The role of single-photon emission computed tomography/computed tomography for precise localization of metastases in patients with differentiated thyroid cancer
Section snippets
Subjects
Ninety-four patients with thyroid cancer with foci uptake of 131I in WBS were included in this study from September 2004 to September 2006 in Xin Hua Hospital. Their average age was 49.16±14.28 years. Among them, 27 were men and 67 were women. The oldest was 73 years old and the youngest was 9 years old. 131I SPECT/CT imaging was performed in all patients after an oral therapeutic dose of 131I (3.7–7.4 GBq). The patients had differentiated thyroid carcinoma (63 with papillary carcinoma, 31 with
Results
All metastases were confirmed by radiologic and clinical follow-up of at least 6 months; because most of the lesions were localized in lung and bone, it is very difficult to identify these lesions by surgery.
According to the foci of 131I uptake in WBS, 94 patients were divided into three groups: (1) 65 patients with neck foci; (2) 31 patients with lung foci; (3) 17 patients with bone foci. SPECT/CT imaging had improved the precise localization in 21% (20/94) of patients.
In the first group with
Discussion
As a DTC, the incidence of regional and distant metastases is very common; the metastases most frequently appear in the neck, lung, and bone. However, precise localization of the foci of 131I uptake is often difficult because of a lack of anatomic landmarks in 131I WBS and SPECT [5], [6]. In addition, there are many other potential sites of physiologic uptake, such as the remnant thyroid, salivary glands, urinary bladder, gastrointestinal tract, and liver, which influences the interpretation of
Conclusion
The results of the current study indicate that the addition of 131I SPECT/CT to WBS can improve the localization of metastases in patients with thyroid cancer. It may also detect metastases missed by planar imaging, exclude false-positive sites from physiologic uptake, and accurately localise the metastases of thyroid cancer. Precise tumor localization for cancer is important for therapeutic management of patients with DTC.
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