Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Sci Rep. 2018 Jan 11;8(1):473. doi: 10.1038/s41598-017-19036-9.
The aim of this study was to assess the usefulness of integrin imaging with Tc-PEG-E[PEG-c(RGDfK)] (Tc-3PRGD2) single photon emission computed tomography (SPECT)/computed tomography (CT) in detecting recurrent disease in patients with differentiated thyroid cancer (DTC), negative radioiodine whole-body scan (WBS) and high serum thyroglobulin (Tg). Thirty-seven patients who underwent total thyroidectomy followed by radioactive iodine ablation and had negative radioiodine WBS but elevated Tg levels were included. Tc-3PRGD2 SPECT/CT was performed 1 week after the negative diagnostic I WBS. Diagnostic performance indicators, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), for Tc-3PRGD2 SPECT/CT was calculated. The correlations between SPECT/CT results and clinic-pathological characteristics were examined. In 30 (81.1%) of the 37 patients, Tc-3PRGD2 SPECT/CT showed positive uptake. The sensitivity, specificity, PPV, and NPV of SPECT/CT to detect recurrent disease at follow-up were 96.6%, 75%, 93.3% and 85.7%, respectively. The sensitivity and PPV of SPECT/CT increased with increasing serum Tg levels. Tc-3PRGD2 SPECT/CT showed high sensitivity and PPV in the detection of recurrence among DTC patients with higher Tg levels and negative WBS, and the probability of obtaining a positive SPECT/CT result was related with the level of Tg.
本研究旨在评估整合素成像与 Tc-PEG-E[PEG-c（RGDfK）]（Tc-3PRGD2）单光子发射计算机断层扫描（SPECT）/计算机断层扫描（CT）在检测分化型甲状腺癌（DTC）患者中的应用，这些患者的放射性碘全身扫描（WBS）为阴性且血清甲状腺球蛋白（Tg）水平升高。 共纳入 37 例患者，这些患者接受了全甲状腺切除术和放射性碘消融术，且放射性碘 WBS 为阴性但 Tg 水平升高。在阴性诊断性 I WBS 后 1 周进行 Tc-3PRGD2 SPECT/CT。计算 Tc-3PRGD2 SPECT/CT 的诊断性能指标，包括敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。检查 SPECT/CT 结果与临床病理特征之间的相关性。在 37 例患者中的 30 例（81.1%）中，Tc-3PRGD2 SPECT/CT 显示阳性摄取。SPECT/CT 检测随访时复发病灶的敏感性、特异性、PPV 和 NPV 分别为 96.6%、75%、93.3%和 85.7%。SPECT/CT 的敏感性和 PPV 随着血清 Tg 水平的升高而增加。对于 Tg 水平较高且 WBS 阴性的 DTC 患者，Tc-3PRGD2 SPECT/CT 在检测复发方面具有较高的敏感性和 PPV，获得阳性 SPECT/CT 结果的概率与 Tg 水平有关。
