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Double-phase 131I whole body scan and 131I SPECT-CT images in patients with differentiated thyroid cancer: their effectiveness for accurate identification

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Abstract

Objective

This study aims to determine whether a 131I double-phase whole body scan (WBS) and SPECT-CT images have added value over a single-phase WBS image in identifying benign and malignant lesions in patients with well-differentiated thyroid cancer (DTC) at their first radioactive iodine (RAI) treatment.

Methods

This study included 42 DTC patients who underwent their first radioablation. Post-therapeutic WBS images were acquired after 3 days (early phase) and 7 days (delayed phase). Following early-phase WBS, SPECT-CT images were obtained. The images were reviewed independently of the clinical data by 2 board-certified observers with a 6-point scoring system (benign to malignant −3 to +3).

Results

The double-phase WBS and SPECT-CT images showed 115 radioiodine-avid localizations (81 benign and 34 malignant accumulations). Confidence levels of benign accumulations were significantly higher with SPECT-CT (average score −2.40 ± 1.06) compared to those of the early-phase WBS (average score −1.39 ± 1.88) (p < 0.0001) and delayed-phase WBS images (average score −1.49 ± 1.19) (p < 0.0001). When the analysis was restricted to accumulations with a low confidence score in the early-phase WBS image, the confidence level of the delayed-phase WBS was higher compared to that of the early-phase WBS images (p = 0.0012). The confidence levels of malignant accumulations were significantly higher with SPECT-CT images (average score 2.37 ± 0.96) compared to the early-phase WBS (average score 1.44 ± 1.21) (p < 0.0001) and the delayed-phase WBS images (average score 1.50 ± 1.13) (p < 0.0001).

Conclusion

Post-therapeutic SPECT-CT image was superior to the early-phase WBS image in enhancing the confidence level and accurately localizing the lesions. The delayed-phase WBS image contributed to the accurate diagnosis of benign lesions with a low confidence level in the early-phase WBS image.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan

    Hiroshi Wakabayashi, Kenichi Nakajima, Makoto Fukuoka, Anri Inaki, Ayane Nakamura, Daiki Kayano & Seigo Kinuya

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  1. Hiroshi Wakabayashi
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  2. Kenichi Nakajima
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  3. Makoto Fukuoka
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  4. Anri Inaki
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  5. Ayane Nakamura
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  6. Daiki Kayano
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  7. Seigo Kinuya
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Correspondence to Hiroshi Wakabayashi.

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Wakabayashi, H., Nakajima, K., Fukuoka, M. et al. Double-phase 131I whole body scan and 131I SPECT-CT images in patients with differentiated thyroid cancer: their effectiveness for accurate identification. Ann Nucl Med 25, 609–615 (2011). https://doi.org/10.1007/s12149-011-0513-z

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  • DOI: https://doi.org/10.1007/s12149-011-0513-z

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