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Annals of Nuclear Medicine

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01-08-2014 | Original Article

Usefulness of ^99mTc-pertechnetate whole body scan with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer patients

Authors: Maythinee Chantadisai, Kanaungnit Kingpetch

Published in: Annals of Nuclear Medicine | Issue 7/2014

Abstract

Objective

The aim of the study was to evaluate the usefulness of ^99mTc-pertechnetate whole body scan (WBS) with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer (DTC) patients.

Methods

Fifty-six post total thyroidectomy patients were included. All patients were prospectively imaged with ^99mTc-pertechnetate WBS with neck and chest SPECT/CT before ¹³¹I ablation. The post-ablative ¹³¹I WBS with SPECT/CT was performed at 5–7 days after receiving ¹³¹I. Both scans were directly compared to determine the concordance of sites and number of remnant and metastasis.

Results

Overall per-patient analysis, the percentage of concordance between two scans was 96.4 %. In thyroid bed, lymph node, lung and bone subgroups, the percentage of concordance between two scans was 96.4, 92.9, 98.2 and 100 %, respectively. All of them show good correlation with unweighted kappa between 0.7 and 1. Overall per-lesion analysis, the percentage of concordance between two scans was 84 %. In thyroid bed, lymph node, lung and bone subgroups, the percentage of concordance between two scans was 89.5, 55, 82.6 and 50 %, respectively.

Conclusions

Pre-ablative pertechnetate WBS with neck and chest SPECT/CT has good correlation for the detection of post-surgical thyroid remnant, cervical node and discrete lung nodule metastasis as compared to ¹³¹I WBS with SPECT/CT per-patient basis. Because ¹³¹I therapeutic activity is desired base on metastatic site and less concerning about the number of lesions, pre-ablative ^99mTc-pertechnetate WBS with SPECT/CT was a good alternative tool to avoid radioiodine stunning in post-surgical DTC patients.

Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.PubMedCrossRef

Muratet JP, Daver A, Minier JF, Larra F. Influence of scanning doses of iodine-131 on subsequent first ablative treatment outcome in patients operated on for differentiated thyroid carcinoma. J Nucl Med. 1998;39(9):1546–50.PubMed

Muratet JP, Giraud P, Daver A, Minier JF, Gamelin E, Larra F. Predicting the efficacy of first iodine-131 treatment in differentiated thyroid carcinoma. J Nucl Med. 1997;38(9):1362–8.PubMed

Postgard P, Himmelman J, Lindencrona U, Bhogal N, Wiberg D, Berg G, et al. Stunning of iodide transport by I-131 irradiation in cultured thyroid epithelial cells. J Nucl Med. 2002;43(6):828–34.PubMed

Lassmann M, Luster M, Hanscheid H, Reiners C. Impact of I-131 diagnostic activities on the biokinetics of thyroid remnants. J Nucl Med. 2004;45(4):619–25.PubMed

Amdur R, Mazzaferri E. Thyroid stunning. In: Amdur R, Mazzaferri E, editors. Essentials of thyroid cancer management. US: Springer; 2005. p. 55–9.CrossRef

Park H-M, Gerard S. Stunning: Untoward effect of I-131 thyroid imaging prior to radioablation therapy. In: Wartofsky L, Nostrand D, editors. Thyroid Cancer: a comprehensive guide to clinical management. 2nd ed. Humana Press; 2006. p. 337–45.

Filesi M, Colandrea M, Montesano T, D’Apollo R, Ronga G. Thyroid stunning in clinical practice: is it a real problem? Minerva Endocrinol. 2009;34(1):29–36.PubMed

Amin A, Amin M, Badwey A. Stunning phenomenon after a radioactive iodine I-131 diagnostic whole-body scan: is it really a point of clinical consideration? Nucl Med Commun. 2013;34(8):771–6.PubMedCrossRef

10.

Huic D, Medvedec M, Dodig D, Popovic S, Ivancevic D, Pavlinovic Z, et al. Radioiodine uptake in thyroid cancer patients after diagnostic application of low-dose I-131. Nucl Med Commun. 1996;17(10):839–42.PubMedCrossRef

11.

Sabri O, Zimny M, Schreckenberger M, Meyer-Oelmann A, Reinartz P, Buell U. Does thyroid stunning exist? A model with benign thyroid disease. Eur J Nucl Med. 2000;27(11):1591–7.PubMedCrossRef

12.

Coakley AJ. Thyroid stunning. Eur J Nucl Med. 1998;25(3):203–4.PubMedCrossRef

13.

Morris LF, Waxman AD, Braunstein GD. The nonimpact of thyroid stunning: remnant ablation rates in I-131 scanned and nonscanned individuals. J Clin Endocrinol Metab. 2001;86(8):3507–11.PubMedCrossRef

14.

Dam HQ, Kim SM, Lin HC, Intenzo CM. I-131 therapeutic efficacy is not influenced by stunning after diagnostic whole-body scanning. Radiology. 2004;232(2):527–33.PubMedCrossRef

15.

Silberstein EB. Comparison of outcomes after I-123 versus I-131 pre-ablation imaging before radioiodine ablation in differentiated thyroid carcinoma. J Nucl Med. 2007;48(7):1043–6.PubMedCrossRef

16.

Hilditch TE, Dempsey MF, Bolster AA, McMenemin RM, Reed NS. Self-stunning in thyroid ablation: evidence from comparative studies of diagnostic I-131 and I-123. Eur J Nucl Med Mol Imaging. 2002;29(6):783–8.PubMed

17.

Iwano S, Kato K, Nihashi T, Ito S, Tachi Y, Naganawa S. Comparisons of I-123 diagnostic and I-131 post-treatment scans for detecting residual thyroid tissue and metastases of differentiated thyroid cancer. Ann Nucl Med. 2009;23(9):777–82.PubMedCrossRef

18.

Kueh SS, Roach PJ, Schembri GP. Role of Tc-99 m pertechnetate for remnant scintigraphy post-thyroidectomy. Clin Nucl Med. 2010;35(9):671–4.PubMedCrossRef

19.

Campbell CM, Khafagi FA. Insensitivity of Tc-99 m pertechnetate for detecting metastases of differentiated thyroid carcinoma. Clin Nucl Med. 1990;15(1):1–4.PubMedCrossRef

20.

Giovanella L, Suriano S, Ricci R, Ceriani L, Anton Verburg F. Postsurgical thyroid remnant estimation by Tc-99 m pertechnetate scintigraphy predicts radioiodine ablation effectiveness in patients with differentiated thyroid carcinoma. Head Neck. 2011;33(4):552–6.PubMedCrossRef

21.

Nadig MR, Pant GS, Bal C. Usefulness of Tc-99 m pertechnetate single-photon emission computed tomography in remnant mass estimation of postsurgical patients of differentiated thyroid cancer during internal dosimetry. Nucl Med Commun. 2008;29(9):809–14.PubMedCrossRef

22.

Khammash NF, Halkar RK, Abdel-Dayem HM. The use of technetium-99 m pertechnetate in postoperative thyroid carcinoma. A comparative study with iodine-131. Clin Nucl Med. 1988;13(1):17–22.PubMedCrossRef

23.

ICRP. Radiation dose to patients from radiopharmaceuticals. ICRP Publication 53. Ann ICRP. 1988;18:1–4.

24.

Lopez OL, Maisano ER. Vascular retention of Tc-99 m pertechnetate simulating ectopic or metastatic thyroid tissue. Clin Nucl Med. 1983;8(10):503–4.PubMedCrossRef

Title: Usefulness of 99mTc-pertechnetate whole body scan with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer patients
Authors: Maythinee Chantadisai
Kanaungnit Kingpetch
Publication date: 01-08-2014
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 7/2014
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-014-0864-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Usefulness of ^99mTc-pertechnetate whole body scan with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer patients

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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