Tc-99m imaging in thyroidectomized differentiated thyroid cancer patients immediately before I-131 treatment

Chi Jung Tsai, Cheng Yi Cheng, Daniel Hueng Yuan Shen, Shou Jen Kuo, Lien Yen Wang, Chiang Hsuan Lee, Jhi Joung Wang, Ming Che Chang, Wen Sheng Huang

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Purpose The aim of this study was to evaluate the clinical role of technetium-99m pertechnetate (Tc-99m) imaging in thyroidectomized differentiated thyroid cancer patients immediately before radioiodine-131 (I-131) treatment (Tx). Patient and methods Eighty-six consecutive post-totalthyroidectomy patients (15 men, 71 women; mean age: 46.8 years) with pathologically diagnosed differentiated thyroid cancer were retrospectively studied. Tc-99m imaging immediately before I-131 Tx using both patient-based and lesion-based measurements were analyzed and were further compared with those of post-Tx I-131 wholebody scans. Results For patients with unequivocally positive Tc-99m uptake, the sensitivity was 77% (patient-based) and 59% (site-based). The positive predictive value (PPV) was 100% for both patient-based and site-based measurements. If equivocal Tc-99m uptake was counted as positive, the sensitivity was 83 and 67%, and the PPV was 100 and 99% for patient-based and site-based measurements, respectively. Conclusion (a) To increase sensitivity yet maintaining high PPV, equivocal Tc-99m uptake should be considered a positive finding. (b) The nearly 100% PPV of Tc-99m imaging immediately before I-131 Tx for remnant detection suggests that Tc-99m imaging not only serves as an alternative to low-dose I-131 scanning in the low-risk post-thyroidectomy patients but also provides a clue for the subsequent I-131 therapeutic dosage and even for the outcome prediction.

Original languageEnglish
Pages (from-to)182-187
Number of pages6
JournalNuclear Medicine Communications
Volume37
Issue number2
DOIs
Publication statusPublished - 2016
Externally publishedYes

Keywords

  • Differentiated thyroid cancer
  • Post-therapeutic I-131 scan
  • Tc-99m imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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