Introduction:Non-iodine avid metastases of differentiated thyroid cancer (DTC) can be found using PET/CT with a fluorine-18-labeled glucose analog ([18F]FDG). There are ongoing discussions on the appropriateness of using exogenous thyrotropin (TSH) stimulation before this examination.Material and Methods:In a retrospective study, 73 PET/CT scans with [18F]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.Results: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 (p= 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 [18F]FDG uptake in the PET/CT lesions.Conclusions:PET/CT with [18F]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.
引言：分化型甲状腺癌（DTC）的非摄碘性转移灶可通过氟-18标记葡萄糖类似物（[18F]FDG）PET/CT检测。关于该检查前使用外源性促甲状腺激素（TSH）刺激的适宜性目前仍存在争议。 材料与方法：本研究回顾性分析了73例接受[18F]FDG PET/CT检查的病例，其中部分患者采用重组人TSH（rhTSH）进行外源性刺激，部分未接受刺激。所有纳入患者均疑似存在DTC非摄碘性病灶。 结果：PET/CT前使用rhTSH刺激并未影响阳性结果比例：rhTSH刺激组为37.5%（18/48），非刺激组为40%（10/25）（p=0.83）。通过ROC曲线分析分别确定了两组亚群中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（无论是否接受刺激）之间无统计学显著差异。PET/CT前的外源性TSH刺激对病灶的[18F]FDG摄取未见影响。 结论：[18F]FDG PET/CT仍是诊断DTC非摄碘性病灶的有效方法；在本研究队列中，虽然发现rhTSH刺激能增加PET/CT可见的DTC病灶数量，但并未影响该检查方法的诊断效能。
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