Incidental Finding of Skull Metastasis on SPECT/CT in a Thyroid Cancer Patient Who Had a Negative Radioiodine-131 Whole Body Scan

甲狀腺癌患者全身掃描影像是陰性而附加電腦斷層的單光子放射電腦斷層掃描偶然檢測有顱骨轉移

謝志芳(Jih-Fang Hsieh) ； 陳俊偉(Robert Tan) ； 李將瑄(Chiang-Hsuan Lee) ； 吳志順(Chih-Shun Wu)

《核子醫學暨分子影像雜誌》 28卷4期 (2015/12) Pp. 163-167

https://doi.org/10.6332/ANMMI.2803.004

摘要

碘-131全身掃描以甲狀腺癌的處置方法，已常規使用於經接受全甲狀腺切除或近全甲狀腺切除之分化良好的甲狀腺癌患者。近期，附加電腦斷層的單光子放射電腦斷層掃描(SPECT/CT)之應用已經逐漸增加，並產生了理想的結果。文獻上曾報導有關甲狀腺癌的治療處置方法，附加電腦斷層的單光子放射電腦斷層掃描與平面閃爍掃描比較，前者可以增加診斷價值。我們報告最近進行之一案例，經150毫居里碘-131治療後之甲狀腺癌患者全身掃描影像是陰性而兩天後進行之附加電腦斷層的單光子放射電腦斷層掃描檢測有顱骨轉移。盡我們所知，碘-131附加電腦斷層的單光子放射電腦斷層掃描顯示顱骨轉移為陽性而平面影像為陰性的分化良好的甲狀腺癌患者案例，這種情況，尚未在文獻報導。

關鍵字

平面閃爍掃描 ； 放射性碘-131 ； 附加電腦斷層的單光子放射電腦斷層掃描 ； 分化良好甲狀腺癌

並列摘要

Radioiodine whole-body scintigraphy is indispensable for the management of patients with well-differentiated thyroid carcinoma who underwent total or near-total thyroidectomy. Recently, additional imaging of SPECT/ CT has been increasingly utilized for a more optimal interpretation. Previous literatures reported that SPECT/ CT had incremental diagnostic values compared to planar scintigraphy on the therapeutic management of thyroid cancer. We presented the case of a post-treatment thyroid cancer patient with whom skull metastasis was detected on a recently performed SPECT/CT, even though two days ago the patient had a negative result on the 150 mCi post-therapy I-131 whole body scan. To the best of our knowledge, this kind of cases where patients with welldifferentiated thyroid carcinoma presented with a positive I-131 SPECT/CT for skull metastasis but had a negative planar image has not been reported in the literature before.

並列關鍵字

planar image ； radioiodine-131 ； SPECT/CT ； well-differentiated thyroid carcinoma