van Sorge-van Boxtel R A, van Eck-Smit B L, Goslings B M
Department of Endocrinology, University Hospital, Leiden, The Netherlands.
Nucl Med Commun. 1993 May;14(5):365-72. doi: 10.1097/00006231-199305000-00004.
To evaluate the significance of 201Tl scintigraphy, 131I scintigraphy and serum thyroglobulin (Tg) levels in the postoperative follow-up of differentiated thyroid carcinoma, 86 patients were examined. Serum Tg was found to have the highest sensitivity (97%) as well as specificity (100%) for the detection of local tumour or metastases. Sensitivity and specificity of 131I scintigraphy after a therapeutic dose of 6100 MBq were 77 and 98%, respectively. For a diagnostic dose of 185 MBq 131I, sensitivity and specificity were 57 and 98%; for 74 MBq 201Tl these figures were 55 and 91%, respectively. The combination of serum Tg and 131I had a sensitivity of 100% and a specificity of 98% to detect the presence, although not always the localization, of persistent or recurrent tumour. 201Tl scintigraphy can provide useful additional information about the localization of local recurrences and metastases, especially in cases where serum Tg becomes positive and 131I uptake is absent. One has to bear in mind the possibility of discrepant results of 131I and 201Tl scintigraphy, in different tumour sites in one patient. There appeared to be no specific tendency for differential uptake of 131I versus 201Tl in relation to tumour type (papillary versus follicular) or localization with the possible exception of a higher preference for 131I uptake in cases of micrometastases of papillary cancer in the lungs.
为评估201铊闪烁扫描、131碘闪烁扫描及血清甲状腺球蛋白（Tg）水平在分化型甲状腺癌术后随访中的意义，对86例患者进行了检查。发现血清Tg对检测局部肿瘤或转移灶具有最高的敏感性（97%）和特异性（100%）。给予6100 MBq治疗剂量后131碘闪烁扫描的敏感性和特异性分别为77%和98%。给予185 MBq诊断剂量的131碘时，敏感性和特异性分别为57%和98%；给予74 MBq 201铊时，这些数字分别为55%和91%。血清Tg与131碘联合检测持续性或复发性肿瘤的存在（尽管不一定能确定其定位）时，敏感性为100%，特异性为98%。201铊闪烁扫描可为局部复发和转移灶的定位提供有用的额外信息，尤其是在血清Tg呈阳性而131碘摄取阴性的情况下。必须牢记一名患者不同肿瘤部位的131碘和201铊闪烁扫描结果可能存在差异。131碘与201铊的摄取差异似乎与肿瘤类型（乳头状癌与滤泡状癌）或定位无特定倾向，可能的例外是肺内乳头状癌微转移病例中131碘摄取的偏好性较高。
