低活性 124I-PET/低剂量 CT 与 99mTc-高锝酸盐平面闪烁显像或 99mTc-高锝酸盐单光子发射计算机断层扫描甲状腺：初步比较。

Low-activity 124I-PET/low-dose CT versus 99mTc-pertechnetate planar scintigraphy or 99mTc-pertechnetate single-photon emission computed tomography of the thyroid: a pilot comparison.

机构信息

From the *Clinic of Nuclear Medicine, Jena University Hospital, and †BioControl Jena, Data Analysis and Process Optimization, Jena, Germany; and ‡Spencer-Fontayne Corporation, Jersey City, NJ.

出版信息

Clin Nucl Med. 2013 Oct;38(10):770-7. doi: 10.1097/RLU.0b013e3182a20d26.

DOI:10.1097/RLU.0b013e3182a20d26

PMID:23877506

Abstract

PURPOSE OF THE REPORT

The standard thyroid functional imaging method, 99mTc-pertechnetate (99mTc-PT) planar scintigraphy, has technical drawbacks decreasing its sensitivity in detecting nodules or anatomical pathology. 124I-PET, lacking these disadvantages and allowing simultaneous CT, may have greater sensitivity for these purposes. We performed a blinded pilot comparison of 124I-PET(/CT) versus 99mTc-PT planar scintigraphy or its cross-sectional enhancement, 99mTc-PT single-photon emission CT (SPECT), in characterizing the thyroid gland with benign disease.

PATIENTS AND METHODS

Twenty-one consecutive adults with goiter underwent low-activity (1 MBq/0.027 mCi) 124I-PET/low-dose (30 mAs) CT, 99mTc-PT planar scintigraphy, and 99mTc-PT-SPECT. Endpoints included the numbers of “hot spots” with/without central photopenia and “cold spots” detected, the proportion of these lesions with morphological correlates, the mean volume and diameter of visualized nodules, and the number of cases of lobus pyramidalis or retrosternal thyroid tissue identified.

RESULTS

124I-PET detected significantly more “hot spots” with/without central photopenia (P < 0.001), significantly more nodules (P < 0.001), and more “cold spots” than did 99mTc-PT planar scintigraphy or 99mTc-PT-SPECT, including all lesions seen on the 99mTc-PT modalities. Ultrasonographic correlates were found for all nodules visualized on all 3 modalities and 92.5% of nodules seen only on 124I-PET. Nodules discernible only on 124I-PET had significantly smaller mean volume or diameter (P < 0.001) than did those visualized on 99mTc-PT planar scintigraphy or 99mTc-PT-SPECT. 124I-PET(/CT) identified significantly more patients with a lobus pyramidalis (P < 0.001) or retrosternal thyroid tissue (P < 0.05).

CONCLUSIONS

124I-PET(/CT) may provide superior imaging of benign thyroid disease compared to planar or cross-sectional 99mTc-PT scintigraphy.

摘要

报告目的

标准甲状腺功能成像方法 99mTc-过锝酸盐（99mTc-PT）平面闪烁显像术具有降低其检测结节或解剖病理学敏感性的技术缺陷。124I-PET 缺乏这些缺点，并允许同时进行 CT，因此对于这些目的可能具有更高的敏感性。我们对 124I-PET(/CT)与 99mTc-PT 平面闪烁显像术或其横断面增强 99mTc-PT 单光子发射 CT（SPECT）进行了盲法初步比较，以确定良性疾病甲状腺的特征。

患者和方法

21 例连续的甲状腺肿成年人接受低活性（1MBq/0.027mCi）124I-PET/低剂量（30mAs）CT、99mTc-PT 平面闪烁显像术和 99mTc-PT-SPECT。终点包括检测到的“热点”和“冷点”的数量（有无中央透光不良）、有形态学相关性的这些病变的比例、可见结节的平均体积和直径以及叶状突或胸骨后甲状腺组织的病例数。

结果

124I-PET 检测到的“热点”和“冷点”（有无中央透光不良）明显多于 99mTc-PT 平面闪烁显像术或 99mTc-PT-SPECT（P<0.001），明显多于 99mTc-PT 平面闪烁显像术或 99mTc-PT-SPECT（P<0.001），包括所有在 99mTc-PT 模式上看到的病变。所有 3 种模式上均可见超声相关性，92.5%的仅在 124I-PET 上可见的结节也有超声相关性。仅在 124I-PET 上可分辨的结节的平均体积或直径明显小于在 99mTc-PT 平面闪烁显像术或 99mTc-PT-SPECT 上可见的结节（P<0.001）。124I-PET(/CT) 明显增加了叶状突（P<0.001）或胸骨后甲状腺组织（P<0.05）的检出率。