대한핵의학회지 (1967년~2009년)
Nucl Med Mol Imaging 2009;43(6)543~556
갑상선미세유두암의 수술 전 진단에서 18F-FDG PET/CT: 이중시간 영상의 유용성
(18F-FDG PET/CT for the Preoperative Diagnosis of Papillary Thyroid Microcarcinoma: The Value of Dual Time Point Imaging)
Author 서영덕1,2, 김성민1,2, 김근호1,2, 김제룡3,
Young-Duk Seo, M.D.1,2, Seong-Min Kim, M.D., Ph.D1,2, Kun-Ho Kim, M.D.1,2, and Je-Ryong Kim, M.D., Ph.D3
Affiliation 충남대학교병원 핵의학과1, 충남대학교 의과대학 핵의학교실2, 외과학교실3
Department of Nuclear Medicine, 1Chungnam National University Hospital and 2College of Medicine, Chungnam National University, 3Department of Surgery, College of Medicine, Chungnam National University, Daejeon, Korea
Abstract

Purpose: We studied the patterns of FDG uptake of primary papillary thyroid microcarcinoma (PTMCa) lesions and benign thyroid nodules in dual time point 18F-FDG PET/CT imaging. Materials and Methods: Consecutive 134 patients (154 lesions) with PTMCa and 49 patients (61 nodules) with benign thyroid nodules equal to or less than 1.0 cm who underwent dual time point 18F-FDG PET/CT study before surgery were enrolled. We calculated the maximum standardized uptake value of PTMCa and benign nodules in both time points, and percent change of SUVmax (Δ%SUVmax) and lesion to background ratio of SUVmax (Δ%L:B ratio) between both time points. The mean time interval between scans was 23.4±4.4 minutes (thyroid to thyroid interval: 10.7±4.4 minutes). Results: The mean of SUVmax of PTMCa was increased from 4.9±4.3 to 5.3±4.7 (p<0.001) and Δ%SUVmax was 12.3±23.6%. But, the mean of SUVmax of benign nodules was no definite change (2.1±1.0 to 2.1±1.3, p=0.686) and Δ%SUVmax was -0.3±20.5%. Of the 154 PTMCa, 100 nodules (64.9%) showed an increase in SUVmax over time, while 19 (31.1%) of the 61 benign thyroid nodules showed an increase (p<0.001). The dual time point 18F-FDG PET/CT found more PTMCa in visual assessment (62.3% vs. 76.6%, p=0.006), even in smaller than 0.5 cm (38.6% vs. 60.0%, p=0.011). Conclusion: Dual time time 18F-FDG PET/CT imaging was more useful than single time point 18F-FDG PET/CT imaging for distinction between PTMCa and benign nodule, especially when nodule showed equivocal or negative findings in single time point 18F-FDG PET/CT imaging or was smaller than 0.5 cm.

Keyword Papillary thyroid microcarcinoma, FDG PET/CT, dual time point imaging
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