원저 : 분화된 갑상선암의 수술후 경과관찰에서 I - 131 스캔 , T1 - 201 스캔 및 혈청 갑상선 글로불린 농도의 비교 ( Comparison of I - 131 Scintigraphy , T1 - 201 Scintigraphy , and Serum Thyroglobulin in the Postoperative Follow - Up of Differentiated Thyroid () |
Author |
이현경(Hyun Kyung Lee),송재순(Jae Soon Song),신준재(Joon Jae Shinn),유계화(Kye Hwa You),차왕기(Wang Ki Cha),김은실(Eun Sil Kim),김종순(Chong Soon Kim), |
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Affiliation |
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Abstract |
To evaluate the utility of I-131, T1-201 scintigraphy,
and serum thyroglobulin(Tg) in the follow-up of
differentiated thyroid cancer, we compared
retrospectively the data from 33 patients who underwent
total or subtotal thyroidectomy. I-131 scintigraphy was
performed after optimal endogenous TSH stimulation
(TSH〉50μ/ml). Total 41 cases of I-l3l and T1-201
scintigraphy pairs were examined. Concomitant serum
thyroglobulin levels were measured for 41 pairs of
scan. Tg-off levels(that measured after discontinuation
of the thyroid hormone) higher than 40ng/ml were
considered positive, and Tg-on levels(that measured
during the thyroid hormone replacement) higher than
5ng/ml were considered positive. The concordance rates
between I-131 therapeutic scintigraphy and T1-201
scintigraphy was 48% in the 38 case of total scan
pairs(59% in the 17 cases of postoperative preablation
group, and 38% in the 21 cases of postoperative
postablation group), Of 17 studies before the I-131
ablation therapy (preablation group), 7 showed positive
I-131 therapeutic scintigraphy despite of negative T1-
201 scintigraphy. Among patients with negative I-131
therapeutic scintigraphy, no patients had abnormal T1-
201 uptake. However, of 21 studies which were done
after radioiodine therapy(postablation group) 6 had
abnormal uptake on T1-201 scintigraphy which were not
seen on I-131 therapeutic scintigraphy, and Tg-off
levels also elevated in this 4 of 6 cases. As a result,
I-131 therapeutic scintigraphy showed highest positive
rate at postoperative preablation follow-up study in
differentiated thyroid cancer patients. T1-201
scintigraphy may be useful in postablation studies, and
the use of the combined modalities(T1-201 and Tg
levels) provides a higher diagnostic yield. |
Keyword |
Thyroid neoplasm, Radionuclide imaging, Neoplasrn recurrence, Iodine radioisotope, Thallium radioisotope, Thyroglobulin |
Full text Article |
28502017.pdf
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