수술 전 갑상선 유두상암의 경부 림프절 전이 진단에 있어 <SUP>18</SUP>F FDG PET-CT의 의의

Significance of <SUP>18</SUP>F FDG PET-CT for Preoperative Diagnosis of Cervical Lymph Nodes Metastasis in Papillary Thyroid Carinoma

Purpose: To compare the diagnostic accuracy of US/CT with US/CT/<SUP>18</SUP>F-FDG PET-CT in the diagnosis of cervical lymph nodes metastasis in papillary thyroid carcinoma. Methods: From July 2008 to May 2010, 36 patients with papillary thyroid carcinoma, confirmed by aspiration cytology analysis, underwent neck US, neck CT and <SUP>18</SUP>F-FDG PET-CT preoperatively. The sensitivity, specificity and diagnostic accuracy of the US/CT, US/CT/PET-CT was analyzed according to lymph node level (all: levels I&#8764;VI, central: level VI, lateral: levels I&#8764;V). Results: At all lymph nodes group (level I&#8764;VI), US/CT/ PET-CT showed a sensitivity of 66.6%, a specificity of 61.9% and a diagnostic accuracy of 63.8%. The corresponding values for US/CT were 60.0%, 85.7%, 75.0% respectively. Considering the central cervical nodes group (level VI), US/CT/PET-CT showed a sensitivity of 57.1%, a specificity of 68.1%, and a diagnostic accuracy of 63.8%. The corresponding values of US/CT were 57.1%, 90.9%, 77.7% respectively. Considering the lateral cervical nodes group (level I&#8764;V), US/CT/PET-CT showed a sensitivity of 100%, a specificity of 84.3%, and a diagnostic accuracy of 86.1%. The corresponding values of US/CT were 75.0%, 84.3%, 83.3% respectively. The diagnostic results of US/ CT, US/CT/PET-CT in initial evaluation of the cervical nodes metastasis did not differ significantly. Conclusion: Our preliminary results suggest that additional PET-CT evaluation in US/CT does not provide statistically significant benefit for initial diagnosis of cervical lymph nodes metastasis in papillary thyroid carcinoma. (Korean J Endocrine Surg 2010;10:235-239)