Sjöstedt Sannia Mia Svenningsen, Hahn Christoffer Holst, Rasmussen Åse Krogh, Oturai Peter Sandor, Cramon Per Karkov
Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Endocr Connect. 2024 Nov 21;13(12). doi: 10.1530/EC-24-0419. Print 2024 Dec 1.
Incidental uptake within or adjacent to the thyroid gland is occasionally observed on somatostatin receptor-targeted PET imaging in patients with neuroendocrine neoplasms (NENs). The reported prevalence and clinical relevance of such findings are not well established.
We reviewed PET scan reports for all patients undergoing [68Ga]Ga-DOTA-TOC PET/CT or [64Cu]Cu-DOTA-TATE PET/CT in our department from 2018 to 2022. Scans reporting incidental uptake within or adjacent to the thyroid gland were reviewed post hoc to extract semi-quantitative scores of tracer uptake for the incidental lesions. We further extracted data from electronic patient charts, including cytology and histology.
A total of 3692 PET scans were performed on 1808 unique patients. Incidental abnormal thyroid uptake was reported in 42 of the 1808 patients, with thyroid malignancy identified in five of these 42 patients. Two patients had medullary thyroid cancers, two had neuroendocrine tumor metastases, and one had a renal clear cell carcinoma metastasis. Focal uptake in close relation to the thyroid gland, suggestive of parathyroid adenoma, was reported in another 13 of the 1808 patients, with biochemical hyperparathyroidism found in six of these 13 patients.
In patients undergoing somatostatin receptor-targeted PET scans for evaluation of NENs, the prevalence of reported abnormal uptake within or adjacent to the thyroid gland was low. However, the rates of thyroid malignancy and parathyroid adenomas were substantial. Prospective studies are needed to determine the optimal diagnostic and therapeutic strategies for these incidental findings.
在神经内分泌肿瘤（NENs）患者的生长抑素受体靶向PET成像中，偶尔会观察到甲状腺内或甲状腺附近的偶然摄取。此类发现的报告患病率和临床相关性尚未明确。
我们回顾了2018年至2022年在我院接受[68Ga]Ga-DOTA-TOC PET/CT或[64Cu]Cu-DOTA-TATE PET/CT检查的所有患者的PET扫描报告。对报告甲状腺内或甲状腺附近偶然摄取的扫描进行事后回顾，以提取偶然病变的示踪剂摄取半定量评分。我们还从电子病历中提取数据，包括细胞学和组织学数据。
对1808例独特患者共进行了3692次PET扫描。1808例患者中有42例报告有甲状腺偶然异常摄取，其中42例患者中有5例确诊为甲状腺恶性肿瘤。2例为甲状腺髓样癌，2例为神经内分泌肿瘤转移，1例为肾透明细胞癌转移。1808例患者中另有13例报告甲状腺附近有局灶性摄取，提示甲状旁腺腺瘤，其中13例患者中有6例发现生化性甲状旁腺功能亢进。
在接受生长抑素受体靶向PET扫描以评估NENs的患者中，报告的甲状腺内或甲状腺附近异常摄取的患病率较低。然而，甲状腺恶性肿瘤和甲状旁腺腺瘤的发生率较高。需要进行前瞻性研究以确定这些偶然发现的最佳诊断和治疗策略。
