Ciappuccini Renaud, Saguet-Rysanek Virginie, Dorbeau Marine, Lequesne Justine, Linard Camille, Lefevre-Arbogast Sophie, Clarisse Bénédicte, Bardet Stéphane
Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, Caen, France.
INSERM 1086 ANTICIPE, Caen University, Caen, France.
Eur Thyroid J. 2022 Jun 21;11(3):e220025. doi: 10.1530/ETJ-22-0025.
18F-Fluorocholine (18FCH) PET/CT has high sensitivity for parathyroid adenoma detection and can reliably exclude malignancy in thyroid nodules with indeterminate cytology. Data regarding 18FCH uptake in chronic autoimmune thyroiditis (CAT) are scarce. We aimed to assess thyroid 18FCH uptake in CAT with biological and histological correlation.
This is an ancillary study from the Chocolate trial (NCT02784223) that prospectively enrolled 107 patients planned for thyroid surgery. 18FCH PET/CT acquisitions were performed 20 and 60 min after injection. 18FCH uptake in the thyroid gland was assessed by measuring maximum (SUVmax) and mean (SUVmean) standardized uptake values. Thyrotropin, free thyroxine (FT4), thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies were collected. The intensity of thyroiditis and the degree of fibrosis were assessed on pathology.
CAT was evidenced in 19/107 (18%) patients. Of these, 13 (68%) displayed an increased and diffuse 18FCH thyroid uptake. This uptake pattern was not observed in patients without CAT. SUVmax and SUVmean were higher in patients with CAT than in those without (P < 0.001). At both acquisition times, SUVmax showed a monotonic relationship with the intensity of thyroiditis (Spearman ρ = 0.44 and 0.51, respectively, P < 0.001) and with the degree of fibrosis (Spearman ρ = 0.55 and 0.62, respectively, P < 0.001). SUVmax showed a linear relationship with TPOAb titers at 20 min (Pearson r = 0.54, P < 0.05; Spearman ρ = 0.59, P = 0.03).
More than two-thirds of the patients with CAT present high and diffuse thyroid 18FCH uptake. This uptake pattern is highly specific to CAT and is correlated with pathology and TPOAb titers.
18F-氟胆碱（18FCH）PET/CT对甲状旁腺腺瘤检测具有高灵敏度，并且能够可靠地排除细胞学检查结果不确定的甲状腺结节的恶性可能性。关于慢性自身免疫性甲状腺炎（CAT）中18FCH摄取的数据较少。我们旨在评估CAT中甲状腺18FCH摄取情况，并进行生物学和组织学相关性分析。
这是一项来自巧克力试验（NCT02784223）的辅助研究，该试验前瞻性纳入了107例计划进行甲状腺手术的患者。在注射后20分钟和60分钟进行18FCH PET/CT扫描。通过测量最大标准化摄取值（SUVmax）和平均标准化摄取值（SUVmean）来评估甲状腺的18FCH摄取情况。收集促甲状腺激素、游离甲状腺素（FT4）、甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体。在病理学上评估甲状腺炎的强度和纤维化程度。
107例患者中有19例（18%）被证实患有CAT。其中，13例（68%）表现出甲状腺18FCH摄取增加且呈弥漫性。未患CAT的患者未观察到这种摄取模式。CAT患者的SUVmax和SUVmean高于未患CAT的患者（P<0.001）。在两个扫描时间点，SUVmax均与甲状腺炎强度呈单调关系（Spearman相关系数分别为0.44和0.51，P<0.001），与纤维化程度也呈单调关系（Spearman相关系数分别为0.55和0.62，P<0.001）。在20分钟时，SUVmax与TPOAb滴度呈线性关系（Pearson相关系数r=0.54，P<0.05；Spearman相关系数ρ=0.59, P=0.03）。
超过三分之二的CAT患者表现出甲状腺18FCH摄取高且呈弥漫性。这种摄取模式对CAT具有高度特异性，并且与病理学和TPOAb滴度相关。
