Department of Nuclear Medicine, General Hospital of Northern Theater Command and .
Department of Radiology, The Peoples Hospital of China Medical University, Shenyang, China.
Nucl Med Commun. 2024 May 1;45(5):396-405. doi: 10.1097/MNM.0000000000001825. Epub 2024 Feb 19.
The objective of this study was to investigate the value of delayed 18F fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) images in patients with small colorectal cancer liver metastases (CRLMs) with hypothyroidism.
We performed a retrospective analysis of 66 small-CRLM patients with hypothyroidism and 66 small-CRLM patients with euthyroidism, all of whom underwent dual-time-point 18 F-FDG PET/CT imaging. First, the diagnostic accuracy of PET/CT early imaging and PET/CT delayed imaging on lesions was analyzed. Next, the correlation of metabolic parameters between PET/CT early imaging and PET/CT delayed imaging was analyzed according to the grouping of all lesions. Finally, PET/CT parameters were analyzed for correlation with thyroid hormones.
The diagnostic accuracy of delayed imaging in small-CRLM patients with hypothyroidism is not as good as that in small-CRLM patients with euthyroidism; PET/CT metabolic parameters are also unfavorable for the diagnosis of small-CRLM. For small-CRLM patients with hypothyroidism, the greater the thyroid-stimulating hormone level, the greater the uptake of 18 F-FDG in normal liver tissue, and the smaller the ratio of tumor lesion uptake to normal liver tissue uptake.
PET/CT-delayed imaging has better performance than early imaging in small-CRLM patients with euthyroidism. However, the more severe the hypothyroidism, the worse the diagnostic delayed imaging performance. The scan time can be extended appropriately to optimize the imaging efficacy.
本研究旨在探讨甲状腺功能减退症(简称甲减)对小结直肠癌肝转移(CRLM)患者氟代脱氧葡萄糖(18F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)延迟图像的影响。
我们对 66 例甲减和 66 例甲状腺功能正常的小 CRLM 患者进行了回顾性分析,所有患者均进行了双时相 18F-FDG PET/CT 成像。首先,分析了 PET/CT 早期和延迟图像对病变的诊断准确性。然后,根据所有病变的分组,分析了 PET/CT 早期和延迟图像代谢参数之间的相关性。最后,分析了 PET/CT 参数与甲状腺激素的相关性。
甲减小 CRLM 患者延迟成像的诊断准确性不如甲状腺功能正常的小 CRLM 患者;PET/CT 代谢参数也不利于小 CRLM 的诊断。对于甲减小 CRLM 患者,促甲状腺激素水平越高,正常肝组织对 18F-FDG 的摄取就越多,肿瘤病变摄取与正常肝组织摄取的比值就越小。
对于甲状腺功能正常的小 CRLM 患者,PET/CT 延迟成像的性能优于早期成像。然而,甲减越严重,诊断延迟成像的性能就越差。可以适当延长扫描时间,以优化成像效果。