Shiga T, Tsukamoto E, Nakada K, Morita K, Kato T, Mabuchi M, Yoshinaga K, Katoh C, Kuge Y, Tamaki N
Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
J Nucl Med. 2001 Mar;42(3):414-9.
There are several reports about the usefulness of (18)F-FDG PET in thyroid cancer. However, few studies have compared FDG PET with (131)I and (201)Tl scintigraphy. The aim of this study was to evaluate the clinical significance of whole-body FDG PET in differentiated thyroid cancer and to compare the results with those obtained from (131)I and (201)Tl scintigraphy.
Whole-body FDG PET was performed on 32 patients (10 men, 22 women; age range, 30-77 y; mean age, 54 y) with differentiated thyroid cancer (5 cases of follicular cancer and 27 of papillary cancer) after total thyroidectomy. An overall clinical evaluation was performed, including cytology, thyroglobulin level, sonography, MRI, and CT, to allow a comparison with functional imaging results for each patient. Metastatic regions were divided into five areas: neck, lung, mediastinum, bone, and other. Multiple lesions in one area were defined as one lesion. The tumor-to-background ratio (TBR) was measured for the lesions that were positive for both (201)Tl uptake and FDG PET uptake.
The number of lesions totaled 47. Forty-one (87%) were detected by all scintigraphic methods. FDG uptake was concordant with (131)I uptake in only 18 lesions (38%). FDG uptake was concordant with (201)Tl uptake in 44 lesions (94%). Only one lesion was negative for FDG uptake and positive for (201)Tl uptake, and two lesions were positive for FDG uptake and negative for (201)Tl uptake. A significant correlation was seen between the TBR of (201)Tl and that of FDG (r = 0.69; P<0.05).
These data indicate that for detecting metastatic lesions, FDG PET and (131)I scintigraphy may provide complementary information, whereas FDG PET may provide results similar to those of (201)Tl scintigraphy. Thus, the combination of (131)I scintigraphy and FDG PET (or (201)Tl scintigraphy) is the method of choice for detecting metastatic thyroid cancer after total thyroidectomy.
有几篇关于（18）F-FDG PET在甲状腺癌中应用价值的报道。然而，很少有研究将FDG PET与（131）I和（201）Tl闪烁扫描术进行比较。本研究的目的是评估全身FDG PET在分化型甲状腺癌中的临床意义，并将结果与（131）I和（201）Tl闪烁扫描术的结果进行比较。
对32例（10例男性，22例女性；年龄范围30 - 77岁；平均年龄54岁）分化型甲状腺癌（5例滤泡状癌和27例乳头状癌）患者在全甲状腺切除术后进行全身FDG PET检查。进行了全面的临床评估，包括细胞学、甲状腺球蛋白水平、超声、MRI和CT，以便与每位患者的功能成像结果进行比较。转移区域分为五个部位：颈部、肺部、纵隔、骨骼和其他部位。一个区域内的多个病灶定义为一个病灶。对（201）Tl摄取和FDG PET摄取均呈阳性的病灶测量肿瘤与本底比值（TBR）。
病灶总数为47个。所有闪烁扫描方法共检测到41个（87%）。FDG摄取仅与18个病灶（38%）的（131）I摄取一致。FDG摄取与44个病灶（94%）的（201）Tl摄取一致。仅1个病灶FDG摄取为阴性而（201）Tl摄取为阳性，2个病灶FDG摄取为阳性而（201）Tl摄取为阴性。（201）Tl的TBR与FDG的TBR之间存在显著相关性（r = 0.69；P<0.05）。
这些数据表明，对于检测转移病灶，FDG PET和（131）I闪烁扫描术可能提供互补信息，而FDG PET可能提供与（201）Tl闪烁扫描术相似的结果。因此，（131）I闪烁扫描术与FDG PET（或（201）Tl闪烁扫描术）联合应用是全甲状腺切除术后检测转移性甲状腺癌的首选方法。
