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[99m-Tc-MIBI for recurrent and metastatic differentiated thyroid carcinoma]
1Abteilung Nuklearmedizin, Radiologischen Klinik der Universität Heidelberg, Deutschland.
Aim:
The aim of the study has been the examination of the diagnostic value of 99mTc-MIBI scintigraphy for the detection of local tumor or metastases following total thyroidectomy and 131I ablation therapy in differentiated thyroid carcinoma.
Methods:
MIBI-scintigraphy has been indicated in 85 patients because of ascending thyroglobulin values or suspected local recurrencies by ultrasonography. The results have been compared to cytology or histology or ultrasonography, computed tomography, X-ray and radioiodine scanning.
Results:
MIBI scintigraphy was found positive in 32 of 40 metastases. Only 18 metastases have been seen by radioiodine. MIBI scintigraphy was most effective in detecting local tumor recurrencies and lymph node metastases (94%). The specificity of MIBI and radioiodine was similar (100%). In inflammatory enlarged lymph nodes no MIBI uptake was found, so it is possible to differentiate reactive lymph node enlargement from metastatic disease.
Conclusion:
In conclusion scintigraphy with 99mTc-MIBI is advisable in suspected local recurrencies and negative radioiodine scan. It is favourable that withdrawing TSH-suppressive hormone medication is not necessary.