Abstract
Objective To explore diagnostic value of therapeutic dose 131I-SPECT/CT fusion imaging (Rx 131I-SPECT/CT) for the pulmonary metastasis of postoperative thyroid cancer, and to compare with therapeutic doses 131I-whole body scan (Rx 131I-WBS). Methods The Rx 131I-WBS and lung Rx 131I-SPECT/CT findings in 18 patients who were suspected pulmonary metastasis of postoperative thyroid cancer with serum thyroglobulin (Tg) levels increased were retrospectively analyzed on the CT features and the iodine intake degree of the pulmonary lesions. The accuracy and the incremental value of the diagnosis for pulmonary metastases by Rx 131I-WBS and lung Rx 131I-SPECT/CT were compared. Results Among 18 patients, 15 cases pulmonary metastasis of postoperative thyroid carcinoma were confirmed by the final clinical diagnosis and follow-up. 12 cases, 5 cases and 1 case were diagnostic accuracy, false positives, and false negatives by Rx 131I-WBS, respectively, and 18 cases, 0 case and 0 case by Rx 131I-SPECT/CT, respectively. The diagnostic accuracy rates of Rx 131I-WBS and Rx 131I-SPECT/CT were 66.7 % (12/18) and 100 % (18/18), respectively (P < 0.05). In 15 patients with pulmonary metastasis, serum thyroglobulin (Tg) was (541.5±274.3) ng/ml, and 30 and 46 pulmonary metastases were found by Rx 131I-WBS and Rx 131I-SPECT/CT, respectively. 5 and 7 pulmonary lesions were found by Rx 131I-WBS and Rx 131I-SPECT/CT in 3 cases of pulmonary non-metastases, respectively. The mean degrees of iodine intake in pulmonary lesions were (368.25±354.31) kBq and (5.87±6.97) kBq in 15 patients with pulmonary metastasis and 3 patients without pulmonary metastasis, respectively. Conclusions Rx 131I-SPECT/CT fusion imaging has a high identification accuracy for the diagnosis of pulmonary metastasis of postoperative thyroid carcinoma, featured by the better localization and qualitative diagnosis compared with 131I-WBS, and it could detect occult lesions to provide the degree of iodine intake and the morphology of lesions. Lung Rx 131I-SPECT/CT plays an important role in the disease assessment and postoperative stage for the elevated serum Tg or uncertain localization of pulmonary lesions by Rx 131I-WBS in thyroid carcinoma postoperative patients. Key words: Tomography, emission-computed, single-photon; Computed tomography; Thyroglobulin; Thyroid neoplasms; 131I therapy
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