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. 2019 Jan;40(1):57-62.
doi: 10.1097/MNM.0000000000000940.

Pituitary 18F-FDG uptake correlates with serum TSH levels in thyroid cancer patients on 18F-FDG PET/CT

Yingli Ding  1 , Shuqi Wu  1 , Jing Xu  1 , Hui Wang  1 , Chao Ma  1   2
Affiliations

Pituitary 18F-FDG uptake correlates with serum TSH levels in thyroid cancer patients on 18F-FDG PET/CT

Yingli Ding et al. Nucl Med Commun. 2019 Jan.

Abstract

Objective: The objective of this study was to evaluate the relationship between fluorine-18-fluorodeoxyglucose (F-FDG) uptake in the pituitary gland and serum thyroid-stimulating hormone (TSH) levels in differentiated thyroid cancer (DTC) patients on F-FDG PET/computed tomography (CT).

Patients and methods: A total of 215 DTC patients and 215 age-paired and sex-paired healthy screening participants were included. DTC patients were divided into hypothyroid, euthyroid and subclinical hyperthyroid patients according to their serum TSH levels. The relationship between F-FDG uptake in the pituitary gland and serum TSH levels was evaluated the in DTC patients, and the pituitary F-FDG metabolism was compared in different thyroid status.

Results: The standardized uptake value of pituitary (SUVp) in all 430 patients was directly correlated with serum TSH levels (r=0.479 and 0.432, all P<0.05). The SUVp in DTC patients was higher than that in 215 healthy participants (z=-10.4, P<0.05). No significant difference of SUVp was observed between euthyroid patients and healthy participants (P=0.145).

Conclusion: Our study established the positive correlation between pituitary F-FDG uptake and serum TSH. TSH values should be measured in patients with incidental pituitary uptake during F-FDG PET/CT. L-T4 replacement for DTC patients may well have the same feedback on the thyroid-pituitary axis as the physiologic thyroid status. The diffuse F-FDG uptake with normal CT or MRI appearance of the pituitary in patients with DTC indicates physiologic uptake.

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Figures

Fig. 1
Fig. 1
(a, b) The maximum standardized uptake value (SUVp) of the pituitary gland on fluorine-18-fluorodeoxyglucose PET/computed tomography. Side-by-side box plots in the total 430 participants and thyroid cancer patients and Spearman’s rank analysis indicated that SUVp directly correlated with serum thyroid-stimulating hormone (TSH) levels (r=0.479 and 0.432, all P<0.05).
Fig. 2
Fig. 2
(a, b) Kruskal–Wallis analysis of variance tests showed patients with hypothyroidism had significant high standardized uptake value of pituitary (SUVp) as compared with patients with euthyroid, subclinical hyperthyroidism and healthy participants. No statistical differences were observed among patients with euthyroid, subclinical hyperthyroidism and healthy participants.
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