Salvatore B, Paone G, Klain M, Storto G, Nicolai E, D'Amico D, Della Morte A M, Pace L, Salvatore M
Fondazione SDN, Naples Italy.
Q J Nucl Med Mol Imaging. 2008 Mar;52(1):2-8.
The aim of this study was to evaluate the role of 18F fluorodeoxyglucose-positron emission tomography (FDG-PET), differentiated thyroid carcinoma (DTC) treated with therapeutic (131)I because of elevated thyroglobulin (Tg) levels during follow up. The results of FDG-PET/CT were compared with post-therapy (131)I whole body scan (131I-t-WBS) and Tg at short term follow up.
Forty-five patients with DTC underwent a new therapeutic (131I) administration based upon Tg values >1.5 ng/mL. All patients underwent (131I-t-WBS) 5-7 days after 131I therapy. A few days before 131I administration, a FDG-PET scan was performed in all patients. FDG-PET/CT was considered positive (PET+) when at least one abnormal focus of FDG uptake was found; likewise, 131I-t-WBS was considered positive(WBS+) when at least on abnormal focus of uptake was found. Assessment of short-term response to radioiodine was performed by measuring Tg values.
FDG-PET/CT was positive in 32 patients, 23 of which had positive 131I-t-WBS and negative in 13, 8 of which had a negative 131I-t-WBS. Overall agreement was 69%. Tg values were significantly higher in FDG-PET/CT positive (502+/-1 027 ng/mL) than in FDG-PET/CT negative patients (57+/-94 ng/mL). A significant difference emerged between 131I-t-WBS positive (561 +/- 1 086 ng/mL) and 131I-t-WBS negative (65+/- 120 ng/mL) findings. In these 45 patients Tg normalized in 36%, was reduced by at least 50% in 24% and remained unchanged in the remaining 40%. Overall, at short-term follow-up, Tg values normalized in 77% of the 13 patients with negative FDG-PET/CT and in 19% of the 32 patients with positive FDG-PET/CT.
FDG-PET/CT is a powerful and useful tool for assessing patients with DTC. it can provide additional information in those patients with high Tg at follow-up and eligible for 131I therapy. A negative FDG-PET/CT could also represent a prognostic tool combined with serum Tg testing a short term follow-up.
本研究旨在评估18F氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在随访期间因甲状腺球蛋白（Tg）水平升高而接受治疗性（131）I治疗的分化型甲状腺癌（DTC）中的作用。将FDG-PET/CT的结果与治疗后（131）I全身扫描（131I-t-WBS）及短期随访时的Tg进行比较。
45例DTC患者基于Tg值>1.5 ng/mL接受了新的治疗性（131I）给药。所有患者在131I治疗后5-7天接受（131I-t-WBS）检查。在给予131I前几天，所有患者均进行了FDG-PET扫描。当发现至少一个FDG摄取异常灶时，FDG-PET/CT被视为阳性（PET+）；同样，当发现至少一个摄取异常灶时，131I-t-WBS被视为阳性（WBS+）。通过测量Tg值评估对放射性碘的短期反应。
32例患者的FDG-PET/CT为阳性，其中23例131I-t-WBS为阳性，13例为阴性，其中8例131I-t-WBS为阴性。总体一致性为69%。FDG-PET/CT阳性患者（502±1027 ng/mL）的Tg值显著高于FDG-PET/CT阴性患者（57±94 ng/mL）。131I-t-WBS阳性（561±1086 ng/mL）和131I-t-WBS阴性（65±120 ng/mL）结果之间存在显著差异。在这45例患者中，36%的患者Tg恢复正常，24%的患者Tg至少降低了50%，其余40%的患者Tg保持不变。总体而言，在短期随访中，13例FDG-PET/CT阴性患者中有77%的患者Tg值恢复正常，32例FDG-PET/CT阳性患者中有19%的患者Tg值恢复正常。
FDG-PET/CT是评估DTC患者的一种强大且有用的工具。它可以为随访中Tg水平高且适合131I治疗的患者提供额外信息。阴性的FDG-PET/CT也可作为一种预后工具，结合血清Tg检测进行短期随访。
