Li Hongyan, Chen Xiaomin, Zhang Yajing, Wang Kun, Gao Zairong
Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, People's Republic of China.
Cancer Manag Res. 2021 Mar 29;13:2869-2876. doi: 10.2147/CMAR.S293005. eCollection 2021.
To evaluate the diagnostic performance of F-FDG PET/MR in detecting recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC) who have increased thyroglobulin (Tg) levels but a negative I whole-body scan (WBS). The relationship between F-FDG PET/MR and serum Tg levels was explored. We also evaluated the therapeutic impact of PET/MR on patient clinical management.
Twenty-nine DTC patients with a negative I-WBS of the last post-therapeutic and increased Tg levels under thyroid-stimulating hormone suppression treatment who underwent F-FDG PET/MR examination were retrospectively analyzed.
Of those 29 patients, F-FDG PET/MR findings were true positive, true negative, false positive, and false negative in 18, 7, 2, and 2 patients, respectively. The overall sensitivity, specificity, and accuracy were 90.0%, 77.8%, and 86.2%, respectively. We noticed significant differences in serum Tg levels between the PET/MR-positive and PET/MR-negative patient groups (=0.049). Receiver operating characteristic curve analysis showed that a Tg level of 2.4 ng/mL was the optimal cut-off value for predicting PET/MR results. The sensitivity, specificity, and accuracy of PET/MR were higher in patients with Tg levels greater than 2.4 ng/mL than in patients with lower levels. By detecting recurrent or metastatic disease, F-FDG PET/MR altered the clinical management in 7 patients (24.1%) of the overall population.
F-FDG PET/MR has high diagnostic accuracy for detecting recurrent or metastatic diseases in DTC patients and is useful for clinical management.
评估F-FDG PET/MR在检测分化型甲状腺癌（DTC）患者中复发或转移疾病的诊断性能，这些患者甲状腺球蛋白（Tg）水平升高但碘-131全身扫描（WBS）结果为阴性。探讨F-FDG PET/MR与血清Tg水平之间的关系。我们还评估了PET/MR对患者临床管理的治疗影响。
回顾性分析29例接受F-FDG PET/MR检查的DTC患者，这些患者在最后一次治疗后碘-131全身扫描结果为阴性，且在促甲状腺激素抑制治疗下Tg水平升高。
在这29例患者中，F-FDG PET/MR检查结果分别为真阳性18例、真阴性7例、假阳性2例和假阴性2例。总体敏感性、特异性和准确性分别为90.0%、77.8%和86.2%。我们注意到PET/MR阳性和PET/MR阴性患者组之间血清Tg水平存在显著差异（P=0.049）。受试者工作特征曲线分析表明，Tg水平为2.4 ng/mL是预测PET/MR结果的最佳临界值。Tg水平大于2.4 ng/mL的患者中，PET/MR的敏感性、特异性和准确性高于Tg水平较低的患者。通过检测复发或转移疾病，F-FDG PET/MR改变了7例（占总人群的24.1%）患者的临床管理。
F-FDG PET/MR在检测DTC患者复发或转移疾病方面具有较高的诊断准确性，对临床管理有帮助。
