（131）I 全身扫描在分化型甲状腺癌患者治疗后第 3 天和第 10 天的比较：初步报告。

The comparison of (131)I whole-body scans on the third and tenth day after (131)I therapy in patients with well-differentiated thyroid cancer: preliminary report.

机构信息

Department of Nuclear Medicine, Jeju National University Hospital, 66 Jeju-Daehakno, Jeju, Korea.

出版信息

Ann Nucl Med. 2011 Jul;25(6):439-46. doi: 10.1007/s12149-011-0486-y. Epub 2011 Apr 8.

DOI:10.1007/s12149-011-0486-y

PMID:21476057

Abstract

OBJECTIVE

The purpose of the present study was to evaluate the clinical usefulness of the delayed post-therapeutic (131)I scan in patients with well-differentiated thyroid cancer by comparing the early scanned images with the delayed images.

METHODS

A total of 81 patients (female:male = 67:14; age 52 ± 13 years) with well-differentiated thyroid cancer who underwent scans the third and tenth day after (131)I treatment were included in this study. The therapeutic dose ranged from 3.7 GBq (100 mCi) to 7.4 GBq (200 mCi). The early and delayed scan images were visually analyzed and the thyroid remnant-to-background uptake ratio (RBR) and the lesion-to-background uptake ratio (LBR) of metastatic lesions were calculated.

RESULTS

Of the 81 patients, 5 lesions (2 lung lesions, 2 cervical lymph node lesions, and one thyroid remnant) in 4 patients (5%) were additionally found on the delayed scans, which were not identified on the early scans. Of 8 patients with high serum thyroglobulin (Tg) and negative finding on the early scan, the delayed scan identified additional lesions in 3 patients (38%). Visual analysis scores significantly decreased for both thyroid remnants and metastatic lesions on the delayed scan (p < 0.001 for all). Diffuse hepatic uptake was visualized in 86% of all patients on the delayed scan, while only 6% of the patients on the early scan (p < 0.001). The RBRs of both scans were compared in 59 patients, and the LBRs were compared in 8 patients with 23 lesions. The mean RBR and LBR on the delayed scan (8.0 ± 7.6 and 5.4 ± 5.2, respectively) were significantly lower than those on the early scan (12.0 ± 10.8 and 10.8 ± 7.6, respectively; p = 0.02 and p = 0.001, respectively).

CONCLUSIONS

The (131)I-avid lesions on the early scan were more easily detected by visual analysis and had higher uptake ratios than those on the delayed scan. However, for patients with high serum Tg and negative finding on the early scan, the delayed scan was helpful in identifying additional (131)I-avid lesions.

摘要

目的

本研究旨在通过比较早期扫描图像与延迟扫描图像，评估（131）I 治疗后延迟扫描在分化型甲状腺癌患者中的临床应用价值。

方法

本研究共纳入 81 例（女：男=67：14；年龄 52±13 岁）分化型甲状腺癌患者，均于（131）I 治疗后第 3 天和第 10 天行扫描。治疗剂量为 3.7GBq（100mCi）至 7.4GBq（200mCi）。对早期和延迟扫描图像进行目测分析，并计算甲状腺残余物与背景摄取比（RBR）和转移病灶与背景摄取比（LBR）。

结果

在 81 例患者中，有 4 例（5%）5 个病灶（2 个肺部病灶、2 个颈部淋巴结病灶和 1 个甲状腺残余病灶）在延迟扫描中发现，而在早期扫描中未发现。在 8 例血清甲状腺球蛋白（Tg）升高且早期扫描阴性的患者中，有 3 例（38%）在延迟扫描中发现了额外的病灶。与早期扫描相比，甲状腺残余物和转移病灶在延迟扫描中的目测分析评分显著降低（所有 P 值均<0.001）。86%的患者在延迟扫描中可见弥漫性肝摄取，而在早期扫描中仅 6%的患者可见（P<0.001）。对 59 例患者进行了两次扫描的 RBR 比较，对 8 例 23 个病灶进行了 LBR 比较。延迟扫描的平均 RBR 和 LBR 分别为 8.0±7.6 和 5.4±5.2，明显低于早期扫描的 12.0±10.8 和 10.8±7.6（P=0.02 和 P=0.001）。