种示踪剂均在颈部识别出不同的甲状腺残余组织。值得注意的是，[F]TFB 在 2 例患者中还显示了额外的（I 阴性）颈部淋巴结转移，因此两种放射性药物的总体一致性为 91%（74/81 个病灶）。
在这项初步研究中，[F]TFB-PET 在检测甲状腺癌及其转移方面并不逊于[I]NaI-PET，并且能够检测到[I]NaI-PET 阴性的存活分化型甲状腺癌转移灶。作为一种用于成像甲状腺病理生理学和表达钠/碘同向转运体的肿瘤的 PET 示踪剂，进一步的临床评估是非常必要的。
