氟-18-氟脱氧葡萄糖正电子发射断层显像（PET）与铊-201闪烁扫描术对甲状腺肿瘤的评估

Fluorine-18-fluorodeoxyglucose PET versus thallium-201 scintigraphy evaluation of thyroid tumors.

作者信息

Uematsu H, Sadato N, Ohtsubo T, Tsuchida T, Nakamura S, Sugimoto K, Waki A, Takahashi N, Yonekura Y, Tsuda G, Saito H, Hayashi N, Yamamoto K, Ishii Y

机构信息

Department of Radiology, Biomedical Imaging Research Center, Fukui Medical School, Japan.

出版信息

J Nucl Med. 1998 Mar;39(3):453-9.

PMID:9529291

Abstract

UNLABELLED

To determine whether PET could help differentiate malignant from benign thyroid tumors, 18F-fluorodeoxyglucose (FDG) accumulation and 201Tl scintigraphy were examined relative to histological diagnosis.

METHODS

Nodular thyroid lesions in 11 patients were evaluated before surgical resection. Static PET scanning with 370 MBq FDG was done for 20 min (from 40 to 60 min postinjection) in all patients, and standardized uptake values (SUVs) in these lesions were calculated. In addition, eight patients were evaluated with dynamic PET scan up to 60 min postinjection, and the lesions were further evaluated using graphical analysis. Thallium-201 delayed images were visually evaluated in 10 patients.

RESULTS

Four of 11 nodules were well-differentiated papillary carcinoma, another five were benign follicular adenomas, one was a multinodular goiter and another a case of chronic thyroiditis that was proved not to contain a nodule. Time-activity curves of FDG uptake showed different patterns in malignant and benign tumors. In the malignant tumors, FDG uptake increased with time after the tracer injection. By contrast, FDG uptake in benign tumors gradually decreased. With use of a cutoff value of 5.0 mg/ml for SUV and 10 microl x min(-1) x ml(-1) for Kc (K complex value determined using the linear fitting of the time-activity curve of FDG accumulation), all of the four malignant nodules and the six benign nodules were separated correctly. Chronic thyroiditis had high SUV in the malignant range. Of the four patients with thyroid carcinoma, the delayed 201Tl images revealed a slightly higher or equal uptake to background activity. In a patient with chronic thyroiditis, the delayed 201Tl images revealed diffuse accumulation higher than background activity.

CONCLUSION

FDG-PET is superior to 201Tl in differentiating malignant from benign tumors. Both SUVs and Kc values were useful indexes for this discrimination. Although careful evaluation is needed for chronic inflammatory lesions, this technique appears to be useful in evaluating thyroid nodules.

摘要

未标注

为了确定正电子发射断层扫描（PET）是否有助于鉴别甲状腺良恶性肿瘤，相对于组织学诊断，对18F-氟脱氧葡萄糖（FDG）摄取和201铊闪烁扫描进行了检查。

方法

对11例患者的甲状腺结节性病变在手术切除前进行评估。所有患者均用370 MBq FDG进行20分钟的静态PET扫描（注射后40至60分钟），并计算这些病变的标准化摄取值（SUV）。此外，对8例患者在注射后60分钟内进行动态PET扫描评估，并使用图形分析对病变进行进一步评估。对10例患者的201铊延迟图像进行视觉评估。

结果

11个结节中4个为高分化乳头状癌，另外5个为良性滤泡性腺瘤，1个为结节性甲状腺肿，另1例为慢性甲状腺炎，经证实不含有结节。FDG摄取的时间-活性曲线在恶性和良性肿瘤中显示出不同模式。在恶性肿瘤中，FDG摄取在示踪剂注射后随时间增加。相比之下，良性肿瘤中的FDG摄取逐渐下降。使用SUV的截断值5.0 mg/ml和Kc（通过FDG积聚的时间-活性曲线的线性拟合确定的K复合物值）的截断值10 μl×min-1×ml-1，所有4个恶性结节和6个良性结节均被正确区分。慢性甲状腺炎在恶性范围内具有高SUV。在4例甲状腺癌患者中，201铊延迟图像显示摄取略高于或等于背景活性。在1例慢性甲状腺炎患者中，201铊延迟图像显示弥漫性积聚高于背景活性。