^(131)I-全身平面显像与^(131)I-SPECT/CT评估术后首次放射性碘治疗后分化型甲状腺癌  

^(131)I whole-body scanning and^(131)I-SPECT/CT for evaluating differentiated thyroid cancer after operation and initial radioactive iodine treatment

作　　者：席欢 林琳 樊蓉 杨珂 魏正茂 郑怿青 王雪鹃 郑容 XI Huan;LIN Lin;FAN Rong;YANG Ke;WEI Zhengmao;ZHENG Yiqing;WANG Xuejuan;ZHENG Rong(Department of Nuclear Medicine,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院核医学科,北京100021

出　　处：《中国医学影像技术》2025年第1期65-69,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的对比^(131)I-全身平面显像(^(131)I-WBS)与^(131)I-SPECT/CT评估分化型甲状腺癌(DTC)术后经首次放射性碘(RAI)治疗后残余甲状腺组织、淋巴结及远处转移,以及复发危险的价值。方法回顾性收集367例于术后接受首次RAI治疗及其后^(131)I-WBS与^(131)I-SPECT/CT显像的DTC患者,对比2种检查识别残留甲状腺、淋巴结转移和远处转移,以及评估DTC复发危险的差异。结果367例中,^(131)I-WBS检出353例存在甲状腺残留、3例可疑甲状腺残留,^(31)I-SPECT/CT诊断349例甲状腺残留,二者差异无统计学意义(P=0.289)。^(131)I-WBS判断36例存在、67例可疑淋巴结转移,^(131)I-SPECT/CT检出52例淋巴结转移;^(131)I-WBS判断20例存在、35例可疑、312例无远处转移,^(131)I-SPECT/CT判断60例存在、3例无法诊断、304例无远处转移;^(31)I-SPECT/CT对淋巴结及远处转移的检出率均高于^(131)I-WBS(P=0.018、<0.001)。随访期间^(131)I-WBS评估DTC复发低危94例、中危155例、高危118例,^(131)I-SPECT/CT评估低危116例、中危137例、高危114例,对其中40例(40/367,10.90%)存在差异。结论相比^(131)I-WBS,^(131)I-SPECT/CT对于评估DTC术后经首次RAI治疗后淋巴结转移、远处转移及复发危险具有更高临床价值。Objective To comparatively observe the value of ^(131)I whole-body scanning(WBS)and ^(131)I-SPECT/CT for evaluating residual thyroid tissue,lymph node and distant metastasis,as well as risk of recurrence of differentiated thyroid cancer(DTC)after surgical resection and initial radioactive iodine(RAI)treatment.Methods Totally 367 DTC patients who underwent initial RAI treatment after surgical resection and then ^(131)I-WBS and ^(131)I SPECT/CT scanning were retrospectively collected.^(131)I-WBS and ^(131)I SPECT/CT were compared for identifying residual thyroid,lymph node and distant metastases.According to follow-up results,the risk of DTC recurrence was evaluated based on ^(131)I-WBS and ^(131)I-SPECT/CT,respectively.Results Residual thyroid was detected in 353 cases and suspected in 3 cases with ^(131)I-WBS,which was diagnosed in 349 cases with ^(131)I-SPECT/CT,and no significant difference was found between 2 methods(P=0.289).^(131)I-WBS detected 36 cases with and suspected 67 cases with lymph node metastases,312 without distant metastases,while ^(131)I-SPECT/CT diagnosed lymph node metastases in 52 cases;^(131)I-WBS detected 20 cases with and suspected 35 cases with distant metastases,while ^(131)I-SPECT/CT diagnosed 60 cases with distant metastases but could not diagnose in 3 cases,304 without distant metastases.The detection rate of ^(131)I-SPECT/CT for lymph node and distant metastasis were both higher than that of ^(131)I-WBS(P=0.018,P<0.001).During follow-up period,there were 94 cases with low risk,155 with medium risk and 118 with high risk of DTC recurrence according to ^(131)I-SPECT/CT,while 116 cases of low risk,137 of medium risk and 114 of high risk based on ^(131)I-SPECT/CT,and the evaluating results were different between 2 methods in 40 cases(40/367,10.90%).Conclusion Compared with ^(131)I-WBS,^(31)I-SPECT/CT had better clinical value for evaluating lymph node and distant metastases and assessing recurrence risk of DTC after initial RAI treatment.

关 键 词：甲状腺肿瘤 细胞分化 碘放射性同位素 体层摄影术 发射型计算机 单光子 

分 类 号：R736.1[医药卫生—肿瘤] R445.6[医药卫生—临床医学]