Correlation of CT Values, Iodine Concentration, and Histological Changes in the Thyroid

Imanishi, Yoshimasa; Ehara, Norishige; Shinagawa, Toshihito; Tsujino, D; Endoh, Ikuyo; Baba, Kouichirou; Kanemaki, Yoshihide; Iida, Shigeharu; Hayakawa, Minako; Miyazaki, Osamu; Shirakawa, Kumiko; Nosaka, Shunsuke

doi:10.1097/00004728-200003000-00026

Cited by 32 publications

(30 citation statements)

References 4 publications

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“…Studies have explored the value of CT imaging in iodine measurement. Imanishi et al [27,28] compared the CT values of different thyroid lesions, and found no significant statistical difference. Zhang et al [26] obtained iodine concentrations of thyroid lesions by using the CT value conversion method, and assessing various thyroid lesions, they found no obvious differences in iodine concentrations among different lesions.…”

Section: Discussionmentioning

confidence: 99%

Identification of benign and malignant thyroid nodules by in vivo iodine concentration measurement using single-source dual energy CT

et al. 2016

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This study proposed to determine whether in vivo iodine concentration measurement by single-source dual energy (SSDE) CT can improve differentiation between benign and malignant thyroid nodules. In total, 53 patients presenting with thyroid nodules underwent SSDE CT scanning. Iodine concentrations were measured for each nodule and normal thyroid tissue using the GSI-viewer image analysis software. A total of 26 thyroid nodules were malignant in 26 patients and confirmed by surgery; 33 nodules from 27 patients were benign, with 10 confirmed by surgery and others after follow-up. Iodine concentrations with plain CT were significantly lower in malignant than benign nodules (0.47 ± 0.20 vs 1.17 ± 0.38 mg/mL, P = 0.00). Receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.93; with a cutoff of 0.67, iodine concentration showed 92.3% sensitivity and 88.5% specificity in diagnosing malignancy. Iodine concentration obtained by enhanced and plain CT were significantly higher in malignant than benign nodules (9.05 ± 3.35 vs 3.46 ± 2.24 mg/mL, P = 0.00). ROC curve analysis showed an AUC of 0.93; with a cutoff value of 3.37, iodine concentration displayed 78% sensitivity, 95% specificity in diagnosing malignancy. Combining unenhanced with enhanced iodine concentrations, the diagnostic equation was: Y = –8.641 × unenhanced iodine concentration + 0.663 × iodine concentration. ROC curve showed an AUC of 0.98 (95% CI, 0.94, 1.00). With Y ≥ –2 considered malignancy, diagnostic sensitivity and specificity were 96%, 96.3%, respectively. This study concluded that SSDE CT can detect the differences in iodine uptake and blood supply between benign and malignant thyroid lesions.

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Section: Discussionmentioning

confidence: 99%

Identification of benign and malignant thyroid nodules by in vivo iodine concentration measurement using single-source dual energy CT

et al. 2016

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“…We have also shown that the non-contrast CT component of SPECT/CT is useful in predicting MIBI retention. Due to the high iodine content of the thyroid parenchyma, the thyroid gland can be well visualized on non-contrast CT (average HU of 107.0 ± 18.3), whereas AITD such as Graves' disease and Hashimoto's thyroiditis has lower iodine concentrations on pathology, which is reflected as lower iodine content on non-contrast CT (average HU of 81.6 ± 21.0) [9,11,12]. Taillefer et al initially introduced the dual phase, single isotope method using MIBI to detect parathyroid adenomas.…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have shown that iodine content decreases in autoimmune thyroid diseases (AITD), such as Graves' disease or Hashimoto thyroiditis, which can be reliably detected with non-contrast CT [10][11][12]. The purpose of this study was to correlate clinical and imaging findings with MIBI retention in the thyroid gland, and to evaluate the additional benefit of SPECT/CT in parathyroid lesion detection in patients with thyroidal MIBI retention.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Hwang

Rhee

Yun

et al. 2016

Nucl Med Mol Imaging

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Purpose Parathyroid adenoma detection with dual-phase 99m Tc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection. We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients. Methods Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CT was performed immediately after delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention. Results In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CT-HU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention. Conclusion AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.

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“…In this study and the study by Taeymans et al (), tumour attenuation values were lower than normal thyroid attenuation values (Taeymans et al ). This is likely due to differences in metabolism and storage of iodine between tumour and normal tissue (Silverman et al , Arger et al , Verschueren et al , Imanishi et al ). In addition, all four hyperthyroid dogs had hypoattenuating tumours compared with normal thyroid (Taeymans et al ).…”

Section: Discussionmentioning

confidence: 99%

Computed tomographic appearance of canine thyroid tumours

Gilmour

Wilke

Riedesel

2014

J of Small Animal Practice

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Correlation of CT Values, Iodine Concentration, and Histological Changes in the Thyroid

Abstract: The decrease in CT values not only revealed a decrease of iodine concentration in the thyroid but also represented an increase of follicular cells and/or interstitial structures in the volume ratio secondary to it.

Cited by 32 publications

References 4 publications

Identification of benign and malignant thyroid nodules by in vivo iodine concentration measurement using single-source dual energy CT

Identification of benign and malignant thyroid nodules by in vivo iodine concentration measurement using single-source dual energy CT

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Computed tomographic appearance of canine thyroid tumours

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