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REVIEW  PET/CT IMAGING IN AUTOIMMUNE DISORDERS 

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 September;66(3):218-28

DOI: 10.23736/S1824-4785.22.03464-1

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The role of PET/CT in thyroid autoimmune diseases

Elena CALIFARETTI 1, Sara DALL’ARMELLINA 1, Guido ROVERA 1, Monica FINESSI 2 , Désirée DEANDREIS 1, 2

1 Unit of Nuclear Medicine, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy; 2 Unit of Nuclear Medicine, Department of Diagnostic Imaging and Interventional Radiology, Città della Salute e della Scienza, Turin, Italy



Autoimmune thyroid diseases (AITD) are a heterogeneous group of disorders. They include, in particular, Graves’ disease and Hashimoto’s thyroiditis with a wide range of different functional status ranging from subclinical biochemical abnormalities to severe hyperthyroidism or severe hypothyroidism respectively. Furthermore, other conditions more frequently infectious or drug related can cause an immune reaction in the thyroid tissue. In AITDs, positron emission tomography/computed tomography (PET/CT) does not play a primary role for disease diagnosis or management, but accidental findings can occur in both symptomatic and asymptomatic patients, and they should be recognized and well interpreted. A comprehensive literature search of the PubMed databases was conducted to identify papers (systematic review, prospective and retrospective study, case report) evaluating the role of PET/CT in thyroid autoimmune diseases. Thyroid diffuse uptake of 18F-fluoro-2-deoxy-2-d-glucose ([18F]FDG) has been shown to be frequently associated with AITDs, but also with immune-induced thyroid disorders related to SARS-CoV-2 or immunotherapy, while malignant lesions more often have a focal aspect. Other radiopharmaceuticals as [68Ga]-DOTA-peptides, [68Ga]-fibroblast activation protein inhibitors (FAPIs) and [68Ga]-prostate specific membrane antigen ([68Ga]-PSMA) showed similar findings. In conclusion, PET/CT scan in AITDs does not play a primary role in the diagnosis, but the occasional finding of a thyroid uptake must always be described in the report and possibly investigated for a better patient’s management.


KEY WORDS: Thyroid diseases; Hashimoto disease; Graves disease; SARS-CoV-2

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