Freudenberg Lutz S, Frilling Andrea, Kühl Hilmar, Müller Stefan P, Jentzen Walter, Bockisch Andreas, Antoch Gerald
Department of Nuclear Medicine, University of Duisburg/Essen, Hufelandstrasse 55, 45122, Essen, Germany.
Eur Radiol. 2007 Dec;17(12):3139-47. doi: 10.1007/s00330-007-0682-2. Epub 2007 May 22.
The usefulness of combined 2-[18F] fluoro-2-deoxy-D: -glucose positron emission tomography and computed tomography (FDG-PET/CT) in locating suspected recurrence in patients with iodine-negative differentiated thyroid cancer (DTC) was evaluated. Thirty-six patients with DTC and suspected iodine-negative recurrence underwent restaging with FDG-PET/CT. The images of CT, FDG-PET, both modalities viewed side by side (CT+PET), and FDG-PET/CT were evaluated by two physicians separately. Imaging results were correlated with either histology (n = 20) and/or clinical follow-up of at least 36 months. Recurrent disease was diagnosed in 22/36 patients. FDG-PET alone, CT alone, CT+PET, and FDG-PET/CT showed a sensitivity of 82%, 73%, 91%, and 96%, respectively. Specificities were 79%, 71%, 79%, and 100%, respectively. FDG-PET/CT significantly improved specificity compared with CT+PET and resulted in a further treatment modification in 5/36 patients (14%). CT alone was especially sensitive for lung metastases, FDG-PET alone for the remainder of the body. Accurate fusion of functional and morphologic data by FDG-PET/CT improves the staging accuracy of patients with suspected recurrence of iodine-negative DTC. This has an impact on patient management in a substantial number of patients.
评估了联合使用2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描和计算机断层扫描（FDG-PET/CT）对碘阴性分化型甲状腺癌（DTC）患者疑似复发灶的定位作用。36例DTC且疑似碘阴性复发的患者接受了FDG-PET/CT重新分期。CT、FDG-PET、两种模式并排观察（CT+PET）以及FDG-PET/CT的图像由两名医生分别评估。成像结果与组织学（n = 20）和/或至少36个月的临床随访结果相关。36例患者中有22例被诊断为复发疾病。单独的FDG-PET、单独的CT、CT+PET以及FDG-PET/CT的敏感性分别为82%、73%、91%和96%。特异性分别为79%、71%、79%和100%。与CT+PET相比，FDG-PET/CT显著提高了特异性，并导致36例患者中有5例（14%）的进一步治疗方案改变。单独的CT对肺转移特别敏感，单独的FDG-PET对身体其他部位敏感。FDG-PET/CT对功能和形态学数据的准确融合提高了碘阴性DTC疑似复发患者的分期准确性。这对相当一部分患者的治疗管理产生了影响。
