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The clinical signification and application value of [68Ga]Ga-PSMA imaging in thyroid malignancy

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Abstract

Purpose

Approximately 5% of differentiated thyroid cancers lose the ability to uptake iodine, leading to limited treatment options and poor prognosis due to invasion and distant metastasis. PSMA imaging probes have been proposed as a potential diagnostic and therapeutic tool for iodine-refractory thyroid cancer. However, there are limited reports and significant heterogeneity in patient selection, warranting further exploration of the application value of PSMA in thyroid cancer.

Methods

We performed Western Blot, PCR, and [68Ga]Ga-PSMA uptake experiments on cell lines and conducted in vivo small animal imaging. Clinical and radiological results of included differentiated thyroid cancer patients were collected. (Trial registration number: 2021-669, Trial registration date: December 30, 2021).

Results

PSMA expression levels were significantly higher in poorly differentiated thyroid cancer (7.86 ± 1.90 vs. 1.00 ± 0, P < 0.01; 7.86 ± 1.90 vs. 0.03 ± 0.02, P < 0.01), but [68Ga]Ga-PSMA imaging correlated with tumor burden, such as 18F-FDG (8.08 ± 7.74 and 5.67 ± 4.23, P = 0.01) and Tg levels (307.1 ± 183.4 vs. 118.0 ± 116.1, P = 0.002).

Conclusion

Our results showed that PSMA expression increased with the decrease of thyroid cancer differentiation. However, the level of [68Ga]Ga-PSMA uptake in thyroid cancer patients was not significantly associated with the degree of thyroid cancer differentiation, but also with the metabolism and burden of tumors such as 2-[18F]FDG and Tg levels. These findings provide additional clinical significance and application value for PSMA in thyroid cancer.

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Funding

This work was supported by the National Natural Science Foundation of China (Project No.82102093), the Natural Science Foundation of Chongqing Municipality (Project No. cstc2020jcyj-msxmX0713), and the scientific research project of Chongqing Medical University (Project No.11).

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Authors and Affiliations

  1. Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing, PR China

    Yu Yue Feng, Yang Rui Shi, Zhu **a, Lu Xu, Wen Bo Li, Hua Pang & Zheng jie Wang

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  1. Yu Yue Feng
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  3. Zhu **a
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Y.Y.F., Y.R.S., Z. X., W.B.L. and L.X. The first draft of the manuscript was written by Y.Y.F. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hua Pang or Zheng jie Wang.

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Feng, Y.Y., Shi, Y.R., **a, Z. et al. The clinical signification and application value of [68Ga]Ga-PSMA imaging in thyroid malignancy. Endocrine 84, 598–606 (2024). https://doi.org/10.1007/s12020-023-03599-x

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