Skip to main content

Advertisement

SpringerLink
Log in

124I PET/CT in the pretherapeutic staging of differentiated thyroid carcinoma: comparison with posttherapy 131I SPECT/CT

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To compare pretherapy 124I PET/CT and posttherapy 131I SPECT/CT in the identification of pathological lesions and the staging of patients with differentiated thyroid carcinoma.

Methods

124I SPECT with low-dose CT in addition to a standard whole-body scan was performed 5 days following 131I therapy with the administration of 1,110–7,728 MBq. Pretherapy 124I PET/CT was done 24 h and 96 h after oral ingestion of 20–28 MBq, including a noncontrast high-dose CT scan. Scans were evaluated by two independent experienced nuclear physicians. In addition to the total number of lesions found, patient-based analyses and lesion-based analyses were performed to ascertain the discrepancies between the findings of the two scanning techniques, as well as to evaluate the clinical impact of the findings.

Results

A group of 20 consecutive patients were analysed. In the lesion-based analysis, a total of 62 foci were found with all modalities together. Of these, 124I PET/CT found 57 (92 %), 131I SPECT/CT 50 (81 %) and planar imaging 39 (63 %). In the patient-based analysis, in 50 % of patients complete concordance between the findings of 124I PET and 131I SPECT was seen, in 5 % complete discordance and in the remaining 45 % partial discordance, i.e. a focus or some foci seen with both modalities but another or others seen more or less with one or other modality. In 5 of the 20 patients (25 %), tumour stage was changed according to the findings of one of the modalities. In 60 % of these patients this was only with the findings of 124I PET/CT.

Conclusion

This study showed that 124I PET/CT is preferred over 131I imaging for staging differentiated thyroid carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Avram AM. Radioiodine scintigraphy with SPECT/CT: an important diagnostic tool for thyroid cancer staging and risk stratification. J Nucl Med. 2012;53:754–64. doi:10.2967/jnumed.111.104133.

    Article  PubMed  Google Scholar 

  2. Schmidt D, Szikszai A, Linke R, Bautz W, Kuwert T. Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med. 2009;50:18–23. doi:10.2967/jnumed.108.052746.

    Article  PubMed  Google Scholar 

  3. Chen L, Luo Q, Shen Y, Yu Y, Yuan Z, Lu H, et al. Incremental value of 131I SPECT/CT in the management of patients with differentiated thyroid carcinoma. J Nucl Med. 2008;49:1952–7. doi:10.2967/jnumed.108.052399.

    Article  PubMed  Google Scholar 

  4. Oh JR, Byun BH, Hong SP, Chong A, Kim J, Yoo SW, et al. Comparison of 131I whole-body imaging, 131I SPECT/CT, and 18F-FDG PET/CT in the detection of metastatic thyroid cancer. Eur J Nucl Med Mol Imaging. 2011;38:1459–68. doi:10.1007/s00259-011-1809-x.

    Article  PubMed  Google Scholar 

  5. Spanu A, Solinas ME, Chessa F, Sanna D, Nuvoli S, Madeddu G. 131I SPECT/CT in the follow-up of differentiated thyroid carcinoma: incremental value versus planar imaging. J Nucl Med. 2009;50:184–90. doi:10.2967/jnumed.108.056572.

    Article  PubMed  Google Scholar 

  6. Wong KK, Sisson JC, Koral KF, Frey KA, Avram AM. Staging of differentiated thyroid carcinoma using diagnostic 131I SPECT/CT. AJR Am J Roentgenol. 2010;195:730–6. doi:10.2214/AJR.09.3458.

    Article  PubMed  Google Scholar 

  7. Freudenberg LS, Jentzen W, Stahl A, Bockisch A, Rosenbaum-Krumme SJ. Clinical applications of 124I-PET/CT in patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging. 2011;38 Suppl 1:S48–56. doi:10.1007/s00259-011-1773-5.

    Article  PubMed  Google Scholar 

  8. Phan HT, Jager PL, Paans AM, Plukker JT, Sturkenboom MG, Sluiter WJ, et al. The diagnostic value of 124I-PET in patients with differentiated thyroid cancer. Eur J Nucl Med Mol Imaging. 2008;35:958–65. doi:10.1007/s00259-007-0660-6.

    Article  PubMed  Google Scholar 

  9. Van Nostrand D, Moreau S, Bandaru VV, Atkins F, Chennupati S, Mete M, et al. 124I positron emission tomography versus 131I planar imaging in the identification of residual thyroid tissue and/or metastasis in patients who have well-differentiated thyroid cancer. Thyroid. 2010;20:879–83. doi:10.1089/thy.2009.0430.

    Article  PubMed  Google Scholar 

  10. Freudenberg LS, Antoch G, Jentzen W, Pink R, Knust J, Gorges R, et al. Value of 124I-PET/CT in staging of patients with differentiated thyroid cancer. Eur Radiol. 2004;14:2092–8. doi:10.1007/s00330-004-2350-0.

    Article  PubMed  CAS  Google Scholar 

  11. Capoccetti F, Criscuoli B, Rossi G, Ferretti F, Manni C, Brianzoni E. The effectiveness of 124I PET/CT in patients with differentiated thyroid cancer. Q J Nucl Med Mol Imaging. 2009;53:536–45.

    PubMed  CAS  Google Scholar 

  12. Kulkarni K, Van Nostrand D, Atkins F, Aiken M, Burman K, Wartofsky L. The relative frequency in which empiric dosages of radioiodine would potentially overtreat or undertreat patients who have metastatic well-differentiated thyroid cancer. Thyroid. 2006;16:1019–23. doi:10.1089/thy.2006.16.1019.

    Article  PubMed  CAS  Google Scholar 

  13. Tuttle RM, Leboeuf R, Robbins RJ, Qualey R, Pentlow K, Larson SM, et al. Empiric radioactive iodine dosing regimens frequently exceed maximum tolerated activity levels in elderly patients with thyroid cancer. J Nucl Med. 2006;47:1587–91.

    PubMed  Google Scholar 

  14. Lind P. 131I whole body scintigraphy in thyroid cancer patients. Q J Nucl Med. 1999;43:188–94.

    PubMed  CAS  Google Scholar 

  15. Chen MK, Yasrebi M, Samii J, Staib LH, Doddamane I, Cheng DW. The utility of I-123 pretherapy scan in I-131 radioiodine therapy for thyroid cancer. Thyroid. 2012;22:304–9. doi:10.1089/thy.2011.0203.

    Article  PubMed  CAS  Google Scholar 

  16. Thomas DL, Menda Y, Bushnell D. A comparison between diagnostic I-123 and posttherapy I-131 scans in the detection of remnant and locoregional thyroid disease. Clin Nucl Med. 2009;34:745–8. doi:10.1097/RLU.0b013e3181b7dbb1.

    Article  PubMed  Google Scholar 

  17. Jentzen W, Freudenberg L, Eising EG, Sonnenschein W, Knust J, Bockisch A. Optimized 124I PET dosimetry protocol for radioiodine therapy of differentiated thyroid cancer. J Nucl Med. 2008;49:1017–23. doi:10.2967/jnumed.107.047159.

    Article  PubMed  Google Scholar 

  18. Van Nostrand D, Khorjekar GR, O’Neil J, Moreau S, Atkins FB, Kharazi P, et al. Recombinant human thyroid-stimulating hormone versus thyroid hormone withdrawal in the identification of metastasis in differentiated thyroid cancer with 131I planar whole-body imaging and 124I PET. J Nucl Med. 2012;53:359–62. doi:10.2967/jnumed.111.096016.

    Article  PubMed  Google Scholar 

  19. Nagarajah J, Jentzen W, Hartung V, Rosenbaum-Krumme S, Mikat C, Heusner TA, et al. Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck. Eur J Nucl Med Mol Imaging. 2011;38:1862–8. doi:10.1007/s00259-011-1866-1.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The technical and logistic support of Florence de Vreede-Lacroix and Renee Franssen is highly appreciated.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Maastricht University Medical Center, Postbox 5800, 6202 AZ, Maastricht, The Netherlands

    Cecile de Pont, Servais Halders, Jan Bucerius, Felix Mottaghy & Boudewijn Brans

  2. Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany

    Jan Bucerius & Felix Mottaghy

  3. Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands

    Jan Bucerius

Authors
  1. Cecile de Pont
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Servais Halders
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan Bucerius
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Felix Mottaghy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Boudewijn Brans
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Boudewijn Brans.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Pont, C., Halders, S., Bucerius, J. et al. 124I PET/CT in the pretherapeutic staging of differentiated thyroid carcinoma: comparison with posttherapy 131I SPECT/CT. Eur J Nucl Med Mol Imaging 40, 693–700 (2013). https://doi.org/10.1007/s00259-012-2331-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-012-2331-5

Keywords

Search

Navigation