论文部分内容阅读
目的比较18F-葡萄糖类似物氟脱氧葡萄糖(FDG)和细胞增殖示踪剂18F-氟胸苷(FLT)的PET/CT对分化型甲状腺癌术后转移的诊断价值。材料与方法本项前瞻性研究经机构审查委员会批准。2010年3月-2012年2月间,20例分化型甲状腺癌术后病人(年龄22~79岁,平均53岁)在放射性碘治疗前行FDG和FLT PET/CT作为初始检查。每例病人均设定28个解剖区域,分析是否有淋巴结转移及远处转移。应用McNemar精确检验或χ2检验比较两种示踪剂PET/CT检测淋巴结转移及远处转移的诊断指标差异。结果 13例病人发现34个淋巴结转移和73处远处转移(70处位于肺,骨、鼻咽及脑转移各有1处)。在以病人为基础的分析中,FDG PET/CT的敏感度、特异度和准确度分别为92%(12/13)、86%(6/7)、90%(18/20),FLT PET/CT的上述指标分别为69%(9/13)、29%(2/7)、55%(11/20)。FDG PET/CT的准确性显著高于FLT PET/CT(P=0.023)。在以病变为基础的分析中,FDG PET/CT诊断淋巴结转移的敏感度、特异度和准确度分别为85%(29/34)、99.6%(245/246)和97.9%(274/280);FLT PET/CT的上述指标为50%(17/34)、90.7%(223/246)和85.7%(240/280)。FDG PET/CT诊断远处转移的敏感度、特异度和准确度分别为45%(33/73)、100%(207/207)、85.7%(240/280),FLT PET/CT的上述指标分别为6.8%(5/73)、100%(207/207)、75.7%(212/280)。FDG PET/CT诊断淋巴结转移的敏感度(P=0.002)、特异度(P<0.001)和准确度(P<0.001)均优于FLT PET/CT。FDG PET/CT诊断远处转移瘤的敏感度(P<0.001)和准确度(P<0.001)同样优于FLT PET/CT。结论 FDG PET/CT诊断分化型甲状腺癌术后淋巴结及远处转移优于FLT PET/CT。因此,与FLT PET/CT相比,FDG PET/CT更适于分化型甲状腺癌术后复发的检查。
Objective To compare the diagnostic value of PET / CT with 18F-glucose analog fluorodeoxyglucose (FDG) and cell proliferation tracer 18F-FLT in the diagnosis of differentiated thyroid carcinoma after operation. Materials and Methods This prospective study was approved by the Institutional Review Board. Between March 2010 and February 2012, 20 patients with differentiated thyroid cancer (aged 22-79 years, mean 53 years) underwent FDG and FLT PET / CT before radiofrequency treatment. Each patient was set 28 anatomical regions, analysis of lymph node metastasis and distant metastasis. McNemar’s exact test or χ2 test was used to compare the diagnostic indexes of two tracer PET / CT in lymph node metastasis and distant metastasis. Results Thirteen patients had 34 lymph node metastases and 73 distant metastases (70 in lung, bone, nasopharynx and brain metastases respectively). In patient-based analyzes, the sensitivity, specificity and accuracy of FDG PET / CT were 92% (12/13), 86% (6/7), 90% (18/20), and FLT PET / CT of the above indicators were 69% (9/13), 29% (2/7), 55% (11/20). The accuracy of FDG PET / CT was significantly higher than that of FLT PET / CT (P = 0.023). The sensitivity, specificity and accuracy of FDG PET / CT for the diagnosis of lymph node metastases were 85% (29/34), 99.6% (245/246) and 97.9% (274/280) in the lesion-based analysis, respectively ; The above indexes of FLT PET / CT were 50% (17/34), 90.7% (223/246) and 85.7% (240/280). The sensitivity, specificity and accuracy of FDG PET / CT in the diagnosis of distant metastasis were 45% (33/73), 100% (207/207) and 85.7% (240/280), respectively They were 6.8% (5/73), 100% (207/207) and 75.7% (212/280), respectively. The sensitivity (P = 0.002), specificity (P <0.001) and accuracy (P <0.001) of FDG PET / CT in diagnosing lymph node metastasis were better than FLT PET / CT. The sensitivity (P <0.001) and accuracy (P <0.001) of FDG PET / CT for the diagnosis of distant metastases were also superior to those of FLT PET / CT. Conclusion FDG PET / CT is superior to FLT PET / CT in the diagnosis of differentiated thyroid cancer after operation. Therefore, FDG PET / CT is more suitable for postoperative recurrence of differentiated thyroid cancer than FLT PET / CT.