| Staging of differentiated thyroid carcinoma using diagnostic 131I SPECT/CT. | |
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MedLine Citation:
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PMID: 20729453 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to evaluate the feasibility of staging differentiated thyroid carcinoma (DTC) before initial radioiodine therapy using diagnostic radioiodine-131 ((131)I) scintigraphy with SPECT/CT and to determine the additional value of SPECT/CT. MATERIALS AND METHODS: Forty-eight patients (12 men and 36 women; age range, 17-82 years) with DTC underwent diagnostic (131)I planar imaging and SPECT/CT scintigraphy reinterpreted by two readers, one of whom was not blinded to patients' clinical details. Staging and scoring of carcinomas was done by use of TNM with three levels of sequential information: histopathologic analysis and chest radiograph data, planar images, and SPECT/CT data. Restaging based on the imaging findings was designated as "iTNM." RESULTS: Diagnostic (131)I scintigraphy allowed TNM staging of DTC before initial radioiodine therapy. Planar images detected previously unsuspected distant disease in four (50%) of eight patients with a score of M1. SPECT/CT changed the planar scan interpretation for 19 (40%) of 48 patients, detecting regional nodal metastases in four patients and clarifying equivocal focal neck uptake in 15 patients. Compared with histopathologic analysis and chest radiograph data, planar images and SPECT/CT changed the postsurgical DTC stage for 10 (21%) of 48 patients. SPECT/CT information changed the proposed (131)I therapeutic dose for 28 (58%) of 48 patients, on the basis of our department protocol. CONCLUSION: Diagnostic (131)I scintigraphy, planar images, and SPECT/CT complete the postsurgical staging of DTC. SPECT/CT reduces the number of equivocal diagnoses on planar imaging and improves the interpretation of (131)I scintigraphy. The consequent changes in TNM scores and staging should influence the (131)I dose prescribed at initial therapy. |
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Authors:
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Ka Kit Wong; James C Sisson; Kenneth F Koral; Kirk A Frey; Anca M Avram |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 195 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-23 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 730-6 Citation Subset: AIM; IM |
Affiliation:
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Division of Nuclear Medicine, University of Michigan Medical Center, B1G505G University Hospital, 1500 E Medical Center Dr., Ann Arbor, MI 48109-5028, USA. kakitw@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Carcinoma / pathology, radiography*, radionuclide imaging* Female Humans Image Interpretation, Computer-Assisted Iodine Radioisotopes / diagnostic use* Male Middle Aged Neoplasm Staging Radiopharmaceuticals / diagnostic use Thyroid Neoplasms / pathology, radiography*, radionuclide imaging* Tomography, Emission-Computed, Single-Photon / methods* Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
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0/Iodine Radioisotopes; 0/Radiopharmaceuticals |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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