Papiller tiroid kanserlerinde nüks ve/veya metastatik hastalık şüphesinde PET-BT'nin klinik önemi
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Date
2011
Authors
Duman, Gani
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Papiller tiroid kanseri hastalarında sağ kalım çok yüksek olmakla birlikte, rekürrens ve/veya metastatik hastalık görülme riski az değildir. Yapılan takiplerde karşılaşılan problemlerden birisi Tg değeri yüksek iken rekürrens ve/veya metastatik odağın tüm vücut iyot tarama veya radyolojik yöntemlerle bulunamamasıdır.Bu çalışmanın amacı Tg değeri yüksek, tüm vücut iyot tarama veya radyolojik görüntülemelerin ise rekürrens veya metastatik hastalık açısından negatif, şüpheli veya yetersiz olduğu papiller tiroid kanseri hastalarında F18-FDG PET-BT'nin değerinin incelenmesidir.Çalışmamızda Ocak 2008-Haziran 2011 tarihleri arasında Anabilim Dalı'mız PET-BT ünitesinde çekimleri yapılan 28 papiller tiroid karsinomu hastası retrospektif olarak incelendi. PET-BT görüntüleri hastaların PET-BT çekimi hemen öncesi ve sonrasında yapılan boyun USG, BT, MR veya I-131 tüm vücut tarama gibi görüntülemelerinin sonuçları, Tg düzeyleri, biyopsi yapılmış veya opere olmuşlarsa patoloji sonuçları gibi takip bilgileriyle karşılaştırılarak değerlendirildi.28 PET-BT çalışmasının sonuçları 16 çalışmada gerçek pozitif, 7 çalışmada gerçek negatif, 4 çalışmada yalancı pozitif, 1 çalışmada yalancı negatif idi. Çalışmamızda PET-BT'nin nüks ve/veya metastaz odağını saptamadaki duyarlılığı %94.1, özgüllüğü %63.6, PTD'i %80, NTD'i % 87.5, doğruluğu ise %82.1 olarak bulundu.F18-FDG PET-BT, Tg değeri yüksek olduğu için rekürrens ve/veya metastaz şüphesi bulunan, ancak ne tüm vücut iyot taramalar ne de radyolojik yöntemlerle hastalık odağının saptanamadığı hastalarda güvenle kullanılabilecek bir tanı metodudur.
Although survival in papillary thyroid carcinoma is very high, presence of recurrence and/or metastatic disease is not rare. During the controls, if Tg value is high, but on the other hand if neither whole body radioiodine scans nor radiological diagnostic methods can detect the recurrence and/or metastasis, then the clinician comes to a complicated point.In this investigation, we aimed to determine the role of F18-FDG PET-CT in papillary thyroid cancer patients with high Tg levels whose whole body radioiodine scans or radiological methods fail to show the recurrent or metastatic sites.We evaluated 28 papillary thyroid cancer patients retrospectively who had PET-CT scans between January 2008 and June 2011 in our department. The results of PET-CT were compared with other data such as USG, CT, MR, and whole body radioiodine scans which were done after the PET-CT scan. Also Tg levels during the controls, the histopathologic results of biopsies or operations were taken into consideration.There were 28 PET-CT scans and in 16 studies, the PET-CT results were true positives, in 7 studies the results were true negatives, in 4 study the result was false positives, and in 1 study the results was false negative. The sensitivity of PET-CT in detecting recurrent or metastatic foci was % 94.1, specificity was % 63.6, positive predictive value was % 80, negative predictive value was % 87.5, and the accuracy was % 82.1.F18-FDG PET-CT can be used to detect recurrence and/or metastases in patients who have high Tg levels, but negative radioiodine scans or radiological findings.
Although survival in papillary thyroid carcinoma is very high, presence of recurrence and/or metastatic disease is not rare. During the controls, if Tg value is high, but on the other hand if neither whole body radioiodine scans nor radiological diagnostic methods can detect the recurrence and/or metastasis, then the clinician comes to a complicated point.In this investigation, we aimed to determine the role of F18-FDG PET-CT in papillary thyroid cancer patients with high Tg levels whose whole body radioiodine scans or radiological methods fail to show the recurrent or metastatic sites.We evaluated 28 papillary thyroid cancer patients retrospectively who had PET-CT scans between January 2008 and June 2011 in our department. The results of PET-CT were compared with other data such as USG, CT, MR, and whole body radioiodine scans which were done after the PET-CT scan. Also Tg levels during the controls, the histopathologic results of biopsies or operations were taken into consideration.There were 28 PET-CT scans and in 16 studies, the PET-CT results were true positives, in 7 studies the results were true negatives, in 4 study the result was false positives, and in 1 study the results was false negative. The sensitivity of PET-CT in detecting recurrent or metastatic foci was % 94.1, specificity was % 63.6, positive predictive value was % 80, negative predictive value was % 87.5, and the accuracy was % 82.1.F18-FDG PET-CT can be used to detect recurrence and/or metastases in patients who have high Tg levels, but negative radioiodine scans or radiological findings.
Description
Keywords
PET-BT, Tiroid kanseri, Tiroglobulin, PET-CT, Thyroid cancer, Thyroglobulin
Citation
Duman, G. (2011). Papiller tiroid kanserlerinde nüks ve/veya metastatik hastalık şüphesinde PET-BT'nin klinik önemi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.