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Evaluate Utility of Thyroid Cancer Discrimination by 18F-FDG PET/CT Delay Scan Images

18F-FDG PET/CT검사에서 지연영상을 이용한 갑상선암 진단의 유용성 평가

  • Lee, Hyeon-Guck (Department of Public Health, The Graduate School of Eulji University) ;
  • Han, Man-Seok (Department of Radiological Science, Kangwon National University) ;
  • Kim, Yong-Kyun (Department of Radiological Technology, Daewon University College) ;
  • Seo, Sun-Youl (Department of Public Health, The Graduate School of Eulji University) ;
  • Jeon, Min-Cheol (Department of Radiology Chungnam National University Hospital) ;
  • Kim, Tae-Hyung (Department of Radiological Science, Kangwon National University) ;
  • Hong, Seong-Jong (Eulji University department of radiiologic science)
  • 이현국 (을지대학교 일반대학원 보건학과) ;
  • 한만석 (강원대학교 방사선학과) ;
  • 김용균 (대원과학대 방사선과) ;
  • 서선열 (을지대학교 일반대학원 보건학과) ;
  • 전민철 (충남대병원 영상의학과) ;
  • 김태형 (강원대학교 방사선학과) ;
  • 홍성종 (을지대학교 방사선학과)
  • Received : 2013.04.01
  • Accepted : 2013.06.05
  • Published : 2013.06.30
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Abstract

Purpose : To evaluate the degree of malignancy of incident thyroid lesion found in 18F-FDG PET/CT findings and the usefulness of the method suggested in this study, we applicate the Delay Scan Method that differentiate a false positive benign tumor, inflammation and malignancy, as well as make the criteria of SUV. Materials and Methods : A retrograde study was conducted of 25 patients(1 exception) who were admitted in E hospital to receive 18F-FDG PET/CT examination until Janaary and April of 2008. 18F-FDG PET/CT image photographing was taken in Biograph-Duo made by SIEMENS, after taking normal 18F-FDG PET/CT image(1hr) and then 1hr later we took the thyroid 1 bed-delayed image for the patients who showed abnormal thyroid 18F-FDG uptake and above 2.0 SUV for 2 minutes every 1 bed. For the patients who showed abnormal thyroid uptake and above 2.0 SUV, 1hr later, we took a 1 bed-delayed image and then made a comparative study between measured maxSUV of 1hr-abnormal uptake image and that of 2hr-delayed image. Results : In this 18F-FDG PET/CT study among the patients who showed incidental 18F-FDG thyroidal uptake the number of thyroid cancer was 5(20.8%), all of then showed benign findings. a comparison of results for 18F-FDG PET/CT. the benign patient measured maxSUV in the PET/CT. image(1hr) mean value 5.06maxSUV and delay image(2hr) mean value 5.23maxSUV differences of two value is 0.19maxSUV and the malignantIt patient measured maxSUV in the PET/CT. image(1hr) mean value 9.63maxSUV and delay image(2hr) mean value 10.65maxSUV differences of two value is 10.65maxSUV in Thyroid abnormal uptake patients. Conclusion : in the case of incidental 18F-FDG uptake in thyroid, max SUV of focal thyroid lesion is above 5.0 if 18F-FDG PET/CT examine the delayed images to add, You could see that reasonable diagnostic method useful. to differentiate whether lesions of malignant.

목적: 본 연구는 $^{18}F$-FDG PET/CT검사 시 우연히 발견된 갑상선병변의 악성여부를 평가하기 위하여 위양성으로 판독되어지는 양성종양이나 염증질환과 악성 종양의 감별이 가능한 검사법으로 지연영상(Delay scan)을 적용하고 결과 값(SUV)의 기준안을 마련하며 이 연구에서 제시되는 검사법의 유용성을 평가하는데 있다. 재료 및 방법 : 2008년 1월부터 2008년 4월 까지 E대학병원에 내원하여 $^{18}F$-FDG PET/CT를 시행한 환자 25명(1명 제외)을 대상으로 후향적 분석을 실시하였다. $^{18}F$-FDG PET/CT영상 촬영은 SIEMENS사에서 만든 Biograph-Duo에서 시행하였으며, $^{18}F$-FDG PET/CT 정상영상(1hr)을 취득한 후 갑상선이상섭취가 있고 SUV 2.0이상인 환자를 대상으로 1시간후에 갑상선부위를 1bed 지연영상을 촬영하였고, 한 bed에 2분 동안 영상을 얻었다. 갑상선이상섭취가 있고 SUV 2.0이상인 환자를 대상으로 이상섭취가 있는 부위의 1시간영상과 2시간지연영상의 maxSUV를 측정하여 비교분석하였다. 결과: $^{18}F$-FDG PET/CT 검사 시 우연히 갑상선에 $^{18}F$-FDG 섭취를 보인 환자 24명중 갑상선 암(Thyroid cancer)이 5명으로 20.8%로 나타났으며 모두 양성병변을 시사하는 소견을 나타냈다. 갑상선기능이상이나 갑상선염 등 단순 갑상선 이상섭취로 판독된 19명의 1시간영상과 2시간 영상의 표준섭취계수(SUV)값은 나타낸 표로 1시간영상의 $^{18}F$-FDG 표준섭취 평균값은 5.06maxSUV이었고, 2시간 평균값은 5.23maxSUV였다. 측정된 두 값의 차이는 0.19maxSUV이었다. 갑상선암으로 판독된 5명의 1시간 PET/CT검사에서 갑상선국소부위의 $^{18}F$-FDG 표준섭취 평균값은 9.63maxSUV 이었고 2시간 평균값은 10.65maxSUV이였다. 두 값의 차이는 1.02maxSUV로 나타났다. 결론 : 본 연구는 우연히 발견된 갑상선 국소부위에 5.0이상 maxSUV의 이상섭취병변이 발견된 경우에는 $^{18}F$-FDG PET/CT 지연영상을 추가로 검사한다면 병소의 악성 여부 감별에 도움을 줄 수 있는 유용한 촬영방법임을 확인할 수 있었다.

Keywords

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