Research Article
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Published Online: 2 August 2010

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

Publication: Thyroid
Volume 20, Issue Number 8

Abstract

Background and Objective: 124I emits a positron and can be imaged with a positron emission tomography (PET) scanner. The objective of this study was to compare the ability of diagnostic 124I PET images versus 131I planar whole-body imaging in detecting residual thyroid tissue and/or metastatic well-differentiated thyroid cancer (WDTC).
Methods: Patients were recruited prospectively for this study who (i) had WDTC, (ii) were suspected of having metastatic WDTC, and (iii) were referred for 131I whole-body dosimetry. The prescribed activity was 1–2 mCi (37–74 MBq) and 1.7 mCi (62.9 MBq) for 131I and 124I, respectively. For each image, one blinded reader (D.V.N.) categorized every focus of 131I and 124I radioiodine uptake as 1 = definite physiological uptake/artifact, 2 = most likely physiological uptake/artifact, 3 = indeterminate, 4 = residual thyroid tissue/metastases in the neck/bed, 5 = most likely metastases, or 6 = definite metastases. Foci categorized as 4, 5, or 6 were considered positive. When available, foci categorized as 4, 5, or 6 were correlated with other diagnostic studies.
Results: Of the 25 patients, 8 patients (32%) had more positive foci on 124I images than on 131I, of which 3 patients to date have had metastases confirmed in one or more of the additional positive 124I foci. 124I demonstrated the same number of foci as on 131I in 16 patients (14 with no positive foci, and 2 with two positive and five positive foci each). One patient had one additional positive focus on 131I not seen on 124I, which has not yet been confirmed as a metastasis. A total of 97 positive foci were identified on either 124I or 131I. 124I identified 49 positive foci not seen with 131I, and 131I identified one positive focus not seen with 124I.
Conclusion: Relative to 131I planar whole-body imaging, 124I PET identified as many as 50% more foci of radioiodine uptake suggestive of additional residual thyroid tissue and/or metastases in as many as 32% more patients who had WDTC.

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Published In

cover image Thyroid®
Thyroid
Volume 20Issue Number 8August 2010
Pages: 879 - 883
PubMed: 20615132

History

Published online: 2 August 2010
Published in print: August 2010
Published ahead of print: 8 July 2010

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Douglas Van Nostrand
Division of Nuclear Medicine, Washington Hospital Center, Washington, District of Columbia.
Shari Moreau
Division of Nuclear Medicine, Washington Hospital Center, Washington, District of Columbia.
Varalakshmi V. Bandaru
Division of Nuclear Medicine, Washington Hospital Center, Washington, District of Columbia.
Frank Atkins
Division of Nuclear Medicine, Washington Hospital Center, Washington, District of Columbia.
Shyam Chennupati
Division of Nuclear Medicine, Washington Hospital Center, Washington, District of Columbia.
Mihriye Mete
Department of Biostatistics and Epidemiology, MedStar Research Institute, Washington, District of Columbia.
Kenneth Burman
Division of Endocrinology, Washington Hospital Center, Washington, District of Columbia.
Leonard Wartofsky
Department of Medicine, Washington Hospital Center, Washington, District of Columbia.

Notes

Address correspondence to:Douglas Van Nostrand, MD, FACP, FACNMDivision of Nuclear MedicineWashington Hospital Center110 Irving St., N.W.Suite GA60BWashington, DC 20010E-mail: [email protected]

Disclosure Statement

The authors declare that no competing financial interests exist.

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