재발유두상갑상선암의 외과적 치료에 있어 FDG-PET의 유용성
The Value of FDG-PET in Reoperation of the Recurrent Papillary Thyroid Carcinoma with Elevated Thyroglobulin Levels and Negative I131 WBS
정동환, 홍석준, 류진숙, 송영기, 안일민, 문대혁,
소속 상세정보
정동환 ( Jung Dong-Hwan )
울산대학교 의과대학 서울중앙병원 일반외과
홍석준 ( Hong Suck-Joon )
울산대학교 의과대학 서울중앙병원 일반외과
류진숙 ( Ryu Jin-Sook )
울산대학교 의과대학 서울중앙병원 핵의학과
송영기 ( Shong Young-Kee )
울산대학교 의과대학 서울중앙병원 내분비내과
안일민 ( Ahn Il-Min )
울산대학교 의과대학 서울중앙병원 내분비내과
문대혁 ( Moon Dae-Hyuk )
울산대학교 의과대학 서울중앙병원 핵의학과
KMID : 0371320010600050501
Abstract
Purpose: We evaluated the diagnostic accuracy and usefulness of FDG-PET to determine the proper extent of surgery in recurrent papillary thyroid cancer patients with elevated thyroglobulin levels and negative I131 WBS.
Methods: FDG-PET was performed in 16 recurrent papillary thyroid cancer patients with elevated thyroglobulin levels and negative I131 WBS. In 9 patients, FDG-PET was performed to localize the recurrent lesions. In 7 patients, the recurrent lesions were initially diagnosed by physical examination or other image studies and the FDG-PET was subsequently performed to detect additional recurrent lesions. All suspected lesions detected by FDG-PET and other studies were explored.
Results: Among the 9 patients in whom FDG-PET was performed to localize the recurrent lesions, the recurrent lesions were detected only by FDG-PET in 4 patients. Among the 7 patients in whom FDG-PET was performed additionally to detect additional recurrent lesions, another recurrent cervical regions were detected by FDG-PET in 2 patients. However, the same lesions were able to be identified by ultrasonography. A total of 26 cervical regions were explored in 16 patients. There were 4 FDG-PET false positive regions and 2 FDG-PET false negative regions. Unnecessary surgery was performed in 4 cervical regions in 4 patients.
Conclusion: FDG-PET was very useful in detecting small early recurrent lesions but was unable to contribute to the detection of additional recurrent cervical regions in the pa-tients in which the recurrent lesion had already been by physical examination or other studies. Other image studies are necessary to supplement the FDG-PET in false positive or false negative cases.
키워드
재발유두상갑상선암;FDG-PET 방사선요오드스캔;혈중갑상선 글로블린
Recurrent papillary carcinoma;FDG-PET; I131 whole body scan;thyroglobulin
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