Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Sci Rep. 2017 Jun 6;7(1):2849. doi: 10.1038/s41598-017-03001-7.
Differentiated thyroid cancer (DTC) patients with negative serum thyroglobulin (Tg), negative I whole-body scintigraphy (I-WBS) at first post-ablation and progressively increased TgAb level are a relatively rare entity in the follow-up after total thyroidectomy and radioactive iodine therapy. The value of F-FDG PET/CT in detecting the recurrence of disease in these patients has only been reported in a small case series. The goal of this study was to investigate the diagnostic accuracy of F-FDG PET/CT in detecting recurrent disease in these specific PTC patients and to identify risk factors for patients with positive F-FDG PET/CT results. Eighty-two PTC patients who had F-FDG PET/CT scans with negative Tg, negative I-WBS at first post-ablation and progressively increased TgAb levels were included. We found that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of F-FDG PET/CT in this patient group were determined as 84%, 72%, 92%, 57% and 82%, respectively. F-FDG PET/CT scan had a good diagnostic performance and should be performed routinely in PTC patients with negative Tg, negative I-WBS at first postablation and progressively increased TgAb level, especially when span for progressively increased TgAb level ≥ 3 years and/or progressively increased TgAb value up to 150 IU/mL.
分化型甲状腺癌（DTC）患者在甲状腺全切和放射性碘治疗后随访中，血清甲状腺球蛋白（Tg）阴性、首次碘扫描（I-WBS）阴性且 TgAb 水平逐渐升高的情况较为少见。在这些患者中，F-FDG PET/CT 对疾病复发的检测价值仅在小病例系列中有所报道。本研究旨在探讨 F-FDG PET/CT 在检测这些特定 PTC 患者疾病复发中的诊断准确性，并确定 F-FDG PET/CT 阳性结果患者的危险因素。本研究纳入了 82 例 PTC 患者，这些患者均行 F-FDG PET/CT 扫描，且首次碘扫描后 Tg 阴性、TgAb 水平逐渐升高。我们发现，在该患者组中，F-FDG PET/CT 的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为 84%、72%、92%、57%和 82%。F-FDG PET/CT 扫描具有良好的诊断性能，应常规用于 Tg 阴性、首次碘扫描后阴性且 TgAb 水平逐渐升高的 PTC 患者，特别是 TgAb 水平逐渐升高持续时间≥3 年和/或 TgAb 值逐渐升高至 150 IU/mL 时。
