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Double-phase (131)I whole body scan and (131)I SPECT-CT images in patients with differentiated thyroid cancer: their effectiveness for accurate identification.
MedLine Citation:
PMID:  21725630     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: This study aims to determine whether a (131)I double-phase whole body scan (WBS) and SPECT-CT images have added value over a single-phase WBS image in identifying benign and malignant lesions in patients with well-differentiated thyroid cancer (DTC) at their first radioactive iodine (RAI) treatment. METHODS: This study included 42 DTC patients who underwent their first radioablation. Post-therapeutic WBS images were acquired after 3 days (early phase) and 7 days (delayed phase). Following early-phase WBS, SPECT-CT images were obtained. The images were reviewed independently of the clinical data by 2 board-certified observers with a 6-point scoring system (benign to malignant -3 to +3). RESULTS: The double-phase WBS and SPECT-CT images showed 115 radioiodine-avid localizations (81 benign and 34 malignant accumulations). Confidence levels of benign accumulations were significantly higher with SPECT-CT (average score -2.40 ± 1.06) compared to those of the early-phase WBS (average score -1.39 ± 1.88) (p < 0.0001) and delayed-phase WBS images (average score -1.49 ± 1.19) (p < 0.0001). When the analysis was restricted to accumulations with a low confidence score in the early-phase WBS image, the confidence level of the delayed-phase WBS was higher compared to that of the early-phase WBS images (p = 0.0012). The confidence levels of malignant accumulations were significantly higher with SPECT-CT images (average score 2.37 ± 0.96) compared to the early-phase WBS (average score 1.44 ± 1.21) (p < 0.0001) and the delayed-phase WBS images (average score 1.50 ± 1.13) (p < 0.0001). CONCLUSION: Post-therapeutic SPECT-CT image was superior to the early-phase WBS image in enhancing the confidence level and accurately localizing the lesions. The delayed-phase WBS image contributed to the accurate diagnosis of benign lesions with a low confidence level in the early-phase WBS image.
Authors:
Hiroshi Wakabayashi; Kenichi Nakajima; Makoto Fukuoka; Anri Inaki; Ayane Nakamura; Daiki Kayano; Seigo Kinuya
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-2
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  -     ISSN:  1864-6433     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan, wakabayashi@nmd.m.kanazawa-u.ac.jp.
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