rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2017-98-2-103-110rentrad-211Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS OF LITERATUREРОЛЬ КОМБИНИРОВАННОЙ ПОЗИТРОННОЙ ЭМИССИОННОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ С 18-ФТОРДЕЗОКСИГЛЮКОЗОЙ В ВЕДЕНИИ БОЛЬНЫХ ДИФФЕРЕНЦИРОВАННЫМ РАКОМ ЩИТОВИДНОЙ ЖЕЛЕЗЫROLE OF COMBINED 18-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN THE MANAGEMENT OF PATIENTS WITH DIFFERENTIATED THYROID CANCERhttps://orcid.org/0000-0003-4122-9285ГелиашвилиТ. М.GeliashviliT. M.

врач-радиотерапевт,

ул. Блюхера, 42, Челябинск, 454087

Radiotherapist,

ul. Blyukhera, 42, Chelyabinsk, 454087

geliashvili_tata@mail.ruhttps://orcid.org/0000-0002-7912-9039ВаженинА. В.VazheninA. V.

д. м. н., профессор, академик РАН, заведующий кафедрой онкологии, лучевой диагностики и лучевой терапии, главный врач,

ул. Блюхера, 42, Челябинск, 454087;

ул. Воровского, 64, Челябинск, 454092

MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Head of Chair of Oncology, Radiation Diagnostics and Radiation Therapy, Head Physician,

ul. Blyukhera, 42, Chelyabinsk, 454087;

ul. Vorovskogo, 64, Chelyabinsk, 454092

https://orcid.org/0000-0002-9432-5396АфанасьеваН. Г.Afanas'evaN. G.

к. м. н., заведующая Центром позитронной эмиссионной томографии,

ул. Блюхера, 42, Челябинск, 454087

MD, PhD, Head of Center for Positron Emission Tomography,

ul. Blyukhera, 42, Chelyabinsk, 454087

ГБУЗ «Челябинский областной клинический онкологический диспансер»РоссияChelyabinsk Regional Oncology CenterRussian FederationГБУЗ «Челябинский областной клинический онкологический диспансер»; ФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияChelyabinsk Regional Oncology Center; South Ural State Medical University, Ministry of Health of the RFRussian Federation201728042017982103110Copyright © Гелиашвили Т.М., Важенин А.В., Афанасьева Н.Г., 20172017Гелиашвили Т.М., Важенин А.В., Афанасьева Н.Г.Geliashvili T.M., Vazhenin A.V., Afanas'eva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/211

Благодаря открытию в России новых центров ядерной медицины для многих пациентов с дифференцированным раком щитовидной железы (ДРЩЖ) стал более доступным не толь- ко такой безальтернативный метод лечения, как радиойодтерапия, но и такой незаменимый метод обследования, как позитронная эмиссионная томография, совмещенная с компьютерной томографией с 18-фтордезоксиглюкозой (ПЭТ/КТ с 18ФДГ).

Целью данной обзорной работы явился анализ многочисленных исследований, касающихся новых тенденций и современных рекомендаций относительно применения ПЭТ/КТ при ДРЩЖ. Главным показанием к этому исследованию остаются состояния, при которых повышен уровень тиреоглобулина (ТГ) и имеются негативные данные сцинтиграфии всего тела с 131I. Однако результаты ПЭТ/КТ с 18ФДГ могут изменить лечебную и диагностическую тактику и в группе больных с йодчувствительными опухолями. До сих пор не определен минимальный уровень ТГ, при котором клинически целесообразно выполнение ПЭТ/КТ с 18ФДГ. Нерешенным пока остается и вопрос необходимости ее проведения на фоне стимуляции тиреотропного гормона. 

Owing to the setting up of new nuclear medicine centers, not only choiceless treatment, such as radioactive iodine therapy, but also an indispensable technique in examination, such as 18-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT), has become available to many patients with differentiated thyroid cancer (DTC). The purpose of this review was to analyze numerous studies of new trends in and current recommendations for the use of PET/CT for DTC. Elevated thyroglobulin (TG) levels and negative 131I whole-body scintigraphy data remain a main indication for these techniques. However, PET/CT is also able to change treatment and diagnostic tactics in patients with iodine-sensitive tumors. The minimum TG level, at which it is clinically appropriate to perform PET/CT, has not so far been determined. Whether there is the need for PET/CT during thyroid-stimulating hormone stimulation remains to be solved.

обзордифференцированный рак щитовидной железыпозитронная эмиссионная томографиясовмещенная с компьютерной томографией с 18-фтордезоксиглюкозойстандартизированный уровень накоплениясцинтиграфия всего тела с 131Iтиреоглобулинreviewdifferentiated thyroid cancercombined 18-fluorodeoxyglucose positron emission tomography/ computed tomographystandardized accumulation level131I whole-body scintigraphythyroglobulinReferencesЧиссов В.И., Дарьялова С.Л. Онкология. М.: ГЭОТАР-Медиа; 2007. [Chissov V.I., Dar'yalova S.L. Oncology. Moscow: GEOTARMedia; 2007 (in Russ.).]Чиссов В.И., Дарьялова С.Л. Онкология. М.: ГЭОТАР-Медиа; 2007. [Chissov V.I., Dar'yalova S.L. Oncology. Moscow: GEOTARMedia; 2007 (in Russ.).]Sherman S.I. Thyroid carcinoma. Lancet. 2003; 361 (9356): 501–11.Sherman S.I. Thyroid carcinoma. Lancet. 2003; 361 (9356): 501–11.Sipos J.A., Mazzaferri E.L. Thyroid cancer epidemiology and prognostic variables. Clinical. Oncology. 2010; 22 (6): 395–404.Sipos J.A., Mazzaferri E.L. Thyroid cancer epidemiology and prognostic variables. Clinical. Oncology. 2010; 22 (6): 395–404.Eustatia-Rutten C.F., Corssmit E.P., Biermasz N.R., Pereira A.M., Romijn J.A., Smit J.W. Survival and death causes in differentiated thyroid carcinoma. J. Clin. Endocr. Metab. 2006; 91 (1): 313–9.Eustatia-Rutten C.F., Corssmit E.P., Biermasz N.R., Pereira A.M., Romijn J.A., Smit J.W. Survival and death causes in differentiated thyroid carcinoma. J. Clin. Endocr. Metab. 2006; 91 (1): 313–9.Davies L., Welch H.G. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006; 295 (18): 2164–7.Davies L., Welch H.G. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006; 295 (18): 2164–7.Joensuu H., Ahonen A. Imaging of metastases of thyroid carcinoma with fluorine-18 fluorodeoxyglucose. J. Nucl. Med. 1987; 28 (5): 910–4.Joensuu H., Ahonen A. Imaging of metastases of thyroid carcinoma with fluorine-18 fluorodeoxyglucose. J. Nucl. Med. 1987; 28 (5): 910–4.Feine U., Lietzenmayer R., Hanke J.P., Held J., Wohrle H., Muller-Schauenburg W. Fluorine-18-FDG and iodine-131-iodide uptake in thyroid cancer. J. Nucl. Med. 1996; 37 (9): 1468–72.Feine U., Lietzenmayer R., Hanke J.P., Held J., Wohrle H., Muller-Schauenburg W. Fluorine-18-FDG and iodine-131-iodide uptake in thyroid cancer. J. Nucl. Med. 1996; 37 (9): 1468–72.Salvatori M., Biondi B., Rufini V. 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in differentiatedthyroid carcinoma: clinical indications and controversies in diagnosis and follow-up. Eur. J. Endocr. 2015; 173 (3): 115–30.Salvatori M., Biondi B., Rufini V. 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in differentiatedthyroid carcinoma: clinical indications and controversies in diagnosis and follow-up. Eur. J. Endocr. 2015; 173 (3): 115–30.Padovani R.P., Robenshtok E., Brokhin M., Tuttle R.M. Even without additional therapy, serum thyroglobulin concentrations often decline for years after total thyroidectomy and radioactive remnant ablation in patients with differentiated thyroid cancer. Thyroid. 2012; 22 (8): 778–83.Padovani R.P., Robenshtok E., Brokhin M., Tuttle R.M. Even without additional therapy, serum thyroglobulin concentrations often decline for years after total thyroidectomy and radioactive remnant ablation in patients with differentiated thyroid cancer. Thyroid. 2012; 22 (8): 778–83.Haugen B.R., Alexander E.K., Bible K.C., Doherty G.M., Mandel S.J., Nikiforov Y.E. et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016; 26 (1): 1–133.Haugen B.R., Alexander E.K., Bible K.C., Doherty G.M., Mandel S.J., Nikiforov Y.E. et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016; 26 (1): 1–133.Treglia G., Bertagna F., Piccardo A., Giovanella L. 131-I-whole-body scan or 18-FDG-PET/CT for patients with elevated thyroglobulin and negative ultrasound? Clin. Translat. Imag. 2013; 1 (3): 175–83.Treglia G., Bertagna F., Piccardo A., Giovanella L. 131-I-whole-body scan or 18-FDG-PET/CT for patients with elevated thyroglobulin and negative ultrasound? Clin. Translat. Imag. 2013; 1 (3): 175–83.Leboulleux S., El Bez I., Borget I., Elleuch M., Deandreis D., Al Ghuzlan A. et al. Post-radioiodine treatment whole body scan in the era of fluorodesoxyglucose positron emission tomography for differentiated thyroid carcinoma with elevated serum thyroglobulin levels. Thyroid. 2012; 22 (8): 832–8.Leboulleux S., El Bez I., Borget I., Elleuch M., Deandreis D., Al Ghuzlan A. et al. Post-radioiodine treatment whole body scan in the era of fluorodesoxyglucose positron emission tomography for differentiated thyroid carcinoma with elevated serum thyroglobulin levels. Thyroid. 2012; 22 (8): 832–8.Dong M.J., Liu Z.F., Zhao K., Ruan L.X., Wang G.L., Yang S.Y. et al. Value of 18F-FDG-PET/Dong M.J., Liu Z.F., Zhao K., Ruan L.X., Wang G.L., Yang S.Y. et al. Value of 18F-FDG-PET/PET-CT in differentiated thyroid carcinoma with radioiodine-negative whole-body scan. Meta-analysis. Nucl. Med. Commun. 2009; 30 (8): 639–50.PET-CT in differentiated thyroid carcinoma with radioiodine-negative whole-body scan. Meta-analysis. Nucl. Med. Commun. 2009; 30 (8): 639–50.Giovanella L. Positron emission tomography/computed tomography in patients treated for differentiated thyroid carcinomas. Expert Rev. Endocr. Metabol. 2012; 7 (1): 35–43.Giovanella L. Positron emission tomography/computed tomography in patients treated for differentiated thyroid carcinomas. Expert Rev. Endocr. Metabol. 2012; 7 (1): 35–43.Masson-Deshayes S., Schvartz C., Dalban C., Guendouzen S., Pochart J.M., Dalac A. et al. Prognostic value of (18)F-FDG PET/CT metabolic parameters in metastatic differentiated thyroid cancers. Clin. Nucl. Med. 2015; 40 (6): 469–75.Masson-Deshayes S., Schvartz C., Dalban C., Guendouzen S., Pochart J.M., Dalac A. et al. Prognostic value of (18)F-FDG PET/CT metabolic parameters in metastatic differentiated thyroid cancers. Clin. Nucl. Med. 2015; 40 (6): 469–75.Robbins R.J., Wan Q., Grewal R.K., Reibke R., Gonen M., Strauss H.W. et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography scanning. J. Clin. Endocr. Metabol. 2006; 91 (2): 498–505.Robbins R.J., Wan Q., Grewal R.K., Reibke R., Gonen M., Strauss H.W. et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography scanning. J. Clin. Endocr. Metabol. 2006; 91 (2): 498–505.Deandreis D., Al Ghuzlan A., Leboulleux S. Do histological, immunohistochemical and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr. Relat. Cancer. 2011; 18 (1): 159–69.Deandreis D., Al Ghuzlan A., Leboulleux S. Do histological, immunohistochemical and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr. Relat. Cancer. 2011; 18 (1): 159–69.Wang W., Larson S.M., Fazzari M., Tickoo S.K., Kolbert K., Sgouros G. et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J. Clin. Endocr. Metabol. 2000; 85 (3): 1107–13.Wang W., Larson S.M., Fazzari M., Tickoo S.K., Kolbert K., Sgouros G. et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J. Clin. Endocr. Metabol. 2000; 85 (3): 1107–13.Rosenbaum-Krumme S.J., Gorges R., Bockisch A., Binse I. 18F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy. Eur. J. Nucl. Med. Mol. Imag. 2012; 39 (9): 1373–80.Rosenbaum-Krumme S.J., Gorges R., Bockisch A., Binse I. 18F-FDG PET/CT changes therapy management in high-risk DTC after first radioiodine therapy. Eur. J. Nucl. Med. Mol. Imag. 2012; 39 (9): 1373–80.Lee J.W., Lee S.M., Lee D.H., Kim Y.J. Clinical utility of 18FFDG PET/CT concurrent withLee J.W., Lee S.M., Lee D.H., Kim Y.J. Clinical utility of 18FFDG PET/CT concurrent withI therapy in intermediate-tohigh-risk patients with differentiated thyroid cancer: dual-center experience with 286 patients. J. Nucl. Med. 2013; 54 (8): 1230–6.I therapy in intermediate-tohigh-risk patients with differentiated thyroid cancer: dual-center experience with 286 patients. J. Nucl. Med. 2013; 54 (8): 1230–6.Gaertner F.C., Okamoto S., Shiga T., Ito Y.M., Uchiyama Y., Manabe O. et al. FDG PET performed at thyroid remnant ablation has a higher predictive value for longterm survival of high-risk patients with well-differentiated thyroid cancer than radioiodine uptake. Clin. Nucl. Med. 2015; 40 (5): 378–83.Gaertner F.C., Okamoto S., Shiga T., Ito Y.M., Uchiyama Y., Manabe O. et al. FDG PET performed at thyroid remnant ablation has a higher predictive value for longterm survival of high-risk patients with well-differentiated thyroid cancer than radioiodine uptake. Clin. Nucl. Med. 2015; 40 (5): 378–83.Bongiovanni M., Paone G., Ceriani L., Pusztaszeri M. Cellular and molecular basis for thyroid cancer imaging in nuclear medicine. Clin. Translat. Imag. 2013; 1 (3): 149–61.Bongiovanni M., Paone G., Ceriani L., Pusztaszeri M. Cellular and molecular basis for thyroid cancer imaging in nuclear medicine. Clin. Translat. Imag. 2013; 1 (3): 149–61.Sisson J.C., Ackermann R.J., Meyer M.A., Wahl R.L. Uptake of 18-fluoro-2-deoxy-D-glucose by thyroid cancer: implications for diagnosis and therapy. J. Clin. Endocr. Metabol. 1993; 77 (4): 1090–4.Sisson J.C., Ackermann R.J., Meyer M.A., Wahl R.L. Uptake of 18-fluoro-2-deoxy-D-glucose by thyroid cancer: implications for diagnosis and therapy. J. Clin. Endocr. Metabol. 1993; 77 (4): 1090–4.Chao Ma, Jiawei Xie, Yanhui Lou, Yanyan Gao, Shuyao Zuo, Xufu Wang. The role of TSH for F-FDGPET in the diagnosis of recurrence and metastases of differentiated thyroid carcinoma with elevated thyroglobulin and negative scan: a meta-analysis. Eur. J. Endocr. 2010; 163 (2): 177–83.Chao Ma, Jiawei Xie, Yanhui Lou, Yanyan Gao, Shuyao Zuo, Xufu Wang. The role of TSH for F-FDGPET in the diagnosis of recurrence and metastases of differentiated thyroid carcinoma with elevated thyroglobulin and negative scan: a meta-analysis. Eur. J. Endocr. 2010; 163 (2): 177–83.Charles M., Whitworth P.W., Surasi D.S., Pai S.I., Subramaniam R.M. PET/CT in the management of thyroid cancers. Am. J. Roentgenol. 2014; 202 (6): 1316–29.Charles M., Whitworth P.W., Surasi D.S., Pai S.I., Subramaniam R.M. PET/CT in the management of thyroid cancers. Am. J. Roentgenol. 2014; 202 (6): 1316–29.Bertagna F., Biasiotto G., Orlando E., Bosio G., Giubbini R. Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients affected by differentiated thyroid carcinoma, high thyroglobulin level, and negative 131I scan: review of the literature. Japan. J. Radiol. 2010; 28 (9): 629–36.Bertagna F., Biasiotto G., Orlando E., Bosio G., Giubbini R. Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients affected by differentiated thyroid carcinoma, high thyroglobulin level, and negative 131I scan: review of the literature. Japan. J. Radiol. 2010; 28 (9): 629–36.Schluter B., Bohuslavizki K.H., Beyer W., Plotkin M., Buchert R., Clausen M. Impact of FDG PET on patients with differentiated thyroid cancer who present with elevated thyroglobulin and negative 131I scan. J. Nucl. Med. 2001; 42 (1): 71–6.Schluter B., Bohuslavizki K.H., Beyer W., Plotkin M., Buchert R., Clausen M. Impact of FDG PET on patients with differentiated thyroid cancer who present with elevated thyroglobulin and negative 131I scan. J. Nucl. Med. 2001; 42 (1): 71–6.Zimmer L.A., McCook B., Meltzer C., Fukui M., Bascom D., Snyderman C. et al. Combined positron emission tomography/computed tomography imaging of recurrent thyroid cancer. Otolar. Head Neck Surg. 2003; 128 (2): 178–84.Zimmer L.A., McCook B., Meltzer C., Fukui M., Bascom D., Snyderman C. et al. Combined positron emission tomography/computed tomography imaging of recurrent thyroid cancer. Otolar. Head Neck Surg. 2003; 128 (2): 178–84.Giovanella L., Trimboli P., Verburg F.A., Treglia G., Piccardo A., Foppiani L., Geriani L. Thyroglobulin levels and thyroglobulin doubling time independently predict a positive 18F-FDG PET/CT scan in patients with biochemical recurrence of differentiated thyroid carcinoma. Eur. J. Nucl. Med. Molec. Imag. 2013; 40 (6): 874–80.Giovanella L., Trimboli P., Verburg F.A., Treglia G., Piccardo A., Foppiani L., Geriani L. Thyroglobulin levels and thyroglobulin doubling time independently predict a positive 18F-FDG PET/CT scan in patients with biochemical recurrence of differentiated thyroid carcinoma. Eur. J. Nucl. Med. Molec. Imag. 2013; 40 (6): 874–80.Shammas A., Degirmenci B., Mountz J.M., McCook B.M., Branstetter B., Bencherif B. et al. 18FFDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer. J. Nucl. Med. 2007; 48 (2): 221–6.Shammas A., Degirmenci B., Mountz J.M., McCook B.M., Branstetter B., Bencherif B. et al. 18FFDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer. J. Nucl. Med. 2007; 48 (2): 221–6.

The authors declare that there are no conflicts of interest present.