上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

18F-FDG PET/CT显像在131I全身显像阴性的分化型甲状腺癌中的应用价值

叶智轶，马超，傅宏亮，王辉   

  1. 上海交通大学 医学院附属新华医院核医学科， 上海 200092
  • 出版日期:2016-01-28 发布日期:2016-02-26
  • 通讯作者: 王辉, 电子信箱: wanghuishanghai@hotmail.com。
  • 作者简介:叶智轶（1983—）， 男， 主治医师， 硕士; 电子信箱: e-zearo-ye@hotmail.com。
  • 基金资助:

    国家自然科学基金(81271612); 上海市卫生局基金(20124016)

Application value of 18F-FDG PET/CT imaging for patients with differentiated thyroid carcinoma and negative results of 131I-whole body scan

YE Zhi-yi, MA Chao, FU Hong-liang, WANG Hui   

  1. Department of Nuclear Medicine， Xinhua Hospital， Shanghai Jiao Tong University School of Medicine， Shanghai 200092， China
  • Online:2016-01-28 Published:2016-02-26
  • Supported by:

    National Natural Science Foundation of China, 81271612; Shanghai Health Bureau Fund, 20124016。

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摘要：

目的 探讨18-氟代脱氧葡萄糖正电子发射型断层扫描/计算机断层扫描（18F-FDG PET/CT）对碘-131（131I）全身显像阴性的分化型甲状腺癌（DTC）患者复发或转移灶探查的价值。方法 对178例接受甲状腺切除术及经131I成功清除残留甲状腺组织和/或转移灶的DTC患者（随访期间颈部超声或胸部CT有持续异常发现，但131I全身显像阴性）给予18F-FDG PET/CT检查，对于18F-FDG PET/CT显像阳性的可疑病灶行超声引导下穿刺活检术或手术切除。以病理学检查结果为金标准，分析不同血清甲状腺球蛋白（Tg）水平下的18F-FDG PET/CT显像探查复发或转移灶的阳性预测值。结果 18F-FDG PET/CT显像阳性患者共77例，病理学检查证实为甲状腺癌转移65例。12例18F-FDG PET/CT显像呈假阳性，病理学检查结果证实为炎症细胞浸润。在77例18F-FDG PET/CT显像阳性的患者中，血清Tg阳性患者50例，病理学检查证实为甲状腺癌转移45例，18F-FDG PET/CT显像对于血清Tg阳性患者的阳性预测值为90.00%（45/50）；血清Tg阴性患者27例，病理学检查证实为甲状腺癌复发或转移20例，18F-FDG PET/CT显像对于Tg阴性患者的阳性预测值为74.07%（20/27）。结论 对于随访期间怀疑存在复发或转移灶，且131I全身显像阴性的DTC患者，18F-FDG PET/CT显像是一种较为有效的检查方法。

关键词: 分化型甲状腺癌, 18-氟代脱氧葡萄糖正电子发射型断层扫描/计算机断层扫描, 碘-131全身显像, 甲状腺球蛋白

Abstract:

Objective To investigate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging for detecting recurrent or metastatic foci of patients with differentiated thyroid carcinoma (DTC) and negative results of 131I-whole body scan. Methods A total of 178 patients with DTC who underwent thyroidectomy and 131I ablation of residual thyroid tissues and/or metastatic foci (results of cervical ultrasound or chest CT were persistent positive but results of 131I-whole body scan were negative during follow-up) were examined by 18F-FDG PET/CT imaging. Patients with suspicious foci and positive results of 18F-FDG PET/CT imaging underwent ultrasound-guiding aspiration biopsy or surgical resection. Values for predicting recurrent or metastatic foci by 18F-FDG PET/CT imaging at different levels of serum thyroglobulin (Tg) were analyzed using the results of pathological examinations as the golden criteria. Results A total of 77 patients with positive results of 18F-FDG PET/CT imaging were enrolled. Among them, 65 patients were pathologically confirmed as DTC metastases and 12 patients with false positive results of 18F-FDG PET/CT imaging were pathologically confirmed as inflammatory cell infiltration. Among 77 patients with positive results of 18F-FDG PET/CT imaging, 50 patients were serum Tg positive and 45 of them were pathologically confirmed as DTC metastases. For serum Tg positive patients, the rate for predicting the positive results by 18F-FDG PET/CT imaging was 90.00% (45/50). Among 27 serum Tg negative patients, 20 of them were pathologically confirmed as DTC recurrence or metastases. For serum Tg negative patients, the rate for predicting the positive results by 18F-FDG PET/CT imaging was 74.07% (20/27). Conclusion 18F-FDG PET/CT imaging is an effective examination method for patients with DTC who have suspicious recurrent or metastatic foci and negative results of 131I-whole body scan during follow-up.

Key words: differentiated thyroid carcinoma, fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography, 131I-whole body scan, thyroglobulin