The role of 99mTc-MIBI in the evaluation of non-functional thyroid gland nodules

Autor: Fischer, Leo, Ilić Tomaš, Maja, Bogović Crnčić, Tatjana, Girotto, Neva, Pribanić, Ivan, Grbac-Ivanković, Svjetlana
Jazyk: chorvatština
Rok vydání: 2019
Předmět:
Zdroj: Medicina Fluminensis : Medicina Fluminensis
Volume 55
Issue 1
ISSN: 1847-6864
1848-820X
1848-1868
Popis: Cilj: Cilj studije je prikazati ulogu oslikavanja 99mTc metoksiizobutilizonitrilom (99mTc-MIBI) pomoću planarnog oslikavanja i jednofotonske emisijske tomografije “niskodoznom” kompjutoriziranom tomografijom (engl. single photon emission computerized tomography – computerized tomography, SPECT-CT), u obradi čvorova štitne žlijezde koji su afunkcionalni na oslikavanju 99mTc-pertehnetatom i potvrđeni ultrazvučnim pregledom. Ispitanici i metode: Retrospektivno su pregledani nalazi pacijenata kojima je učinjeno oslikavanje štitne žlijezde 99mTc-MIBI-jem i citološka punkcija u periodu od 2008. do 2018., te su uspoređeni s patohistološkim nalazom (engl. pathohistological diagnosis, PHD). Studije su snimljene gama-kamerom s kolimatorom visoke rezolucije na dva načina: planarno i tomografski (SPECT-CT). Rezultati citološke punkcije klasificirani su po Bethesda klasifikaciji dok su PHD rezultati klasificirani kao benigni ili maligni. Rezultati: U razdoblju od 2008. do 2018. snimljena je 271 studija štitne žlijezde 99mTc-MIBI-jem. Kod 42 pacijenta bili su zadovoljeni svi uključni kriteriji. Od ta 42 pacijenta s PHD nalazom 28 ih je bilo suspektno, odnosno čvor se na oslikavanju 99mTc-MIBI-jem prikazao kao hipermetabolički. Negativna prediktivna vrijednost metode iznosi 78,6 % (NPV = 11/(3+11) = 0,786), a pozitivna prediktivna vrijednost 18 % (PPV = 5/(5+23) = 0,179). Zaključak: S obzirom na visoku negativnu prediktivnu vrijednost, slikovna dijagnostika 99mTc-MIBI-jem može se preporučiti kao komplementarna metoda citološkoj punkciji u obradi čvorova u štitnoj žlijezdi.
Aim: The objective of the study is to show the role of 99mTc methoxyisobutylisonitrile (99mTc-MIBI) with planar imaging and single photon emission tomography with “low dose” CT (SPECT-CT) in a work up of non-functioning thyroid nodules on imaging with 99mTc- pertechnetate, which were confirmed by ultrasound examination. Patients and methods: Patients who underwent thyroid imaging with 99mTc-MIBI in the period from 2008 to 2018 were reviewed. The findings were compared with PHD results. The imaging was performed on gamma camera with high resolution collimator as planar scintigraphy and SPECT-CT. The results of fine needle aspiration biopsy were classified by the Bethesda classification, while PHD results were classified, as benign or malignant. Results: In the period from 2008-2018, 271 thyroid imaging with 99mTc- MIBI were performed. In 42 patients all-inclusive criteria were met.Out of those 42 patients, 28 of the PHD findings were concordant with the imaging, i.e. a node was presented as hypermetabolic. The calculated negative predictive value of the procedure is 78.6% (NPV = 11/ (3+11) = 0,786), and positive predictive value 18% (PPV = 5/ (5+23) = 0.179). Conclusion: Given the high negative predictive value, obtained from our results, 99mTc -MIBI imaging may be recommended as a complementary diagnostic method to fine-needle aspiration (FNA) in work up of thyroid nodules.
Databáze: OpenAIRE
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