Pediatric Radiology

, 41:1008

SPECT/CT imaging in children with papillary thyroid carcinoma

  • Hwa-Young Kim
  • Michael J. Gelfand
  • Susan E. Sharp
Original Article

DOI: 10.1007/s00247-011-2039-x

Cite this article as:
Kim, HY., Gelfand, M.J. & Sharp, S.E. Pediatr Radiol (2011) 41: 1008. doi:10.1007/s00247-011-2039-x

Abstract

Background

SPECT/CT improves localization of single photon-emitting radiopharmaceuticals.

Objective

To determine the utility of SPECT/CT in children with papillary thyroid carcinoma.

Materials and methods

20 SPECT/CT and planar studies were reviewed in 13 children with papillary thyroid carcinoma after total thyroidectomy. Seven studies used I-123 and 13 used I-131, after elevating TSH by T4 deprivation or intramuscular thyrotropin alfa. Eight children had one study and five children had two to four studies. Studies were performed at initial post-total thyroidectomy evaluation, follow-up and after I-131 treatment doses. SPECT/CT was performed with a diagnostic-quality CT unit in 13 studies and a localization-only CT unit in 7. Stimulated thyroglobulin was measured (except in 2 cases with anti-thyroglobulin antibodies).

Results

In 13 studies, neck activity was present but poorly localized on planar imaging; all foci of uptake were precisely localized by SPECT/CT. Two additional foci of neck uptake were found on SPECT/CT. SPECT/CT differentiated high neck uptake from facial activity. In six studies (four children), neck uptake was identified as benign by SPECT/CT (three thyroglossal duct remnants, one skin contamination, two by precise anatomical CT localization). In two children, SPECT/CT supported a decision not to treat with I-131. When SPECT/CT was unable to identify focal uptake as benign, stimulated thyroglobulin measurements were valuable. In three of 13 studies with neck uptake, SPECT/CT provided no useful additional information.

Conclusion

SPECT/CT precisely localizes neck iodine uptake. In small numbers of patients, treatment is affected. SPECT/CT should be used when available in thyroid carcinoma patients.

Keywords

Thyroid cancerRadioactive iodineSPECT/CTNeck imagingPediatrics

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Hwa-Young Kim
    • 1
  • Michael J. Gelfand
    • 1
  • Susan E. Sharp
    • 1
  1. 1.Department of RadiologyCincinnati Children’s HospitalCincinnatiUSA