An Analysis of Influencing Factors of 99TcmO4-Thyroid Scan in the Diagnosis of Remnant Thyroid Tissue and 24h Thyroid Radioactive Iodine Uptake on Its Positive Prediction
Objective To analyze influence factors of 99TcmO4-thyroid scan in the diagnosis of remnant thyroid tissue and the value of 24h thyroid iodine uptake(RAIU)in its positive prediction.Methods A retrospective analysis was performed on 164 DTC patients(52 males and 112 females,23-76 years old)who received 131Ⅰtreatment for the first time in the Department of Nuclear Medicine of the First People's Hospital of Suqian City from January,2020 to December,2022.These patients were divided into a 131Ⅰ pre-treatment 99TcmO4-thyroid imaging positive group(114 cases)and a negative group(50 cases).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 99TcmO4-thyroid imaging were calculated using 131Ⅰ-SPECT/CT fusion imaging 72 hours after the oral therapeutic dose of 131Ⅰ as the"gold standard".Factors that could affect 99TcmO4-thyroid imaging were identified by single factor analysis.The receiver operating characteristic curve(ROC)of 24h RAIU was drawn to evaluate the positive prediction performance of 99TcmO4-thyroid residual nail.Results The remnant thyroid sensitivity of 99TcmO4-thyroid imaging was 70.44％(112/159),along with the specificity of 60.00％(3/5),the accuracy of 70.12％(115/164),the positive predictive value of 98.24％(112/114)and the negative predictive value of 3.75％(3/50).Gender and serum TSH level of patients between the two groups were both factors affecting 99TcmO4-thyroid scan remnant positive(x2=10.416,Z=2.78,all P＜0.05),while there was no statistical significance for age,serum sTg and sTgAb levels between the two groups(Z value:0.738,1.470 and 0.909,all P＞0.05).In addition,the 24h RAIU in the positive group of 99TcmO4-thyroid scan remnant was significantly higher than that in the negative group(Z=7.607,P＜0.05).The area under ROC curve for the prediction of the 24h RAIU for positive 99TcmO4-thyroid thyroid imaging was 0.873,and the optimal threshold was 1.05％(95％CI 0.818-0.928),with the sensitivity and specificity of 99 TcmO4-remnant thyroid positive of 74.6％and 90％,respectively.Conclusion 99TcmO4-thyroid scan has a high clinical value in the evaluation of remnant thyroid after the operation of differentiated thyroid carcinoma.Gender and the serum TSH level of patients are the independent influencing factors of positive remnant thyroid of 99 TcmO4-thyroid imaging.When the 24h RAIU is higher than 1.05％,there is a higher probability of positive remnant thyroid of 99TcmO4-thyroid scan.
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