镓-68前列腺特异性膜抗原（[Ga]Ga-PSMA-11）PET/CT与2-[F]氟-2-脱氧-D-葡萄糖（2-[F]FDG）PET/CT在检测甲状腺癌病灶中的价值：一项前瞻性直接比较研究。

The value of Gallium-68 prostate-specific membrane antigen ([Ga]Ga-PSMA-11) PET/CT and 2-[F]fluoro-2-deoxy-D-glucose (2-[F]FDG) PET/CT in the detection of thyroid cancer lesions: a prospective head-to-head comparison.

作者信息

Shi Yangrui, Feng Yuyue, Xu Lu, Li Wenbo, Guan Lili, Zuo Rui, Liu Shuang, Pang Hua, Wang Zhengjie

机构信息

Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing 400016, People's Republic of China.

出版信息

Br J Radiol. 2023 Jul 2:20230291. doi: 10.1259/bjr.20230291.

DOI:10.1259/bjr.20230291

PMID:37393530

Abstract

OBJECTIVE

Thyroid cancer is increasing in incidence. Prostate-specific membrane antigen (PSMA) targeted radionuclide imaging and treatment demonstrated remarkable value in prostate cancer patients. Studies have shown that PSMA is also expressed in thyroid cancer. Our purpose is to evaluate the clinical usefulness of [Ga]Ga-PSMA-11 PET/CT for the diagnosis of thyroid cancer.

METHODS

We enrolled 23 DTC and 17 RAIR-DTC patients prospectively. All patients underwent [Ga]Ga-PSMA-11 PET/CT and 2-[F]FDG PET/CT. PSMA expression was determined by immunohistochemistry on histological samples of lymphatic metastasis of 12 patients. We compared the detection rates and semi-quantitative parameters between [Ga]Ga-PSMA-11PET/CT and 2-[F]FDG PET/CT.

RESULTS

A total of 72 lesions were detected. Detection rates of DTC and RAIR-DTC by [Ga]Ga-PSMA-11 PET/CT were lower than those by 2-[F]FDG PET/CT (60.00% 90.00%, = 0.004; 59.38% 96.88%). Compared with DTC, RAIR-DTC had higher semi-quantitative parameters of 2-[F]FDG PET/CT. There was no significant difference in semi-quantitative parameters of [Ga]Ga-PSMA-11 PET/CT between DTC and RAIR-DTC. Immunohistochemistry showed a significantly higher PSMA expression for RAIR-DTC than for DTC. However, there was no significant correlation between PSMA expression and SUVmax on Ga-PSMA [Ga]Ga-PSMA-11 PET/CT.

CONCLUSIONS

[Ga]Ga-PSMA-11 PET/CT can detect thyroid cancer metastases but its detection rate was lower than that of 2-[F]FDG PET/CT. There was a difference in PSMA expression levels between DTC and RAIR-DTC, but the difference was not reflected on [Ga]Ga-PSMA-11 PET/CT.

ADVANCES IN KNOWLEDGE

[Ga]Ga-PSMA-11 PET/CT has potential value in the diagnosis of thyroid cancer. [Ga]Ga-PSMA-11 PET/CT could screen out patients who may benefit from PSMA targeted radionuclide therapy.

摘要

目的

甲状腺癌的发病率正在上升。前列腺特异性膜抗原（PSMA）靶向放射性核素成像及治疗在前列腺癌患者中显示出显著价值。研究表明，PSMA在甲状腺癌中也有表达。我们的目的是评估[镓]镓 - PSMA - 11 PET/CT对甲状腺癌诊断的临床实用性。

方法

我们前瞻性地纳入了23例分化型甲状腺癌（DTC）患者和17例放射性碘难治性分化型甲状腺癌（RAIR - DTC）患者。所有患者均接受了[镓]镓 - PSMA - 11 PET/CT及2 - [氟]氟代脱氧葡萄糖（2 - [F]FDG）PET/CT检查。通过对12例患者淋巴结转移组织样本进行免疫组织化学检测来确定PSMA的表达情况。我们比较了[镓]镓 - PSMA - 11 PET/CT与2 - [F]FDG PET/CT之间的检测率及半定量参数。

结果

共检测到72个病灶。[镓]镓 - PSMA - 11 PET/CT对DTC和RAIR - DTC的检测率低于2 - [F]FDG PET/CT（分别为60.00%对90.00%，P = 0.004；59.38%对96.88%）。与DTC相比，RAIR - DTC的2 - [F]FDG PET/CT半定量参数更高。DTC与RAIR - DTC之间，[镓]镓 - PSMA - 11 PET/CT的半定量参数无显著差异。免疫组织化学显示，RAIR - DTC的PSMA表达显著高于DTC。然而，在[镓]镓 - PSMA - 11 PET/CT上，PSMA表达与SUVmax之间无显著相关性。