文章：

甲状腺功能减退状态下与重组人促甲状腺激素刺激下分化型甲状腺癌患者垂体氟-18-氟脱氧葡萄糖摄取增加对比研究

Increased Pituitary Fluorine-18-Fluorodeoxyglucose Uptake in Patients with Differentiated Thyroid Cancer in Hypothyroidism versus under Recombinant Human Thyroid-Stimulating Hormone Stimulation

原文发布日期：31 March 2024

DOI: 10.3390/cancers16071382

类型: Article

开放获取: 是

英文摘要：

Background:18F-FDG PET/CT is performed for the assessment of radioactive iodine non-avid disease in patients with DTC. In patients prepared by THW, increased pituitary uptake of18F-FDG in the absence of pituitary disease may reflect the physiological activation of pituitary thyrotroph cells by hypothyroidism. This study aimed to compare pituitary18F-FDG uptake in patients with DTC under THW vs. rhTSH stimulation. Methods: A total of 57 patients with DTC undergoing18F-FDG PET/CT (40 under THW and 17 under rhTSH stimulation) were retrospectively analyzed. Pituitary metabolism was expressed as maximum standardized uptake value (SUVmax) and as SUVratio using the right cerebellum as reference. Results: Pituitary hypermetabolism (SUVmax ≥ 4.1) was present in more patients in the THW group compared to the rhTSH group (62.5% vs. 23.5%;p= 0.01). Pituitary metabolism was significantly higher in the THW group compared to the rhTSH group, as assessed by either SUVmax (mean ± SD: 4.61 ± 1.22, 95%CI: 4.22–5.00 vs. 3.34 ± 0.86, 95%CI: 2.9–3.8;p< 0.001) or SUVratio (0.52 ± 0.11, 95%CI: 0.49–0.56 vs. 0.42 ± 0.07, 95%CI: 0.38–0.46;p< 0.001). Serum TSH levels correlated positively with SUVmax (r = 0.41,p< 0.01) and SUVratio (r = 0.44,p< 0.01) in the THW group only. Conclusions: The present findings support the hypothesis that pituitary hypermetabolism on18F-FDG PET/CT in patients with DTC undergoing THW is a common physiological response to hypothyroidism. Awareness of this physiological hypermetabolism is important to avoid potential pitfalls in image interpretation.

摘要翻译： 

背景：18F-FDG PET/CT用于评估分化型甲状腺癌（DTC）患者中不摄取放射性碘的病灶。在通过甲状腺激素撤退（THW）准备的患者中，若无垂体疾病，18F-FDG在垂体的摄取增加可能反映了甲状腺功能减退状态下垂体促甲状腺激素细胞的生理性激活。本研究旨在比较THW与重组人促甲状腺激素（rhTSH）刺激下DTC患者垂体18F-FDG的摄取情况。方法：回顾性分析了57例接受18F-FDG PET/CT检查的DTC患者（40例采用THW准备，17例采用rhTSH刺激）。垂体代谢以最大标准化摄取值（SUVmax）表示，并以右侧小脑为参考计算SUV比值。结果：与rhTSH组相比，THW组中出现垂体高代谢（SUVmax ≥ 4.1）的患者比例更高（62.5% vs. 23.5%；p=0.01）。无论是通过SUVmax（平均值±标准差：4.61 ± 1.22，95%置信区间：4.22–5.00 vs. 3.34 ± 0.86，95%置信区间：2.9–3.8；p<0.001）还是SUV比值（0.52 ± 0.11，95%置信区间：0.49–0.56 vs. 0.42 ± 0.07，95%置信区间：0.38–0.46；p<0.001）评估，THW组的垂体代谢均显著高于rhTSH组。仅在THW组中，血清促甲状腺激素水平与SUVmax（r=0.41，p<0.01）和SUV比值（r=0.44，p<0.01）呈正相关。结论：本研究结果支持以下假设：在接受THW的DTC患者中，18F-FDG PET/CT显示的垂体高代谢是对甲状腺功能减退的一种常见生理反应。认识这种生理性高代谢对于避免图像解读中的潜在误判至关重要。

原文链接：

Increased Pituitary Fluorine-18-Fluorodeoxyglucose Uptake in Patients with Differentiated Thyroid Cancer in Hypothyroidism versus under Recombinant Human Thyroid-Stimulating Hormone Stimulation