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The value of I-131 SPECT in the detection of recurrent differentiated thyroid cancer
Jackelien A C Geerlings1, Anke van Zuijlen, Ellen M Lohmann
1Department of Radiology, Division of Nuclear Medicine, Leiden University Medical Centre, The Netherlands.
Aim:
The aim of this study is to assess the additional value of radioiodine-131 (I-131) single-photon emission computed tomography (SPECT) to whole-body scintigraphy (WBS) in the detection of recurrent differentiated thyroid cancer.
Materials And Methods:
Eighty-seven consecutive patients with differentiated thyroid cancer, who had undergone a diagnostic SPECT WBS study, were included. In all patients, posttreatment scans, computed tomography scanning or ultrasonography were used to assess positive results, whereas follow-up was used in patients with a negative scan result. General data, such as primary tumor, histology and biochemical parameters were also gathered.
Results:
In this study cohort, nine positive diagnostic WBS were found compared with 31 positive SPECT scans. In eight of the nine (89%) positive WBS, recurrent thyroid cancer was found at the same location on the SPECT scan. In 56 patients SPECT and WBS were negative. Moreover, eight patients with a positive SPECT study had a serum thyroglobulin level less than 1 microg/l, which, in our hospital, was the cut-off level for treatment. On the basis of the serum thyroglobulin measurements and the WBS, 9% of the patients would not have been treated.
Conclusion:
I-131 SPECT of the head and neck region and chest has a complementary role for planar imaging in the follow-up of patients treated for differentiated thyroid cancer. Therefore, its use in addition to WBS is strongly recommended in clinical practice.
