(99m)Tc-Pertechnetate Scintigraphy Predicts Successful Postoperative Ablation in Differentiated Thyroid Carcinoma Patients Treated with Low Radioiodine Activities
- Author:
Luca GIOVANELLA
1
;
Gaetano PAONE
;
Teresa RUBERTO
;
Luca CERIANI
;
Pierpaolo TRIMBOLI
Author Information
- Publication Type:Original Article
- Keywords: Differentiated thyroid carcinoma; Radioiodine; Radionuclide imaging; Sodium pertechnetate Tc 99m
- MeSH: Follow-Up Studies; Humans; Neck; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroglobulin; Thyroid Gland; Thyroid Neoplasms; Thyroidectomy; Thyrotropin; Ultrasonography; Whole Body Imaging
- From:Endocrinology and Metabolism 2019;34(1):63-69
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Postoperative routine radioiodine (RAI) treatment is currently debated for patients with low-risk differentiated thyroid carcinoma (DTC) patients. If performed, a low 131I activity (i.e., 1 to 2 GBq) is recommended with the aim to ablate thyroid remnant and facilitate subsequent follow-up by thyroglobulin measurement. The purpose of this study was to evaluate the relationship between postsurgical technetium-99m (99mTc)-pertechnetate scintigraphy and the rate of successful remnant ablation after low activity radioiodine ablation in patients with DTC. METHODS: Enrolled were 193 patients with low risk DTC who underwent total thyroidectomy and RAI ablation with a fixed 1.1 GBq activity of 131I. 99mTc-pertechnetate scans were done and thyrotropin stimulated thyroglobulin (sTg) levels measured just before ablation. Ablation effectiveness was assessed 6 to 12 months later by sTg measurement, neck ultrasound and diagnostic whole body scan. RESULTS: A negative 99mTc-perthecnetate scans was the best predictor of successful ablation (P<0.001) followed by preablative sTg levels <0.8 ng/mL (P=0.008) and 99mTc-pertechnetate uptake rate values <0.9% (P=0.065). Neither sex nor age of the patient at the time of ablation or tumor histology and size showed a significant association with the rate of successful ablation. CONCLUSION: The 99mTc-pertechnetate scintigraphy is a simple and feasible tool to predict effectiveness of low activity 131I thyroid to ablate thyroid remnants in patients with DTC.