Zoller Michael, Kohlfuerst Susanne, Igerc Isabel, Kresnik Ewald, Gallowitsch Hans-Jürgen, Gomez Iris, Lind Peter
Department of Nuclear Medicine and Special Endocrinology, PET/CT Centre, Landeskrankenhaus Klagenfurt, St. Veiter Str. 47, 9020, Klagenfurt, Austria.
Eur J Nucl Med Mol Imaging. 2007 Apr;34(4):487-95. doi: 10.1007/s00259-006-0276-2. Epub 2006 Nov 14.
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a well-established method in the follow-up of patients with differentiated thyroid carcinoma (DTC), elevated thyroglobulin (Tg) and negative 131I scans. This retrospective clinical study was designed to evaluate the impact of computed tomography (CT) and that of FDG-PET in combined FDG-PET/CT examinations on the restaging of DTC patients.
Forty-seven FDG-PET/CT scans of 33 patients with a history of DTC, elevated Tg levels and negative 131I uptake or additionally suspected 131I-negative lesions were studied. PET and CT images were analysed independently by an experienced nuclear medicine specialist and a radiologist. Afterwards a final consensus interpretation, the gold standard in our department, was provided for the fused PET/CT images and, if available, for supplementary investigations.
Thirty-five investigations (74%) revealed pathological FDG-PET/CT findings. In summary, 25 local recurrences, 62 lymph node metastases and 122 organ metastases (41 lung, 60 bone, 21 other organs) were diagnosed. In 36 out of 47 examinations (77%), the original PET diagnoses were modified in the final consensus interpretation owing to the CT assessments. In 8 of the 35 pathological FDG-PET/CT examinations (23%), the final consensus interpretation of the PET/CT images led to an alteration in the treatment plan.
PET/CT is a powerful fusion of two pre-existing imaging modalities, which not only improves the diagnostic value in restaging DTC patients with elevated Tg and negative 131I scan, but also provides accurate information regarding subsequent treatment options and may lead to a change in treatment management.
18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）是分化型甲状腺癌（DTC）患者、甲状腺球蛋白（Tg）升高且131I扫描阴性时进行随访的一种成熟方法。这项回顾性临床研究旨在评估计算机断层扫描（CT）以及FDG-PET在联合FDG-PET/CT检查中对DTC患者再分期的影响。
对33例有DTC病史、Tg水平升高且131I摄取阴性或另外怀疑有131I阴性病变的患者进行了47次FDG-PET/CT扫描。PET和CT图像由一位经验丰富的核医学专家和一位放射科医生独立分析。之后，针对融合后的PET/CT图像以及（如有）补充检查结果，给出了最终的共识解读，这是我们科室的金标准。
35次检查（74%）显示FDG-PET/CT有病理结果。总体而言，诊断出25处局部复发、62处淋巴结转移和122处器官转移（41处肺部、60处骨骼、21处其他器官）。在47次检查中的36次（77%）中，由于CT评估，最终的共识解读修改了最初的PET诊断。在35次FDG-PET/CT病理检查中的8次（23%）中，PET/CT图像的最终共识解读导致了治疗方案的改变。
PET/CT是两种现有成像模式的有力融合，不仅提高了对Tg升高且131I扫描阴性的DTC患者再分期的诊断价值，还提供了有关后续治疗选择的准确信息，并可能导致治疗管理的改变。
