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- Title
Clinical Relevance of Single-Photon Emission Computed Tomography/Computed Tomography of the Neck and Thorax in Postablation <sup>131</sup>I Scintigraphy for Thyroid Cancer.
- Authors
Aide, Nicolas; Heutte, Natacha; Rame, Jean-Pierre; Rousseau, Elise; Loiseau, Cédric; Henry-Amar, Michel; Bardet, Stéphane
- Abstract
Context: In patients with differentiated thyroid carcinoma, postablation 131I scintigraphy aims to detect residual neck disease and distant metastases, usually found in lungs and bones. New hybrid single-photon emission computed tomography/computed tomography (SPECT-CT) cameras that permit functional and anatomical image fusion may improve its clinical relevance. Objective: Our objective was to test the added value of neck and thorax SPECT-spiral CT to wholebody scan (WBS) in postablation 131I scintigraphy. Design and Setting: This was a single-referral-center prospective study with a median follow-up of 21 months. Patients and Methods: Postablation 131I WBS and neck and thorax SPECT-CT were performed in 55 consecutive patients treated in 2006. WBS and SPECT-CT data were blindly reviewed, scored negative (benign), positive (malignant), or indeterminate and were correlated to the patient outcome. Results: At patient level, WBS and SPECT-CT were negative in 67 and 78% of patients, positive in 4 and 15%, and indeterminate in 29 and 7%, respectively. Overall, nine patients (16%) presented treatment failure (persistent or recurrent disease) 1–16 months after radioiodine ablation. In the 16 patients with indeterminate WBS, negative SPECT-CT ruled out suspicion of disease in nine of nine patients, and positive SPECT-CT confirmed malignant lesions in four of five patients. Positive SPECT-CT predicted treatment failure better than positive WBS (McNemar’s test, P = 0.03). Conclusions: This study demonstrates the complementary role of neck and thorax SPECT-CT to WBS in postablation 131I scintigraphy. Because SPECT-CT allows one to confirm or to rule out residual disease in most cases where WBS remains indeterminate, we recommend its use when available.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2009, Vol 94, Issue 6, p2075
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/jc.2008-2313