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Comparative Study of Initial Post-Therapeutic 131I Single-Photon Emission Computed Tomography/Computed Tomography and Reoperation for the Detection of Residual Lymph Node Metastasis in Patients With Papillary Thyroid Cancer |
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| Institution: | 1. Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China;2. Department of Nuclear Medicine, Jiujiang First People’s Hospital, Jiujiang, Jiangxi, People’s Republic of China |
| Abstract: | ObjectiveTo assess the diagnostic performance of initial post-therapeutic 131I single-photon emission computed tomography/computed tomography (SPECT/CT) compared with that of reoperation in detecting residual lymph node metastasis (LNM).MethodsPatients with iodine-avid LNM detected on the initial post-therapeutic 131I SPECT/CT and who underwent reoperative dissection within 6 months were included. LNMs (numbers and locations) detected via both methods were compared. The American Thyroid Association dynamic risk stratification was performed for patients receiving second radioactive iodine therapy after reoperation.ResultsFifty-three patients with 95 iodine-avid LNMs detected by 131I SPECT/CT were enrolled. Fifty-one (96.2%) patients had 212 LNMs confirmed by reoperation (P = .004). The sensitivity and specificity of 131I SPECT/CT in detecting LNM were 44.8% (95/212) and 91.6% (87/95), respectively. The location frequency of residual LNMs found by 131I SPECT/CT was similar to that of reoperation (P = .057). Thirty-two patients received a second radioactive iodine treatment, and 6 (18.8%) patients still had residual iodine-avid LNM on SPECT/CT. Therapeutic response was evaluated by American Thyroid Association dynamic risk stratification in 16 patients. The number of patients with structural incomplete response, biochemical incomplete response, indeterminate response, and excellent response was 4 (23.5%), 4 (23.5%), 5 (29.4%), and 3 (17.6%), respectively.Conclusion131I SPECT/CT has high specificity but relatively low sensitivity in detecting all residual LNMs. Approximately 80% of patients were rendered structurally disease free after reoperation. |
| Keywords: | papillary thyroid cancer residual lymph node metastasis SPECT/CT reoperation BIR"} {"#name":"keyword" "$":{"id":"kwrd0040a1"} "$$":[{"#name":"text" "_":"biochemical incomplete response CRM"} {"#name":"keyword" "$":{"id":"kwrd004f0a"} "$$":[{"#name":"text" "_":"Certified Reference Materials DSV-PTC"} {"#name":"keyword" "$":{"id":"kwrd0040ffga"} "$$":[{"#name":"text" "_":"diffuse sclerosing variant DTC"} {"#name":"keyword" "$":{"id":"kwrd0040ia"} "$$":[{"#name":"text" "_":"differentiated thyroid cancer ER"} {"#name":"keyword" "$":{"id":"kwrd00ll40a"} "$$":[{"#name":"text" "_":"excellent response FNA"} {"#name":"keyword" "$":{"id":"kwrd0040oa"} "$$":[{"#name":"text" "_":"fine needle aspiration IR"} {"#name":"keyword" "$":{"id":"kwrdr0040a"} "$$":[{"#name":"text" "_":"indeterminate response LN"} {"#name":"keyword" "$":{"id":"kwr9d0040a"} "$$":[{"#name":"text" "_":"lymph node LNM"} {"#name":"keyword" "$":{"id":"kwrd0040rrffa"} "$$":[{"#name":"text" "_":"lymph node metastasis PTC"} {"#name":"keyword" "$":{"id":"kwrd0040arfvgt"} "$$":[{"#name":"text" "_":"papillary thyroid cancer PTCFV-PTC"} {"#name":"keyword" "$":{"id":"krrttwrd0040a"} "$$":[{"#name":"text" "_":"follicular variant PTCLND"} {"#name":"keyword" "$":{"id":"kwrd0mmn040a"} "$$":[{"#name":"text" "_":"lymph node dissection RAI"} {"#name":"keyword" "$":{"id":"kwrd0040ayhhhha"} "$$":[{"#name":"text" "_":"radioactive iodine SIR"} {"#name":"keyword" "$":{"id":"kwrdcc0040ayhhhh"} "$$":[{"#name":"text" "_":"structural incomplete response SPECT/CT"} {"#name":"keyword" "$":{"id":"kwrd0040ayhgghhhh"} "$$":[{"#name":"text" "_":"single-photon emission computed tomography/computed tomography Tg"} {"#name":"keyword" "$":{"id":"kwrd0040ayhhhhuu"} "$$":[{"#name":"text" "_":"stimulated thyroglobulin TgAb"} {"#name":"keyword" "$":{"id":"kwrd0040ayffhhhh"} "$$":[{"#name":"text" "_":"thyroglobulin antibody TSH"} {"#name":"keyword" "$":{"id":"kwrdiii0040ayhhhh"} "$$":[{"#name":"text" "_":"thyroid-stimulating hormones TT"} {"#name":"keyword" "$":{"id":"kwrd00rrreeeee40ayhhhh"} "$$":[{"#name":"text" "_":"total thyroidectomy US"} {"#name":"keyword" "$":{"id":"kwrd004eewwqqaa0ayhhhh"} "$$":[{"#name":"text" "_":"Ultrasound WBS"} {"#name":"keyword" "$":{"id":"kwrd0042220ayhhhh"} "$$":[{"#name":"text" "_":"whole-body scan |
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