Carril J M, Quirce R, Serrano J, Banzo I, Jiménez-Bonilla J F, Tabuenca O, Barquín R G
Department of Nuclear Medicine, Marqués de Valdecilla University Hospital, Santander, Spain.
J Nucl Med. 1997 May;38(5):686-92.
We analyzed the significance of total body scintigraphy with 201Tl in the follow-up of patients with differentiated thyroid cancer, both in the preablation and ablated stages.
Prospective assessment was performed in 116 patients who were involved in 178 studies (115 in preablation and 63 after ablation). For ablation, an absence of uptake in the thyroid bed was required in the total 131I follow-up scan after 131I ablation therapy. Each study consisted of a 201Tl scan performed while the patient was receiving thyroid hormone therapy, an 131I scan performed when endogenous thyroid-stimulating hormone levels were higher than 50 mlU/ml and determination of thyroglobulin (Tg) concentration using the same sample.
In the 115 scans in the preablation group, the findings for 201Tl and 131I agreed in 26 scans and disagreed in 89 scans. In 59 discordant studies, only 131I detected focal accumulation, and, in 54 of these, Tg levels were undetectable. Of the other 30 discordant studies, 201Tl and 131I detected focal uptake in 27 studies, although they did not reveal the same lesions, and in 3 studies, only 201Tl detected focal accumulation; in these 30 studies, the association of detectable Tg predominated. Of the 63 studies in the ablated group, the results agreed for the two tracers in 49 and disagreed in 14 studies. In 13 of the 14 discordant studies, 201Tl detected focal uptake, and, in 10 of these, Tg was detectable. Thus, 31 of the 116 patients assessed (15 preablation and 16 ablated) had at least one lesion that was detected by 201Tl but not detected by 131I. A definitive diagnosis could be established in 26 patients, and the presence of thyroid cancer was confirmed in 23. The sensitivity and specificity in the ablated group were 94% and 96%, respectively, for 201Tl and 29% and 100%, respectively, for 131I.
The high sensitivity of 201Tl scintigraphy in detecting tumor tissue indicates that the inclusion of this technique in the follow-up of patients with differentiated thyroid carcinoma should be considered in both the preablation and the ablated stages.
我们分析了201铊全身闪烁扫描在分化型甲状腺癌患者随访中的意义，包括消融前和消融后阶段。
对116例患者进行前瞻性评估，共涉及178项研究（消融前115项，消融后63项）。对于消融，131碘消融治疗后131碘全身扫描甲状腺床无摄取。每项研究包括患者接受甲状腺激素治疗时进行的201铊扫描、内源性促甲状腺激素水平高于50 mIU/ml时进行的131碘扫描以及使用同一样本测定甲状腺球蛋白（Tg）浓度。
在消融前组的115次扫描中，201铊和131碘的结果在26次扫描中一致，在89次扫描中不一致。在59次不一致的研究中，只有131碘检测到局灶性聚集，其中54次Tg水平不可测。在其他30次不一致的研究中，201铊和131碘在27次研究中检测到局灶性摄取，尽管它们显示的不是同一病变，在3次研究中，只有201铊检测到局灶性聚集；在这30次研究中，可检测到Tg的关联占主导。在消融后组的63次研究中，两种示踪剂的结果在49次中一致，在14次中不一致。在14次不一致的研究中的13次，201铊检测到局灶性摄取，其中10次可检测到Tg。因此，在评估的116例患者中，有31例（15例消融前和16例消融后）至少有一个病变被201铊检测到但未被131碘检测到。26例患者可确诊，23例确诊为甲状腺癌。消融后组中，201铊的敏感性和特异性分别为94%和96%，131碘的敏感性和特异性分别为29%和100%。
201铊闪烁扫描在检测肿瘤组织方面的高敏感性表明，在分化型甲状腺癌患者随访的消融前和消融后阶段都应考虑将该技术纳入。
Zotero 插件