Regional lymph node involvement in T1 papillary thyroid carcinoma: a bicentric prospective SPECT/CT study

Mustafa, Mona; Kuwert, Torsten; Weber, Kathrin; Knesewitsch, P.; Negele, Thomas; Haug, Alexander; Linke, Rainer; Bartenstein, Peter; Schmidt, Daniela

doi:10.1007/s00259-010-1408-2

Cited by 59 publications

(54 citation statements)

References 10 publications

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“…In a large, bicentric study of 151 patients, using a combination of nodal staging based on histopathology (pN1) information (in 46% patients who underwent surgical neck dissection) and imaging information (SPECT/CT in 54% patients who did not undergo neck dissection), Mustafa et al reported that nodal metastases occurred in 26% of T1 tumors and in 22% of microcarcinomas (T1a tumors, #1.0 cm). Regarding nodal staging, SPECT/CT was more accurate than planar imaging in 24.5% of patients (46).…”

Section: Utility Of Post-therapy Radioiodine Spect/ctmentioning

confidence: 95%

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

Avram¹

2012

J Nucl Med

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 Post-therapy Radioiodine Spect/ctmentioning

confidence: 95%

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

Avram¹

2012

J Nucl Med

122

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“…In recent years, it has been shown that the analysis of SPECT-CT images helps to precisely localize focal iodine uptake and to characterize it as either normal or abnormal. In postablation setting, neck and thorax SPECT-CT improves the N staging of patients with DTC (4,9). SPECT-CT data may also reduce the need for additional cross-sectional imaging in 20% of patients and alter the ATA risk of recurrence classification in 6% of patients (10).…”

Section: Discussionmentioning

confidence: 99%

Postablation 131I scintigraphy with neck and thorax SPECT–CT and stimulated serum thyroglobulin level predict the outcome of patients with differentiated thyroid cancer

Ciappuccini

Heutte

Trzepla

et al. 2011

European Journal of Endocrinology

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Objective: Neck and thorax single photon emission computed tomography with computed tomography (SPECT-CT) improves the reliability of postablation 131 I whole-body scan (WBS) for differentiated thyroid cancer (DTC). The aim of this study was to assess the prognostic value for persistent or recurrent disease of postablation 131 I scintigraphy combining WBS and neck and thorax SPECT-CT with that of the previously known predictive factors. Methods: This is a single referral center prospective study with a median follow-up of 29 months. Postablation 131 I WBS and neck and thorax SPECT-CT were performed in 170 consecutive patients treated between 2006 and 2008. Stimulated serum thyroglobulin (Tg) and anti-thyroglobulin antibodies (TgAb) levels were measured. The impact on disease-free survival of age; gender; postablation 131 I scintigraphy; stimulated serum Tg level; T, N, and M status; and macroscopic lymph node involvement was assessed by univariate and multivariate analyses. Results: Persistent or recurrent disease was observed in 32 (19%) patients. In the whole group of patients, only positive WBS with SPECT-CT was related to an increased risk of persistent or recurrent disease (hazards ratio (HR)Z65.21, 95% confidence interval (CI)Z26.03-163.39, P!0.0001). In patients without TgAb (nZ146), both positive WBS with SPECT-CT (HRZ18.86, 95% CIZ5.02-70.85, P!0.0001) and serum Tg level R58 ng/ml (HRZ4.42, 95% CIZ1.18-16.53, PZ0.0271) were associated with an increased risk. Conclusion: In patients with DTC, the cross analysis of postablation 131 I scintigraphy with neck and thorax SPECT-CT and stimulated serum Tg level enables early assessment of the risk of persistent or recurrent disease.European Journal of Endocrinology 164 961-969

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“…GBq (30-260? 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%

“…Impact of SPET-CT on thyroid cancer staging, management and prognosis Accurate staging and risk stratification are critical considerations in the management of thyroid cancer. Post-therapy I-131 SPET-CT studies [20,25,26,30,33,37,40] and follow-up diagnostic scans after thyroid remnant ablation [19,41] have demonstrated improved characterization of nodal (N) and distant metastases (M) status on TNM staging schema. At the first radioablation therapy, posttherapy SPET-CT was found to restage the cervical N status in 20/57 (35 %) patients [33].…”

Section: Comparison With Other Imaging Modalities In Thyroid Cancermentioning

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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Regional lymph node involvement in T1 papillary thyroid carcinoma: a bicentric prospective SPECT/CT study

Cited by 59 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

Postablation 131I scintigraphy with neck and thorax SPECT–CT and stimulated serum thyroglobulin level predict the outcome of patients with differentiated thyroid cancer

SPET–CT in thyroid cancer: a systematic review

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