Thyroid cancer poses a significant challenge in clinical management, necessitating precise diagnostic tools and treatment strategies for optimal patient outcomes. This review explores the evolving field of radiotracers in the diagnosis and management of thyroid cancer, focusing on prostate-specific membrane antigen (PSMA)-based radiotracers, fibroblast activation protein inhibitor (FAPI)-based radiotracers, Arg-Gly-Asp (RGD)-based radiotracers, and18F-tetrafluoroborate (18F-TFB). PSMA-based radiotracers, initially developed for prostate cancer imaging, have shown promise in detecting thyroid cancer lesions; however, their detection rate is lower than18F-FDG PET/CT. FAPI-based radiotracers, targeting fibroblast activation protein highly expressed in tumors, offer potential in the detection of lymph nodes and radioiodine-resistant metastases. RGD-based radiotracers, binding to integrin αvβ3 found on tumor cells and angiogenic blood vessels, demonstrate diagnostic accuracy in detecting radioiodine-resistant thyroid cancer metastases.18F-TFB emerges as a promising PET tracer for imaging of lymph node metastases and recurrent DTC, offering advantages over traditional methods. Overall, these radiotracers show promise in enhancing diagnostic accuracy, patient stratification, and treatment selection in differentiated thyroid cancer, warranting further research and clinical validation. Given the promising staging capabilities of 18F-TFB and the efficacy of FAP-targeting tracers in advanced, potentially dedifferentiated cases, continued investigation in these domains is justified.
甲状腺癌的临床管理面临重大挑战，需要精准的诊断工具和治疗策略以实现最佳患者预后。本综述探讨放射性示踪剂在甲状腺癌诊断与管理领域的最新进展，重点聚焦基于前列腺特异性膜抗原（PSMA）、成纤维细胞激活蛋白抑制剂（FAPI）、精氨酸-甘氨酸-天冬氨酸（RGD）的示踪剂及18F-四氟硼酸盐（18F-TFB）。PSMA示踪剂虽最初用于前列腺癌成像，在甲状腺癌病灶检测中展现出潜力，但其检出率低于18F-FDG PET/CT。靶向肿瘤高表达成纤维细胞激活蛋白的FAPI示踪剂，在淋巴结及放射性碘难治性转移灶检测中具有应用前景。RGD示踪剂通过与肿瘤细胞及新生血管表达的整合素αvβ3结合，在检测放射性碘难治性甲状腺癌转移灶方面展现出诊断准确性。18F-TFB作为新型PET示踪剂，在淋巴结转移及复发型分化型甲状腺癌成像中表现突出，较传统方法更具优势。总体而言，这些示踪剂在提升分化型甲状腺癌诊断准确性、患者分层及治疗选择方面具有重要价值，值得进一步研究与临床验证。鉴于18F-TFB在分期评估中的潜力，以及FAPI靶向示踪剂在晚期潜在去分化病例中的效能，持续开展相关领域研究具有充分必要性。
肿瘤(癌症)患者之家