分化型甲状腺癌~(18)F-FDG PET显像的临床应用

低分化型甲状腺癌细胞摄取碘能力的下降或丧失导致 1 31 　 I WBS(全身显像 )假阴性 (约 2 0 % ) ,高水平的血清 Tg(甲状腺球蛋白 )只能说明有分化型甲状腺癌 (DTC)的复发或转移 ,不能确定 DTC复发或转移的具体位置 ,而低分化型甲状腺癌正是 DTC病人死亡的主要类型。本文主要探讨 1 8F- FDG(1 8F-氟代脱氧葡萄糖 ) PET显像在1 31　 I的 WBS阴性而血清 Tg水平增高的 DTC病人中鉴别复发和转移的应用以及评价 DTC病人预后的价值 ,当嗜1 8F- FDG肿瘤显示的体积大于 12 5 m L 或 FDG标准摄取值大于 10 g/ m L 时 ,病人的预后不良。

Application of~(18)F-FDG PET scan in patients with differentiated thyroid cancer

Poorly differentiated thyroid cancer lesions often lose the ability to concentrate radioactive 131 I ] iodine and exhibit increased metabolic activity,as evidenced by enhanced glucose uptake. 18 F FDG PET was able to localize residual and metastatic thyroid cancer lesions in patients with negative diagnostic 131 I WBS and elevated serum thyroglobulin levels,although it uas not sensitve enough to detect mivimal metastatic disea in cervical nodes. multivariate analysis demonstrated that the single strongest predictor of survial was the volume of FDG avid disease.Subjects with a FDG volume greater than 125mL or with SUV greater than 10g/mL have significantly reduced short survival.