Dadparvar S, Krishna L, Brady L W, Slizofski W J, Brown S J, Chevres A, Micaily B
Department of Radiation Oncology and Nuclear Medicine, Hahnemann University Hospital, Philadelphia, PA 19102.
Cancer. 1993 Jun 1;71(11):3767-73. doi: 10.1002/1097-0142(19930601)71:11<3767::aid-cncr2820711146>3.0.co;2-w.
A prospective study was conducted to evaluate the use of iodine-131 sodium scintigraphy, thallium-201 chloride scintigraphy, and quantitative serum thyroglobulin estimation in the detection of differentiated thyroid carcinoma after thyroidectomy and iodine-131 sodium ablative therapy.
Thirty-one patients with a median age of 45.6 years (range, 20-73 years) were included in the study. After optimal endogenous thyroid-stimulating hormone stimulation (> 50 mU/ml), 53 pairs of iodine-131 and thallium-201 scans were performed. Concomitant serum thyroglobulin levels were available for 32 pairs of scans. The presence or absence of thyroid cancer was established by clinical, radiologic, and/or biopsy findings.
The concordance between iodine-131 and thallium-201 scan findings in the presence of disease (25 scan sets) was 36%. The concordance in the absence of disease (28 scan sets) was 82%. Iodine-131 scanning was found to be significantly better (P < 0.05) than thallium-201 scanning, in terms of sensitivity (0.8 versus 0.6), specificity (0.96 versus 0.82), accuracy (0.89 versus 0.72), and the predictive value of a positive test (0.95 versus 0.75). The measurement of serum thyroglobulin had a low sensitivity (0.3) in the study but had a specificity of 1.0.
It was concluded that iodine-131 sodium scintigraphy is superior to thallium-201 scintigraphy and serum thyroglobulin estimation for the detection of residual or metastatic differentiated thyroid carcinoma. However, the use of combined modalities provides a higher diagnostic yield. Thallium-201 scintigraphy was especially useful in cases in which iodine-131 scintigraphy was negative and quantitative thyroglobulin levels were elevated.
开展一项前瞻性研究，以评估碘-131钠闪烁扫描、氯化铊-201闪烁扫描以及血清甲状腺球蛋白定量测定在甲状腺切除术后及碘-131钠消融治疗后检测分化型甲状腺癌中的应用。
31例患者纳入研究，中位年龄45.6岁（范围20 - 73岁）。在最佳内源性促甲状腺激素刺激（>50 mU/ml）后，进行了53对碘-131和氯化铊-201扫描。32对扫描同时有血清甲状腺球蛋白水平数据。通过临床、影像学和/或活检结果确定是否存在甲状腺癌。
存在疾病的情况下（25组扫描），碘-131和氯化铊-201扫描结果的一致性为36%。不存在疾病的情况下（28组扫描），一致性为82%。在敏感性（0.8对0.6）、特异性（0.96对0.82）、准确性（0.89对0.72）以及阳性试验预测值（0.95对0.75）方面，发现碘-131扫描显著优于氯化铊-201扫描（P < 0.05）。血清甲状腺球蛋白测定在本研究中敏感性较低（0.3），但特异性为1.0。
得出结论，碘-131钠闪烁扫描在检测残留或转移性分化型甲状腺癌方面优于氯化铊-201闪烁扫描和血清甲状腺球蛋白测定。然而，联合使用多种检查方法可提高诊断率。氯化铊-201闪烁扫描在碘-131闪烁扫描阴性且甲状腺球蛋白定量水平升高的病例中尤其有用。
