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1.
The role of thallium-201 (201TI) scintigraphy in the follow-up evaluation of differentiated thyroid carcinoma (DTC) is controversial. Desirable characteristics of 201TI scintigraphy including the potential for no thyroid hormone withdrawal, immediate imaging postinjection, and low radiation burden relative to iodine-131 (131I) suggests it is logistically superior to 131I scintigraphy. Fifty-two patients with DTC were evaluated with 201TI and 131I neck and chest images, and serum thyroglobulin measurements. In post-thyroidectomy and pre-131I ablation therapy patients, very little 201TI accumulation was noted within the thyroid bed, with discordantly increased 131I activity and normal serum thyroglobulin measurements. Twenty-nine percent of patients evaluated after 131I ablative therapy had elevated serum thyroglobulin levels and localized neck and chest abnormalities on 201TI scan that were not seen on 131I studies. Our data suggest that 201TI is more sensitive than 131I diagnostic (5 mCi) studies for detection of DTC, while 131I is more sensitive in detecting normal residual thyroid tissue postoperatively.  相似文献   

2.
Despite extensive use of iodine-131 ((131)I) treatment for Graves' hyperthyroidism, the optimal regimen of pretreatment with antithyroid drugs is still a matter of discussion. Our aim was to evaluate the success of (131)I treatment in patients with Graves' disease without and with pretreatment with methimazole (MMI). In a prospective randomized study 156 patients with Graves' disease were treated with fixed activity of 550 MBq (131)I. First group of 59 patients received only (131)I. The second group of 50 patients received MMI which was stopped seven days before (131)I. The third group of 47 patients received MMI until (131)I application. Patients were followed clinically and biochemically 1, 3, 6 and 12 months after (131)I treatment. Absorbed dose of (131)I and thyroid volume were measured in each patient. Our result showed that (131)I treatment success after twelve months was equally effective in the first and second group (96.6% and 96%, respectively), while in the third group, success was significantly lower (63.8%). Accordingly, the absorbed dose of (131)I was significantly higher in the first and in second group (144±104 Gy and 164±107 Gy, respectively), and lower in the third group (105±58 Gy). Thyroid volume gradually decreased without any significant difference between the three groups. In conclusion, our study provides evidence that application of (131)I is equally effective in the nonpretreated with MMI group and in the group discontinuing MMI one week before (131)I treatment, and it is more effective in these two groups as compared to the group in which pretreatment with MMI was administered till the day of (131)I application.  相似文献   

3.
The blood, tumour and whole-body levels and survivals of 131I- and 111In-labelled monoclonal antibody (791T/36) have been compared in mice with human tumour xenografts. The blood levels and survivals of 131I- and 111In-labelled antibody were similar when expressed as proportions of the injected doses. However, the whole-body survival of 111In following administration of 111In-labelled antibody was over twice as long as that of 131I after administration of 131I-labelled antibody, principally because free 131I was rapidly excreted but free 111In was retained, primarily in liver, spleen and kidneys. Consequently, when expressed in relation to the whole body, blood levels of 111In became progressively lower than those of 131I following administration of labelled antibodies. In mice with human tumour xenografts the proportion of the injected dose of 111In from 111In-labelled antibody deposited in tumour tissue was 4-5 times higher than that of 131I from 131I-labelled antibody. When compared with the whole-body levels of radiolabel the difference was less marked, although 111In accumulation in tumour was more rapid. The higher levels and longer retention of 111In in tumour produced tumour-to-blood ratios that were 7-8 times those achieved with 131I-labelled antibody.  相似文献   

4.
Iodine-131 is the most specific radionuclide to follow up patients with differentiated thyroid cancer (DTC). However there are some aspects that should be considered if 131I whole body scintigraphy (131I WBS) is performed. 1) Several prior conditions, including a bTSH above 30 mU/l and an urinary iodine excretion below 100-150 micrograms/g Crea, should be fulfilled. 2) Only about two thirds of metastases from DTC accumulate iodine. Therefore, in addition to 131I WBS, there is a need for other nonspecific tracers such as 99mTc Tetrofosmin WBS, 99mTc Sestamibi WBS or F-18 FDG PET to detect also iodine negative recurrences or metastases. There new tracers, especially F-18 FDG PET have demonstrated a very high detection rate of iodine negative metastases with mostly low differentiation. 3) The sensitivity of 131I WBS depends on the administered dose. Whereas the sensitivity of a diagnostic 131I WBS (up to 185 MBq) is below 60%, the value for a post-therapeutic 131I WBS (after 3700-7400 MBq) increases up to 75%. This means that in case of elevated serum thyroglobulin, iodine positive metastases cannot be excluded until WBS after 131I therapy is performed. 4) In patients with elevated serum thyroglobulin and/or known metastases, who are scheduled for 131I treatment, the question arises whether a diagnostic 131I WBS should be performed and if so, which dose should be administered to avoid thyroid stunning. There is evidence in the literature that the dose for a pre-therapeutic diagnostic 131I WBS should not exceed 74 MBq. 5) Despite the high specificity of 131I WBS, several pitfalls of iodine accumulation in non-malignant diseases and malignancies of other origin than thyroid cancer should be taken into account.  相似文献   

5.
目的探讨^131ISPECT/CT对^131I全身平面显像(WBS)不能确定性质的摄碘灶的鉴别诊断价值。方法DTC患者56例,男19例,女37例,年龄20~85(45±15)岁。于^131I治疗后第5天行^131IWBS,对^131IWBS不确定的摄碘灶进行^131ISPECT/CT显像。采用四格表,检验对比分析2种显像的差异。结果”。IWBS共显示摄碘灶288处,其中不能明确诊断的摄碘灶108处(37.5%)。经^131ISPECT/CT显像后,108处中27处摄碘灶被明确诊断为DTC转移灶(25.O%),71处被确定为非DTC转移灶(65.7%),分别为鼻、口腔、唾液腺、上颌窦囊肿、残留甲状腺组织、胸腺、胆囊炎、胃肠道、子宫、体表污染等非特异性摄取;其余10处^131ISPECT/CT也不能明确定性(9.3%)。与^131IWBS相比,^131ISPECT/CT提高了对DTC转移灶和非转移灶的鉴别能力(X2=102.35,P〈0.01)。结论对DTC患者^131IWBS难以判别的摄碘灶,^131ISPECT/CT可提高临床鉴别诊断率。  相似文献   

6.
目的 观察131Ⅰ治疗甲状腺功能亢进症(甲亢)的疗效及分析影响因素.方法 Graves病患者783例,服用131Ⅰ前记录患者性别、年龄、病程、甲状腺肿大程度和性质、甲亢程度、服用抗甲状腺药(ATD)情况、甲状腺质量、有否结节、24h摄131Ⅰ率、131Ⅰ总剂量、每克甲状腺给予131Ⅰ剂量、血清甲状腺激素及甲状腺自身抗体水平,量化各指标值,治疗3、6、12及24个月后分别观察患者症状和体征的变化情况,按完全缓解(包括甲状腺功能减退症)、部分缓解进行评价.统计分析使用SAS8.2软件包,采用CMH卡方检验(CMHχ2)、Wilcoxon秩和检验及Logistic回归.结果 疗效与服用131Ⅰ后的时间存在线性关系(CMHχ2=69.21,P<0.01);服用131Ⅰ12个月后甲状腺质量、急躁、易惊、食欲亢进、心悸等症状和体征均有明显的改善(P值均<0.05);Logistic回归结果显示:年龄、甲状腺24 h摄131Ⅰ率、甲状腺质量、每克甲状腺组织131Ⅰ剂量、结节对疗效的影响有统计学意义(P值均<0.05).结论 服用131Ⅰ后随访期内疗效较好,甲状腺质量、急躁、易惊、食欲亢进、心悸等症状和体征明显改善.对于年龄偏大、甲状腺24h摄131Ⅰ率高、甲状腺质量大、甲状腺有结节的患者,疗效较差,应适当增加服131Ⅰ剂量;反之,应减少.  相似文献   

7.
We present data on repeated iodine-131 whole body scans ((131)I-WBS) in differentiated thyroid cancer patients (DTC) after surgery and (131)I remnant ablation and on increased thyroglobulin (Tg) with negative (131)I-WBS, in a retrospective study at our hospital. A total of 106 patients (91 female and 15 male) treated with (131)I for DTC met the inclusion criteria. The mean age of the patients was 45 years, age range 16-81 years. A total of 101 patients had complete 24 months follow-up following (131)I remnant ablation treatment. The mean (131)I dose administered after the first 6 months of follow- up was 3GBq while mean total dose was 4.9GBq, range 1.1-7.4GBq. Our results showed that at the end of the first 6 months post treatment, 58/101 patients had a negative (131)I-WBS. By the end of the 4th (131)I treatment at 24th months, the remaining 43 patients became negative for (131)I-WBS. We found increased Tg and negative (131)I-WBS in 2 of the 101 patients at the 24th months examination the so called Tg elevated negative (131)I-WBS (TENIS syndrome). The possible explanation of this syndrome is discussed. In conclusion, our study in DTC operated patients does not support the use of repeated diagnostic (131)I-WBS after an undetectable Tg because we found no Tg rebound in patients with negative (131)I-WBS, after 24 months of follow-up with serial measurements of Tg on and of suppression with L thyroxine.  相似文献   

8.
False positive 131I whole body scans in thyroid cancer   总被引:3,自引:0,他引:3  
Well differentiated thyroid cancer is a rare disease in the UK. It is the only cancer which, having metastasized, remains curable by radioisotope therapy with 131I. The main indication for administering repeat doses of 131I is the appearance of abnormal uptake in a whole body scan following diagnostic or therapeutic 131I administration. False positive scans, showing the presence of 131I uptake in the absence of residual thyroid tissue or metastases can occur, although they are uncommon. Unless recognized as a false positive, 131I uptake may result in diagnostic error and lead to administration of an unnecessary therapy dose. We describe a series of nine patients in whom the scans showed false positive uptake of 131I, including cases where the cause of the uptake is still uncertain. We demonstrate the common sites of false positive uptake, discuss the underlying mechanisms and suggest a systematic approach to the interpretation of whole body scans in order to prevent unnecessary treatment with 131I.  相似文献   

9.
Factors affecting the effect of 131I treatment and survival after pulmonary metastases in patients with differentiated thyroid cancer, were studied. Between 1984-1999, pulmonary metastases was observed in 51 out of 153 patients with differentiated thyroid cancer at our institution. Of these 41 patients had papillary and 10 follicular thyroid cancer. There were 37 females and 14 males with mean age (+/- S.D.) of 50.5 +/- 19.0 years. These 51 patients were subjected to 131I therapy. The effect of 131I treatment and the prognostic values of the following variables were examined: sex, age at the time of 131I treatment, histologic type of cancer, size of pulmonary metastases on CT, total-body scintigraphy with 201Tl and 131I, serum thyroglobulin levels and presence of metastases in distant sites other than lung. The effect of 131I treatment was evaluated by means of changes in the number and size of metastatic shadows on chest CT and by serum thyroglobulin levels. The minimum duration of follow-up was 12 months. Therapeutic 131I dose scans revealed detectable uptake in 25 of 51 patients. Therapeutic 131I dose uptake was achieved more frequently in patients under 40 years of age and in those with follicular cancers. Of the 51 patients, 13 were evaluated to be treated successfully. Those under 40 years of age, with 131I uptake in the lung and presence of other metastases showed a good response to treatment than others. Follicular cancer showed a more significant association with coarse type of lung metastases (> 5 mm in diameter on chest CT) and good 131I uptake than papillary cancer. Of all the variables studied, the best prognosis for survival was demonstrated by increased 131I uptake in pulmonary metastases. These results indicate that age, 131I uptake and presence of other metastases are important factors in predicting the effect of 131I treatment for pulmonary metastases of differentiated thyroid cancer.  相似文献   

10.
131I is one of the most important radionuclides used in nuclear medicine. The accompanying isotope 129I with insignificant activities in 131I-pharmaceuticals, produced in THOR, were determined in terms of 129I/131I ratio by neutron activation analysis. The detection limit of 129I can be lowered to order of 0.1 Bq, superior to conventional radiometric methods. The 129I/131I ratios in the 131I-pharmaceuticals, were measured to be in the range from 3.9 to 8.3.  相似文献   

11.
分化型甲状腺癌(DTC)是最常见的内分泌系统恶性肿瘤,早期易发生淋巴结转移。131I全身显像联合SPECT/CT(简称131I SPECT/CT)常可发现残留和(或)漏诊的淋巴结转移灶,可能会改变患者的术后再分期及危险度分层,从而影响后续的手术或131I治疗的方式选择。131I治疗是DTC术后颈部淋巴结转移的有效治疗方法之一,而131I SPECT/CT可以诊断淋巴结转移灶。笔者对131I SPECT/CT在DTC术后淋巴结转移的诊断及治疗中的应用价值进行综述。  相似文献   

12.
A new radiopharmaceutical, I-131 metaiodobenzylguanidine (I-131 MIBG) was used to determine the location and to follow-up tumors in a 13-month-old girl with neuroblastoma. I-131 MIBG imaging revealed both a primary abdominal tumor and a distant metastatic orbital tumor. Follow-up study with I-131 MIBG imaging demonstrated significant resolution of tumors after external radiotherapy and chemotherapy. I-131 MIBG imaging is a simple, safe, and specific method of determining the location of tumors and also is clinically useful in the evaluation and management of patients with neuroblastoma.  相似文献   

13.
目的评价131ISPECT/CT显像在DTC患者中相对于131I全身显像(WBS)的增益价值。方法回顾性对比分析97例DTC患者[男31例,女66例,平均年龄44.1(17—74)岁]176个摄碘灶的131IWBS和131ISPECT/CT显像资料。显像均为131I治疗后的常规扫描,SPECT/CT显像针对WBS发现的病灶进行。由2位核医学科医师阅片,以病理及随访结果为诊断标准,分析131ISPECT/cT及131IIWBS对摄碘灶定位定性的诊断能力,并应用SPSS13.0对两者诊断准确性进行∥检验。结果131IWBS检出摄碘灶175个(颈部128个,远处灶47个),SPECT/CT检出病灶176个(颈部128个,远处灶48个)。173个病灶经病理及随访确诊,良性78个,恶性95个;3个未定性(仍在随访中)。确诊的摄碘灶中,残留甲状腺组织51个,颈部淋巴结转移或局部残留病灶67个,生理性摄取灶7个,远处转移灶30个,远处生理性摄取灶18个。131IIWBS诊断摄碘灶的灵敏度73.7%(70/95),特异性78.2%(61/78),准确性61.3%(106/173);其准确性低于131ISPECT/CT(98.8%,171/173;x2=72.3,P〈0.05)。131ISPECT/CT纠正131IWBS误判摄碘灶67个,其中纠正定位错误27个,定性错误40个;颈部37个[占全部颈部灶的28.9%(37/128)],远处灶30个(62.5%,30/48)。与131IWBS的最初诊断相比,131IISPECT/CT显像改变了27个转移部位的诊断,改变了8例患者临床分期的诊断,并最终改变了14例患者的治疗方案。结论131ISPECT/CT可以弥补131IWBS的不足,更准确区分残余甲状腺组织和淋巴结、肺或骨等远处转移及生理性摄取,对于DTC的诊治有较好的增稀价值。  相似文献   

14.
目的 研究应用低剂量(1.11 GBq)和高剂量(3.70 GBq)放射性131I清除非高危分化型甲状腺癌(DTC)术后残留甲状腺组织的疗效。 方法 回顾性分析行131I清甲治疗的63例非高危DTC患者的临床资料,采用Binary Logistic回归分析年龄、首次手术距清甲的时间间隔、甲状腺24 h摄碘率、血清TSH水平和清甲剂量对清甲疗效的影响;27例患者给予低剂量、36例患者给予高剂量的131I清甲治疗,采用Pearsonχ2检验分析低剂量和高剂量131I清甲疗效的差异,P < 0.05表示差异有统计学意义。 结果 63例非高危DTC患者中,清甲成功者46例(73.02%,46/63)、未成功者17例(26.98%,17/63);Binary Logistic回归分析显示,131I清甲剂量是清甲成功与否的主要影响因素(Wald=6.42,P=0.011);27例给予低剂量131I清甲患者中有15例清甲成功,36例给予高剂量131I清甲者中31例清甲成功,Pearsonχ2检验结果表明,高剂量131I清甲成功率(86.11%,31/36)明显高于低剂量(55.56%,15/27)(χ2=7.311,P=0.007)。 结论 在临床实践中,当残余甲状腺组织较少时,对于非高危DTC患者可考虑采用高剂量131I清甲治疗,提高一次清甲成功率。  相似文献   

15.
目的 通过对Graves病患者服用碳酸锂后甲状腺摄131I率变化的观察,探讨碳酸锂在低摄131I率Graves病患者131I治疗中的应用价值.方法 46例摄131I率低的Graves病患者口服碳酸锂,每日3次,每次250 mg,餐后服用,连续服用10 d,分别在用药前、后进行甲状腺摄131I率的测定,并比较用药前后差别.结果 46例摄131I率低的Graves病患者在服用碳酸锂10 d后甲状腺的24 h摄131I率比服用前明显升高(27%),两者具有统计学差异(t=3.24,P<0.01).结论 碳酸锂能够提高Graves病患者的甲状腺摄131I率,达到了患者要求并减少了131I的治疗用量,具有实用推广价值.  相似文献   

16.
目的 评价131I全身显像联合血清甲状腺球蛋白(Tg)测定在分化型甲状腺癌(DTC)131I治疗随访中的临床应用价值。 方法 153例经手术病理确诊为DTC的患者,均在术后接受了1次以上的131I治疗,每次剂量为1.85~9.25 GBq,131I治疗前测定血清Tg,治疗5 d后进行131I全身显像。 结果 153例行131I治疗的DTC患者共行血清Tg和131I全身显像检查各为262次,其中55.6%(85/153)的患者的血清Tg水平与131I全身显像均异常,13.7%(21/153)的患者两者均为正常,30.7%(47/153)的患者两者结果不一致,不一致的47例患者经其他影像学检查证实19例131I全身显像异常的患者中有13例异常,28例血清Tg异常的患者中有25例异常。血清Tg诊断DTC转移的灵敏度和特异度分别为89%(110/123)和90%(27/30),而131I全身显像的灵敏度和特异度分别为79.6%(98/123)和80%(24/30)。 结论 DTC手术及131I治疗后,常规进行血清Tg测定和131I全身显像检查,对术后判定复发转移灶及制定最佳131I诊疗计划、评价131I疗效具有重要的临床应用价值。  相似文献   

17.
The I-131 whole-body scan is a useful test to investigate the presence of metastatic disease of thyroid cancer after thyroidectomy. A 53-year-old woman received I-131 4 months after total thyroidectomy for papillary thyroid carcinoma for postsurgical ablation of the residual tumor cells. Whole-body scan demonstrated focal uptake of I-131 in the right iliac fossa that persisted 2 days later even after administration of laxatives. Computed tomography of this area showed only focal bowel scar presumably resulting from a complicated appendectomy 31 years ago. Intestinal adhesions accumulate I-131 and give false-positive activity on whole-body I-131 scans.  相似文献   

18.
Rats with one kidney clamped (2K1C), both kidneys clamped (2K2C), unilaterally nephrectomized with remaining kidney clamped (1K1C), and normals, were studied using 99mTc mercaptoacetyltriglycine ([ 99mTc]MAG-3) and 131I orthoiodohippurate ([131I]OIH). Clearances of [99mTc]MAG-3 and [131I]OIH were performed after constricted rats became hypertensive. Clearances were repeated after i.v. Captopril. Clearances of [99mTc]MAG-3 and [131I]OIH in normals didn't change significantly after Captopril. Clearances of [99mTc]MAG-3 and [131I]OIH decreased insignificantly after Captopril in the 2K2C model. in the 2K1C group, normal kidney clearance increased ([99mTc]MAG-3 p less than 0.01 and [131I]OIH p less than 0.025) and clamped kidney clearance decreased after inhibition ([99mTc]MAG-3, p less than 0.01, [131I]OIH p less than 0.02). Clearances increased in the 1K1C group after Captopril ([99mTc]MAG-3 p less than 0.0025 and [131I]OIH, p less than 0.001). The ratio of [99mTc]MAG-3 to [131I]OIH before Captopril was 0.81 and 0.84 after Captopril. Changes in renal function after Captopril depend on the model of renovascular hypertension and possibly the dose administered. Technetium-99m MAG-3 clearance parallels [131I]orthoiodohippurate in renovascular hypertension.  相似文献   

19.
目的 探讨分化型甲状腺癌(DTC)术后131I治疗患者胸腺生理性摄取131I的临床特点及131I全身显像(WBS)的影像学特征.方法 收集2007年至2013年收治的1882例次DTC术后131I治疗后第3~5天行WBS的患者,分析WBS上纵隔部位有131I摄取,并根据甲状腺球蛋白、甲状腺球蛋白抗体测定、其他影像学检查及临床随访结果最终被证实为胸腺生理性摄取131I的患者资料.结果 胸腺生理性摄取131I者共16例,年龄均<45岁,其中有15例患者至少接受过2次131I治疗,仅有1例第1次131I治疗后胸腺显影;WBS上胸腺生理性摄取131I主要表现为“弥漫性”或“哑铃状”浓聚灶;且胸腺对131I的生理性摄取随重复131I治疗次数的增加而越来越明显.结论 胸腺生理性摄取131I是45岁以下DTC术后患者多次131I治疗后WBS假阳性的重要原因之一,充分认识到这一现象并予以鉴别,对于患者下一步的恰当诊治是十分必要的.  相似文献   

20.
Objective  To observe the antitumor effect of 131I-17-allylamino-17-demethoxygeldanamycin (131I-17-AAG) in vitro/in vivo and explore its antitumor mechanism with a view to its potential therapeutic application. Methods   131I-17-AAG was prepared by the reaction of 17-AAG with Na [131I] in the presence of hydrogen peroxide. The effects of 13117-AAG on cell growth inhibition and cell cycle distribution in vitro were studied in BEL-7402 cells lines. Following BEL-7402 tumor implantation by subcutaneous xenografts into nude mice, the reagents were injected through the tail vein, and the tumor volume was measured and analyzed. At the end of the experiment, tumor specimens were processed for histopathological analysis. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was used to investigate apoptosis. The expression change of Akt2 was tested by Western-blot analysis. Results  Methyl-thiazolyl-tetrazolium assay showed inhibition rates of 27.7 ± 5.3%, 57.3 ± 4.3%, and 63.7 ± 3.1%, in Na131I group, 17-AAG group, and 131I-17-AAG group, respectively. The inhibition rate in the 131I-17-AAG group differed significantly between Na131I group and 17-AAG group (F = 229.49, P < 0.001). Following 48 h of treatment with the drug in each group, flow cytometry analysis indicated that detected sub-G peaks (black) were 1.54 ± 0.13%, 5.72 ± 1.05%, 12.97 ± 1.44%, and 20.65 ± 1.36%, in dimethyl sulfoxide (DMSO) group, Na131I group, 17-AAG group, and 131I-17-AAG group, respectively. Following infusion for 32 days, the tumor volumes in the 131I-17-AAG group were significantly smaller than those in the DMSO group (F = 24.18, P < 0.001) or the 131I group (F = 20.68, P < 0.001). Histopathological and TUNEL analyses showed that 131I-17-AAG inhibited the proliferation of tumor cells and induced apoptosis. The expression of Akt2 in 131I-17-AAG was significantly lower than that in the DMSO group or 131I group. Conclusions   131I-17-AAG can effectively inhibit the growth of BEL-7402 tumor cells in vitro and in vivo. 131I-17-AAG is a promising agent for the treatment of BEL-7402 cell tumor.  相似文献   

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