Abstract
Thirty-seven patients with Hürthle cell carcinoma of the thyroid gland underwent total thyroidectomy and then technetium-99m sestamibi (2-methoxyisobutylisonitrile), iodine-131 and thallium-201 wholebody scans. Twenty-two of them had elevated human serum thyroglobulin (HTg) levels. Among these 22 patients, abnormal uptake of 131I was seen in four (18.1%), abnormal uptake of 201Tl chloride in 15 (68.1%), and abnormal 99mTc-sestamibi accumulation in 18 (81.8%). No patients with normal levels had a positive whole-body scan. In comparison with the 1311 and 201T1 chloride images, the 99mTc-sestamibi images were of superior quality and detected significantly more (P < 0.05) metastatic lesions of Hurthle cell carcinoma of the thyroid gland in patients with elevated HTg after total thyroidectomy. A mechanism is proposed that may explain these findings.
References
Beller GA, Watson DD. Physiological basis of myocardial perfusion imaging with the technetium-99m agents. Semin Nucl Med 1991; 21: 173–181.
Delmon-Moingeon LI, Piwnica-Worms D, Van de Abbeele AD, Holman BL, Davison A, Jone AG. Uptake of the cation hexakis(2-methoxyisobutylisonitrile)-technetium-99m by human carcinoma cell line in vitro. Cancer Res 1990; 50: 2198–2202.
Backus M, Piwnica-Worms D, Hockett D, et al. Microprobe analysis of 99-Tc-MIBI in heart cells: calculation of mitochondrial membrane potential. Am J Physiol 1993; 265 (Cell Physiol 34): c178-c187.
Aktolun C, Bayhan H, Kir M. Clinical experience with Tc99m. MIDI imaging in patients with malignant tumors. Preliminary results and comparison with T1–201. Clin Nucl Med 1992; 17: 171–176.
Balon HR, Fink-Bennett D, Stoffer SS. Technetium-99m-sestamibi uptake by recurrent Hürthle cell carcinoma of the thyroid. J Nucl Med 1992; 33: 1393–1395.
Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves form the same cases. Radiology 1983; 148: 839–843.
Har-el G, Hadar T, Segal K, et al. Hürthle cell carcinoma of the thyroid gland. Cancer 1986; 57: 1613–1617.
Rosai J, Carcangiu ML, DeLellis RA. Tumors with oncocytic features (Hürthle cell carcinoma). In: Rosai J, ed. Atlas of tumor pathology; tumors of the thyroid gland. Washington, D.C.: Armed Forces Institute of Pathology, 1992.
Goellner JR, Gharib H, Grant C, et al. Fine needle aspiration cytology of the thyroid, 1980 to 1986. Acta Cytol 1987; 31: 587–590.
Hedinger C. Histological typing of thyroid tumors. Berlin Heidelberg New York: Springer; 1988: 7–14.
Bauman A, Strawbridge HTG. Spontaneous disappearance of an atypical Hurthle cell adenoma. Am J Clin Pathol 1983; 80: 399–402.
McLeod MK, Thompson NW, Hürthle cell neoplasms of the thyroid. Otolaryngol Clin North Am 1990; 23: 441–452.
Bondeson L, Bondeson A, Ljungberg O, et al. Oxyphil tumors of the thyroid. Ann Surg 1981; 194: 677–680.
Joensuu H, Ahonen A, Klemi PJ. 18F-fluorodeoxyglucose imaging in preoperative diagnosis of thyroid malignancy. Eur J Nuct Med 1988; 13: 502–506.
Vergara E, Lastoria S, Varrella P, Lapenta L, Salvatore M. Technetium-99m-pentavalent dimercaptosuccinic acid uptake in Hürthle cell tumor of the thyroid. J Nucl Biol Med 1993; 37: 65–68.
Tsuda T, Kubota M, Iwakubo A, et al. A case of Hurthle cell carcinoma in the superior mediastinum. Jpn J Nucl Med 1990; 27: 741–748.
Abdel-Nabi H, Hinkle GH, Jalko JM, Helly K, Olsen JO, Martin EW. Iodine-131-labeled anti-CEA antibodies uptake by Hürthle cell carcinoma. Clin Nucl Med 1985; 10: 713–715.
Piwnica-Worms D, Kronauge JF, Homman BL, Davison A, Jones AG. Comparative myocardial uptake characteristics of hexakis (alkylisonitrile)technetium(I) complexes: effect of lipophilicity. Invest Radiol 1989; 24: 25–29.
Piwnica-Worms D, Kronauge JF, Chiu ML. Uptake and retention of hexakis(2-methoxyisobutyl isonitrile) technetium (I): mitochondrial and plasma membrane potential dependence. Circulation 1990; 82: 1826–1838.
Johnson LV, Walsh ML, Chen LB. Localization of mitochondria- in living cells with rhodamine 123. Proc Natl Acad Sci USA 1980; 77: 990–994.
Ritchie RJ. A critical assessment of the use of lipophilic cations as membrane potential probes. Prog Biophys Mol Biol 1984; 43:1–32.
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Yen, TC., Line, HD., Lee, CH. et al. The role of technetium-99m sestamibi whole-body scans in diagnosing metastatic Hurthle cell carcinoma of the thyroid gland after total thyroidectomy: a comparison with iodine-131 and thallium-201 whole-body scans. Eur J Nucl Med 21, 980–983 (1994). https://doi.org/10.1007/BF00238123
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DOI: https://doi.org/10.1007/BF00238123