The Diagnostic Usefulness of 131I-SPECT/CT at Both Radioiodine Ablation and during Long-Term Follow-Up in Patients Thyroidectomized for Differentiated Thyroid Carcinoma: Analysis of Tissue Risk Factors Ascertained at Surgery and Correlated with Metastasis Appearance.

Angela Spanu,Andrea De Vito,Luciana Mele,Maria Rondini,Ilaria Gelo,Andrea Marongiu,Susanna Nuvoli,Giuseppe Madeddu

doi:10.3390/diagnostics11081504

Angela Spanu, Andrea De Vito + Show 6 more

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https://doi.org/10.3390/diagnostics11081504

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Journal: Diagnostics	Publication Date: Aug 20, 2021
Citations: 10	License type: CC BY 4.0

Affiliation: University of Sassari

Abstract

131I Single-photon emission computerized tomography/computerized tomography (SPECT/CT) in the management of patients thyroidectomized for differentiated thyroid carcinoma (DTC) was further investigated. Retrospectively, 106 consecutive DTC patients were enrolled at the first radioiodine ablation, 24 at high risk (H), 61 at low risk (L) and 21 at very low risk (VL). 131I whole-body scan (WBS) and SPECT/CT were performed after therapeutic doses using a hybrid dual-head gamma camera. At ablation, SPECT/CT correctly classified 49 metastases in 17/106 patients with a significantly (p < 0.001) more elevated number than WBS which evidenced 32/49 foci in 13/17 cases. In this case, 86/106 patients could be monitored in the follow-up including 13/17 cases with metastases already at post-therapeutic scans. SPECT/CT after radioiodine diagnostic doses more correctly than WBS ascertained disease progression in 4/13 patients, stable disease in other 4/13 cases and disease improvement in the remaining 5/13 cases. Further 13/86 patients with only residues at post-therapeutic scans showed at SPECT/CT 16 neck lymph node (LN) metastases, three unclear and 13 occult at WBS. Significant involvement of some tissue risk factors with metastasis appearance was observed, such as minimal extrathyroid tumor extension and neck LN metastases. These risk factors should be carefully considered in DTC patient follow-up where 131I-SPECT/CT routinely use is suggested as a support tool of WBS.

Highlights

Introduction iationsThyroid cancer represents the most common endocrine tumor and its incidence continues to rise; based on histology, differentiated thyroid carcinomas (DTC) comprise the majority of thyroid cancers and include more frequently papillary, follicular and Hürthle cell carcinomas [1,2,3,4]
The statistical software used was STATA 16.1 (StataCorp LLC, College Station, TX, USA). At both procedures SPECT/CT and wholebody scan (WBS) the radioiodine-avid foci resulted concordantly absent in 5/106 patients with undetectable thyroglobulin levels, excluding tissue residues and malignant lesions
Retrospective study on DTC patients already submitted to total thy131I-SPECT/CT performed 5–7 days after a therapeuroidectomy and radioiodine ablation, In the present, retrospective study on DTC patients already submitted to total thy131 tic dose, proved a reliable procedure identifyperformed and characterize radioiodine-avid roidectomy and radioiodine ablation, to better

Summary

Introduction

Thyroid cancer represents the most common endocrine tumor and its incidence continues to rise; based on histology, differentiated thyroid carcinomas (DTC) comprise the majority of thyroid cancers (about 90%) and include more frequently papillary, follicular and Hürthle cell carcinomas [1,2,3,4] These types of carcinomas generally have a good prognosis, but the presence of neck lymph node (LN) metastases can be correlated with tumor recurrences [5,6,7,8,9,10] and distant metastases can cause a significant disease progression [3,11,12].

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