[1]胡斌,王锦锋,毛秋粉.18F-FDG PET/CT显像在Tg阳性131I全身显像阴性的分化型甲状腺癌患者中的应用价值[J].国际放射医学核医学杂志,2015,39(3):242-246,251.[doi:10.3760/cma.j.issn.1673-4114.2015.03.012]
　Hu Bin,Wang Jinfeng,Mao Qiufen.The application value of 18F-FDG PET/CT in patients with differentiated thyroid cancer of high thyroglobulin level and negative 131I whole body scan[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(3):242-246,251.[doi:10.3760/cma.j.issn.1673-4114.2015.03.012]
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18F-FDG PET/CT显像在Tg阳性131I全身显像阴性的分化型甲状腺癌患者中的应用价值(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
39
期数:
2015年第3期
页码:
242-246,251
栏目:
出版日期:
2015-05-25

文章信息/Info

Title:
The application value of 18F-FDG PET/CT in patients with differentiated thyroid cancer of high thyroglobulin level and negative 131I whole body scan
作者:
胡斌;  王锦锋;  毛秋粉
河南科技大学第一附属医院核医学科, 洛阳, 471003
Author(s):
Hu Bin;  Wang Jinfeng;  Mao Qiufen
Department of Nuclear Medicine, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, China
关键词:
氟脱氧葡萄糖F18; 正电子发射断层显像术; 体层摄影术; X线计算机; 甲状腺肿瘤; 甲状腺球蛋白; 血清白蛋白; 放射性碘标记
Keywords:
Fluorodeoxyglucose F18; Positron-emission tomography; Tomography;  X-ray computed; Thyroid neoplasms; Thyroglobulin; Serum albumin;  radio-iodinated
DOI:
10.3760/cma.j.issn.1673-4114.2015.03.012
摘要:
目的 评判18F-FDG PET/CT作为一个常规的检查工具对临床诊断怀疑为分化型甲状腺癌(DTC)复发、伴有甲状腺球蛋白(Tg)升高且131I全身显像阴性患者的价值。方法 对甲状腺全切后经放射性131I去除治疗后的32例Tg升高伴全身131I显像阴性的DTC患者行18F-FDG PET/CT显像。按照Tg水平将患者分2组:H组21例(>10 ng/ml)和L组11例(2~10 ng/ml)。分别采用超声、病理学检查和临床随访对结果进行验证,评估18F-FDG PET/CT在DTC中的诊断价值。结果 32例患者中,20例18F-FDG PET/CT显像阳性,其中18例真阳性,2例假阳性。在18例真阳性患者中,15例是局部复发,6例有远处转移,3例患者同时有局部侵犯伴远处转移。12例18F-FDG PET/CT显像阴性,其中真阴性4例,假阴性8例,总体灵敏度、特异度和准确率分别为69.2%、66.7%和68.8%。H组的18F-FDG PET/CT显像灵敏度(80%)、特异度(100%)和准确率(80.9%)跟L组(33.3%、60.0%和45.5%)比较均显著增加。32例患者中的18例(56.2%)的临床处理策略发生了改变,12例(37.5%)进行了指导性根治手术。结论 18F-FDG PET/CT可以探测和准确定位DTC中Tg升高且131I全身显像阴性的区域复发和远处转移,因此可推荐为常规的诊断工具。
Abstract:
Objective To estimate the valuate of 18F-FDG PET/CT as a routine examination for the patients with suspected differentiated thyroid carcinoma (DTC) recurrence,accompanied by the increase of thyroglobulin (Tg) and negative 131I whole body scan.Method 32 patients who suffered from DTC receiving post-operative 131I therapy,with increase of Tg and negative 131I whole body scan,were performed 18F-FDG PET/CT,and follow-up continued.Patients were divided into two groups according to the level of Tg:H group (Tg>10 ng/ml) and L group (Tg<10 ng/ml).Histopathological examination,ultrasound examination and clinical follow-up were used to verify the result,and assess the clinical value of PET/CT.Result PET/CT imaging results indicated that among 32 patients,there were 20 positive (18 true-positive and 2 false-positive) and 12 negative (4 true-negative and 8 false-negative).Among 18 patients with true positive,15 cases with local disease,6 cases with distant metastasis,and 3 patients with both local invasion and distant metastasis.The overall sensitivity,specificity and accuracy were 69.2%,66.7% and 68.8%,respectively.Compared with the L group,H group developed higher sensitivity (80% versus 33.3%),specificity (100% versus 60%) and accuracy (80.9% versus 45.5%).In 32 patients,18 cases (56.2%) changed the strategies of clinical treatment,and 12 cases (37.5%) were received the radical operation under guidance.Conclusion 18F-FDG PET/CT can detect and locate accurately for the regional metastasis and recurrence of patients with DTC,accompanied by the increase of serum Tg and negative 131I whole body scan.Therefore,it can be recommended as a routine diagnostic tool.

参考文献/References:

[1] Schlumberger MJ, Torlantano M. Papillary and follicular thyroid carcinoma[J]. Best Pract Res Clin Endocrinol Metab, 2000, 14(4):601-613.
[2] Makeieff M, Burcia V, Raingeard I, et al. Positron emission tomog-raphy-computed tomography evaluation for recurrent differentiated thyroid carcinoma[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2012, 129(5):251-256.
[3] Sherman SI. Thyroid carcinoma[J]. Lancet, 2003, 361(9356):501-511.
[4] Stokkel MP, Duchateau CS, Dragoiescu C. The value of FDG-PET in the follow-up of differentiated thyroid cancer:a review of the lit-erature[J]. Q J Nucl Med Mol Imaging, 2006, 50(1):78-87.
[5] Lee JW, Lee SM, Lee DH, et al. Clinical utility of 18F-FDG PET/CT concurrent with 131I therapy in intermediate-to-high-risk patients with differentiated thyroid cancer:dual-center experience with 286 patients[J]. J Nucl Med, 2013, 54(8):1230-1236.
[6] Shammas A, Degirmenci B, Mountz JM, et al. 18F-FDG PET/CT in patients with suspected recurrent or metastatic well-differentiated thyroid cancer[J]. J Nucl Med, 2007, 48(2):221-226.
[7] Von Schulthess GK, Hany TF. Imaging and PET-PET/CT imaging[J]. J Radiol, 2008, 89(3 Pt 2):438-448.
[8] Townsend DW. Dual-modality imaging:combining anatomy and function[J]. J Nucl Med, 2008, 49(6):938-955.
[9] Bannas P, Derlin T, Groth M, et al. Can 18F-FDG-PET/CT be gener-ally recommended in patients with differentiated thyroid carcinoma and elevated thyroglobulin levels but negative 131I whole body scan?[J]. Ann Nucl Med, 2012, 26(1):77-85.
[10] Bertagna F, Bosio G, Biasiotto G, et al. 18F FDG-PET/CT evaluation of patients with differentiated thyroid cancer with negative 131I total body scan and high thyroglobulin level[J]. Clin Nucl Med, 2009, 34(11):756-761.
[11] Ko MS, Lee JH, Shong YK, et al. Normal and abnormal sonographic findings at the thyroidectomy sites in postoperative patients with thyroid malignancy[J]. AJR Am J Roentgenol, 2010, 194(6):1596-1609.
[12] Vural GU, Akkas BE, Ercakmak N, et al. Prognostic significance of FDG PET/CT on the follow-up of patients of differentiated thyroid carcinoma with negative 131I whole-body scan and elevated thy-roglobulin levels:correlation with clinical and histopathologic characteristics and long-term follow-up data[J]. Clin Nucl Med, 2012, 37(10):953-959.
[13] Torlontano M, Attard M, Crocetti U, et al. Follow-up of low risk pa-tients with papillary thyroid cancer:role of neck ultrasonography in detecting lymph node metastases[J]. J Clin Endocrinol Metab,2004, 89(7):3402-3407.
[14] Rosário PW, De Faria S, Bicalho L, et al. Ultrasonographic differ-entiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma[J]. J Ultrasound Med, 2005, 24(10):1385-1389.
[15] 滕卫平, 刘永峰, 高明, 等. 甲状腺结节和分化型甲状腺癌诊治指南[J]. 中国肿瘤临床, 2012, 33(17):1249-1272.
[16] David A, Blotta A, Rossi R, et al. Clinical value of different re-sponses of serum thyroglobulin to recombinant human thyrotropin in the follow-up of patients with differentiated thyroid carcinoma[J]. Thyroid, 2005, 15(2):158-164.
[17] Ozkan E, Aras G, Kucuk NO. Correlation of 18F-FDG PET/CT find-ings with histopathological results in differentiated thyroid cancer patients who have increased thyroglobulin or antithyroglobulin anti-body levels and negative 131I whole-body scan results[J]. Clin Nucl Med, 2013, 38(5):326-331.
[18] Ozkan E, Soydal C, Araz M, et al. The additive clinical value of 18F-FDG PET/CT in defining the recurrence of disease in patients with differentiated thyroid cancer who have isolated increased antithy-roglobulin antibody levels[J]. Clin Nucl Med, 2012, 37(8):755-758.

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备注/Memo

备注/Memo:
收稿日期:2014-10-23。
通讯作者:胡斌,Email:Hubin16@sina.com
更新日期/Last Update: 1900-01-01