Department of Surgery, University Hospital Ulm, Ulm, Germany.
Horm Metab Res. 2012 Nov;44(12):904-8. doi: 10.1055/s-0032-1316351. Epub 2012 Jul 12.
Fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) is able to localize persistent or recurrent disease in differentiated thyroid carcinoma (DTC). The aim of the study was to correlate PET/CT results with precise intraoperative localization of persistent or recurrent papillary and follicular thyroid carcinoma. Patients with differentiated thyroid carcinoma who received FDG-PET scans were prospectively documented. The PET/CT results were correlated with other localization studies (neck ultrasound, ¹³¹I whole-body scan) and accurately compared to intraoperative findings and histopathological examinations. FDG-PET/CT scans were performed in 18 patients, between 16 and 84 years of age, from December 2008 to June 2011. Fourteen patients had papillary thyroid carcinomas and 4 had follicular thyroid carcinomas. All patients had a previous thyroidectomy and radioiodine ablation. Before cervical re-exploration, FDG-PET/CT-positive findings were reported in 14 individuals, whereas 4 PET scans provided no evidence of disease. Intraoperatively, 13 of 14 FDG-PET/CT-positive localizations of recurrent or persistent thyroid carcinomas were verified and confirmed by histopathology (sensitivity 93%). In another patient lymph node metastases of lung cancer were detected intraoperatively. However, FDG-PET/CT underestimated the number of lesions in 5 of 6 patients undergoing systematic lymphadenectomy. No lymph node or soft tissue metastases were found intraoperatively in 3 of the 4 patients with negative FDG-PET scans. A solitary cystic lymph node metastasis was found in the fourth patient but was not detected by FDG-PET/CT (specificity 75%). FDG-PET/CT has high sensitivity and specificity for the detection of persistent or recurrent differentiated thyroid carcinoma. FDG-PET/CT helps to select patients who might benefit from surgery because it provides precise anatomical details.
氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）/计算机断层扫描（CT）可定位分化型甲状腺癌（DTC）中的持续性或复发性疾病。本研究旨在将 PET/CT 结果与对持续性或复发性乳头状和滤泡状甲状腺癌的精确术中定位进行相关分析。前瞻性记录了接受 FDG-PET 扫描的分化型甲状腺癌患者。将 PET/CT 结果与其他定位研究（颈部超声、¹³¹I 全身扫描）相关联，并与术中发现和组织病理学检查进行准确比较。2008 年 12 月至 2011 年 6 月，对 18 例年龄在 16-84 岁之间的患者进行了 FDG-PET/CT 扫描。14 例患者患有乳头状甲状腺癌，4 例患者患有滤泡状甲状腺癌。所有患者均行甲状腺切除术和放射性碘消融术。在进行颈部再次探查之前，14 例患者报告 FDG-PET/CT 阳性发现，而 4 例 PET 扫描未发现疾病。在 14 例 FDG-PET/CT 阳性的复发性或持续性甲状腺癌局部定位中，13 例经手术证实并经组织病理学证实（敏感性 93%）。另一名患者术中发现肺癌淋巴结转移。然而，在 6 例行系统淋巴结切除术的患者中，有 5 例 FDG-PET/CT 低估了病变数量。在 4 例 FDG-PET 扫描阴性的患者中，术中未发现淋巴结或软组织转移。第四例患者发现单个囊性淋巴结转移，但未被 FDG-PET/CT 检测到（特异性 75%）。FDG-PET/CT 对检测持续性或复发性分化型甲状腺癌具有较高的敏感性和特异性。FDG-PET/CT 有助于选择可能受益于手术的患者，因为它提供了精确的解剖细节。
