Diehl M, Risse J H, Brandt-Mainz K, Dietlein M, Bohuslavizki K H, Matheja P, Lange H, Bredow J, Körber C, Grünwald F
Department of Nuclear Medicine, University of Frankfurt/Main, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
Eur J Nucl Med. 2001 Nov;28(11):1671-6. doi: 10.1007/s002590100614.
The aim of this study was to evaluate the clinical use of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in medullary thyroid cancer (MTC) on the basis of comparison with findings obtained using indium-111 pentetreotide (SMS), pentavalent technetium-99m dimercaptosuccinic acid (DMSA), technetium-99m sestamibi (MIBI), computed tomography (CT) and magnetic resonance imaging (MRI). One hundred FDG-PET examinations in 85 patients (40 males, 45 females) with elevated tumour marker levels and/or pathological findings on other imaging methods were evaluated retrospectively. Eighty-two patients were examined after total thyroidectomy, and the remaining three patients prior to surgery. Overall, 181 lesions could be identified with at least one of the imaging techniques. Fifty-five lesions were confirmed histologically. FDG-PET detected 123 of 181 sites, which is a lesion detection probability of 68%. In the 55 cases with histological confirmation, we found 32 true positive, 3 false positive, 11 true negative and 9 false negative lesions using FDG-PET, resulting in a sensitivity of 78% and a specificity of 79%. Sensitivity and specificity were, respectively, 25% and 92% for SMS, 33% and 78% for DMSA, 25% and 100% for MIBI, 50% and 20% for CT and 82% and 67% for MRI. Compared with morphological techniques and functional imaging methods with single-photon emitters, FDG-PET showed the highest lesion detection probability for MTC tissue, with a high sensitivity and specificity. It is concluded that FDG-PET is a useful method in the staging and follow-up of MTC.
本研究的目的是在与使用铟 - 111 喷替酸奥曲肽（SMS）、五价锝 - 99m 二巯基丁二酸（DMSA）、锝 - 99m 甲氧基异丁基异腈（MIBI）、计算机断层扫描（CT）和磁共振成像（MRI）所获结果进行比较的基础上，评估氟 - 18 氟脱氧葡萄糖正电子发射断层扫描（FDG - PET）在甲状腺髓样癌（MTC）中的临床应用。对 85 例（40 例男性，45 例女性）肿瘤标志物水平升高和 / 或其他成像方法有病理结果的患者进行的 100 次 FDG - PET 检查进行了回顾性评估。82 例患者在全甲状腺切除术后接受检查，其余 3 例在手术前接受检查。总体而言，至少一种成像技术可识别出 181 个病灶。55 个病灶经组织学证实。FDG - PET 检测到 181 个部位中的 123 个，病灶检测概率为 68%。在 55 例经组织学证实的病例中，使用 FDG - PET 我们发现 32 个真阳性、3 个假阳性、11 个真阴性和 9 个假阴性病灶，灵敏度为 78%，特异性为 79%。SMS 的灵敏度和特异性分别为 25%和 92%，DMSA 为 33%和 78%，MIBI 为 25%和 100%，CT 为 50%和 20%，MRI 为 82%和 67%。与形态学技术和单光子发射体功能成像方法相比，FDG - PET 对 MTC 组织显示出最高的病灶检测概率，具有高灵敏度和特异性。结论是 FDG - PET 是 MTC 分期和随访中的一种有用方法。
