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

Abstract

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.

Rare renal metastases from differentiated thyroid carcinoma: early clinical detection and treatment based on radioiodine

“…Similar to our patients, most of the previously reported patients had advanced DTC with metastases to other organs when renal metastases were found. In our study, a 31-yearold female with a single left renal metastasis from DTC was the only case detected by I-SPECT/CT has emerged in this setting as a useful tool for accurately locating sites of pathological uptake and identifying physiological mimics of disease, thus providing a more accurate staging of prognostic information for risk stratification which, in its turn, tailors management and follow-up regimens (37).…”

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

“…But the accurate localization of abnormal foci of activities is not possible usually because of the lack of anatomic landmarks. 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].…”

American Thyroid Association Statement on Preoperative Imaging for Thyroid Cancer Surgery

“…In patients who have undergone prior remnant ablation, these scans have a high specificity but low THYROID CANCER IMAGINGsensitivity, and the low resolution has traditionally been insufficient for surgical planning. Newer technology utilizing radioiodine with SPECT/CT fusion significantly improves anatomic localization of radioiodine avid disease and may be used to guide surgical intervention with or without radioguidance (48)(49)(50).…”