^(18)F-FDG PET/CT检测^(131)I-治疗剂量全身显像阴性而甲状腺球蛋白阳性分化型甲状腺癌复发和转移  

^(18)F-FDG PET/CT in detection of recurrence and/or metastasis of differentiated thyroid carcinoma in patients with elevated serum thyroglobulin levels and negative ^(131)I post-therapy whole body scan

作　　者：程旭[1] 李永军[1] 许昕丹 徐兆强[1] 袁孝军[1] 包丽华[1] CHENG Xu;LI Yongjun;XU Xindan;XU Zhaoqiang;YUAN Xiaojun;BAO Lihua(Department of Nuclear Medicine,the First Affiliated Hospital of NanjingMedical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院核医学科,江苏南京210029

出　　处：《中国医学影像技术》2018年第6期855-859,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察^(18)F-FDG PET/CT显像对^(131)I-治疗剂量全身显像(^(131)I-RxWBS)阴性且甲状腺球蛋白(Tg)阳性分化型甲状腺癌(DTC)复发或转移的诊断价值及对治疗方案的影响。方法对72例接受^(131)I清除残留甲状腺并接受大剂量^(131)I治疗后随访中发现Tg阳性而^(131)I-RxWBS阴性DTC术后患者行^(18)F-FDG PET/CT显像,将显像结果与手术病理或6~36个月临床随访结果进行对照,评价^(18)F-FDG PET/CT显像对Tg升高而^(131)I-RxWBS阴性DTC复发或转移的诊断效能。结果^(18)F-FDG PET/CT诊断Tg升高而^(131)I-RxWBS阴性的DTC复发或转移的准确率、灵敏度、特异度、阳性预测值和阴性预测值分别为83.33%(60/72)、89.47%(34/38)、76.47%(26/34)、80.95%(34/42)和86.67%(26/30)。^(18)F-FDG PET/CT显像改变了35例(35/72,48.61%)患者的治疗方案,其中23例(23/35,65.71%)接受手术者在临床随访中均未见甲状腺癌复发及转移,其余12例(12/35,34.29%)随访期内均显示病情进展。结论对于^(131)I-RxWBS阴性而Tg阳性的DTC患者,^(18)F-FDG PET/CT有助于诊断和定位复发及转移病灶,指导后续治疗。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 131I post-therapy whole body scan（131I-RxWBS）.Methods Totally 72 patients with DTC who had elevated serum Tg levels and negative 131I-RxWBS were enrolled,and 18F-FDG PET/CT was performed.The imaging results of 18F-FDG PET/CT were compared with the clinical results of surgical pathology or 6 to 36 months follow-up.The diagnostic efficacy of 18FFDG PET/CT in detection of recurrence and/or metastasis of DTC with elevated Tg levels and negative 131I-RxWBS was evaluated.Results The accuracy,sensitivity,specificity,positive prediction value and negative prediction value of 18FFDG PET/CT in diagnosis of DTC with elevated Tg levels and negative 131I-RxWBS was 83.33%（60/72）,89.47%（34/38）,76.47%（26/34）,80.95%（34/42）and 86.67%（26/30）,respectively.18F-FDG PET/CT changed the treatment strategies of 35 patients（35/72,48.61%）among 72 patients,while recurrence or metastasis of DTC was not found during clinical follow-up in 23 of these 35 patients（23/35,65.71%）who underwent reoperation,but was detected in the other 12 patients（12/35,34.29%）.Conclusion 18F-FDG PET/CT is a valuable method for detection of recurrence and/or metastasis of DTC with elevated Tg levels and negative 131I-RxWBS,also for guiding the follow-up treatment strategy.

关 键 词：正电子发射断层显像术 体层摄影术 发射型计算机 单光子 18F氟脱氧葡萄糖 甲状腺肿瘤 甲状腺球蛋白 

分 类 号：R736.1[医药卫生—肿瘤] R817.4[医药卫生—临床医学]