Objective To evaluate the predictive value of posttreatment whole body scan (RxWBS) for radiation damage to the salivary glands in patients with differentiated thyroid carcinoma (DTC).Methods From April 2015 to June 2015,24 patients (8 males,16 females;age:26-64 years) with DTC,who accepted 131I therapy only one time and underwent Rx-WBS 2-4 d after 131I treatment,were recruited from the First Hospital of China Medical University.All patients had normal salivary glands function on salivary gland scintigraphy (SGS) performed on the day before 131I treatment,and 21 patients underwent SGS again 3 months after 131I treatment.The SGS results and clinical manifestations were used to evaluate the function of salivary glands after 131I therapy.Rx-WBS was analyzed by visual analysis and quantitative analysis (salivary gland to background uptake ratios,SUR).The SUR was compared between patient groups with different function of salivary glands.Mann-Whitney u test was used.Receiver operating characteristic (ROC) curve analysis was used to calculate the sensitivity of SUR for predicting the salivary gland damage.Results The SUR in dysfunctional parotid glands (n =12) was significantly higher than that in other glands with normal function (n=30;3.60(2.55,4.33) vs 2.75(2.33,3.29);z=-2.005,P＜0.05).The SUR was not different between submandibular glands with lower function (n =15) and those with normal function (n=27;z=-0.144,P＞0.05).The SUR of parotid glands (n =32) in patients with parotitis was significantly higher than that in others (n=16;3.16(2.53,4.01) vs 2.49(206,2 81);z=-3.073,P＜0.05).The SUR of submandibular glands (n=28) in patients with sialadenitis was significantly higher than that in others (n=20;4.43(2.67,7.61) vs 2.93(1.92,4.65);z=-2.740,P＜0.05).When 2.97 and 3.66 were selected as cutoff values,the sensitivities of SUR for predicting parotitis and sialadenitis were 59％(19/32) and 64％ (18/ 28),respectively.Conclusion Rx-WBS may play a role in predicting radiation damage to the salivary glands.%目的 探讨131I治疗后全身显像(Rx-WBS)对分化型甲状腺癌(DTC)患者131I治疗后唾液腺损伤发生风险的预测价值.方法 回顾性分析2015年4月至2015年6月间24例(男8例,女16例;年龄26～64岁)DTC术后首次行131I治疗且在131I治疗后2～4d行Rx-WBS的患者.所有患者(48个腮腺,48个颌下腺)在131I治疗前1d行唾液腺动态显像(SGS)均提示唾液腺功能正常,其中21例(42个腮腺,42个颌下腺)131I治疗后3个月复查时行SGS.分别从SGS结果和临床表现判断唾液腺损伤情况,并将Rx-WBS图像上唾液腺对131I的浓聚情况[唾液腺放射性计数与本底放射性计数比值(SUR)]与其对比.采用Mann-Whitneyu检验分析数据,利用受试者工作特征(ROC)曲线分析计算SUR预测唾液腺炎性损伤的灵敏度.结果 根据SGS结果分组,腮腺功能降低组(n=12)和腮腺功能正常组(n=30)的Rx-WBS所测SUR分别为3.60(2.55,4.33)和2.75(2.33,3.29)(z=-2.005,P＜0.05).Rx-WBS图像上,颌下腺功能降低者(n=15)与功能正常者(n=27) SUR差异无统计学意义(z=-0.144,P＞0.05).腮腺炎组(n=32)和颌下腺炎组(n=28) SUR均高于对应的无炎性病变组[n=16,3.16(2.53,4.01)和2.49(2.06,2.81);n=20,4.43(2.67,7.61)和2.93(1.92,4.65);z值:-3.073和-2.740,均P＜0.05];SUR阈值分别取2.97和3.66时,其预测发生腮腺炎和颌下腺炎的灵敏度分别为59％(19/32)和64％ (18/28).结论 可通过Rx-WBS来预测DTC患者131I治疗后唾液腺损伤的发生风险.
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