Wei J P, Burke G J
Section of Endocrine and Oncologic Surgery, Medical College of Georgia, Augusta 30912, USA.
Ann Surg Oncol. 1995 May;2(3):233-7. doi: 10.1007/BF02307029.
Radionuclide scans that use Tc-99m-pertechnetate or I-123 currently lack the specificity to assess the malignant potential of solitary solid lesions of the thyroid gland. Tc-99m-sestamibi scanning was used to determine the neoplastic potential of thyroid lesions.
Patients with lesions of the thyroid underwent Tc-99m-sestamibi imaging to assess the neoplastic potential of their thyroid lesions, identified as solitary and cold by radionuclide imaging with Tc-99m-pertechnetate. Tc-99m-sestamibi uptake was correlated with fine-needle aspiration cytology or surgical pathology.
Twenty-seven patients were evaluated using Tc-99m-pertechnetate and Tc-99m-sestamibi scans: 14 had right thyroid lesions, and 13 had left thyroid lesions. Of 27 patients, 10 had a positive Tc-99m-sestamibi scan: one Hürthle cell adenoma, one papillary carcinoma, six follicular adenomas, and two nodular goiters. Of 27 patients, 17 had a negative Tc-99m-sestamibi scan: one follicular carcinoma, one papillary carcinoma, two follicular adenomas, one Hürthle cell adenoma, one metastatic adenocarcinoma, one medullary carcinoma, four nodular goiters, and six colloid nodules. Positive Tc-99m-sestamibi scan identified neoplasms with a sensitivity of 53%, a specificity of 83%, and a positive predictive value of 80%.
Tc-99m-sestamibi scanning lacks sufficient sensitivity for diagnosis of solitary thyroid nodules. Future work may define a role for its use in recurrent or metastatic thyroid neoplasms.
目前使用锝-99m高锝酸盐或碘-123的放射性核素扫描缺乏评估甲状腺孤立实性病变恶性潜能的特异性。锝-99m甲氧基异丁基异腈扫描用于确定甲状腺病变的肿瘤潜能。
甲状腺有病变的患者接受锝-99m甲氧基异丁基异腈成像，以评估其甲状腺病变的肿瘤潜能，这些病变经锝-99m高锝酸盐放射性核素成像确定为孤立性且为冷结节。锝-99m甲氧基异丁基异腈摄取与细针穿刺细胞学检查或手术病理结果相关。
27例患者接受了锝-99m高锝酸盐和锝-99m甲氧基异丁基异腈扫描评估：14例右侧甲状腺有病变，13例左侧甲状腺有病变。27例患者中，10例锝-99m甲氧基异丁基异腈扫描呈阳性：1例许特耳细胞腺瘤、1例乳头状癌、6例滤泡性腺瘤和2例结节性甲状腺肿。27例患者中，17例锝-99m甲氧基异丁基异腈扫描呈阴性：1例滤泡癌、1例乳头状癌、2例滤泡性腺瘤、1例许特耳细胞腺瘤、1例转移性腺癌、1例髓样癌、4例结节性甲状腺肿和6例胶样结节。锝-99m甲氧基异丁基异腈扫描阳性诊断肿瘤的敏感性为53%，特异性为83%，阳性预测值为80%。
锝-99m甲氧基异丁基异腈扫描对孤立性甲状腺结节的诊断缺乏足够的敏感性。未来的研究可能会明确其在复发性或转移性甲状腺肿瘤中的应用价值。
