HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ünal, S. Articles by Cantez, S. Search for Related Content PubMed PubMed Citation Articles by Ünal, S. Articles by Cantez, S.

Thallium-201, Technetium-99m-Tetrofosmin and Iodine-131 in Detecting Differentiated Thyroid Carcinoma Metastases

Seher Ünal, Yusuf Menda, Iik Adalet, Harika Boztepe, Nee Özbey, Faruk Alagöl and Sema Cantez

Department of Nuclear Medicine and Division of Endocrinology, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey

Correspondence: For correspondence or reprints contact: Seher Üenal, MD, stanbul Üniversitesi, stanbul Tip Fakültesi, Nükleer Tip Anabilim Dali-, 34 390 Çapa-Istanbul/Türkiye.

ABSTRACT

The purpose of this study was to asses the detectability of differen tiated thyroid carcinoma (DTC) metastasesby ^99mTc-tetrofosmin and to compare the results of ^99mTc-tetrofosmin with ¹³¹I and ²⁰¹TI. The reliability of ²⁰¹TI and ^99mTc-tetrofosmin scanning during supression therapy also has been studied. Methods: A prospective study was performed on 41 patients (30 females, 11 males) with DTC (30 papillary, 11 follicular) who had undergone total thyroidectomy and received an average dose of 117 mCi (4329 MBq) of radioiodine for ablation of postsurgical residual thyroid tissue. All patients (n =41)had ²⁰¹TI, ^99mTc-tetrofosmin or ¹³¹I whole-body imaging after discontinuation of thyroid hormone replacement (thyroxine-off group). Eight of 14 patients with distant metastases also were imaged when they were on thyroxine therapy both with ²⁰¹TI and ^99mTc-tetrofosmin (thyroxine on-and-off group). Radiologic studies (chest radiography, CT and MRI), serum thyroglobulin assays and histopathologic examinations were performed to clarify the presence of metastases with positive uptake on any of three radionuclide studies. Results: In 26 of 41 patients all three scans were negative. These patients also clinically didn't show any evidence of metastases. Fourteen patients were considered to have distant metastases on the basis of clinical, radiologic and histopathologic findings. The sensitivities of ²⁰¹TI, ^99mTc-tetrofosmin and ¹³¹I in diagnosing distant metastases were comparable (0.85, 0.85 and 0.78, respectively), Iodine-131 was much more sensitive than ²⁰¹TI and ^99mTc-tetrofosmin for demonstrating residual thyroid tissue after surgery (1.00, 0.33 and 0.33, respectively). The only false-positive case involved radioiodine uptake in a tuberculoma. Thyroxine-on images of 8 patients with distant metastases showed no difference from their thyroxine-off images regarding the site, number and uptake of metastases. Conclusion: Technetium-99m-tetrofosmin and ²⁰¹TI imaging are highly sensitive for detecting differentiated thyroid carcinoma metastases and do not require prior withdrawal of thyroid hormone suppressive therapy.

Key Words: differentiated thyroid carcinoma • iodine-131 • thallium-201 • technetium-99m-tetrofosmin

This article has been cited by other articles:

				A. Shammas, B. Degirmenci, J. M. Mountz, B. M. McCook, B. Branstetter, B. B. Bencherif, J. M. Joyce, S. E. Carty, H. A. Kuffner, and N. Avril 18F-FDG PET/CT in Patients with Suspected Recurrent or Metastatic Well-Differentiated Thyroid Cancer J. Nucl. Med., February 1, 2007; 48(2): 221 - 226. [Abstract] [Full Text] [PDF]

				M. E. Spieth, S. B. Standiford, M. E. Starkman, and J. Gough Recombinant TSH-Stimulated, Radioguided Differentiated Thyroid Carcinoma Surgery Clin. Med. Res., January 1, 2003; 1(1): 53 - 56. [Abstract] [Full Text] [PDF]

				R. J. Robbins, J. T. Chon, M. Fleisher, S. M. Larson, and R. M. Tuttle Is the Serum Thyroglobulin Response to Recombinant Human Thyrotropin Sufficient, by Itself, to Monitor for Residual Thyroid Carcinoma? J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3242 - 3247. [Abstract] [Full Text] [PDF]

				S E M Clarke and S C Rankin The thyroid gland Imaging, April 1, 2002; 14(2): 103 - 114. [Abstract] [Full Text] [PDF]

				S. Mruck, A. Pfahlberg, T. Papadopoulos, C. Stremmel, and T. Kuwert Uptake of 201Tl into Primary Cell Cultures from Human Thyroid Tissue Is Multiplied by TSH J. Nucl. Med., February 1, 2002; 43(2): 145 - 152. [Abstract] [Full Text] [PDF]

				S E M Clarke Advances in radionuclide imaging: radionuclide imaging as a guide to therapy Imaging, September 1, 2001; 13(3): 171 - 184. [Abstract] [Full Text] [PDF]

				R. J. Robbins, R. M. Tuttle, R. N. Sharaf, S. M. Larson, H. K. Robbins, R. A. Ghossein, A. Smith, and W. D. Drucker Preparation by Recombinant Human Thyrotropin or Thyroid Hormone Withdrawal Are Comparable for the Detection of Residual Differentiated Thyroid Carcinoma J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 619 - 625. [Abstract] [Full Text]