中国癌症杂志2025，Vol.35Issue(9)：815-825,11.DOI:10.19401/j.cnki.1007-3639.2025.09.001
《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读:分化型甲状腺癌的核医学诊治进展
Interpretation of the 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer:progress in nuclear medicine diagnosis and treatment of differentiated thyroid cancer
摘要
Abstract
The"2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer"released by the American Thyroid Association(ATA)in 2025 include several important updates regarding nuclear medicine diagnosis and treatment for post-operative differentiated thyroid cancer(DTC).This article systematically reviewed advances in the nuclear medicine aspects of post-operative DTC assessment,decision-making for radioactive iodine therapy(RAIT),dynamic response evaluation,and follow-up strategies,guided by the 2025 ATA guidelines'DATA clinical management framework—Diagnosis,risk/benefit Assessment,Treatment decisions,and response Assessment.Building on the 2015 ATA guidelines and recent research evidence,the 2025 ATA guidelines emphasize the critical importance of post-operative response assessment(including serological and imaging evaluations)for the real-time refinement of risk stratification.It further subcategorizes recurrence risk from the original three categories(low,intermediate,high)to four categories(low,low-intermediate,intermediate-high and high)to more accurately predict the risk of structural recurrence.Regarding RAIT strategy,the 2025 ATA guidelines clearly state that remnant ablation is no longer routinely recommended for low-risk patients to avoid unnecessary radiation exposure,and highlight the preferred use of recombinant human thyroid stimulating hormone(rhTSH)for RAIT preparation in low-and intermediate-risk patients.The 2025 ATA guidelines further clarify the appropriate clinical application scenarios for nuclear medicine molecular imaging methods such as diagnostic whole-body scan(DxWBS)and 18F-FDG positron emission tomography and computed tomography(PET/CT).At the same time,concerning post-RAIT follow-up strategies,indications for repeated RAIT,as well as the diagnostic criteria and management principles for radioactive iodine-refractory DTC(RAIR-DTC),this article highlighted the key updated points in the 2025 ATA guideline.关键词
分化型甲状腺癌/DATA(诊断、风险-获益评估、治疗决策及治疗反应评估)/核医学诊疗/指南解读/放射性碘难治性Key words
Differentiated thyroid cancer/DATA(Diagnosis,risk/benefit Assessment,Treatment decisions,and response Assessment)/Nuclear medicine diagnosis and treatment/Guideline interpretation/Radioactive-iodine refractory分类
医药卫生引用本文复制引用
赵翊含,林岩松..《2025版美国甲状腺学会成人分化型甲状腺癌管理指南》解读:分化型甲状腺癌的核医学诊治进展[J].中国癌症杂志,2025,35(9):815-825,11.基金项目
国家自然科学基金(82472027). National Natural Science Foundation of China(82472027). （82472027）
