Campennì Alfredo, Violi Maria A, Ruggeri Rosaria M, Sindoni Alessandro, Moleti Mariacarla, Vermiglio Francesco, Baldari Sergio
Department of Radiological Sciences, Unit of Nuclear Medicine, University of Messina, Italy.
Nucl Med Commun. 2010 Apr;31(4):274-9. doi: 10.1097/MNM.0b013e3283342319.
Tc-methoxyisobutyl isonitrile (MIBI) has been reported to show considerable clinical utility in the study of many neoplastic diseases. The aim of our study was to investigate the possible role of Tc-MIBI in the initial follow-up of patients with differentiated thyroid cancer (DTC) for detecting residual thyroid uptake and/or loco-regional/distant metastases.
Eighty-two patients with DTC (61 women, 21 men; mean age: 49 years) were studied after total or near-total thyroidectomy (not earlier than 3 months after thyroidectomy but before they underwent radioiodine therapy). About 20 min after the intravenous administration of 370 MBq of Tc-MIBI, planar images (and, if necessary, tomographic images, single photon emission tomography) of the cervical and thoracic regions were recorded and compared with posttherapy radioiodine scanning and thyreoglobulin serum levels.
MIBI scans detected thyroid remnants in 53 of 82 patients (65%) and metastatic foci in 10 of 11 (91%) patients, in whom a standard activity of 1110 MBq of I administered following MIBI scan had shown the presence of thyroid remnants or metastatic foci, respectively. One metastatic patient was false negative for both MIBI scan and post-I dose whole body scan.
Our data indicate that an MIBI scan has a high sensitivity in detecting metastatic lesions from DTC. Therefore, an MIBI scan after thyroidectomy and immediately before radioiodine treatment may be clinically useful for choosing the best therapeutic approach in terms of either ablative or therapeutic I activity for both thyroid remnants and/or DTC metastases and for evaluating surgical reappraisal of metastatic lymph nodes.
据报道，锝-甲氧基异丁基异腈（MIBI）在多种肿瘤疾病的研究中显示出相当大的临床应用价值。我们研究的目的是探讨MIBI在分化型甲状腺癌（DTC）患者初始随访中检测残留甲状腺摄取及/或局部/远处转移的可能作用。
对82例DTC患者（61例女性，21例男性；平均年龄：49岁）进行了研究，这些患者均接受了全甲状腺切除术或近全甲状腺切除术（甲状腺切除术后不早于3个月，但在接受放射性碘治疗之前）。静脉注射370MBq的MIBI约20分钟后，记录颈部和胸部区域的平面图像（如有必要，记录断层图像，即单光子发射断层扫描），并与治疗后的放射性碘扫描及血清甲状腺球蛋白水平进行比较。
MIBI扫描在82例患者中的53例（65%）检测到甲状腺残余组织，在11例患者中的10例（91%）检测到转移灶，在这些患者中，MIBI扫描后分别给予1110MBq标准活度的碘，显示存在甲状腺残余组织或转移灶。1例转移患者的MIBI扫描和碘剂注射后全身扫描均为假阴性。
我们的数据表明，MIBI扫描在检测DTC转移灶方面具有较高的敏感性。因此，甲状腺切除术后且在放射性碘治疗前立即进行MIBI扫描，对于选择针对甲状腺残余组织和/或DTC转移灶的最佳消融或治疗性碘活度治疗方法以及评估转移淋巴结的手术再评估可能具有临床应用价值。
