| PurposeThe SPECT/CT fusion imaging and 131I whole body imaging (131I-WBI) diagnosis results in detection and location of lesions for differentiated thyroid carcinoma (DTC) patients after total thyroidectomy and therapeutic dose of 131I treatment is compared to evaluate the clinical application value of SPECT/CT fusion imaging in DTC with 131I therapy.Subjects and methodsThe subbjects are a total of 130 DTC patients with average age of 45 years. All patients were underwent total or subtotal thyroidectomy, contemporaneous thyroglobulin (TG) measurement and nect sonography or CT examination, thereinto, 80 cases were followed-up at least 6 months. Before 131I treatment, all patients withdraw thyroid tablets for 4-6 weeks. The patients who had surgery recently have 131I treatment 3 weeks later. The dose of 131I was 3.7-5.5GBq (100-150mCi).5-7days after 131I treatment, all patients were underwent 131I-WBI and SPECT/CT fusion imaging. Referring to other contemporary diagnostic imaging methods such as US and CT et al, measured value of TG, results of Biopsy of Lymph node and clinical following-up, the final diagnose result was got. The results of 131I-WBI and SPECT/CT fusion imaging were compared with the final result, and the sensitivity, specificity, accuracy of metastasis and detection rate in the diagnosis of lesions are calculated respectively, and then have x2 test, p<0.05 means significant.Results325 lesions were proved by the comprehensive analysis of the results of 131I-WBI, SPECT/CT fusion imaging, B ultrasonic, CT, measured value of TG, Biopsy of Lymph node and clinical following-up. According to the location of lesions, 155 thyroid residual lesions were determined, the rate was 47.69%(155/325); 170 metastasis lesions were determined, the rate was 52.31%(170/325), thereinto,90 lymph node metastases were on the head and neck or/and mediastinum parts and 80 lesions were distant metastases.The results of 131I-WBI:It shown 290 positive lesions in 130 patients,130 thyroid residue lesions, and 128 metastases including 68 lymph node metastases on head and neck or/and mediastinum parts and 60 distant metastases. The number of false positive foci were 32 and 67 lesions were not found.The results of SPECT/CT fusion imaging: It shown 310 positive lesions in 130 patients,150 thyroid residue lesions, and 160 metastases including 85 lymph node metastases in head and neck or/and mediastinum parts and 75 distant metastases. There were no false-positive lesionsand 15 lesions were not found.The sensitivity, specificity and accuracy of 131I-WBI in the diagnosis of metastasis with 130 cases of DTC patients were 75.29%,83.87%,79.38% and that of SPECT/CT fusion imaging were 94.12%,96.77%,95.38%. The difference between the two methods was significant. (x2=23.25,17.76,42.00, P<0.05, respectively)In the view of the lesions detected rate, the detection rates of 131I-WBI and SPECT/CT fusion imaging in the diagnosis for 155 thyroid residue were 83.87% and 96.77% respectively. The detection rates for 170 metastasis were 75.29% and 94.12% respectively. The difference was significant. (%2=14.76,23.25, P<0.05, respectively). In the view of the anatomy region of DTC metastasis,90 lymph node metastases in brain and neck or/and mediastinum parts were proved in 130 patients,131I-WBI found 68 (75.56%) and SPECT/CT fusion imaging found 85 (94.44%); 80 distant metastases,131I-WBI found 60 (75.00%) and SPECT/CT fusion imaging found 75 (93.75%). The difference was significant. (X2=12.59,10.67,P<0.05, respectively).ConlusionSPECT/CT fusion imaging can improve the lesions detected rate of DTC patients after thyroidectomy and show the specific lesions location and the state of iodine uptake. It can change the clinical staging of some patients and provide clinical evidence for further treatment. The sensitivity, specificity and accuracy of SPECT/CT fusion imaging were significantly higher than 131I-WBI. |
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