99mTcO4-SPECT/CT显像对分化型甲状腺癌术后残留甲状腺组织的评估价值

目的:探讨99mTcO4-甲状腺SPECT/CT显像对分化型甲状腺癌(DTC)患者术后残甲及颈部腺外转移灶的评估价值。方法:入组240例拟行术后131I清甲治疗的DTC患者。患者131I治疗前行99mTcO4-甲状腺SPECT/CT显像,服131I后5天行SPECT/CT全身扫描,必要时行颈部断层扫描。把131I显像结果作为标准,评价99mTcO4-甲状腺SPECT/CT显像对术后残甲和颈部腺外转移灶的评估价值。结果:99mTcO4-甲状腺SPECT/CT显像对DTC患者术后残甲评价的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为83.7%、89.5%、84.2%、98.9%、32.1%;其对DTC患者术后颈部腺外转移灶评估的灵敏度为40.2%。结论:99mTcO4-甲状腺SPECT/CT显像可作为DTC患者清甲治疗前对残甲的评估检查方法;但在发现颈部腺外转移灶的敏感度方面尚不如131I显像。

Evaluation of 99mTcO4-SPECT/CT thyroid imaging in detection of residual thyroid tissue for DTC patients after surgery

Objective To evaluate the value of 99mTcO4-SPECT/CT imaging in detection of residual thyroid tissue for patients with differentiated thyroid cancer after surgery.Methods 240 DTC patients were recruited in this study.The 99mTcO4-SPECT/CT scan were performed for all patients before 131I ablation and 5 days after 131I therapy all the patients were given 131I whole body scan.If it was necessary,the patient were given neck tomography.We used the result of 131I imaging as standard to evaluate the ability of the 99mTcO4-SPECT/CT thyroid imaging in detection of residual thyroid tissue and extra-thyroid metastases in the neck.Results The sensitivity,specificity,accuracy,the positive predictive value and the negative predictive value of the 99mTcO4-thyroid SPECT/CT imaging in detection of residual thyroid tissue were 83.7%,89.5%,84.2%,98.9% and 32.1% respectively.The sensitivity of the 99mTcO4-SPECT/CT thyroid imaging in detection of extra-thyroid metastases in the neck was 40.2%.Conclusion 99mTcO4-thyroid SPECT / CT scan can be used as a substitute for 131I neck scan to evaluate thyroid remnant.But it has less sensitivity in detection of extra-thyroid metastases than 131I scan.