Incremental diagnostic value of [ 18 F]tetrafluoroborate PET-CT compared to [ 131 I]iodine scintigraphy in recurrent differentiated thyroid cancer.

Autor:	Dittmann M; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Gonzalez Carvalho JM; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Rahbar K; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Schäfers M; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.; European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany.; Cells in Motion Interfaculty Centre (CiM), University of Münster, Münster, Germany., Claesener M; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Riemann B; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Seifert R; Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. robert.seifert@uni-muenster.de.; European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany. robert.seifert@uni-muenster.de.
Jazyk:	angličtina
Zdroj:	European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2020 Oct; Vol. 47 (11), pp. 2639-2646. Date of Electronic Publication: 2020 Apr 04.
DOI:	10.1007/s00259-020-04727-9
Abstrakt:	Introduction: Efficient therapy of recurrent differentiated thyroid cancer (DTC) is dependent on precise molecular imaging techniques targeting the human sodium iodide symporter (hNIS), which is a marker both of thyroid and DTC cells. Various iodine isotopes have been utilized for detecting DTC; however, these come with unfavorable radiation exposure and image quality ([ 131 I]iodine) or limited availability ([ 124 I]iodine). In contrast, [ 18 F]tetrafluoroborate (TFB) is a novel radiolabeled PET substrate of hNIS, results in PET images with high-quality and low radiation doses, and should therefore be suited for imaging of DTC. The aim of the present study was to compare the diagnostic performance of [ 18 F]TFB-PET to the clinical reference standard [ 131 I]iodine scintigraphy in patients with recurrent DTC. Methods: Twenty-five patients with recurrent DTC were included in this retrospective analysis. All patients underwent [ 18 F]TFB-PET combined with either CT or MRI due to newly discovered elevated TG levels, antiTG levels, sonographically suspicious cervical lymph nodes, or combinations of these findings. Correlative [ 131 I]iodine whole-body scintigraphy (dxWBS) including SPECT-CT was present for all patients; correlative [ 18 F]FDG-PET-CT was present for 21 patients. Histological verification of [ 18 F]TFB positive findings was available in 4 patients. Results: [ 18 F]TFB-PET detected local recurrence or metastases of DTC in significantly more patients than conventional [ 131 I]iodine dxWBS and SPECT-CT (13/25 = 52% vs. 3/25 = 12%, p = 0.002). The diagnosis of 6 patients with cervical lymph node metastases that showed mildly increased FDG metabolism but negative [ 131 I]iodine scintigraphy was changed: [ 18 F]TFB-PET revealed hNIS expression in the metastases, which were therefore reclassified as only partly de-differentiated (histological confirmation present in two patients). Highest sensitivity for detecting recurrent DTC had the combination of [ 18 F]TFB-PET-CT/MRI with [ 18 F]FDG-PET-CT (64%). Conclusion: In the present cohort, [ 18 F]TFB-PET shows higher sensitivity and accuracy than [ 131 I]iodine WBS and SPECT-CT in detecting recurrent DTC. The combination of [ 18 F]TFB-PET with [ 18 F]FDG-PET-CT seems a reasonable strategy to characterize DTC tumor manifestations with respect to their differentiation and thereby also individually plan and monitor treatment. Future prospective studies evaluating the potential of [ 18 F]TFB-PET in recurrent DTC are warranted.
Databáze:	MEDLINE
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