| 薛明媚,刘保平,谢新立,王瑞华,程兵,韩星敏,刘艳,靳水.18F-FDG PET/CT检测Tg阳性而131I-诊断剂量全身显像阴性分化型甲状腺癌患者复发和转移[J].中国医学影像技术,2016,32(2):218~222 |
| 18F-FDG PET/CT检测Tg阳性而131I-诊断剂量全身显像阴性分化型甲状腺癌患者复发和转移 |
| 18F-FDG PET/CT in detection of recurrence or metastatic of DTC patients with elevated serum Tg levels and negative 131I-Dx-WBS |
| 投稿时间：2015-06-10 修订日期：2015-11-23 |
| DOI：10.13929/j.1003-3289.2016.02.014 |
| 中文关键词: 甲状腺肿瘤 氟脱氧葡萄糖F18 体层摄影术,发射型计算机,单光子 甲状腺球蛋白 放射性核素显像 |
| 英文关键词:Thyroid neoplasms Fluorodeoxyglucose F 18 Tomography,emission computed,single photon Thyroglobulin Radionuclide imaging |
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| 中文摘要: |
| 目的 探讨18F-FDG PET/CT显像对甲状腺球蛋白(Tg)阳性而131I-诊断剂量全身显像(131I-Dx-WBS)阴性的分化型甲状腺癌(DTC)患者复发或转移的诊断价值及对治疗方案的影响。方法 对33例接受甲状腺全切或次全切术并进行大剂量131I治疗后随访中发现Tg阳性而131I-Dx-WBS阴性的DTC患者行18F-FDG PET/CT显像,将显像结果与手术病理或6~36个月的临床随访结果进行对照,评价18F-FDG PET/CT显像对Tg升高而131I-Dx-WBS阴性的DTC患者复发或转移的诊断效能。结果 18F-FDG PET/CT诊断Tg升高而131I-Dx-WBS阴性的DTC患者复发或转移的灵敏度和阳性预测值分别为85.71%(18/21)和90.00%(18/20)。18F-FDG PET/CT显像对血清Tg≥47.59 ng/ml的DTC患者诊断复发或转移的灵敏度(100%)明显高于对血清Tg<47.59 ng/ml的DTC患者(66.67%)。18F-FDG PET/CT显像改变了15例(15/33,45.45%)患者的治疗方案,其中4例(4/15,26.67%)再次接受手术治疗,11例(11/15,73.33%)再次接受大剂量131I治疗。结论 18F-FDG PET/CT显像对诊断Tg升高而131I-Dx-WBS阴性的DTC患者有无复发或转移是一种有价值的方法,同时可用于指导后续治疗。 |
| 英文摘要: |
| Objective To investigate the diagnostic value and the impact on treatment decision of 18F-FDG PET/CT in differentiated thyroid carcinoma (DTC) patients with elevated serum thyroglobulin (Tg) levels and negative radioiodine diagnostic 131I whole body scan (131I-Dx-WBS).Methods A total of 33 patients with DTC,who had elevated serum Tg levels and negative 131I-Dx-WBS,were enrolled,and 18F-FDG PET/CT were performed.The imaging results of 18F-FDG PET/CT were compared with the clinical results of surgical pathology or 6-36 months follow-up.The diagnostic efficacy of 18F-FDG PET/CT in detection of the recurrence or metastasis DTC with elevated Tg levels and negative 131I-Dx-WBS were evaluated.Results The sensitivity and positive predictive value of 18F-FDG PET/CT in diagnosis of DTC with elevated Tg levels and negative 131I-Dx-WBS were 85.71% (18/21) and 90.00% (18/20),respectively.The sensitivity of 18F-FDG PET/CT increased significantly in patients with serum Tg levels more than 47.59 ng/ml (100%) in comparison with patients with serum Tg levels less than 47.59 ng/ml (66.67%).18F-FDG PET/CT changed the treatment strategies of 15 patients (15/33,45.45%) in 33 patients,4 of 15 patients (4/15,26.67%) underwent the reoperation,and the other 11 patients (11/15,73.33%) received 131 I ablation therapy.Conclusion 18F-FDG PET/CT is a valuable method in detection of recurrence or metastasis DTC with elevated Tg levels and negative 131I-Dx-WBS,which can also be used to guide the follow-up treatment strategy. |
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