Wu Yi-Ju, Wu Hurng-Sheng, Yen Ruoh-Fang, Shen Yeh-You, Kao Chia-Hung
Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
Anticancer Res. 2003 May-Jun;23(3C):2973-6.
The aim of this study was to evaluate the usefulness of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) and technetium-99m tetrofosmin (Tc-99m TF) single photon emission computed tomography (SPECT) to detect metastatic neck lymph nodes (LN) in papillary thyroid carcinoma (PTC) after total thyroidectomy and radioiodine-131 (I-131) treatments in patients with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). Thirteen PTC patients underwent nearly total thyroidectomy and I-131 treatments with proven neck LN metastases were included in this study. All subjects had negative I-131 WBS and elevated hTg levels (hTg > or = 10 mu IU/ml) under thyroid-stimulating hormone (TSH) stimulation (TSH > or = 30 mu IU/ml). FDG-PET and Tc-99m TF SPECT were used to detect metastatic neck LN in PTC. FDG-PET could detect all of the 13 (100%) patients with metastatic neck LN, but Tc-99m TF SPECT revealed lesions in only 8 out of 13 (61.5%) patients (p < 0.05). This study demonstrated that FDG-PET is more sensitive than Tc-99m TF SPECT to detecting metastatic neck LN in PTC with elevated serum hTg levels but negative I-131 WBS.
本研究的目的是评估18-氟-2-脱氧葡萄糖（FDG）正电子发射断层扫描（PET）和锝-99m替曲膦（Tc-99m TF）单光子发射计算机断层扫描（SPECT）在血清人甲状腺球蛋白（hTg）水平升高但碘-131（I-131）全身扫描（WBS）阴性的甲状腺乳头状癌（PTC）患者全甲状腺切除及碘-131（I-131）治疗后检测颈部转移性淋巴结（LN）的效用。13例接受了近全甲状腺切除及I-131治疗且已证实有颈部LN转移的PTC患者纳入本研究。所有受试者在促甲状腺激素（TSH）刺激下（TSH≥30 μIU/ml）I-131 WBS均为阴性且hTg水平升高（hTg≥10 μIU/ml）。FDG-PET和Tc-99m TF SPECT用于检测PTC患者颈部转移性LN。FDG-PET能够检测出所有13例（100%）有颈部转移性LN的患者，但Tc-99m TF SPECT仅在13例患者中的8例（61.5%）发现病变（p<0.05）。本研究表明，对于血清hTg水平升高但I-131 WBS阴性的PTC患者，FDG-PET在检测颈部转移性LN方面比Tc-99m TF SPECT更敏感。
