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Clinical Usefulness of Fusion of ¹³¹I SPECT and CT Images in Patients with Differentiated Thyroid Carcinoma

Department of Radiology, Faculty of Medicine, Kagawa Medical University, Kagawa, Japan

View larger version (58K): [in a new window]   FIGURE 1. A 47-y-old woman (patient 5) with differentiated papillary thyroid carcinoma underwent total thyroidectomy. (A) 131I whole-body images (left, anterior view; right, posterior view). (B) CT images (first row), 131I transaxial SPECT images (second row), and 131I SPECT/CT fusion images (third row). 131I planar and SPECT images show intense focal uptake in posteromedial region, but slightly on left side of chest, suggesting thoracic spine involvement. Uptake in neck is thyroid bed. Bone appears normal on diagnostic CT scan. 131I SPECT/CT fusion images show that intense tracer uptake is in posterior portion of 9th rib and not in thoracic vertebra. In this patient, final diagnosis was made on basis of follow-up; follow-up period was 12 mo, and clinically, fusion images confirmed precision of localization of abnormal 131I uptake.

View larger version (46K): [in a new window]   FIGURE 2. A 72-y-old woman (patient 13) with differentiated papillary thyroid carcinoma underwent total thyroidectomy. (A) 131I whole-body images (left, anterior view; right, posterior view). (B) CT images (first row), 131I transaxial SPECT images (second row), and 131I SPECT/CT fusion images (third row). 131I planar and SPECT images show focal uptake in posterior part of right thigh, suggestive of right femoral bone or muscle involvement. Intense uptake in neck is thyroid bed. Bone appears normal on diagnostic CT scan. 131I SPECT/CT fusion images show that intense tracer uptake is located in biceps of right thigh and not in femoral bone. In this patient, final diagnosis was made on basis of follow-up; follow-up period was 9 mo, and clinically, fusion images confirmed precision of localization of abnormal 131I uptake.