Piccardo Arnoldo, Fiz Francesco, Righi Sergio, Raffa Stefano, Riondato Mattia, Bottoni Gianluca, Bauckneht Matteo, Massollo Michela, Rizzo Alessio, Naseri Mehrdad Shoushtari Zadeh, Trimboli Pierpaolo, Treglia Giorgio
Eur Thyroid J. 2025 Feb 5;14(1). doi: 10.1530/ETJ-24-0320. Print 2025 Feb 1.
In relapsing differentiated thyroid cancer (DTC), the in vivo evaluation of natrium-iodide symporter (NIS) expression is pivotal in the therapeutic planning and is achieved by 131/123Iodine (131/123I) whole body scan. However, these approaches have low sensitivity due to the low resolution of SPECT. 18F-Tetrafluoroborate (TFB) has been proposed as a viable alternative, which could outperform 131/123I scans owing to the superior PET resolution. We have reviewed the literature to collect the available data on TFB diagnostic performance and compare it with the standard methods.
Two authors searched PubMed, CENTRAL, Scopus, Web of Science and the web for studies evaluating the biodistribution and dosimetry of TFB in patients with DTC. General characteristics, technical parameters, procedures' sensitivities and standards of reference were extracted from the selected studies. The risk of bias was evaluated with the QUADAS-2 scoring system.
Five studies were included in the review. Two analysed TFB's biodistribution and dosimetry, while the other three assessed its diagnostic performance. The diagnostic comparators were 18F-FDG PET/CT (all cases), 124I-PET/CT (one study) and diagnostic/therapeutic 131I-SPECT/CT (one study each). TFB performed better than 131I; the TFB and 18F-FDG PET/CT combination achieved the best sensitivity. TFB delivered significantly less dose than the other NIS tracers.
TFB is a promising tracer in relapsing DTC, showing higher sensitivity and less radiation exposure than the standard methods. The TFB and 18F-FDG combination appears particularly intriguing, especially when disease heterogeneity is suspected. However, data are still sparse and need to be confirmed by further investigations.
在复发性分化型甲状腺癌（DTC）中，体内评估钠碘同向转运体（NIS）的表达对于治疗方案的制定至关重要，通常通过131/123碘（131/123I）全身扫描来实现。然而，由于单光子发射计算机断层扫描（SPECT）分辨率较低，这些方法的灵敏度也较低。18F-四氟硼酸盐（TFB）已被提议作为一种可行替代方法，由于正电子发射断层扫描（PET）具有更高的分辨率，它可能比131/123I扫描表现更优。我们回顾了文献，收集有关TFB诊断性能的现有数据，并将其与标准方法进行比较。
两位作者检索了PubMed、CENTRAL、Scopus、科学网和网络，以查找评估TFB在DTC患者中的生物分布和剂量学的研究。从选定的研究中提取一般特征、技术参数、程序的灵敏度和参考标准。采用QUADAS-2评分系统评估偏倚风险。
该综述纳入了五项研究。两项分析了TFB的生物分布和剂量学，另外三项评估了其诊断性能。诊断对照物为18F-氟代脱氧葡萄糖（18F-FDG）PET/CT（所有病例）、124I-PET/CT（一项研究）以及诊断性/治疗性131I-SPECT/CT（各一项研究）。TFB的表现优于131I；TFB与18F-FDG PET/CT联合使用时灵敏度最高。TFB的辐射剂量明显低于其他NIS示踪剂。
TFB在复发性DTC中是一种有前景的示踪剂，与标准方法相比，显示出更高的灵敏度和更低的辐射暴露。TFB与18F-FDG联合使用显得特别有吸引力，尤其是在怀疑疾病存在异质性时。然而，数据仍然较少，需要进一步研究加以证实。
