18F-FDG PET/CT显像在131I全身扫描及血清Tg均阴性的已清除残留甲状腺组织的分化型甲状腺癌患者中的应用价值

目的探讨18F-FDG PET/CT显像在血清Tg和131I-全身扫描均为阴性的行甲状腺癌切除和清除残留甲状腺组织治疗后的患者中检测肿瘤复发和转移的应用价值。方法 41例接受了甲状腺全切和大剂量131I清除残留甲状腺组织治疗的DTC患者,在随访中进行了血清Tg测定、131I-WBS、颈部B超、胸部CT及18F-FDG PET/CT全身显像。结果 41例患者血清Tg和131I-WBS均为阴性,颈部B超或胸部CT均显示存在异常病灶;其中23例患者18F-FDG PET/CT显像阳性,18例患者18F-FDG PET/CT显像阴性。18F-FDG PET/CT显像阳性患者中,有3例经病理检查证实为甲状腺癌转移;18F-FDG PET/CT显像阳性病灶与阴性病灶的长短径差异无统计学意义。结论接受甲状腺全切和大剂量131I清除残留甲状腺组织治疗后的DTC患者术后随访血清Tg及131I-WBS均为阴性时,18F-FDG PET/CT显像可显示可疑的阳性病灶,有助于发现复发和转移病灶。

Application of 18F-FDG PET/CT in patients with negative findings in serum Tg measurement and 131I-whole body scan after ablation of remaining thyroid tissues for differentiated thyroid carcinoma

Objective To investigate the application of 18F-FDG PET/CT in detection of tumor recurrence and metastasis among patients with negative findings in serum thyroglobulin(Tg) measurement and 131I-whole body scan(131I-WBS) after total thyroidectomy and 131I ablation of the remaining thyroid tissues for differentiated thyroid carcinoma(DTC).MethodsForty-one patients with DTC underwent total thyroidectomy and 131I ablation of the remaining thyroid tissues,and were followed up with serum Tg measurement,131I-WBS,neck ultrasound,chest CT and whole body 18F-FDG PET/CT.ResultsAll these 41 patients had negative findings in serum Tg measurement and 131I-WBS,while abnormal lesions were detected by neck ultrasound or chest CT.Twenty-three patients had positive findings in 18F-FDG PET/CT,3 of whom were confirmed as thyroid carcinoma metastases by pathological examinations.There was no significant difference between the size of 18F-FDG PET/CT positive lesions and that of 18F-FDG PET/CT negative lesions.Conclusion 18F-FDG PET/CT may demonstrate suspicious positive lesions in patients with negative findings in serum Tg measurement and 131I-WBS after total thyroidectomy and 131I ablation of the remaining thyroid tissues for DTC,which may help in the detection of tumor recurrence and metastasis.