The Incremental Value Of I-131 Spect/Ct Of The Neck In The Management Of Differentiated Thyroid Carcinoma
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Date
2017
Authors
Mohamad Najib, Fatin Hayyani
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Aim: To assess the clinical value of single-photon emission computed
tomography/computed tomography (SPECT/CT) of the neck in the management of
differentiated thyroid carcinoma (DTC).
Material and methods: I-131 planar whole body scan and SPECT/CT of the neck were
performed in 78 patients with histologically confirmed diagnosis of differentiated
thyroid carcinoma. The scan findings made by each I-131 planar whole body scan and
SPECT/CT of the neck were analysed. Clinical staging based on TNM staging
classification and risk stratification group were assessed and compared based on
information given by each I-131 planar whole body scan and SPECT/CT of the neck.
Subsequently, clinical management plan made by each planar and SPECT/CT of the
neck were assessed and compared for significant impact on overall patient management.
Results: Data from 78 patients with total of 91 radioiodine foci in the neck region was
observed and analysed by both I-131 planar whole body scan and SPECT/CT of the
neck. On lesion based analysis, I-131 planar whole body scan yield diagnostic
information in 76 foci (83.5%) in which 49 foci were classified as thyroid remnant
while the remaining 27 foci were classified as lymph node. SPECT/CT of the neck yield
a better diagnostic information in 88 foci (96.7%). SPECT/CT of the neck has changed
diagnosis given by I-131 planar whole body scan in 30 foci (33%, p<0.001). On patient
based analysis, the findings of I-131 planar whole body scan were altered in 29 (37.2%,
p<0.001) out of 78 patients in based on SPECT/CT findings. Clinical staging according
to TNM classification was revised with additional information obtained by using
SPECT/CT in 8 (10.2%) of 78 patients. The risk stratification group was revised with
additional information obtained from SPECT/CT in 15 (19.2%) of 78 patients.
SPECT/CT of the neck may significantly alter the personalised treatment planning for
each patient with differentiated thyroid carcinoma (p<0.001).
Conclusion: SPECT/CT of the neck has shown a significant diagnostic impact as
compared to I-131 planar whole body scan alone. SPECT/CT also had a significant
impact on the management of patients with differentiated thyroid carcinoma.
Description
Keywords
Differentiated thyroid carcinoma , iodine-131, planar scintigraphy