Star-Shaped Intense Uptake of ¹³¹I on Whole Body Scans Can Reflect Good Therapeutic Effects of Low-Dose Radioactive Iodine Treatment of 1.1 GBq.
10.3803/EnM.2018.33.2.228
- Author:
Sung Hye KONG
1
;
Jung Ah LIM
;
Young Shin SONG
;
Shinje MOON
;
Ye An KIM
;
Min Joo KIM
;
Sun Wook CHO
;
Jae Hoon MOON
;
Ka Hee YI
;
Do Joon PARK
;
Bo Youn CHO
;
Young Joo PARK
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. yjparkmd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Radioactive iodine;
Remnant ablation;
Star artifact;
Thyroid neoplasms;
Therapeutic uses
- MeSH:
Artifacts;
Diagnosis;
Follow-Up Studies;
Humans;
Iodine*;
Neoplasm Metastasis;
Prognosis;
Recurrence;
Retrospective Studies;
Therapeutic Uses*;
Thyroglobulin;
Thyroid Neoplasms;
Whole Body Imaging*
- From:Endocrinology and Metabolism
2018;33(2):228-235
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: After initial radioactive iodine (RAI) treatment in differentiated thyroid cancer patients, we sometimes observe a star-shaped region of intense uptake of 131I on whole body scans (WBSs), called a ‘star artifact.’ We evaluated the clinical implications of star artifacts on the success rate of remnant ablation and long-term prognosis. METHODS: Total 636 patients who received 131I dose of 1.1 GBq for the initial RAI therapy and who did not show distant metastasis at the time of diagnosis were retrospectively evaluated. A negative second WBS was used for evaluating the ablation efficacy of the RAI therapy. Among them, 235 patients (36.9%) showed a star artifact on their first WBS. RESULTS: In patients with first stimulated thyroglobulin (sTg) levels ≤2 ng/mL, patients with star artifacts had a higher rate of negative second WBS compared with those without star artifacts (77.8% vs. 63.9%, P=0.044), and showed significantly higher recurrence-free survival (P=0.043) during the median 8.0 years (range, 1.0 to 10.0) of follow-up. The 5- and 10-year recurrence rates (5YRR, 10YRR) were also significantly lower in patients with star artifacts compared with those without (0% vs. 4.9%, respectively, P=0.006 for 5YRR; 0% vs. 6.4%, respectively, P=0.005 for 10YRR). However, ablation success rate or recurrence-free survival was not different among patients whose first sTg levels >2 ng/mL regardless of star artifacts. CONCLUSION: Therefore, star artifacts at initial RAI therapy imply a good ablation efficacy or a favorable long-term prognosis in patients with sTg levels ≤2 ng/mL.
