The Clinical Value Of 99mTc-DMSA And 99mTc-MIBI Scintigraphy In Differentiating Thyroid Carcinoma From Cold Nodule

Purpose To evaluate the clinical value of 99mTc-DMSA and 99mTc-MIBI scintigraphy in differentiating thyroid carcinoma from cold nodule. Methods 40 patients with thyroid cold nodule were randomly divided into a 99mTc-DMSA scintigraphy group with 21 cases and a 99mTc-MIBI scintigraphy group with 19 cases. The early image and delay image were acquired 15 minutes and 2 hours after drug was injected into ulnar vein. The qualitative analysis and half-quantitative analysis by ROI were adopted to estimate the property of nodules. Results 1,10 cases of malignant tumor were found in 99mTc (V)-DMSA scintigraphy group by pathology, and 9 cases of malignant tumor were found in 99mTc MIBI scintigraphy group by pathology finally.2 positive cases and 8 negative cases were detected by 99mTc (V)-DMSA with qualitative analysis, and 7 positive cases and 2 negative cases were detected by Tc-MIBI with qualitative analysis. Difference between them has statistical significance (P<0.05) 2, In 99mTc(V)-DMSA group, the early ratio of malignant lesions and innocence lesions were 1.03±0.29 and 0.84±0.18 respectively, which achieved no statistical difference (P>0.05); And the delay ratio of malignant lesions and innocence lesions were 1.29±0.43 and 0.99±0.16 respectively, whose difference had statistical significance(P<0.05). 3 positive cases and 7 negative cases were diagnosed by half-quantitative analysis when the Mean±SD of DR in innocence lesions was set as the threshold. In 99mTc-MIBI group, the early ratio of malignant lesions and innocence lesions were 1.19±0.19 and 1.05±0.28 respectively, which achieved no statistical difference (P>0.05); And the delay ratio of malignant lesions and innocence lesions were 1.67±0.23 and 1.16±0.31 respectively, whose difference had statistical significance (P<0.05).8 positive cases and 1 negative case were diagnosed by half-quantitative analysis when the Mean±SD of DR in innocence lesions was set as the threshold.3, When the half-quantitative results were set as standard, the sensitivity and specificity of 99mTc (V)-DMSA were 30% and 100% respectively, and total coincidence were 66.7% and Kappa is 0.31. The sensitivity and specificity of 99mTc-MIBI is 88.9% and 90% respectively, and total coincidence is 90.3% and Kappa is 0.789. Conclusion The sensitivity and specificity of 99mTc-MIBI scintigraphy are superior to that of 99mTc (V)-DMSA scintigraphy, and the 99mTc-MIBI has important clinical value in differentiate thyroid carcinoma from cold nodule.