I-131 Postablation SPECT/CT Predicts Relapse of Papillary Thyroid Carcinoma more Accurately than Whole Body Scan

Malamitsi, J.; Koutsikos, John; Giourgouli, Stamatia; Zachaki, Sophia; Pipikos, Theodoros; Vlachou, Fani; Prassopoulos, Vassilios

doi:10.21873/invivo.11731

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…In 2 of our patients, RAI foci in the middle of the neck could not be distinguished from thyroid remnant or TGDR in WBS, and parapharyngeal LN was found in SPECT-CT (2,5%). Many publications in the literature are most useful in differential diagnosis of lymph nodes (11)(12)(13)(14)(15). In our study, there was a change in the cervical lymph node interpretation of 43% of the patients.…”

Section: Discussionmentioning

confidence: 49%

Diferansiye Tiroid Kanserlerinde ablasyon sonrası görüntülemede boyun ve toraks bölgesindeki odakların ayırıcı tanısında SPECT-BT'nin Planar görüntülemeye katkısı ve klinik önemi

2022

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Background: The aim of this study is to demonstrate the superiority of Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT) over planar imaging in distinguishing benign from malignant foci and patient management after 131I ablation therapy in patients with differentiated thyroid cancer (DTC). Material and Methods: Planar and SPECT-CT imaging findings were retrospectively analyzed in 80 patients who received I-131 therapy for thyroid cancer. Possible foci in whole body scanning (WBS), neck, and thorax were compared with SPECT-CT. Anatomical localization of the foci and differential diagnosis of the benign and malignant lesion was made with SPECT-CT. Those without anatomical counterparts were recorded as equivocal foci. According to the 2015 American Thyroid Association (ATA) guidelines, patients were divided into three groups: High, intermediate, low-risk groups. Interpretation changes between both scannings were recorded as downstage and upstage. Results: There were 53 female and 27 male patients. The patients' age ranged from 21 to 88 years with a mean age of 47 ±14.2. In 80 patients, 139 foci were detected in planar images and SPECT-CT images (neck: 118, thorax: 21). SPECT-CT revealed that 50% of the lateral neck foci were compatible with pathologies in malignant nature and 50% with pathologies in benign nature. Foci in the middle part of the neck were found to be not only thyroid remnant (56%), but also thyroglossal duct remnant (40%) foci at a significant rate It was determined that 66% of the foci in the thorax region were lung metastases and 34% were bone metastases. It was proved that 33% of the foci in the mediastinal region were lymph nodes. Although only one of the remaining patients had a pathological diagnosis, it was thought that all of them might have thymus pathologies. SPECT-CT images changed the interpretation of 18 patients (22.5%), of which 5 (6.25%) were upstage and 13 (16.25%) were downstage. Conclusions: The use of SPECT-CT will be very effective, facilitating patient management and avoiding unnecessary procedures, especially in moderate/high-risk patients with suspicious focal lesions. The presence of benign iodine avid foci (thyroglossal duct residue, etc.) in the neck showing iodine uptake other than the thyroid remnant may be effective in making ablation decisions in low-risk patients.

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Section: Discussionmentioning

confidence: 49%

Diferansiye Tiroid Kanserlerinde ablasyon sonrası görüntülemede boyun ve toraks bölgesindeki odakların ayırıcı tanısında SPECT-BT'nin Planar görüntülemeye katkısı ve klinik önemi

2022

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“…The utility and benefits of synergistic SPECT-CT when applied to baseline planar scintigraphy following I-131 therapy have been proposed by many ( 8 , 9 , 15 , 16 ), but few data have provided evidence of the broad clinical utility (e.g. risks and benefits) in the real-world setting of thyroid cancer care.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience following implementation of routine SPECT-CT imaging following 131-iodine administration for thyroid cancer

Ahmadi

Coleman

Morais

et al. 2022

Endocrine Connections

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Background: Planar scintigraphy has long been indicated in patients receiving I-131 therapy for thyroid cancer to determine the anatomic location of metastases. We studied our experience upon implementing additional SPECT-CT scanning in these patients. Method: We performed a retrospective study of consecutive adult patients with newly diagnosed thyroid cancer treated with I-131 between 2011 and 2017. Radiologic findings detected with planar scintigraphy alone versus those identified with SPECT- CT scanning were primary endpoints. Result: 212 consecutive patients with thyroid cancer were analyzed in two separate cohorts (107 planar scintigraphy alone;105 planar scintigraphy with SPECT-CT). The addition of SPECT-CT resulted in more findings, both thyroid-related and incidental. However, we identified only 3 of 21 cases in which SPECT- CT provided unequivocal additional benefit by changing clinical management beyond planar scintigraphy alone. No difference in the detection of distant metastatic disease or outcome was identified between cohorts. Conclusion: Synergistic SPECT-CT imaging in addition to planar nuclear scintigraphy adds limited clinical value to thyroid cancer patients harboring low risk of distant metastases, while frequently identifying clinically insignificant findings. These data from a typical cohort of patients receiving standard thyroid cancer care provide insight into the routine use of SPECT-CT in such patients.

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“…Moreover, predictors such as Mts1 up-regulation for cases with initial surgery in thyroid cancer had been researched immunohistochemically and radiologically (18)(19)(20), and we believe that detailed research for predictors of cases with salvage surgery will be needed in the future.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Age and Distant Metastasis in Differentiated Thyroid Carcinoma Undergoing Salvage Surgery

et al. 2020

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Aim: To investigate the association between survival outcomes and clinicopathological factors, including pathological restaging based on the UICC8 th , among patients with recurrence differentiated thyroid carcinoma undergoing salvage surgery of local site. Patients and Methods: A total of 54 patients who underwent salvage surgery of local site for recurrence differentiated thyroid carcinoma were enrolled. The optimal cutoff ages at salvage surgery for predicting death and cancer-specific death were determined by receiver operating curve analysis. Overall and cancer-specific survivals were determined using logrank test and Cox's proportional hazards model. Results: Univariate analysis showed that age and the presence of distant metastasis at salvage surgery were significantly associated with overall survival (p=0.01 and p<0.05, respectively) and cancer-specific survival (p=0. 02 and p=0.01, respectively). The optimal cutoff age at salvage surgery for predicting the detection of both death (p=0.01) and cancer-specific death (p=0.02) was 65 years. Multivariate analysis showed that age ≥65 years and the presence of distant metastasis were significantly associated with shorter overall survival (p<0.01 and p=0.03, respectively) and shorter cancer-specific survival (p<0.01 and p=0.01, respectively). Conclusion: Older age and the presence of distant metastasis at salvage surgery of local site were identified as predictors for poor survival outcomes in recurrence differentiated thyroid carcinoma.

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I-131 Postablation SPECT/CT Predicts Relapse of Papillary Thyroid Carcinoma more Accurately than Whole Body Scan

Cited by 13 publications

References 27 publications

Diferansiye Tiroid Kanserlerinde ablasyon sonrası görüntülemede boyun ve toraks bölgesindeki odakların ayırıcı tanısında SPECT-BT'nin Planar görüntülemeye katkısı ve klinik önemi

Diferansiye Tiroid Kanserlerinde ablasyon sonrası görüntülemede boyun ve toraks bölgesindeki odakların ayırıcı tanısında SPECT-BT'nin Planar görüntülemeye katkısı ve klinik önemi

Clinical experience following implementation of routine SPECT-CT imaging following 131-iodine administration for thyroid cancer

Prognostic Value of Age and Distant Metastasis in Differentiated Thyroid Carcinoma Undergoing Salvage Surgery

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