Diagnosis Of Differentiated Thyroid Carcinoma By 131I Whole Body Imaging, CT And Tg / TgAb

Objective To investigate the results of131I-WBS、CT and Tg/TgAb in the patients of DTC with pulmonary metastasis. To provide a reference for the diagnosis and differential diagnosis of pulmonary metastasis, and solutions to the treatment of disease.Methods Observing 55 cases of DTC patients with pulmonary metastases who received 131 I treatment in course of Jan.2007 to Jul.2014 in Department of Nuclear Medicine of our hospital. 55 patients were divided into131I-WBS positive group and131I-WBS negative group, 131I-WBS positive group included 131 I diffuse uptake and131 I nodular uptake of two kinds. Chest CT were divided into three kinds, including small nodules(diameter of nodule less than 10mm) 、 large nodules(diameter of nodule large than 10mm) and no nodules. The three kinds of CT were compared with131I-WBS, and the Tg/Tg Ab level of the different images of chest CT and 131I-WBS was analyzed and compared.Results The sensitivity of 131I-WBS、CT and Tg/TgAb were 74.5%, 76.4% and90.9% respectively. There was no significant difference between the131I-WBS and chest CT( ?2=0.05, P > 0.05). Patients with large nodular metastasis and small nodular metastasis on CT, had different 131I-WBS( ?2=3.98,P<0.05). The sensitivity of Tg/Tg Ab was higher than the 131 I-WBS( ?2=5.15,P<0.05). There was significant difference in the CT and Tg/Tg Ab( ?2=4.25,P<0.05). CT showed no significant differences in Tg levels between three types nodules, large nodules and no nodules(F=1.63,P> 0.05). with 18.2% of DTC patients with pulmonary metastasis have only positive 131I-WBS.Conclude The sensitivity of131I-WBS 、CT and Tg/TgAb are all pretty high in the diagnosis of DTC pulmonary metastases. The sensitivity of Tg/Tg Ab is significantly higher than the131I-WBS and CT. Lung metastases, poorly differentiated or not differentiation, lower taken iodine ability, surface contamination, and lung benign disease can lead to the inconsistent between131I- WBS and chest CT. The combination of Tg/Tg Ab、 131 I SPECT/CT and PET/CT is necessary to make a better treatment.