Incremental Value of Diagnostic 131I SPECT/CT Fusion Imaging in the Evaluation of Differentiated Thyroid Carcinoma

Wong, Ka Kit; Zarzhevsky, Natalia; Cahill, John; Frey, Kirk A.; Avram, Anca M.

doi:10.2214/ajr.08.1218

Cited by 86 publications

(59 citation statements)

References 10 publications

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“…Rapid exclusion of physiologic activity or contamination resulted in elimination of equivocal interpretations on planar scans. Reader confidence increased for interpretation of 104 of 147 foci (71%) seen on planar images after the review of SPECT/CT (67).…”

Section: Utility Of Diagnostic Preablation Radioiodine Spect/ctmentioning

confidence: 99%

Radioiodine Scintigraphy with SPECT/CT: An Important Diagnostic Tool for Thyroid Cancer Staging and Risk Stratification

Avram¹

2012

J Nucl Med

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122

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than September 2015. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. Participants who have already taken the exam using JNM and passed cannot retake the exam.Staging and risk stratification predicate the postoperative management of thyroid cancer patients, determining not only the need for 131 I therapy or alternative options (conservative management without ablation, surgical reintervention, or externalbeam radiation therapy) but also the long-term follow-up strategy. This paper presents the progress made in the field of thyroid cancer imaging by application of SPECT/CT technology to radioiodine scintigraphy in both diagnostic and post-therapy settings and reviews the impact of fusion radioiodine imaging on staging, risk stratification, and clinical management of patients with thyroid cancer. In addition, this paper addresses the role of preablation radioiodine imaging and provides nuclear medicine physicians with the background knowledge required for integrating information from fusion imaging into the clinical and histopathologic risk stratification for developing an individualized treatment plan for patients with thyroid cancer.

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Section: Utility Of Diagnostic Preablation Radioiodine Spect/ctmentioning

confidence: 99%

Radioiodine Scintigraphy with SPECT/CT: An Important Diagnostic Tool for Thyroid Cancer Staging and Risk Stratification

Avram¹

2012

J Nucl Med

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122

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“…In addition, physiological I-131 uptake in the salivary glands, nose, mouth and residual thyroid tissue is also an important problem because some abnormal foci of activities can be hidden by these overlapping structures [8][9][10][11]. In some studies, SPECT/CT was performed on only selected patients whose planar images showed inconclusive findings [11,12]. Chen et al [11] reported that SPECT/CT was of incremental value over planar I-131 WBS in increasing accuracy, reducing pitfalls and modifying therapy in 73.9% of patients with DTC.…”

Section: Discussionmentioning

confidence: 99%

Value of SPECT/CT in Cervical Vertebra Metastasis Mimicking Residual Thyroid Tissue on Planar I-131 Scan

Omur¹

2014

Thyroid Disorders Ther

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A total thyroidectomy was performed on a 62 year-old male patient with 3.5 cm cold nodule and diagnosis of differentiated thyroid carcinoma was made. He received 200 mCi of I-131 because pulmonary metastases were founded on computed tomography and his serum thyroglobulin level was high (>300 ng/ml). Post-therapy planar whole body scan showed diffuse pulmonary tracer accumulation consistent with pulmonary metastases, 3 foci of activities in the thyroid region of neck and physiological tracer uptake in the liver. Initially, it was considered that high serum thyroglobulin level was caused by pulmonary metastases and activities in the neck were due to residual thyroid tissue. But, single photon emission computed tomography/computed tomography (SPECT/CT) images demonstrated that the activity in the midline of the neck was originated in the cervical (C5-6) vertebra due to bone metastasis. Cervical vertebra metastasis in the same level with probable residual thyroid tissue in planar I-131 whole body scan can be easily overlooked. We considered that the complementary SPECT/CT for head and neck region should be used not only in the selected differentiated thyroid carcinoma patients with unexpected abnormal activity but also in patients with expected residual thyroid tissue, salivary gland or mouth activity in planar I-131 whole body scan.

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“…The identified I-131 and I-123 SPET-CT studies concerned patients prepared with either endogenous hypothyroidism or exogenous recombinant human TSH stimulation, and they used diagnostic imaging doses ranging from 37 to 430 MBq (1-11 mCi) [19][20][21][22][23][24] and post-therapy imaging doses ranging from 1.1 to 9.7? GBq (30-260?…”

Section: Study Characteristics and Protocols For Spet-ctmentioning

confidence: 99%

“…mCi) [20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Radioiodine SPET-CT was used for surveillance for thyroid cancer recurrence, before I-131 therapy [19,20,27,41,42], in the post-surgical setting for radioiodine ablation of normal thyroid remnants, [21,22,24], or in post-therapy imaging [25-30, 32, 33, 36, 37, 39, 40, 43-45].…”

Section: Study Characteristics and Protocols For Spet-ctmentioning

confidence: 99%

SPET–CT in thyroid cancer: a systematic review

Wong

Wale

Fig

et al. 2014

Clin Transl Imaging

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The purpose of this study was to systematically review the utility of single-photon emission tomographycomputed tomography (SPET-CT) fusion imaging in the investigation of thyroid cancer. We performed a systematic search of the world literature on radionuclide SPET-CT imaging of thyroid cancer using the medical databases Medline (OVID) and PubMed. The following search terms were used to identify relevant studies: (a) thyroid, combined with (b) SPECT/CT or SPECT-CT or SPET/CT or SPET-CT. The electronic searches returned citations for 1,189 potentially eligible articles and 98 abstracts were reviewed for relevance by two co-authors. Thirty-one peerreviewed full articles reporting the utility, value and diagnostic performance of radioiodine SPET-CT for the imaging of well-differentiated thyroid cancer were selected. The quality of these studies was assessed using the quality assessment of diagnostic accuracy studies-2 tool.As there was heterogeneity in the studies, a systematic review analysis was conducted as our chosen research synthesis method. A total of 31 studies published between 2003 and 2014 report the utility of radioiodine SPET-CT. These studies uniformly found incremental diagnostic value of I-123 and I-131 SPET-CT over SPET and/or planar imaging. SPET-CT allows accurate characterization of radioiodine uptake in the neck and at distant sites, clarifies equivocal foci of radioactivity, improves specificity for disease, and evaluates benign physiological etiologies. Additional pilot uses of SPET-CT have been reported, e.g., for thyroid nodule evaluation, medullary thyroid cancer work-up, and investigation of lingual thyroid. Radioiodine SPET-CT fusion imaging of thyroid cancer has incremental utility, improving image interpretation as compared to planar and SPET imaging. It is likely to see more widespread application in the future.

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Incremental Value of Diagnostic 131I SPECT/CT Fusion Imaging in the Evaluation of Differentiated Thyroid Carcinoma

Abstract: Iodine-131 SPECT/CT is useful for accurate evaluation of regional and distant activity in characterization of foci as residual thyroid tissue or nodal, pulmonary, or osseous metastasis. Suspected physiologic mimics of disease can be confirmed with increased reader confidence.

Cited by 86 publications

References 10 publications

Radioiodine Scintigraphy with SPECT/CT: An Important Diagnostic Tool for Thyroid Cancer Staging and Risk Stratification

Radioiodine Scintigraphy with SPECT/CT: An Important Diagnostic Tool for Thyroid Cancer Staging and Risk Stratification

Value of SPECT/CT in Cervical Vertebra Metastasis Mimicking Residual Thyroid Tissue on Planar I-131 Scan

SPET–CT in thyroid cancer: a systematic review

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