背景:双能量计算机断层扫描(DECT)是一种允许查看计算机断层扫描光谱图像的技术。这种方法,由于能够呈现特定的元素和物质(如水,钙和碘),可用于定位选定类型的组织。甲状腺组织由于富含内源性碘,即使不施用造影剂也可以定位。
方法:在介绍的病例中,作者使用甲状腺衍生组织中内源性碘积累的特征来诊断分化型甲状腺癌转移。在患者1中,DECT是符合手术资格的决定性参数。由于在患者2中使用DECT,因此可以直接定位甲状腺癌转移,使用标准技术(闪烁显像和[18F]FDGPET/CT)是不可行的。它有助于进行靶向活检并确认甲状腺癌转移的诊断,允许引入索拉非尼贝治疗。
结论:DECT证实了它在甲状腺组织定位中的效用,包括分化型甲状腺癌(DTC)转移。该方法可以在未来使用,特别是在超声检查中没有DTC定位的边缘或模棱两可的病例中,RAI闪烁显像,或[18F]FDGPET/CT,以及有造影CT禁忌症的患者。
BACKGROUND: Dual Energy Computed Tomography (DECT) is a technology that allows for viewing computed tomography spectral images. This method, due to ability of presenting specific elements and substances (like water, calcium and iodine), can be used to locate selected type of tissues. Thyroid tissue due to being rich in endogenous iodine, can be located even without administration of contrast agent.
METHODS: In presented cases authors used a feature of accumulating endogenous iodine in thyroid derivative tissue for diagnosis of differentiated thyroid cancer metastases. In Patient One DECT was a decisive parameter qualifying for the surgery. Due to use of DECT in Patient Two it was possible to directly localize thyroid cancer metastases, which was unfeasible using standard techniques (scintigraphy and [18 F]FDG PET/CT). It helped to perform targeted biopsy and confirm diagnosis of thyroid cancer metastases, allowing to introduce treatment with sorafenibe.
CONCLUSIONS: DECT confirmed its utility in locating thyroid tissues, including differentiated thyroid cancer (DTC) metastases. The method could be used in the future, especially in borderline or ambiguous cases with no localization of DTC in ultrasonography, RAI scintigraphy, or [18 F]FDG PET/CT, and among patients having contraindications for contrast-CT.