SPECT/CT imaging in children with papillary thyroid carcinoma
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SPECT/CT improves localization of single photon-emitting radiopharmaceuticals.
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).
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.
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.
- Bockisch A, Freudenberg LS, Schmidt D et al (2009) Hybrid imaging by SPECT/CT and PET/CT: proven outcomes in cancer imaging. Semin Nucl Med 39:276–289 CrossRef
- Aide N, Heutte N, Rame JP et al (2009) Clinical relevance of single-photon emission computed tomography/computed tomography of the neck and thorax in postablation (131)I scintigraphy for thyroid cancer. J Clin Endocrinol Metab 94:2075–2084 CrossRef
- Tharp K, Israel O, Hausmann J et al (2004) Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma. Eur J Nucl Med Mol Imaging 31:1435–1442 CrossRef
- Wong KK, Zarzhevsky N, Cahill JM et al (2008) Incremental value of diagnostic 131I SPECT/CT fusion imaging in the evaluation of differentiated thyroid carcinoma. AJR 191:1785–1794 CrossRef
- Wang H, Fu HL, Li JN et al (2009) The role of single-photon emission computed tomography/computed tomography for precise localization of metastases in patients with differentiated thyroid cancer. Clin Imaging 33:49–54 CrossRef
- Chen L, Luo Q, Shen Y et al (2008) Incremental value of 131I SPECT/CT in the management of patients with differentiated thyroid carcinoma. J Nucl Med 49:1952–1957 CrossRef
- Kohlfuerst S, Igerc I, Lobnig M et al (2009) Posttherapeutic (131)I SPECT-CT offers high diagnostic accuracy when the findings on conventional planar imaging are inconclusive and allows a tailored patient treatment regimen. Eur J Nucl Med Mol Imaging 36:886–893 CrossRef
- Schmidt D, Szikszai A, Linke R et al (2009) Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med 50:18–23 CrossRef
- ImPACT. London, UK. www.impactscan.org
- O’Gorman CS, Hamilton J, Rachmiel M et al (2010) Thyroid cancer in childhood: a retrospective review of childhood course. Thyroid 20:375–380 CrossRef
- Lee SW, Lee J, Lee HJ et al (2007) Enhanced scintigraphic visualization of thyroglossal duct remnant during hypothyroidism after total thyroidectomy: prevalence and clinical implication in patients with differentiated thyroid cancer. Thyroid 17:341–346 CrossRef
- Sisson JC, Dewaraja YK, Wizauer EJ et al (2009) Thyroid carcinoma metastasis to skull with infringement of brain: treatment with radioiodine. Thyroid 19:297–303 CrossRef
- Freudenberg LS, Fromke C, Petrich T et al (2010) Thyroid remnant dose: 124I-PET/CT dosimetric comparison of rhTSH versus thyroid hormone withholding before radioiodine remnant ablation in differentiated thyroid cancer. Exp Clin Endocrinol Diabetes 118:393–399 CrossRef
- Freudenberg LS, Jentzen W, Marlowe RJ et al (2007) 124-iodine positron emission tomography/computed tomography dosimetry in pediatric patients with differentiated thyroid cancer. Exp Clin Endocrinol Diabetes 115:690–693 CrossRef
- Kolbert KS, Pentlow KS, Pearson JR et al (2007) Prediction of absorbed dose to normal organs in thyroid cancer patients treated with 131I by use of 124I PET and 3-dimensional internal dosimetry software. J Nucl Med 48:143–149
- Freudenberg LS, Frilling A, Kuhl H et al (2007) Dual-modality FDG-PET/CT in follow-up of patients with recurrent iodine-negative differentiated thyroid cancer. Eur Radiol 17:3139–3147 CrossRef
- Saab G, Driedger AA, Pavlosky W et al (2006) Thyroid-stimulating hormone-stimulated fused positron emission tomography/computed tomography in the evaluation of recurrence in 131I-negative papillary thyroid carcinoma. Thyroid 16:267–272 CrossRef
- Wong KK, Zarzhevsky N, Cahill JM et al (2009) Hybrid SPECT-CT and PET-CT imaging of differentiated thyroid carcinoma. Br J Radiol 82:860–876 CrossRef
- SPECT/CT imaging in children with papillary thyroid carcinoma
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