治疗前124I PET与治疗中131I成像在检测碘阳性甲状腺癌转移灶方面高度一致。

High Level of Agreement Between Pretherapeutic 124I PET and Intratherapeutic 131I Imaging in Detecting Iodine-Positive Thyroid Cancer Metastases.

作者信息

Ruhlmann Marcus, Jentzen Walter, Ruhlmann Verena, Pettinato Cinzia, Rossi Gloria, Binse Ina, Bockisch Andreas, Rosenbaum-Krumme Sandra

机构信息

Department of Nuclear Medicine, University Hospital, University Duisburg-Essen, Essen, Germany

Department of Nuclear Medicine, University Hospital, University Duisburg-Essen, Essen, Germany.

出版信息

J Nucl Med. 2016 Sep;57(9):1339-42. doi: 10.2967/jnumed.115.169649. Epub 2016 May 5.

DOI:10.2967/jnumed.115.169649

PMID:27151981

Abstract

UNLABELLED

The aim of this retrospective study was to assess the level of agreement between PET and scintigraphy using diagnostic amounts of (124)I and therapeutic amounts of (131)I, respectively, in detecting iodine-positive metastases in patients with differentiated thyroid carcinoma.

METHODS

The study included patients who underwent PET /: CT 24 and 120 h after administration of approximately 25 MBq of (124)I and subsequently underwent imaging 5-10 d after administration of 1-10 GBq of (131)I. For each patient, the intratherapeutic (131)I imaging comprised a whole-body scintigraphy scan and a SPECT/CT scan of the neck to distinguish between metastatic and thyroid remnant tissues. Iodine uptake was rated as a metastatic focus if located outside the thyroid bed. Lesion- and patient-based analyses were performed.

RESULTS

The study included 137 patients with 227 metastases iodine-positive on both functional imaging modalities. In the lesion-based analysis, (124)I PET and (131)I imaging detected 98% (223/227) and 99% (225/227) of the iodine-positive metastases, respectively; the level of agreement between (124)I PET and (131)I imaging was 97% (221/227). Four metastases (3 lymph node and 1 bone) in 4 patients were (124)I-negative but (131)I-positive, and 2 lymph node metastases in 2 patients were (131)I-negative but (124)I-positive. In the patient-based analysis, 61 of the 137 patients presented with iodine-positive metastases. (124)I PET and (131)I imaging detected at least one iodine-positive metastasis in 97% (59/61) and 98% (60/61) of the patients, respectively. The level of agreement was 95% (58/61). Both imaging modalities concordantly identified 76 of 137 patients without pathologic iodine uptake.

CONCLUSION

Because of the high level of agreement, pretherapeutic (124)I PET/CT is an adequate methodology in the detection of iodine-positive metastases and can be used as a reliable tool for staging of thyroid cancer patients and individualized treatment planning.

摘要

未标注

本回顾性研究的目的是评估分别使用诊断剂量的（124）I和治疗剂量的（131）I进行PET和闪烁扫描在检测分化型甲状腺癌患者碘阳性转移灶方面的一致性水平。

方法

该研究纳入了在给予约25MBq的（124）I后24小时和120小时接受PET/CT检查，随后在给予1 - 10GBq的（131）I后5 - 10天接受成像检查的患者。对于每位患者，治疗期间的（131）I成像包括全身闪烁扫描和颈部SPECT/CT扫描，以区分转移组织和甲状腺残余组织。如果碘摄取位于甲状腺床外，则被评定为转移灶。进行了基于病灶和基于患者的分析。

结果

该研究纳入了137例患者，共227个转移灶在两种功能成像模式下均为碘阳性。在基于病灶的分析中，（124）I PET和（131）I成像分别检测到98%（223/227）和99%（225/227）的碘阳性转移灶；（124）I PET和（131）I成像之间的一致性水平为97%（221/227）。4例患者中的4个转移灶（3个淋巴结和1个骨转移灶）为（124）I阴性但（131）I阳性，2例患者中的2个淋巴结转移灶为（131）I阴性但（124）I阳性。在基于患者的分析中，137例患者中有61例出现碘阳性转移灶。（124）I PET和（131）I成像分别在97%（59/61）和98%（60/61）的患者中检测到至少一个碘阳性转移灶。一致性水平为95%（58/61）。两种成像模式均一致地识别出137例无病理性碘摄取的患者中的76例。