DIAGNOSIS AND AN EVALUATION OF THERAPEUTIC RESPONSE OF THYROID CANCER BY ASSESSING TUMOR METABOLISM USING PET.

1.应用正电子发射断层扫描（PET）技术，分别以18氟脱氧葡萄糖（FDG）和11甲硫氨酸（MET）为显像剂，测定了正常人甲状腺的糖代谢和氨基酸代谢。正常甲状腺的FDG摄取率为0.97 ± 0.99SY。[] 0.20 SUV（n=5），其MET摄取为1.02 SY ±. 2.甲状腺肿瘤患者中，甲状腺乳头状癌FDG摄取为6.68SUV（n=2），滤泡性腺瘤FDG摄取为2.12SUV（n=3）。乳头状癌MET摄取率为3.40SUV（n=2）和3.8SY ± 0.36SUV（n=3）。0.70 SUV（n=3）。甲状腺肿瘤的葡萄糖代谢和氨基酸代谢均高于正常甲状腺组织。3.甲状腺乳头状癌术后复发患者的FDG摄取为4.40 ± 0.05（SY）。滤泡性癌为4.62 SUV（n=2）。乳头状癌的MET摄取为2.90 SUV（n=1）和7.80 SUV（n=1）。因此，复发性甲状腺癌患者的葡萄糖代谢和氨基酸代谢均高于正常甲状腺。4.我们比较了10例甲状腺癌患者的FDG-PET和I-131显像，其中4例为复发性甲状腺癌，6例为非复发性甲状腺癌。FDG-PET的敏感性、特异性和准确性分别为100%、100%和100%，而I-131造影的敏感性、特异性和准确性分别为50%、0%和30%。FDG-PET对甲状腺癌复发的检出率上级优于I-131显像。

1.We measured both a glucose metabolism and an amino acid metabolism of the normal thyroid gland in healthy volunteers by using positron emission tomography (PET) with F-18-fluorodeoxyglucose (FDG) and C-11-methionine (MET), respectively. The FDG uptake of the normal thyroid gland was 0.97(]SY.+-。[)0.20 SUV (n=5), and the MET uptake of that was 1.02(]SY.+-。[)0.29 SUV (n=3).2.In newly diagnosed patients with thyroid tumor, the FDG uptake of papillary carcinoma was 6.68 SUV (n=2) and that of follicular adenoma 2.12(]SY.+-。[)0.36 SUV (n=3).The MET uptake of papillary carcinoma was 3.40 SUV (n=2) and 3.8(]SY.+-。[)0.70 SUV (n=3). Thus, both the glucose metabolism and the amino acid metabolism of thyroid tumor were increased in comparison with those of the normal thyroid gland.3.In patients with recurrent tumor after the resection, the FDG uptake of papillary carcinoma was 4.40(]SY.+-。[)3.04 SUV (n=14) and that of follicular carcinoma 4.62 SUV (n=2). The MET uptake of papillary carcinoma was 2.90 SUV (n=1) and 7.80 SUV (n=1). Thus, both the glucose metabolism and the amino acid metabolism of recurrent thyroid carcinoma were increased in comparison with those of the normal thyroid gland.4.We compared the FDG-PET and I-131scintigraphy for the detection of thyroid cancer in 10 patients consisting of 4 with recurrent carcinoma and 6 without. The sensitivity, specificity and accuracy of the FDG-PET was 100%, 100% and 100%, respectively, while those of the I-131 scintigraphy 50%, 0% and 30%, respectively.5.In conclusion, both the FDG-PET for measuring a glucose metabolism and the MET-PET for measuring an amino acid metabolism were useful for the differential diagnosis of thyroid tumors. Furthermore, the FDG-PET was superior to the I-131 scintigraphy for the detection of the recurrent thyroid cancer.