Klain Michele, Nappi Carmela, Nicolai Emanuele, Romeo Valeria, Piscopo Leandra, Giordano Alessia, Gaudieri Valeria, Zampella Emilia, Pace Leonardo, Carlo Cavaliere, Salvatore Marco, Schlumberger Martin, Cuocolo Alberto
Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
IRCCS-SDN, Naples, Italy.
Eur J Nucl Med Mol Imaging. 2020 Dec;47(13):3066-3073. doi: 10.1007/s00259-020-04938-0. Epub 2020 Jun 30.
F-FDG PET/CT is the most accurate imaging modality in differentiated thyroid cancer (DTC) patients with either an aggressive histology, an absence of radioiodine uptake in neoplastic foci, or in the absence of imaging abnormalities in patients with an elevated serum thyroglobulin (Tg) level that progresses with time. We evaluated the diagnostic performance of FDG PET/MR in comparison with that of PET/CT.
Following the injection of a single F-FDG activity, PET/MR and PET/CT were sequentially performed in 40 consecutive patients with DTC previously treated with total thyroidectomy and radioiodine ablation. All patients were then followed up for at least 6 months. PET/MR was positive in 11 patients and PET/CT in 10. PET/MR detected 33 tumor foci and PET/CT 30. During the follow-up of the 12 patients with negative initial PET studies and with a detectable serum Tg, only one patient had a neck recurrence and the administration of an empiric high activity of I in the other 11 patients did not reveal any tumor focus. In the 17 patients with an initial serum Tg level < 2 ng/mL, no recurrence occurred.
This study confirms the high diagnostic accuracy of FDG PET studies in DTC patients with elevated serum Tg levels and shows that PET/MR brings similar information as compared to PET/CT imaging.
对于具有侵袭性组织学特征、肿瘤病灶无放射性碘摄取或血清甲状腺球蛋白（Tg）水平升高且随时间进展但影像学无异常的分化型甲状腺癌（DTC）患者，F-FDG PET/CT是最准确的成像方式。我们评估了FDG PET/MR与PET/CT相比的诊断性能。
在注射单次F-FDG活性后，对40例先前接受过全甲状腺切除术和放射性碘消融治疗的DTC患者依次进行PET/MR和PET/CT检查。然后对所有患者进行至少6个月的随访。PET/MR检查结果为阳性的有11例患者，PET/CT检查结果为阳性的有10例患者。PET/MR检测到33个肿瘤病灶，PET/CT检测到30个。在对12例初始PET检查结果为阴性且血清Tg可检测的患者进行随访期间，只有1例患者出现颈部复发，其他11例患者给予经验性高活性碘治疗未发现任何肿瘤病灶。在17例初始血清Tg水平<2 ng/mL的患者中，未发生复发。
本研究证实了FDG PET检查在血清Tg水平升高的DTC患者中具有较高的诊断准确性，并表明PET/MR与PET/CT成像相比能提供相似的信息。
