This article investigates the association of the time interval between the diagnostic dose and ablation with the stunning effect, when a 74 MBq I pretherapy scanning was performed on patients with differentiated thyroid carcinoma (DTC); the patients who were diagnosed as DTC and would be performed radioiodine (RAI) ablation of thyroid remnants or metastases were recruited during January 2011 and May 2012 in our hospital.Thirty-seven patients with DTC who had the RAI ablation of thyroid remnants or metastases for the first time were recruited. All the patients received a dose of 1850 to 7400 MBq of I for ablation and a diagnostic scan was performed 24 hours after the administration of 74 MBq I before ablation. A posttherapy scan was performed 2 to 7 days after the ablation. The patients were broken down into 3 groups (G1, G2, and G3) according to the interval time between the diagnostic dose and therapy (1-3, 4-7, and >7 days). The fractional concentrations of I in remnants or functional metastases were quantified and expressed as therapeutic/diagnostic (Rx/Dx). The level of significance was set at 0.05.Sixty-seven foci were found both on pretherapy and posttherapy scans, the mean ratio of Rx/Dx was 0.43 ± 0.29, and the ratio of 49 foci (73.13%) was <0.6. The ratios in G1, G2, and G3 were 0.46 ± 0.29, 0.29 ± 0.18, and 0.55 ± 0.33, respectively. The differences between G1 and G2, and G2 and G3 were statistically significant (t = 2.40, P = 0.021 and t = 3.28, P = 0.002), whereas the difference between G1 and G3 was not significant (t = 1.01, P = 0.319).By a diagnostic scan of 74 MBq I, stunning prominently occurs with a time of 4 to 7 days between the diagnostic dose and ablation. We recommend that for less stunning effect, RAI ablation should be performed within 3 days or postponed until 1 week after the diagnostic dose administrated.

译文

本文研究了对分化型甲状腺癌 (DTC) 患者进行74  MBq I治疗前扫描时,诊断剂量和消融之间的时间间隔与惊人效果的关系; 在我院2011年1月和2012年5月期间,招募了诊断为DTC并将进行甲状腺残留或转移的放射性碘 (RAI) 消融的患者。37例首次进行甲状腺残留或转移的RAI消融的DTC患者。所有患者均接受了1850年剂量至7400  MBq的I消融,并在消融前给予74  MBq I后24小时进行了诊断扫描。消融后2至7天进行治疗后扫描。根据诊断剂量和治疗之间的间隔时间 (1-3、4-7和> 7天),将患者分为3组 (G1,G2和G3)。对残留或功能性转移中的I的部分浓度进行定量,并表示为治疗性/诊断性 (Rx/Dx)。显著性水平设定为0.05,治疗前和治疗后共发现67个病灶,Rx/Dx的平均比值为0.43   ±   0.29,49个病灶 (73.13%) 的比值 <0.6。G1、G2和G3的比值分别为0.46   ±   0.29、0.29   ±   0.18和0.55   ±   0.33。G1与G2、G2与G3之间差异有统计学意义 (t   =   2.40,p   =   0.021,t   =   3.28,p   =   0.002),而G1与G3之间差异无统计学意义 (t   =   1.01,P   =   0.319)。通过74  MBq I的诊断扫描,在诊断剂量和消融之间的4到7天的时间内显着发生惊艳。我们建议,对于较小的惊人效果,RAI消融应在3天内进行或推迟至1周后给药诊断剂量。

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