Berna Okudan, Bedri Seven*, Nedim C.M. Gülaldı, Mustafa Çapraz and Yusuf Açıkgöz
Background: The therapeutic approaches of differentiated thyroid carcinoma (DTC) are surgery, ablation therapy with the postoperative use of radioiodine-131 (131I), and thyroid-stimulating hormone (TSH) suppression therapy. After the surgical therapy, the patient should be assessed for remnants/metastases.
Objective: The purpose of this research was to investigate the role of technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT) in the postoperative management of patients with DTC.
Methods: The study comprised 22 DTC patients (13 women, 9 men; mean age 46.55 ± 13.27 y) who underwent a total thyroidectomy previously. All patients were investigated for thyroid remnants/metastases by 99mTc-MIBI SPECT/CT, posttherapy 131I whole-body scan (WBS) and ultrasound (US). Serum TSH, thyroglobulin and anti-Tg antibody levels were measured. Results of imaging modalities and laboratory measurements were compared with each other.
Results: 99mTc-MIBI SPECT/CT, 131I WBS and US respectively demonstrated thyroid remnants in 15 (68.18%), 22 (100%) and 14 (63.63%) of the all patients and metastatic lymph nodes in 8 (100%), 6 (75%) and 6 (75%) of the 8 patients with lymph node metastases. 99mTc-MIBI SPECT/CT also demonstrated lung metastases in 2 patients (9.09% of all patients). The same result was obtained with 131I WBS.
Conclusion: The findings of this study show that 99mTc-MIBI SPECT/CT can be effective for detecting metastases in patients with DTC who underwent surgery prior to 131I therapy.
Differentiated thyroid carcinoma, radioiodine-131, SPECT/CT, thyroid, 99mTc-MIBI, whole-body scan
Department of Nuclear Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Department of Nuclear Medicine, Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya, Department of Nuclear Medicine, Ankara City Hospital, Ankara, Department of Internal Medicine, School of Medicine, University of Amasya, Amasya, Division of Medical Oncology, Department of Internal Medicine, Ankara City Hospital, Ankara