Kołodziej Maciej, Saracyn Marek, Lubas Arkadiusz, Brodowska-Kania Dorota, Mazurek Andrzej, Dziuk Mirosław, Durma Adam Daniel, Niemczyk Stanisław, Kamiński Grzegorz
Department of Endocrinology and Isotope Therapy, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland.
Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine-National Research Institute, 04-141 Warsaw, Poland.
Cancers (Basel). 2024 Oct 8;16(19):3413. doi: 10.3390/cancers16193413.
Non-iodine avid metastases of differentiated thyroid cancer (DTC) can be found using PET/CT with a fluorine-18-labeled glucose analog ([F]FDG). There are ongoing discussions on the appropriateness of using exogenous thyrotropin (TSH) stimulation before this examination. In a retrospective study, 73 PET/CT scans with [F]FDG performed after exogenous stimulation with recombinant human TSH (rhTSH) and without such stimulation were analyzed. All analyzed patients were suspected of having non-iodine-avid foci of DTC. The stimulation with rhTSH before the PET/CT did not affect the percentage of positive results: 37.5% (18/48) with rhTSH and 40% (10/25) without rhTSH ( = 0.83). The analysis of the ROC curves established the cut-off thyroglobulin point for a positive PET/CT result separately for both subgroups. There was no statistically significant difference between obtaining a positive PET/CT result and the baseline thyroglobulin concentration (both stimulated and unstimulated). The exogenous stimulation of TSH prior to the PET/CT had no effect on the [F]FDG uptake in the PET/CT lesions. PET/CT with [F]FDG remains a useful method for the diagnosis of non-iodine-avid DTC lesions; in the presented group, a positive effect of rhTSH stimulation on the number of DTC foci visible in the PET/CT was found, but without affecting its effectiveness.
使用含氟 - 18标记的葡萄糖类似物（[F]FDG）的PET/CT可发现分化型甲状腺癌（DTC）的非碘摄取性转移灶。关于在该项检查前使用外源性促甲状腺激素（TSH）刺激是否合适，目前仍在讨论中。在一项回顾性研究中，分析了73例在重组人促甲状腺激素（rhTSH）外源性刺激后以及未进行此类刺激的情况下进行的[F]FDG PET/CT扫描。所有分析的患者均疑似患有DTC的非碘摄取性病灶。PET/CT前使用rhTSH刺激并未影响阳性结果的百分比：使用rhTSH刺激的为37.5%（18/48），未使用rhTSH刺激的为40%（10/25）（P = 0.83）。对ROC曲线的分析分别为两个亚组确定了PET/CT阳性结果的甲状腺球蛋白临界值。PET/CT阳性结果与基线甲状腺球蛋白浓度（刺激和未刺激状态下）之间无统计学显著差异。PET/CT前TSH的外源性刺激对PET/CT病灶中的[F]FDG摄取无影响。使用[F]FDG的PET/CT仍然是诊断非碘摄取性DTC病灶的有用方法；在本研究组中，发现rhTSH刺激对PET/CT中可见的DTC病灶数量有积极影响，但不影响其有效性。
