Cervical Distribution of Iodine 131 Following Total Thyroidectomy for Thyroid Cancer

Usefulness of 99mTc-pertechnetate single-photon emission computed tomography in remnant mass estimation of postsurgical patients of differentiated thyroid cancer during internal dosimetry

“…The simplest one is the surgeon's presumptive assessment of the residual tissue [2,14]. The estimate of the remnant thyroid mass by this method, however, has been reported to be inaccurate especially for small size remnants [15]. The thyroid tissue left behind after surgery is under constant stimulation by the rising levels of TSH.…”

RAI thyroid bed uptake after total thyroidectomy: A novel SPECT‐CT anatomic classification system

“…In studies from highly specialized surgical centers in the US and Europe, 52% to 93% of total thyroidectomy patients had visibly evident residual thyroid bed uptake postoperatively . Thus far, the literature has limited information on the discreet anatomical localization of residual uptake foci, but on planar imaging, the residual radioactive iodine (RAI) uptake appears to be localized in the pyramidal lobe in some patients, and in other patients it is localized in various regions within the thyroid bed and superior pole . The ability to fuse RAI scans with cross sectional imaging with single photon emission computerized tomography‐computed tomography (SPECT‐CT) has dramatically improved RAI uptake localization to specific anatomical locations, both within the thyroid bed and lymph node metastases, and provides the anatomic substrate of our study …”

“…16,17 Thus far, the literature has limited information on the discreet anatomical localization of residual uptake foci, but on planar imaging, the residual radioactive iodine (RAI) uptake appears to be localized in the pyramidal lobe in some patients, and in other patients it is localized in various regions within the thyroid bed and superior pole. 15,18 The ability to fuse RAI scans with cross sectional imaging with single photon emission computerized tomography-computed tomography (SPECT-CT) has dramatically improved RAI uptake localization to specific anatomical locations, both within the thyroid bed and lymph node metastases, and provides the anatomic substrate of our study. 14,[19][20][21][22][23][24] In addition to the expected uptake often seen in the pyramidal lobe, we hypothesized that the discrete areas of residual RAI avid thyroid tissue in the thyroid bed would correspond to specific anatomical sites, including:…”

Surgical management of the recurrent laryngeal nerve in thyroidectomy: American Head and Neck Society Consensus Statement

“…Despite meticulous attempts to remove all visible normal thyroid tissue during total thyroidectomy by experienced surgeons, high‐resolution postoperative radioactive iodine scanning can detect very small foci of uptake in the thyroid bed and/or pyramidal lobe in >95% of patients . The radioactive iodine uptake in these small foci is usually very low, being <2% in >90% of the patients in a multicenter randomized phase III trial and demonstrating a median of only 0.32% in a single high‐volume institution …”

“…Despite meticulous attempts to remove all visible normal thyroid tissue during total thyroidectomy by experienced surgeons, high-resolution postoperative radioactive iodine scanning can detect very small foci of uptake in the thyroid bed and/or pyramidal lobe in >95% of patients. [67][68][69][70] The radioactive iodine uptake in these small foci is usually very low, being <2% in >90% of the patients in a multicenter randomized phase III trial and demonstrating a median of only 0.32% in a single high-volume institution. 69,71 When evaluated using posttherapy high-resolution single photon emission computerized tomography-CT, discrete foci can be localized in the region of Berry's ligament in 87%, superior thyroid poles in 79%, paratracheal lobar regions in 67%, the isthmus region in 54%, and the pyramidal lobe in 46% of the patients 69 (Figure 10).…”