TSH Stimulation before PET/CT as Our Frenemy in Detecting Thyroid Cancer Metastases-Final Results of a Retrospective Analysis

Non-iodine avid metastases of differentiated thyroid cancer (DTC) can be found using PET/CT with a fluorine-18-labeled glucose analog ([ F]FDG). There are ongoing discussions on the appropriateness of using exogenous thyrotropin (TSH) stimulation before this examination. In a retrospective study, 73...

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Bibliographic Details
Published in:Cancers 2024-10, Vol.16 (19), p.3413
Main Authors: Kołodziej, Maciej, Saracyn, Marek, Lubas, Arkadiusz, Brodowska-Kania, Dorota, Mazurek, Andrzej, Dziuk, Mirosław, Durma, Adam Daniel, Niemczyk, Stanisław, Kamiński, Grzegorz
Format: Article
Language:English
Subjects:
Diagnosis
Drug dosages
Health aspects
Hospitalization
Iodine
Lesions
Metastases
Metastasis
Nuclear medicine
Patients
Positron emission tomography
Research centers
Scintigraphy
Statistical analysis
Thyroglobulin
Thyroid cancer
Thyroid gland function tests
Thyroid-stimulating hormone
Thyrotropin
Ultrasonic imaging
Work stations
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Summary:Non-iodine avid metastases of differentiated thyroid cancer (DTC) can be found using PET/CT with a fluorine-18-labeled glucose analog ([ F]FDG). There are ongoing discussions on the appropriateness of using exogenous thyrotropin (TSH) stimulation before this examination. In a retrospective study, 73 PET/CT scans with [ F]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. 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 ( = 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 [ F]FDG uptake in the PET/CT lesions. PET/CT with [ F]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.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16193413