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Clinical applications of single-photon emission computed tomography/computed tomography in post-ablation 131iodine scintigraphy in children and young adults with differentiated thyroid carcinoma

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Abstract

Background

The utility of integrated single-photon emission computed tomography/computed tomography (SPECT/CT) in children and young adults with differentiated thyroid carcinoma is incompletely studied.

Objective

To determine the value of adding SPECT/CT to conventional whole-body scintigraphy in post-ablation iodine-131 (131I) scintigraphy for children and young adults with differentiated thyroid carcinoma.

Materials and methods

Planar scintigraphy and SPECT/CT were performed on 42 post-surgical children and young adults (32 female, 10 male; mean age 14.3±4.9 years, range 7–20 years) with differentiated thyroid carcinoma (39 papillary, 2 follicular, 1 mixed) 5 days after the therapeutic administration of 1.9–7.4 GBq of 131I. Planar and SPECT/CT images were interpreted independently, and sites of uptake were categorized as positive or equivocal with respect to thyroid bed, lymph node and distant metastasis uptake. An experienced thyroid endocrinologist used a combination of surgical histopathology and scintigraphic findings to determine whether the addition of SPECT/CT would change patient management.

Results

Planar scintigraphy evidenced 88 radioiodine-avid foci and SPECT/CT confirmed all foci. No additional foci were disclosed by SPECT/CT. SPECT/CT correctly classified 16/88 (18%) foci that were unclear or wrongly classified at planar scintigraphy. Globally, SPECT/CT showed an incremental value over planar scintigraphy in 9 (21.4%) patients and changed therapeutic management in 3 (7.1%; 95% confidence interval, 2–20%) patients.

Conclusion

SPECT/CT improved localization and characterization of focal 131I uptake on post-ablation whole-body scintigraphy in children and young adults with differentiated thyroid carcinoma. Further prospective evaluation in a larger series is justified to prove the effect of post-ablation SPECT/CT-based management decisions.

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Acknowledgments

This work was supported by the Science and Technology Fund of Sichuan Province (grant 19ZDYF1737).

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Authors and Affiliations

  1. Department of Nuclear Medicine, West China Hospital, Sichuan University, No 37. Guoxue Alley, Chengdu, 610041, China

    Lisha Jiang, Yongzhao Xiang, Rui Huang, Rong Tian & Bin Liu

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  1. Lisha Jiang
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  2. Yongzhao Xiang
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  3. Rui Huang
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  4. Rong Tian
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  5. Bin Liu
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Correspondence to Bin Liu.

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Jiang, L., Xiang, Y., Huang, R. et al. Clinical applications of single-photon emission computed tomography/computed tomography in post-ablation 131iodine scintigraphy in children and young adults with differentiated thyroid carcinoma. Pediatr Radiol 51, 1724–1731 (2021). https://doi.org/10.1007/s00247-021-05039-2

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  • DOI: https://doi.org/10.1007/s00247-021-05039-2

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