Jiang Jinjin, Yang Zhongyi, Zhang Yongping, Xu Xiaoping, Wang Mingwei, Hu Silong, Yao Zhifeng, Pan Herong, Zhang Yingjian, Li Duanshu
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Clin Imaging. 2014 Nov-Dec;38(6):797-801. doi: 10.1016/j.clinimag.2014.05.007. Epub 2014 May 21.
To evaluate the value of fluorine-18 2-deoxy-2-d-glucose positron emission tomography/computed tomography ([(18)F]FDG-PET/CT) in the detection of metastatic medullary thyroid cancer.
From November 2006 to November 2012, 50 medullary thyroid cancer patients (median age 48.7 years, range 18-76) who had a total thyroidectomy operation underwent whole-body [(18)F]FDG-PET/CT scans. The diagnostic accuracy of [(18)F]FDG-PET/CT was determined through both lesion-based and patient-based analyses. Further pathological tests were performed on all identified lesions or clinically followed for a minimum period of 6 months.
One hundred forty-four suspicious lesions were identified by organ-based analysis. Of these lesions, [(18)F]FDG-PET/CT detected 99 true-positive lesions, sensitivity was 73.3%, and specificity was 66.7%. On the patient-based analysis, the overall sensitivity and specificity were calculated as 65.7% and 92.3%, respectively. Using a cutoff calcitonin value of 1000 pg/ml, in patients with calcitonin lower than this value, sensitivity and specificity were 42.9% and 91.0%, respectively. In patients with calcitonin exceeding this value, they raised to 77.3% (χ(2)=4.392, P<.05) and 100% (χ(2)=0.197, P>.05), respectively. Compared with conventional imaging modality, PET/CT scans detected more lesions in 10 patients (20.4%) and correctly changed the treatment in 8 patients (16.3%).
[(18)F]FDG-PET/CT has excellent sensitivity and specificity, especially when the calcitonin value is higher than 1000 pg/ml for detecting metastatic medullary thyroid cancer. Compared to conventional morphologic imaging methods, it provides additional information for diagnosis.
评估氟-18 2-脱氧-2-D-葡萄糖正电子发射断层扫描/计算机断层扫描（[(18)F]FDG-PET/CT）在检测转移性甲状腺髓样癌中的价值。
2006年11月至2012年11月，50例行甲状腺全切术的甲状腺髓样癌患者（中位年龄48.7岁，范围18 - 76岁）接受了全身[(18)F]FDG-PET/CT扫描。[(18)F]FDG-PET/CT的诊断准确性通过基于病灶和基于患者的分析来确定。对所有识别出的病灶进行进一步病理检查或临床随访至少6个月。
基于器官分析识别出144个可疑病灶。在这些病灶中，[(18)F]FDG-PET/CT检测到99个真阳性病灶，敏感性为73.3%，特异性为66.7%。在基于患者的分析中，总体敏感性和特异性分别计算为65.7%和92.3%。使用降钙素临界值1000 pg/ml时，降钙素低于此值的患者中，敏感性和特异性分别为42.9%和91.0%。降钙素超过此值的患者中，敏感性和特异性分别提高到77.3%（χ(2)=4.392，P<0.05）和100%（χ(2)=0.197，P>0.05）。与传统成像方式相比，PET/CT扫描在10例患者（20.4%）中检测到更多病灶，并在8例患者（16.3%）中正确改变了治疗方案。
[(18)F]FDG-PET/CT具有出色的敏感性和特异性，尤其是当降钙素值高于1000 pg/ml时，对检测转移性甲状腺髓样癌具有重要价值。与传统形态学成像方法相比，它为诊断提供了额外信息。
