Evaluation of Usefulness of Radio-iodine SPECT/CT in Differentiated Thyroid Cancer.
- Author:
Jeong Won LEE
1
;
Ho Young LEE
;
So Won OH
;
Seok Ki KIM
;
Ki Wook JEONG
;
Seon Wook KIM
;
Keon Wook KANG
Author Information
1. Hospital and Research Institute, National Cancer Center, Gyeonggi-do, Korea. skkim@ncc.re.kr
- Publication Type:Original Article
- Keywords:
thyroid cancer;
iodine radioisotope;
SPECT/CT
- MeSH:
Diagnosis;
Humans;
Lymph Nodes;
Neck;
Neoplasm Metastasis;
Serologic Tests;
Thyroid Gland*;
Thyroid Neoplasms*;
Whole Body Imaging
- From:Nuclear Medicine and Molecular Imaging
2007;41(5):350-358
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Localizing and differentiating a metastatic lesion of differentiated thyroid cancer (DTC) by using radio?iodine whole body scan could be difficult because a whole body scan (WBS) lacks anatomic information. This study was performed to evaluate the usefulness of radio-iodine SPECT/CT for differentiating equivocal lesions. MATERIALS AND METHODS: Among 253 patients with DTC who had undergone radio-iodine scan between February and July 2006, 26 patients were enrolled (M:F = 8:18, Age 50.7 +/- 12.5 years) in this study. The patients had abnormal uptakes in the WBSs that necessitated precise anatomical localization for differentiating between a metastatic lesion and a false-positive lesion. SPECT/CT was performed for the region with abnormal uptake in the WBS. WBS and SPECT/CT were evaluated visually. Metastases were diagnosed based on the results of the radio-iodine scan along with the results of other radiological examinations and serological tests. RESULTS: Based on the WBS images, 13 were suspected with cervical lymph node (LN) metastases in 16 patients with abnormal neck uptake, and in the 11 patients with abnormal extra-cervical uptakes, extra-cervical metastases were doubtful in all. After SPECT/CT was performed, the diagnostic results were altered for 16 patients (62%). SPECT/CT revealed that only 5 patients had cervical LN metastases, while 3 patients had extra-cervical (mediastinal) LN metastases. Overall, there was a 58% (15/26) change in diagnoses and plans for treatment due to SPECT/CT. Among 8 patients suspected with metastases on SPECT/CT, 6 patients underwent another radio-iodine therapy. In 96% (24/25) of the patients, the results of SPECT/CT corresponded with those of further radiological examinations and with other clinical information. CONCLUSION: Radio-iodine SPECT/CT images permitted the differentiation of abnormal radio-iodine uptake and improved anatomical interpretation in DTC.
