Abstract
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Objectives This retrospective study estimated the incremental value of 131I-SPECT/CT fusion imaging over 131I whole-body scintigraphy (WBS) in the management of patients with differentiated thyroid carcinoma (DTC).
Methods 82 DTC patients whose localization or qualitative analysis of foci in WBS was difficult to confirm were added to take SPECT/CT imaging. We analysed the capacity of localization or qualitative analysis of SPECT/CT imaging compared with WBS and evaluated the impact of SPECT/CT imaging on diagnosis of metastases, clinical stage and therapeutic strategy.
Results A total of 232 foci were observed by both SPECT/CT imaging and WBS. After the accurate location by SPECT/CT imaging, 120 (59.11%) foci were distributed in the neck and the other 83 (40.89%) were out of the neck. WBS determined 52 benign foci, 36 malignant foci and 115 uncertain ones while the number of SPECT/CT imaging were respectively 94, 79 and 30. There was a significant difference of the uncertain foci between SPECT/CT imaging and WBS (t=77.51, P=0<0.01). Besides, 6 lesions without 131I uptake were detected by SPECT/CT imaging. Among all 83 patients, 14 (17.07%) were changed diagnosis of metastatic localization; 5 (6.1%) were changed clinical state and 23 (28.05%) were changed the therapeutic strategy.
Conclusions 131I-SPECT/CT fusion imaging has incremental value in differentiatial diagnosis of foci, detection of un-foci, increasing the diagnostic accuracy and changing therapeutic strategy. 131I-SPECT/CT fusion imaging is a better method than 131I-WBS in the management of patients with DTC