Comparison of131I-whole Body Scan and18F-FDG PET/CT on the Metastatic Management of Differentiated Thyroid Cancer After Operation
10.3969/j.issn.1005-5185.2014.11.002
- VernacularTitle:131I全身扫描及18F-FDG PET/CT对分化型甲状腺癌术后转移诊治价值的比较
- Author:
Yongjun LI
;
Zhaoqiang XU
;
Wei LIU
;
Xu CHENG
;
Lihua BAO
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Surgical procedures,operative;
Neoplasm metastasis;
Iodine radioisotopes;
Positron-emission tomography;
Tomography,X-ray computed;
Fluorodeoxyglucose F18
- From:
Chinese Journal of Medical Imaging
2014;(11):805-810
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the clinical value of131I-whole body scan (131I-WBS) and 18F-FDG PET/CT on the metastatic management of patients with differentiated thyroid cancer (DTC) after operation.Materials and Methods Serum thyroglobulin (Tg) of 27 patients after DTC surgery was measured one day before131I therapy, and the patients underwent131I-WBS on 3-5 days after131I therapy. According to the results of Tg and 131I-WBS, all the patients were divided into 4 types as follows: type I: Tg (+),131I-WBS (-); type II: Tg (+),131I-WBS (+); type III: Tg (-),131I-WBS (+); and type IV: Tg (-), 131I-WBS (-). Then the patients received18F-FDG PET/CT scan within a week after 131I-WBS. The results of131I-WBS and18F-FDG PET/CT scan were analyzed according to histopathologic findings or clinical and imaging follow-up of at least 6 months as diagnosis standard.Results The examinations uncovered that metastasis occurred in 52 lesions of 22 cases out of the 27 cases.131I-WBS revealed 24 metastatic lesions (46.2%) in 8 cases (36.4%), and18F-FDG PET/CT showed 35 metastatic lesions (67.3%) in 15 cases (68.2%), the difference with statistic significance (χ2=4.46 and 4.74,P<0.05). Metastasis were confirmed in 13 type I cases (100.0%); 5 type II cases (100.0%); 3 type III cases (100.0%) and 1 type IV case (16.7%), respectively. The rate of detecting metastasis by 18F-FDG PET/CT was 100.0% in type I, 20.0% in type II, 0% in type III respectively, the difference with statistic significance (χ2=9.14 and 10.11,P<0.05); and 100.0% in type IV, the difference without statistic significance (χ2=1.25,P>0.05). Based on that, therapeutic plans were modified for 13 patients with type I metastasis and 1 patient with type IV metastasis.Conclusion131I-WBS and18F-FDG PET/CT are complementary for detecting metastatic lesion and help to decide the following treatment of DTC patients after surgery. Moreover,18F-FDG PET/CT shows advantages in detecting metastatic lesion in Tg-positive and negative131I-WBS type of DTC patients after surgery, thus can provide an important clinical guidance for this type of patients.
