갑상선암 환자에서 방사성옥소 진단스캔과 치료 후 스캔의 비교 및 임상경과 ( Comparison of Diagnostic and Post-therapy Radioiodine Scan in Well-Differentiated Thyroid Cancer and the Clinical Outcome ) () |
Author |
이석모(Seok Mo Lee),배상균(Sang Kyun Bae),염하용(Ha Yong Yum), |
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Affiliation |
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Abstract |
Purpose: We compared the first postoperative diagnostic
and post-therapy scans of patients who received
therapeutic doses of I-131, to investigate the
difference in clinical outcomes between patients with
concordant findings of diagnostic and post-therapy
scans and patients with discrepant (more lesions in
post-therapy scan) findings. Materials and Methods: The
first postoperative diagnostic and post-therapy
radioiodine scans of one hundred forty three patients
with well differentiated thyroid carcinoma were
reviewed. Diagnostic scans were obtained following
ingestion of 185 MBq of I-131 and post-therapy scans
were obtained after therapeutic dose of 3.7∼9.3 GBq of
I-131. Successful ablation was defined as no
radioiodine uptake on diagnostic radioiodine scan and
normal range of serum thyroglobulin level (<10 ng/ml)
during serum TSH elevation. Results: Discrepant scan
findings were noted in 25 (17.5%) patients. Twenty-two
patients (15.4%) showed more lesions in post-therapy
scan and 3 patients (2.1%) showed stunning effect. Nine
(64.3%) of 14 patients with distant metastasis revealed
metastatic lesion(s) only on post-therapy scan.
Stunning effect was considered as sublethal damage in 1
patient and treatment by a diagnostic dose in 2
patients. Ablation was achieved in 52.4% (75/143) of
all patients. Ablation rate and mean cumulative
radioiodine dose were not different statistically
between concordant and discrepant groups. Conclusion:
There were 17.5% difference between diagnostic and
post-therapy scan findings when using 185 MBq of I-131
as a diagnostic dose. However, 64.3% of distant
metastases were revealed only on post-therapy scan.
Ablation rate and mean cumulative radioiodine dose were
not different statistically between concordant and
discrepant groups. The stunning effect was considered
as not only sublethal damage but also treatment by a
small diagnostic dose of radioiodine. (Korean J Nucl
Med 2000;34: 22-9) |
Keyword |
Iodine-131, Whole-body scan, Well-differentiated thyroid cancer, Post-therapy scan, Stunning |
Full text Article |
28502644.pdf
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