• Hell J Nucl Med · May 2018

    Technetium-99m-pertechnetate whole-body SPET/CT scan in thyroidectomized differentiated thyroid cancer patients is a useful imaging modality in detecting remnant thyroid tissue, nodal and distant metastases before 131I therapy. A study of 416 patients.

    • Kequan Lou, Yushen Gu, Yan Hu, Siyang Wang, and Hongcheng Shi.
    • Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China. shihongcheng163@163.com.
    • Hell J Nucl Med. 2018 May 1; 21 (2): 121-124.

    ObjectiveIn this study we aimed to evaluate the role of technetium-99m pertechnetate whole body scan (99mTc WBS) with single photon emission tomography/computed tomography (SPET/CT) in detecting remnant thyroid tissue, nodal and distant metastases, in differentiated thyroid cancer (DTC) patients before radioiodine (131I) therapy.Subjects And MethodsA retrospective analysis was performed in 416 pathologically confirmed DTC patients with total/near-total thyroidectomy. All patients had undergone 99mTc WBS, followed by 131I therapy and post therapy scans, under thyroid hormone withdrawal protocol. Eighteen patients had an additional 99mTc SPET/CT of certain lesions. Foci of uptake on the 99mTc WBS and when indicated additional foci on the SPET/CT scan were assessed and compared with findings from post-therapy 131I scans study which served as gold standard.ResultsThe 99mTc WBS showed a sensitivity and positive predictive value of 79% and 100%, respectively, for remnant thyroid tissue detection, while 60% and 98%, respectively for metastatic lymph nodes evaluation. High specificity (99%) and negative predictive value (93%) but low sensitivity (37%) was found in detecting distant metastases. By adding 99mTc WBS to 99mTc SPET/CT findings, 2/18 patients were confirmed as false-positive.ConclusionOur findings suggested that 99mTc WBS is a useful imaging modality in detecting remnant thyroid tissue, nodal and distant metastases before 131I therapy. The additional SPET/CT scan when needed in 18 cases supported the 99mTc WBS diagnosis.

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