Department of Biomedical and Dental Sciences and Morpho-functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy.
Sci Rep. 2017 Jul 21;7(1):6147. doi: 10.1038/s41598-017-06603-3.
Quantitative Tc-MIBI thyroid scintigraphy is a useful tool in differentiating malignant from benign thyroid nodules with indeterminate cytology. The aim of our report is to compare the diagnostic performance of different quantitative methods. We prospectively evaluated 20 patients affected by a thyroid nodule with a cytological diagnosis of class III or IV according to the Bethesda system. Planar images of the thyroid were acquired 10 and 60 minutes after Tc-MIBI administration and two different quantitative methods applied (i.e. wash-out index, WOind; retention index, R.I.). All patients underwent lobectomy or thyroidectomy and final histological findings were matched with MIBI results obtained with both quantitative methods. Four out of 20 patients had a final histological result of differentiated thyroid cancer, while benign findings were found in the remaining cases. Overall sensitivity, specificity, accuracy, PPV and NPV were 100% in all for the WOind and 100%, 57.1%, 62.5%, 25% for the R.I., respectively. In conclusion Tc-semiquantitative MIBI thyroid scintigraphy with WOind calculation is highly accurate in differential diagnosis of nodules with indeterminate cytology reading.
锝-99m 甲氧基异丁基异腈甲状腺闪烁显像术是鉴别甲状腺良、恶性结节的一种有效方法，尤其适用于细胞学检查结果为不确定的甲状腺结节。本研究旨在比较不同定量方法的诊断效能。我们前瞻性地评估了 20 例甲状腺结节患者，这些患者的细胞学诊断为 Bethesda 系统 III 或 IV 级。在 Tc-MIBI 给药后 10 分钟和 60 分钟获取甲状腺平面图像，并应用两种不同的定量方法（洗脱指数，WOind；滞留指数，R.I.）。所有患者均行甲状腺叶切除术或甲状腺切除术，并将最终的组织学结果与两种定量方法获得的 MIBI 结果进行匹配。20 例患者中有 4 例最终的组织学结果为分化型甲状腺癌，其余均为良性发现。总的来说，WOind 在所有病例中的敏感性、特异性、准确性、阳性预测值和阴性预测值均为 100%，而 R.I.的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 100%、57.1%、62.5%、25%。总之，计算洗脱指数的锝-99m 甲氧基异丁基异腈甲状腺闪烁显像术在诊断具有不确定细胞学结果的结节方面具有很高的准确性。
