Almeida-Filho P, Ravizzini G C, Almeida C, Borges-Neto S
Division of Nuclear Medicine, Federal University of Recife and CERPE Laboratory, Pernambuco, Brazil.
Clin Nucl Med. 2000 Jun;25(6):443-6. doi: 10.1097/00003072-200006000-00011.
This study evaluated the potential of Tc-99m sestamibi whole-body scan (WBMIBI) as an alternative to whole-body I-131 scan (WBI) for the follow-up of patients with differentiated thyroid carcinoma.
We evaluated 99 consecutive patients with differentiated thyroid carcinoma who had total or nearly total thyroidectomy followed by an ablative dose of I-131 (86 women, 13 men; mean age, 44 +/- 12 years). WBMIBI was performed and serum thyroglobulin (TG) levels were obtained at least 6 months after I-131 treatment. All persons were receiving levothyroxine therapy.
From the total of 110 studies performed, WBMIBI and TG were in agreement in 96% and discordant in 4%. From the 27 crossed studies (WBMIBI x TG) with at least one abnormal result, 16 were compared with WBI. In four cases, the WBI did not reveal functioning thyroid tissue when both TG and WBMIBI indicated tumoral activity. In one case of pulmonary metastasis confirmed by chest radiographs, with a normal TG value, the results of both WBMIBI and WBI were positive.
WBMIBI should be considered as a scintigraphic method in the follow-up of differentiated thyroid carcinoma. This technique can show the sites of tumoral activity with optimal image resolution, particularly in those with abnormal TG and negative WBI results, and it is a potentially valuable tool in patients with anti-TG antibodies. The WBI in patients having ablation should be reserved only for therapy planning.
本研究评估了锝-99m 甲氧基异丁基异腈全身扫描（WBMIBI）作为分化型甲状腺癌患者随访中全身碘-131 扫描（WBI）替代方法的潜力。
我们评估了 99 例分化型甲状腺癌患者，这些患者均接受了甲状腺全切或近全切手术，随后给予碘-131 消融剂量治疗（86 例女性，13 例男性；平均年龄 44±12 岁）。在碘-131 治疗后至少 6 个月进行 WBMIBI 检查并检测血清甲状腺球蛋白（TG）水平。所有患者均接受左甲状腺素治疗。
在总共进行的 110 项检查中，WBMIBI 和 TG 结果一致的占 96%[1]，不一致的占 4%。在 27 项至少有一项异常结果的交叉检查（WBMIBI×TG）中，16 项与 WBI 进行了比较。在 4 例中，当 TG 和 WBMIBI 均显示肿瘤活性时，WBI 未发现有功能的甲状腺组织。在 1 例经胸部 X 光片证实为肺转移且 TG 值正常的病例中，WBMIBI 和 WBI 结果均为阳性。
WBMIBI 应被视为分化型甲状腺癌随访中的一种闪烁显像方法。该技术能够以最佳图像分辨率显示肿瘤活性部位，特别是在 TG 异常而 WBI 结果为阴性的患者中，并且对于存在抗 TG 抗体的患者是一种潜在的有价值的工具。对于接受消融治疗的患者，WBI 仅应保留用于治疗计划。 [1] 原文此处为“96% of the total 110 studies performed, WBMIBI and TG were in agreement”，翻译时调整语序使表达更通顺。
