F-18 FDG PET/CT在放射性碘难治性甲状腺癌患者中促甲状腺激素水平升高与降低时的头对头比较：一项初步研究

Head-to-head comparison of F-18 FDG PET/CT in radioidine refractory thyroid cancer patients with elevated versus suppressed TSH levels a pilot study.

作者信息

Almeida Ludmila Santiago, Araújo Maidane Luisi, Santos Allan Oliveira, Montali da Assumpção Lígia Vera, Lima Mariana Lopes, Ramos Celso Darío, Zantut-Wittmann Denise Engelbrecht, Etchebehere Elba Cristina

机构信息

Division of Nuclear Medicine of the Department of Radiology, Campinas State University (UNICAMP), São Paulo, Brazil.

Division of Endocrinology of the Department of Internal Medicine, Campinas State University (UNICAMP), São Paulo, Brazil.

出版信息

Heliyon. 2020 Mar 5;6(3):e03450. doi: 10.1016/j.heliyon.2020.e03450. eCollection 2020 Mar.

DOI:10.1016/j.heliyon.2020.e03450

PMID:32154413

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7058905/

Abstract

INTRODUCTION

To perform a head-to-head comparison of the uptake pattern of F-18 fluorodeoxyglucose in positron emission computed tomography (FDG PET/CT) in radioiodine refractory thyroid carcinomas (RAIR) in the same patient under elevated TSH levels (TSH) and suppressed TSH levels (TSH).

METHODS

FDG PET/CT studies were performed under two conditions: levothyroxine intake (TSH) and 30 days after hormonal withdrawal (TSH). SUVmax values and the number of lesions detected (local recurrence and metastases in cervical and distant lymph nodes, lungs and bone) where blindly evaluated. Blood serum TSH and Tg levels were obtained prior to both studies. FDG PET/CT imaging, neck ultrasound, biopsy and follow-up were considered the reference standard.

RESULTS

Fifteen patients performed both TSH and TSH FDG PET/CT studies. Both were positive for metastases in 80% of the patients. TSH FDG PET/CT studies did not reveal increased uptake (p = 0.0640) and did not demonstrate a higher number of lesions (p = 0.320) when compared to sTSH FDG PET/CT studies. There was no change in the clinical management of these patients.

CONCLUSIONS

TSH FDG PET/CT in patients with RAIR did not show more metastases in comparison to TSH FDG PET/CT and there was no impact in clinical management of patients. Elevating TSH levels (whether by hormonal withdrawal or recombinant TSH) in patients being submitted to FDG PET/CT may not be necessary.

摘要

引言

在促甲状腺激素（TSH）升高和TSH抑制水平下，对同一例放射性碘难治性甲状腺癌（RAIR）患者进行正电子发射计算机断层显像（FDG PET/CT）中F-18氟脱氧葡萄糖摄取模式的直接比较。

方法

在两种情况下进行FDG PET/CT研究：服用左甲状腺素（TSH）时和激素撤药30天后（TSH）。对SUVmax值以及检测到的病变数量（局部复发、颈部和远处淋巴结、肺和骨转移）进行盲法评估。在两项研究之前均获取血清TSH和Tg水平。FDG PET/CT成像、颈部超声、活检和随访被视为参考标准。

结果

15例患者进行了TSH和TSH状态下的FDG PET/CT研究。80%的患者在两种状态下均有转移阳性表现。与sTSH状态下的FDG PET/CT研究相比，TSH状态下的FDG PET/CT研究未显示摄取增加（p = 0.0640），也未显示更多的病变数量（p = 0.320）。这些患者的临床管理没有变化。