PT  - JOURNAL ARTICLE
AU  - Sergieva, Sonya
AU  - Robev, Bozhil
TI  - 131I SPECT-CT imaging in management of differentiated thyroid carcinoma (DTC)
DP  - 2016 May 01
TA  - Journal of Nuclear Medicine
PG  - 1517--1517
VI  - 57
IP  - supplement 2
4099  - http://jnm.snmjournals.org/content/57/supplement_2/1517.short
4100  - http://jnm.snmjournals.org/content/57/supplement_2/1517.full
SO  - J Nucl Med2016 May 01; 57
AB  - 1517Objectives 131I whole-body scintigraphy (WBS) and Tg assessment has been published as a “gold standard” in monitoring of patients with DTC. Recently SPECT-CT studies have been utilized in order to increase the diagnostic sensitivity and specificity of planar and SPECT images. The purpose of this work was to evaluate retrospectively clinical role of 131I SPECT-CT imaging in follow-up of DTC patients after 131I treatment.Methods 307 pts aged of 8-75 yr with DTC were involved; 426 131I WB scans as well as target SPECT-CT studies including neck, chest and/or abdominal images were performed in all pts 5 days after 131I therapy. Focal uptake on the WBS and fusion images was described as likely benign, malignant and equivocal. Our results were interpreted based on all other clinical and radiological data.Results 131I SPECT-CT images in the neck region enabled differentiation of equivocal foci as thyroid remnant in 110 pts, tumoral persistence - in 10 pts and recurrent disease - in 13 cases in the thyroid bed; enlarged cervical and mediastinal lymph nodes in 159 pts from physiological uptake in esophagus and/or salivary glands. SPECT-CT was very useful modality in non-131I avid disease in 24 pts with lung and/or cervical lymphadenopathy due to lack or subsequent loss of radioiodine uptake possibility and increased Tg. SPECT-CT findings changed the therapeutic management in these 24 pts (7,8%) in order to avoid additional 131I therapy. Proposed changes included cervical lymph node dissection, external beam radiotherapy in non-operable cases and bone osteolytic lesions and chemotherapy. 131I SPECT-CT was applicable in follow-up of DTC patients with clinical data for disease progression but with negative Tg due to positive TAT to continue radioiodine treatment. SPECT-CT showed morphology and correct localization of distant “hot” secondary lung, bone and lymph node lesions in 15 cases.Conclusions In conclusion: 131I SPECT-CT studies improved accuracy of 131I WB scan and changed management of DTC determining indications for surgery intervention, the need to give or withhold 131I treatment, to select cases for radio/chemotherapy.