Nĕmec J, Röhling S, Zamrazil V, Pohunková D
J Nucl Med. 1979 Feb;20(2):92-7.
In 206 patients with differentiated thyroid cancer, the distribution of iodine-131 were compared after diagnostic (200-500 microCi) and thyroblative (approximately 100 mCi) doses. In the diagnostic scans, only normal thyroid tissue could be seen, whereas in one-fourth of the patients the therapeutic scans showed tumor tissue as well, usually in lymphnode metastases. In 16% of patients, the therapeutic scan was the only way to demonstrate the presence of tumor tissue, since no further uptake was achievable. In patients in whom all tumor was believed to have been removed by surgery alone, a "preventive" I-131 ablation was used, and in 16 of these 97 patients tumor was revealed in the therapeutic scan. In ten more, tumor was found in subsequent followup scans, its functioning having been induced by destruction of postsurgical remnants of normal thyroid. Some possible explanations for the differences in scans are proposed, and the importance of therapeutic scans for correct staging of thyroid cancer is stressed.
在206例分化型甲状腺癌患者中，对诊断剂量（200 - 500微居里）和治疗剂量（约100毫居里）的碘-131分布情况进行了比较。在诊断性扫描中，仅能看到正常甲状腺组织，而在四分之一的患者中，治疗性扫描也显示出肿瘤组织，通常为淋巴结转移灶。在16%的患者中，治疗性扫描是显示肿瘤组织存在的唯一方法，因为无法实现进一步摄取。对于那些认为仅通过手术已切除所有肿瘤的患者，采用了“预防性”碘-131消融治疗，在这97例患者中的16例，治疗性扫描显示出肿瘤。另外还有10例患者，在后续的随访扫描中发现了肿瘤，其功能是由手术切除后正常甲状腺残余组织的破坏所诱导产生的。文中提出了一些对扫描差异的可能解释，并强调了治疗性扫描对于甲状腺癌正确分期的重要性。
