Details

Autor(en) / Beteiligte

• Aide, Nicolas
• Heutte, Natacha
• Rame, Jean-Pierre
• Rousseau, Elise
• Loiseau, Cédric
• Henry-Amar, Michel
• Bardet, Stéphane

Titel

Clinical relevance of single-photon emission computed tomography/computed tomography of the neck and thorax in postablation (131)I scintigraphy for thyroid cancer

Ist Teil von

• The journal of clinical endocrinology and metabolism, 2009-06, Vol.94 (6), p.2075-2084

Ort / Verlag

United States

Erscheinungsjahr

2009

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• In patients with differentiated thyroid carcinoma, postablation (131)I 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. Our objective was to test the added value of neck and thorax SPECT-spiral CT to whole-body scan (WBS) in postablation (131)I scintigraphy. This was a single-referral-center prospective study with a median follow-up of 21 months. Postablation (131)I 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. 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). This study demonstrates the complementary role of neck and thorax SPECT-CT to WBS in postablation (131)I 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.