F-18-FDG-PET bei Schilddrüsen-Autonomien

Anne-Rose Börner; E. Voth; K. Wienhard; R. Wagner; H. Schicha

doi:10.1055/s-0038-1632181

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1999; 38(01): 1-6
DOI: 10.1055/s-0038-1632181

Originalarbeiten — Original Articles

Schattauer GmbH

F-18-FDG-PET bei Schilddrüsen-Autonomien

F-18-FDG-PET in Autonomous Goiter

Anne-Rose Börner

¹Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln

,

E. Voth

¹Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln

,

K. Wienhard

²Max-Planck-Institut für Neurologische Forschung, Köln, Deutschland

,

R. Wagner

²Max-Planck-Institut für Neurologische Forschung, Köln, Deutschland

,

H. Schicha

¹Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln

› Author Affiliations

Abstract

Zusammenfassung:

Ziel: Die Schilddrüsenautonomie im lodmangelgebiet beruht in der Mehrzahl der Fälle auf konstitutiven, funktionsaktivierenden Mutationen des Thyreotropin-(TSH-)Rezeptors. Diese Studie evaluiert F-18-Fluoro-Deoxy-Glukose-(F-18-FDG-)PET der Schilddrüse bei Patienten mit funktionell relevanter Autonomie der Schilddrüse. Methoden: 20 Patienten mit fokaler und 10 Patienten mit disseminierter Autonomie der Schilddrüse wurden am Tag vor geplanter Radioiod-Therapie mit FDG-PET untersucht. 20 Patienten mit Kopf/Halstumoren und normaler Schilddrüsenfunktion dienten als Kontrollgruppe. Ergebnisse: Die F-18-FDG-Aufnahme in die Schilddrüse war signifikant höher bei Patienten mit funktionell relevanter Autonomie im Vergleich zu den Kontrollen. Fokale Autonomien zeichneten sich ausnahmslos durch einen intensiven, fokal gesteigerten Glukose-Uptake aus, während disseminierte Autonomien ein variables Muster globaler Steigerungen des Glukose-Uptakes zeigten. Schlußfolgerung: Funktionelle Autonomien der Schilddrüse zeigen einen gleichzeitig gesteigerten Glukose- und lodstoffwechsel als Folge der konstitutiven Mutation des TSH-Rezeptors, wobei das Ausmaß beider Veränderungen positiv korreliert.

Summary

Aim: Gain-of-function mutations of the thyrotropin receptor (TSHR) gene have been invoked as one of the major causes of toxic thyroid adenomas. This study evaluates F-18-FDG-PET in these patients. Methods: Twenty patients with focal autonomous nodules and ten with disseminated autonomy were investigated the day before radioiodine therapy. Twenty patients with cancer of the head or neck and normal thyroid function served as controls. Results: F-18-FDG-Uptake was higher in patients than in controls. Focal autonomous nodules were associated with focally enhanced glucose metabolism. Disseminated autonomous goiters showed various patterns of focal or global hypermetabolism. Conclusion: Autonomous thyroid tissue caused by constitutive mutations of the TSH receptor is characterised by simultaneous increases in glucose and iodine metabolism which are correlated.

Schlüsselwörter

Schilddrüsenautonomie - Glukosemetabolismus - FDG-PET - TSH - konstitutive Rezeptormutat

Key words

Autonomous goiter - glucose metabolism - FDG-PET - TSH - constitutive receptor mutation

Full Text

References

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