The Incremental Value of Single-photon Emission Computed Tomography / Computed Tomography in Post-thyroidectomy Iodine-131 Scanning of Differentiated Thyroid Carcinoma. Part I: Retrospective Analysis of 26 Cases

Objective: This study investigated whether single-photon emission computed tomography (SPECT) with integrated low-dose computed tomography (CT) may have additional value over whole-body scintigraphy in determining the presence and location of tumour uptake in patients with differentiated thyroid car...

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Published in:Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi 2012-12, Vol.15 (4), p.213
Main Authors: Tang, P, Wang, K, Cheung, CY, Leung, S F
Format: Article
Language:English
Subjects:
Case reports
Iodine
Metastasis
Scintigraphy
Thyroid cancer
Thyroidectomy
Tomography
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Summary:Objective: This study investigated whether single-photon emission computed tomography (SPECT) with integrated low-dose computed tomography (CT) may have additional value over whole-body scintigraphy in determining the presence and location of tumour uptake in patients with differentiated thyroid carcinoma. Methods:Between 1 January and 31 December 2011, planar imaging was performed on 79 patients after total or nearly total thyroidectomy for differentiated thyroid carcinoma. Of these patients, 26 also underwent SPECT/ CT (using an integrated system) because the planar findings were inconclusive. Fusion images were considered to have incremental value over planar images when they better localised sites of increased iodine-131 uptake. The final diagnosis was supplemented by other imaging modalities, serological correlation, and clinical follow-up. The impact of SPECT/CT results on therapeutic strategy was assessed. Results:SPECT/CT had an incremental value over planar imaging in all of the 26 patients who underwent fusion imaging, by exclusion of distant metastases (42%), differentiation of pathological versus physiological uptake (38%), more accurate localisation of equivocal uptake (50%), discrimination between normal remnants and lymph node metastases in the neck (12%), and identification of occult lesions in the skeleton unsuspected on planar imaging (12%). SPECT/CT led to modified therapeutic management in nine (35%) of the 26 patients studied. Conclusion: The use of SPECT/CT fusion imaging offered incremental value over whole-body scintigraphy in increasing diagnostic accuracy, improving the interpretation of equivocal uptake, and modifying therapeutic strategies.
ISSN:2223-6619
2307-4620