Nüks veya metastatik hastalık şüphesi olan I-131 tarama sintigrafisi negatif papiller tiroid kanseri hastalarında F-18 FDG PET/BT’nin klinik önemi
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Date
2012-10-09
Authors
Duman, Gani
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızın amacı tiroglobulin (Tg) değeri yüksek, iyot (I)-131 tüm vücut tarama sintigrafisi (TVİTS) veya radyolojik görüntülemelerin rekürrens/metastaz açısından negatif veya yetersiz olduğu papiller tiroid kanseri (PTK) hastalarında flor-18-florodeoksiglukoz pozitron emisyon tomografi/bilgisayarlı tomografinin (F18-FDG-PET/BT) değerinin incelenmesidir. Ocak 2008-Haziran 2011 tarihlerinde PET/BT ünitemizde görüntülenen 28 PTK hastasının imajları retrospektif olarak incelendi. BT karşılığında anormal yumuşak doku lezyonu olan fokal artmış F18-FDG tutulumları patolojik olarak değerlendirildi ve tutulum ölçütü olarak standardize tutulum değeri (SUVmax) hesaplandı. PET/BT bulguları, Tg düzeyleri, TVİTS veya radyolojik görüntülemeler ve cerrahi/biyopsi sonrası histopatoloji sonuçları ile karşılaştırıldı. Tg ve SUVmax değerleri ile PET/BT bulguları arasındaki ilişki istatistiksel olarak analiz edildi. 28 F18-FDG-PET/BT çalışmasının 16’sı gerçek pozitif (GP), 7’si gerçek negatif, 4’ü yalancı pozitif (YP), 1’i yalancı negatifti. F18-FDG-PET/BT’nin rekürrens veya metastaz odağını saptamadaki duyarlılığı %94.1, özgüllüğü %63.6, pozitif tahmin edici değeri (PTD) %80.0, negatif tahmin edici değeri %87.5, doğruluğu %82.1 olarak bulundu. Tg değerleri ile F18-FDG-PET/BT pozitif ve negatif olan gruplar karşılaştırıldığında istatistiksel olarak anlamlı farklılık saptanmadı (p>0.05). SUVmax değerleri açısından GP-YP gruplar arasında anlamlı istatistiksel fark bulundu (p=0,048). F18-FDGPET/BT, Tg değeri yüksek, TVİTS’i negatif rekürrens veya metastaz şüpheli tiroid kanser hastalarında oldukça duyarlı bir görüntüleme metodudur.
We aimed to determine the role of 18F-fluoro-deoxy-glucose positron-emission tomography/computed tomography (18F-FDG-PET/CT) in papillary thyroid cancer (PTC) patients with high thyroglobulin (Tg) levels whose whole-body radioiodine scans (WBIS) or radiological methods fail to show the recurrent/metastatic sites. We evaluated 28 PTC patients retrospectively who had undergone PET/CT scans between January 2008-June 2011 in our department. Focal increased 18F-FDG uptake with corresponding abnormal soft tissue lesion on CT was interpreted as pathologic and SUVmax was calculated. PET/CT results were compared with Tg levels, WBIS, radiological methods and histopathological results following surgery/biopsy. Relationship between PET/CT results and Tg levels and SUVmax were analyzed, statistically. Of 28 PET/CT scans, 16 were true positive (TP), 7 were true negative, 4 were false positive (FP) and one was false negative. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT in detecting recurrent/metastatic foci was 94.1%, 63.6%, 82.1%, 80%, 87.5%, respectively. No statistically significant difference was found between Tg levels of PET/CT positive and negative groups. There was statistically significant difference in SUVmax (p=0.049) between TP and FP groups. 18F-FDG-PET/CT is a highly sensitive imaging method to detect suspected recurrence/metastases in PTC patients who have high Tg levels but negative WBIS.
We aimed to determine the role of 18F-fluoro-deoxy-glucose positron-emission tomography/computed tomography (18F-FDG-PET/CT) in papillary thyroid cancer (PTC) patients with high thyroglobulin (Tg) levels whose whole-body radioiodine scans (WBIS) or radiological methods fail to show the recurrent/metastatic sites. We evaluated 28 PTC patients retrospectively who had undergone PET/CT scans between January 2008-June 2011 in our department. Focal increased 18F-FDG uptake with corresponding abnormal soft tissue lesion on CT was interpreted as pathologic and SUVmax was calculated. PET/CT results were compared with Tg levels, WBIS, radiological methods and histopathological results following surgery/biopsy. Relationship between PET/CT results and Tg levels and SUVmax were analyzed, statistically. Of 28 PET/CT scans, 16 were true positive (TP), 7 were true negative, 4 were false positive (FP) and one was false negative. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT in detecting recurrent/metastatic foci was 94.1%, 63.6%, 82.1%, 80%, 87.5%, respectively. No statistically significant difference was found between Tg levels of PET/CT positive and negative groups. There was statistically significant difference in SUVmax (p=0.049) between TP and FP groups. 18F-FDG-PET/CT is a highly sensitive imaging method to detect suspected recurrence/metastases in PTC patients who have high Tg levels but negative WBIS.
Description
Keywords
FDG, Tiroglobulin, Tiroid kanseri, PET/BT, PET/CT, Thyroid cancer, Thyroglobulin
Citation
Duman, G. vd. (2012). "Nüks veya metastatik hastalık şüphesi olan I-131 tarama sintigrafisi negatif papiller tiroid kanseri hastalarında F-18 FDG PET/BT’nin klinik önemi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 38(3), 185-191.