| 99TcmO4-全身显像联合颈胸SPECT/CT在DTC患者术后肺转移灶显影中的应用 |
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| 引用本文： | 邓玮玮,朱娅华,范敏,张春银.99TcmO4-全身显像联合颈胸SPECT/CT在DTC患者术后肺转移灶显影中的应用[J].国际放射医学核医学杂志,2018,42(3):207-211. |
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| 作者姓名： | 邓玮玮 朱娅华 范敏 张春银 |
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| 作者单位： | 646000 泸州, 西南医科大学附属医院核医学科 |
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| 摘 要： | 目的探讨99TcmO4-全身显像联合颈胸SPECT/CT在分化型甲状腺癌（DTC）术后肺转移灶检出中的应用。方法回顾性分析2013年1月至2016年1月收治的34例DTC肺转移患者在术后131I治疗前的99TcmO4-全身显像联合颈胸SPECT/CT中肺转移灶的检出情况，计算99TcmO4-全身显像联合颈胸SPECT/CT检出肺转移灶的灵敏度、阳性预测值，并评估其对治疗决策的影响。结果34例肺转移患者中，2例表现为阳性（放射性浓聚+结构异常），10例表现为可疑阳性（仅有典型肺转移CT表现），22例表现为可疑阴性，若将可疑阳性与阳性均视为阳性发现，则99TcmO4-全身显像联合颈胸SPECT/CT发现肺转移灶的灵敏度为35.3%（12/34），阳性预测值为100%（12/12），11例患者在后续的131I治疗中增加了剂量。结论99TcmO4-全身显像联合颈胸SPECT/CT能发现部分无99TcmO4-浓聚的肺转移灶，提高了肺转移灶的检出率；指导临床调整131I治疗剂量，改善预后。
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| 关 键 词： | 甲状腺肿瘤 肿瘤转移 99m锝高锝酸钠 单光子发射计算机体层摄影术 |
| 收稿时间： | 2018-02-04 |
Effectiveness of 99Tcm-pertechnetate whole body scan with neck and chest SPECT/CT for the detection of post-surgical pulmonary metastasis in differentiated thyroid carcinoma patients |
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| Weiwei Deng,Yahua Zhu,Min Fan,Chunyin Zhang.Effectiveness of 99Tcm-pertechnetate whole body scan with neck and chest SPECT/CT for the detection of post-surgical pulmonary metastasis in differentiated thyroid carcinoma patients[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,42(3):207-211. |
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| Authors: | Weiwei Deng Yahua Zhu Min Fan Chunyin Zhang |
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| Affiliation: | Department of Nuclear Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China |
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| Abstract: | ObjectiveTo evaluate the effectiveness of 99Tcm-pertechnetate whole body scan with neck and chest SPECT/CT for detecting post-surgical pulmonary metastasis in differentiated thyroid carcinoma(DTC) patients.MethodsA total of 34 DTC patients were evaluated retrospectively. The patients underwent 99Tcm-pertechnetate whole body scan with neck and chest SPECT/CT after surgery and before 131I treatment. The sensitivity and positive predictive value of this imaging in detecting pulmonary metastasis were calculated. Moreover, its impact on formulating therapeutic schedule was analyzed.ResultsTwo of the 34 patients were defined as positive, which was manifested as an anatomical finding from CT with increased radiotracer uptake. Ten patients were equivocal positive, which was manifested as typical abnormal anatomical localization of lung metastasis without radiotracer uptake. The remaining 22 patients were considered as equivocal negative. Considering positive and equivocal results as positive findings, the sensitivity of the 99Tcm-pertechnetate whole body scan with neck and chest SPECT/CT in detecting pulmonary metastasis was 35.3%(12/34), and its positive predictive value was 100%(12/12). Consequently, 11 of 34 patients received increased radioactive dosage in the subsequent 131I treatment.ConclusionsMost pulmonary metastasis of DTC manifested as no radiotracer uptake in 99Tcm-pertechnetate planar imaging, and bigger lesions tended to show positive pertechnetate uptake. 99Tcm-pertechnetate whole body scan with neck and chest SPECT/CT could detect several pulmonary metastasis lesions which showed no pertechnetate uptake. Thus, this process can increase the positive detection rate of pulmonary metastasis lesions and adjust the treatment program of some patients. |
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