TSH Stimulation Reveals Additional Bone Metastases on [¹⁸F]FDG PET/CT in Metastatic Follicular Thyroid Carcinoma.
- 1Departments of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun-gun 58128, Republic of Korea.
- 2Departments of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju 61469, Republic of Korea.
Abstract
A 62-year-old woman with metastatic follicular thyroid carcinoma underwent 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) PET/CT before a second course of radioactive iodine therapy because of a markedly elevated serum thyroglobulin level (498.0 ng/mL). The initial PET/CT was performed under thyroid-stimulating hormone (TSH) suppression (0.01 μIU/mL) and demonstrated FDG uptake in known osseous metastases involving the T10 and L5 vertebrae, while additional skeletal metastases were not conspicuous. Repeat PET/CT performed 6 days later after recombinant human TSH (rhTSH) stimulation (TSH, 70.96 μIU/mL) showed substantially increased FDG uptake in the known T10 and L5 lesions, with SUVmax increasing from 3.33 to 6.31 and from 3.98 to 11.61, respectively. In addition, metastases in the T9 vertebra and sternum became conspicuous only after TSH stimulation and remained evident on subsequent follow-up imaging, supporting their metastatic nature. This paired within-patient comparison directly demonstrates that, in this patient, osseous lesions inconspicuous under TSH suppression became clearly visualized after rhTSH stimulation and persisted on follow-up imaging, illustrating the potential influence of TSH status on the apparent skeletal metastatic burden on [¹⁸F]FDG PET/CT.
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BibTeX
@article{moon2026stimulation,
title = {{TSH Stimulation Reveals Additional Bone Metastases on [¹⁸F]FDG PET/CT in Metastatic Follicular Thyroid Carcinoma.}},
author = {Jang Bae Moon and Sang-Geon Cho and Sae-Ryung Kang and Jahae Kim and Seong-Young Kwon and Su Woong Yoo},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/diagnostics16193146},
url = {https://europepmc.org/article/MED/42882301},
note = {CC BY},
}
RIS
TY - JOUR
TI - TSH Stimulation Reveals Additional Bone Metastases on [¹⁸F]FDG PET/CT in Metastatic Follicular Thyroid Carcinoma.
AU - Jang Bae Moon
AU - Sang-Geon Cho
AU - Sae-Ryung Kang
AU - Jahae Kim
AU - Seong-Young Kwon
AU - Su Woong Yoo
PY - 2026
DA - 2026/09/28
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193146
UR - https://europepmc.org/article/MED/42882301
AB - A 62-year-old woman with metastatic follicular thyroid carcinoma underwent 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) PET/CT before a second course of radioactive iodine therapy because of a markedly elevated serum thyroglobulin level (498.0 ng/mL). The initial PET/CT was performed under thyroid-stimulating hormone (TSH) suppression (0.01 μIU/mL) and demonstrated FDG uptake in known osseous metastases involving the T10 and L5 vertebrae, while additional skeletal metastases were not conspicuous. Repeat PET/CT performed 6 days later after recombinant human TSH (rhTSH) stimulation (TSH, 70.96 μIU/mL) showed substantially increased FDG uptake in the known T10 and L5 lesions, with SUVmax increasing from 3.33 to 6.31 and from 3.98 to 11.61, respectively. In addition, metastases in the T9 vertebra and sternum became conspicuous only after TSH stimulation and remained evident on subsequent follow-up imaging, supporting their metastatic nature. This paired within-patient comparison directly demonstrates that, in this patient, osseous lesions inconspicuous under TSH suppression became clearly visualized after rhTSH stimulation and persisted on follow-up imaging, illustrating the potential influence of TSH status on the apparent skeletal metastatic burden on [¹⁸F]FDG PET/CT.
SN - 2075-4418
ER -