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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-07-2019 | Thyroid Disease | Original Article

TSH suppression aggravates arterial inflammation — an ¹⁸F-FDG PET study in thyroid carcinoma patients

Authors: Ellen Boswijk, Karin J. C. Sanders, Evie P. M. Broeders, Marlies de Ligt, Guy H. E. J. Vijgen, Bas Havekes, Alma M. A. Mingels, Roel Wierts, Wouter D. van Marken Lichtenbelt, Patrick Schrauwen, Felix M. Mottaghy, Joachim E. Wildberger, Jan Bucerius

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2019

Abstract

Purpose

We aimed to investigate the influence of both hypothyroidism and thyroid-stimulating hormone (TSH) suppression on vascular inflammation, as assessed with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT).

Methods

Ten thyroid carcinoma patients underwent an ¹⁸F-FDG PET/CT during post-thyroidectomy hypothyroidism and during thyrotropin (TSH) suppression after ¹³¹I (radioiodine) ablation therapy. We analysed the ¹⁸F-FDG uptake in the carotids, aortic arch, ascending, descending, and abdominal aorta to investigate the effects of thyroid hormone status on arterial inflammation. Target-to-background ratios (TBRs) corrected for blood pool activity were established for all arterial territories. Results were further compared to euthyroid historic control subjects.

Results

In general, there was a trend towards higher vascular TBRs during TSH suppression than during hypothyroidism (TBR_max all vessels = 1.6 and 1.8, respectively, p = 0.058), suggesting a higher degree of arterial inflammation. In concurrence with this, we found increased C-reactive protein (CRP) levels after levothyroxine treatment (CRP = 2.9 mg/l and 4.8 mg/l, p = 0.005). An exploratory comparison with euthyroid controls showed significant higher TBRs during TSH suppression for the carotids, aortic arch, thoracic descending aorta, and when all vascular territories were combined (TBR_maxp = 0.013, p = 0.016, p = 0.030 and p = 0.018 respectively).

Conclusions

Arterial inflammation is increased during TSH suppression. This finding sheds new light on the underlying mechanism of the suspected increased risk of cardiovascular disease in patients with TSH suppression.

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Title: TSH suppression aggravates arterial inflammation — an 18F-FDG PET study in thyroid carcinoma patients
Authors: Ellen Boswijk
Karin J. C. Sanders
Evie P. M. Broeders
Marlies de Ligt
Guy H. E. J. Vijgen
Bas Havekes
Alma M. A. Mingels
Roel Wierts
Wouter D. van Marken Lichtenbelt
Patrick Schrauwen
Felix M. Mottaghy
Joachim E. Wildberger
Jan Bucerius
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keywords: Thyroid Disease
Thyroid Disease
Arterial Occlusive Disease
Positron Emission Tomography
Hypothyroidism
Levothyroxine
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04292-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

TSH suppression aggravates arterial inflammation — an ¹⁸F-FDG PET study in thyroid carcinoma patients

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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