ISSN: 1859 - 2872
Role of 131I SPECT/CT imaging in high-risk post-surgical patients with differentiated thyroid carcinoma
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Abstract
Objective: To investigate whether 131I Single-Photon Emission Tomography/Computed Tomograpy (SPECT/CT) may have additional value over planar whole-body scan (WBS) in detecting residues and metastases in high-risk differentiated thyroid carcinoma (DTC) patients. Subject and method: 125 high-risk post-surgical DTC patients were enrolled in present study. All these DTC patients undewent 131I diagnostic and post-therapeutic 131I planar WBS and SPECT/CT. We compared and assigned an incremental value to SPECT/CT when it provided better identification and interpretation of the foci of 131I uptake, correct anatomic localization, precise differentiation between tumor lesions and physiologic uptake. Result: SPECT/CT confirmed all foci seen on planar WBS and localized an additional 24.2 % occult foci in thyroid remnant, cervical and mediastinal lymph nodes, lung metastases and physiological uptakes where WBS imaging not indentified. SPECT/CT findings allowed diagnostic changes in 3.2% to N1, 2.4 % to M1 stages and disease stages in 3.2%. Diagnostic 131I SPECT/CT modified therapeutic management in 27.2 % and 131I treatment doses in 37.6% of high-risk DTC patients. Conclusion: 131I SPECT/CT improved a higher number of DTC lesions, more precisely localizing compared to planar WBS imaging. Therefore, SPECT/CT could complement planar WBS in high and intermediate-risk post-surgical DTC patients.
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References
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