The Application of Dual-Phase Whole Body MIBI Scan and SPECT/CT in Recurrent Parathyroid Carcinoma

雙相全身MIBI掃描與SPECT/CT在復發性副甲狀腺癌的應用

莊紫翎(Tzyy-Ling Chuang) ； 何國維(Kuo-Wei Ho) ； 曾志恩(Chih-En Tseng) ； 王昱豐(Yuh-Feng Wang)

《核子醫學暨分子影像雜誌》 35卷1期 (2022/03) Pp. 33-39

https://doi.org/10.6332/ANMMI.202203_35(1).0005

摘要

A 79-year-old man with 2 parathyroid carcinomas in the left inferior and perithyroid regions received left thyroidectomy, parathyroidectomy, and mediastinal tumor excision on 2017/12/18 (pT1(2)N0(0/1)M0 [AJCC, 2017]). Nine months later, gradually elevated calcium and intact parathyroid hormone were noted. Dual-phase whole body MIBI scan with routine parathyroid scan and delayed single photon emission computed tomography/computed tomography (SPECT/CT) showed 1 abnormal focus with persistent accumulation of radiotracer in the supra-manubrial region. Planar imaging showed prominent visualization of the right thyroid bed initially with normal washout in delayed images, and no other prominent focus in whole body survey. Ultrasound-guided biopsy of anterior neck soft tissue showed recurrent parathyroid carcinoma.

關鍵字

parathyroid carcinoma ； SPECT/CT ； whole body MIBI scan

並列摘要

一名79歲男性，患有位於左下副甲狀腺合併左側甲狀腺周圍的兩個副甲狀腺癌，於2017/12/18進行左側甲狀腺切除術、副甲狀腺切除術和縱膈腫瘤切除術，pT1（2）N0（0/1）M0（AJCC, 2017）。九個月後，注意到鈣和副甲狀腺激素（intact parathyroid hormone, iPTH）逐漸升高。雙相全身MIBI掃描與常規副甲狀腺掃描，及延遲相的單光子電腦斷層／電腦斷層造影（single photon emission computed tomography/computed tomography, SPECT/CT），顯示一個異常病灶—放射性示踪劑在胸骨柄上方持續積聚。此外，平面影像於早期影像顯示右側甲狀腺床的顯著可見，且於延遲相表現正常洗出（washout），全身掃描中沒有其他顯著亮點。超音波引導下之前側頸部軟組織活檢切片，顯示副甲狀腺癌復發。

並列關鍵字

副甲狀腺癌 ； 單光子電腦斷層／電腦斷層造影 ； 全身MIBI掃描