Head-to-head comparison of [ 18 F] fluorodeoxyglucose PET/CT and [ 68 Ga]Ga-prostate specific membrane antigen-11 PET/CT in radioactive iodine refractory differentiated thyroid cancer.

IF 1.3 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Nuclear Medicine Communications Pub Date : 2025-11-01 Epub Date: 2025-08-01 DOI:10.1097/MNM.0000000000002036

Ali Kibar, Sait Sager, Onur Erdem Sahin, Sertac Asa, Lebriz Uslu-Besli, Nebi Serkan Demirci, Irem Onur, Tulin Ozturk, Serkan Teksoz, Kerim Sonmezoglu, Haluk Burcak Sayman

{"title":"Head-to-head comparison of [ 18 F] fluorodeoxyglucose PET/CT and [ 68 Ga]Ga-prostate specific membrane antigen-11 PET/CT in radioactive iodine refractory differentiated thyroid cancer.","authors":"Ali Kibar, Sait Sager, Onur Erdem Sahin, Sertac Asa, Lebriz Uslu-Besli, Nebi Serkan Demirci, Irem Onur, Tulin Ozturk, Serkan Teksoz, Kerim Sonmezoglu, Haluk Burcak Sayman","doi":"10.1097/MNM.0000000000002036","DOIUrl":null,"url":null,"abstract":"Objectives: Radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) is associated with challenges in both imaging and treatment due to resistance to I-131. The aim of this study is to compare the lesion detection rates of [ 18 F] fluorodeoxyglucose (FDG) PET/computed tomography [CT] and [ 68 Ga]Ga-prostate specific membrane antigen (PSMA)-11 PET/CT, and to investigate the theranostic potential of PSMA in RAIR-DTC.Methods: Thirty-eight RAIR-DTC patients followed between 2022 and 2024 underwent [ 18 F]FDG PET/CT and [ 68 Ga]Ga-PSMA-11 PET/CT. Lesions with uptake exceeding background activity were considered positive, while physiological uptake areas and benign-appearing foci were excluded. Lesion maximum standardized uptake value (SUVmax), tumor-to-background ratio (TBR), and detection rates were calculated and compared.Results: [ 18 F]FDG PET/CT detected more lesions overall than [ 68 Ga]Ga-PSMA-11 PET/CT (96.8 vs. 60.1%), particularly in the thyroid bed, lymph nodes, and lungs. However, both modalities identified the same number of bone lesions. While [ 18 F]FDG PET/CT was superior in most patients, [ 68 Ga]Ga-PSMA-11 PET/CT detected more lesions in a subset of patients and performed better in the pure classic papillary thyroid carcinoma subtype compared to other subtypes (71.7 vs. 50.3%). SUVmax and TBR values were higher on [ 18 F]FDG PET/CT, yet in 14 patients (36.8%), [ 68 Ga]Ga-PSMA-11 PET/CT identified lesions with SUVmax exceeding liver SUVmax, indicating potential eligibility for PSMA-based radionuclide therapy.Conclusion: Although [ 18 F]FDG PET/CT demonstrated superior overall lesion detection, [ 68 Ga]Ga-PSMA-11 PET/CT identified more lesions in a subset of patients. [ 68 Ga]Ga-PSMA-11 PET/CT appears to be more beneficial in the pure classic subtype compared to other histological variants. Notably, [ 68 Ga]Ga-PSMA-11 PET/CT demonstrated high uptake in a considerable number of patients and may provide theranostic value in RAIR-DTC patients with limited treatment options.","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"1078-1089"},"PeriodicalIF":1.3000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nuclear Medicine Communications","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MNM.0000000000002036","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/1 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives: Radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) is associated with challenges in both imaging and treatment due to resistance to I-131. The aim of this study is to compare the lesion detection rates of [ 18 F] fluorodeoxyglucose (FDG) PET/computed tomography [CT] and [ 68 Ga]Ga-prostate specific membrane antigen (PSMA)-11 PET/CT, and to investigate the theranostic potential of PSMA in RAIR-DTC.

Methods: Thirty-eight RAIR-DTC patients followed between 2022 and 2024 underwent [ 18 F]FDG PET/CT and [ 68 Ga]Ga-PSMA-11 PET/CT. Lesions with uptake exceeding background activity were considered positive, while physiological uptake areas and benign-appearing foci were excluded. Lesion maximum standardized uptake value (SUVmax), tumor-to-background ratio (TBR), and detection rates were calculated and compared.

Results: [ 18 F]FDG PET/CT detected more lesions overall than [ 68 Ga]Ga-PSMA-11 PET/CT (96.8 vs. 60.1%), particularly in the thyroid bed, lymph nodes, and lungs. However, both modalities identified the same number of bone lesions. While [ 18 F]FDG PET/CT was superior in most patients, [ 68 Ga]Ga-PSMA-11 PET/CT detected more lesions in a subset of patients and performed better in the pure classic papillary thyroid carcinoma subtype compared to other subtypes (71.7 vs. 50.3%). SUVmax and TBR values were higher on [ 18 F]FDG PET/CT, yet in 14 patients (36.8%), [ 68 Ga]Ga-PSMA-11 PET/CT identified lesions with SUVmax exceeding liver SUVmax, indicating potential eligibility for PSMA-based radionuclide therapy.

Conclusion: Although [ 18 F]FDG PET/CT demonstrated superior overall lesion detection, [ 68 Ga]Ga-PSMA-11 PET/CT identified more lesions in a subset of patients. [ 68 Ga]Ga-PSMA-11 PET/CT appears to be more beneficial in the pure classic subtype compared to other histological variants. Notably, [ 68 Ga]Ga-PSMA-11 PET/CT demonstrated high uptake in a considerable number of patients and may provide theranostic value in RAIR-DTC patients with limited treatment options.

查看原文本刊更多论文

[18F]氟脱氧葡萄糖PET/CT与[68Ga] ga -前列腺特异性膜抗原-11 PET/CT在放射性碘难治性分化甲状腺癌中的头部比较

目的：放射性碘难治性分化甲状腺癌（RAIR-DTC）由于对I-131的耐药性，在影像学和治疗方面都面临挑战。本研究的目的是比较[18F]氟脱氧葡萄糖（FDG） PET/CT [CT]和[68Ga] ga -前列腺特异性膜抗原(PSMA)-11 PET/CT的病变检出率，探讨PSMA对RAIR-DTC的治疗潜力。方法：在2022 - 2024年间随访的38例RAIR-DTC患者接受了[18F]FDG PET/CT和[68Ga]Ga-PSMA-11 PET/CT检查。摄取超过背景活性的病变被认为是阳性的，而生理摄取区和良性病灶被排除在外。计算并比较病灶最大标准化摄取值（SUVmax）、肿瘤与背景比（TBR）和检出率。结果：[18F]FDG PET/CT检出率总体高于[68Ga]Ga-PSMA-11 PET/CT (96.8 vs 60.1%)，特别是在甲状腺床、淋巴结和肺部。然而，两种方法鉴定出相同数量的骨损伤。虽然[18F]FDG PET/CT在大多数患者中表现优越，但[68Ga]Ga-PSMA-11 PET/CT在一小部分患者中检测到更多病变，并且在纯经典甲状腺乳头状癌亚型中比其他亚型表现更好（71.7%对50.3%）。[18F]FDG PET/CT上SUVmax和TBR值较高，但在14例（36.8%）患者中，[68Ga]Ga-PSMA-11 PET/CT发现病变SUVmax超过肝脏SUVmax，表明可能适合基于psma的放射性核素治疗。结论：尽管[18F]FDG PET/CT在整体病变检测方面表现出色，但[68Ga]Ga-PSMA-11 PET/CT在部分患者中发现的病变更多。[68Ga]与其他组织学变异相比，Ga-PSMA-11 PET/CT在纯经典亚型中似乎更有利。值得注意的是，[68Ga]Ga-PSMA-11 PET/CT在相当多的患者中显示出高摄取，可能对治疗选择有限的RAIR-DTC患者提供治疗价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nuclear Medicine Communications 医学-核医学

CiteScore

2.20

自引率

6.70%

发文量

212

审稿时长

3-8 weeks

期刊介绍： Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.