Preoperative Scintigraphic Detection of Cervical Metastases from Thyroid Carcinoma with Technetium-99m Pertechnetate

Vieras, Frank

doi:10.1097/00003072-198508000-00009

Cited by 18 publications

(4 citation statements)

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“…[ 17 ] However, there is limited literature describing the value of pertechnetate scans in detecting metastatic disease, and its clinical implication has not been fully assessed. [ 16 – 18 , 20 ] Our group demonstrated that the information obtained at the time of 99m Tc-pertechnetate scans led to a change in management decision in 19/184 (10.3%) patients, including referral for resection (n = 6) or alternating the prescribed 131 I dose (n = 13). More importantly, during analysis of association between avidity of 99m Tc-pertechnetate and the response of 131 I therapy in 72 patients who had 131 I-avid foci in the Rx-SPECT/CT, we found that ssTg in pertechnetate-avid group decreased more significantly than in pertechnetate-nonavid group.…”

Section: Discussionmentioning

confidence: 99%

“…Pertechnetate-avid metastatic lesions from DTC have been described by several case reports. [ 15 – 18 ] However, only 3 comparative studies with 131 I can be retrieved, mainly focusing on the diagnostic efficiency of 99m Tc-pertechnetate scan for thyroid remnant. [ 19 – 21 ] To date, the value of 99m Tc-pertechnetate scan (planar scan combined with SPECT/CT [single photon emission computed tomography/computed tomography]) in the management of DTC patients has not been adequately assessed.…”

Section: Introductionmentioning

confidence: 99%

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99mTc-pertechnetate-avid metastases from differentiated thyroid cancer are prone to benefit from 131I therapy

et al. 2017

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The aim of this study is to determine the contribution of neck and chest 99mTc-pertechnetate scan to the management of postoperative patients with suspicious metastatic differentiated thyroid cancer (DTC), particularly to the prediction of response to radioiodine (131I) therapy. Just before 131I administration, a total of 184 postoperative DTC patients with stimulated serum thyroglobulin (ssTg) >10 ng/mL were enrolled to undergo neck and chest 99mTc-pertechnetate scan, which were directly compared with post-therapeutic 131I scan to determine the concordance of site and number of metastatic lesions. The percentage changes in ssTg between 99mTc-pertechnetate-avid group and 99mTc-pertechnetate-nonavid group were compared, and the response to 131I in both groups was analyzed according to the nature of 99mTc-pertechnetate avidity as well. The percentages of concordance between 99mTc-pertechnetate and 131I scan in detecting metastases were 65.7% and 26.0% in per-patient and per-site analyses with low unweighted kappa, respectively. 99mTc-pertechnetate scan led to a change in therapeutic decision making in 19/184 (10.3%) patients. In 72 patients with 131I-avid metastases, the ssTg in 99mTc-pertechnetate-avid group (n = 13) decreased significantly compared with that in 99mTc-pertechnetate-nonavid group (n = 59) (median: −81.56% vs −48.14%; Z = −4.276, P = .000). The difference of therapeutic response between 99mTc-pertechnetate-avid group and 99mTc-pertechnetate-nonavid group was statistically significant (χ2 = 8.4; P = .03). Although the consistency between 99mTc-pertechnetate scan before 131I administration and post-therapy 131I scan in detecting metastases is low, identifying metastases in postoperative DTC patients with elevated ssTg via 99mTc-pertechnetate scan prior to 131I therapy provides incremental value for therapeutic decision making. Notably, patients with 99mTc-pertechnetate-avid metastases may be more prone to benefit from 131I therapy than those with 99mTc-pertechnetate-nonavid metastases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

99mTc-pertechnetate-avid metastases from differentiated thyroid cancer are prone to benefit from 131I therapy

et al. 2017

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“…[1][2][3][4][5][6][7][8][9][10] Cases in which tumors without removal of normal thyroid tissue showed signs of accumulation of both Tc-99m pertechnetate and radioiodine have rarely been reported. 2 ' 3 ' 7 Usually, in the presence of normal thyroid tissue, the uptake of radioiodine in the cancerous tissue is extremely poor.…”

Section: Discussionmentioning

confidence: 99%

Accumulation of technetium-99m pertechnetate in a patient with metastases of thyroid carcinoma

et al. 1999

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Accumulation of both Tc-99m pertechnetate and radioiodine upon scintigraphy in thyroid carcinoma and/or in its metastases is a rare occurrence. In this paper we describe a patient who was taken to surgery for left lobectomy of the thyroid with follicular adenocarcinoma and who had accumulation of both I-131 and Tc-99m pertechnetate in lung metastases. The accumulation of I-131 was less than that of Tc-99m pertechnetate. The use of Tc-99m pertechnetate for imaging for diagnosis of functioning thyroid metastases is discussed.

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“…For that reason, case reports of incidental initial findings of extrathyroidal tumor manifestations are rare and mainly about lymphonodal metastases from papillary thyroid cancer. [5][6][7][8][9] Reports about bone metastases in preoperative conditions are even scarcer. Mathiopoulou et al reported a case of a metastasis of a poorly differentiated thyroid carcinoma with a preoperative pertechnetate-positive metastasis of the soft tissue and adjacent bone.…”

Section: Figurementioning

confidence: 99%

Unexpected Bone Metastases in 99mTc-Pertechnetate Scan of Recurrent Goiter

et al. 2019

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A 68-year-old woman who underwent a thyroidectomy for bilateral goiter 20 years ago was referred to our department. The examination revealed a newly occurred thyroid nodule in the right central lobe. Unexpectedly the 99m Tc-pertechnetate scan revealed several extrathyroidal foci right-sided supraclavicular, beside a cold thyroid nodule in the right lower lobe. Consecutive surgery and histology confirmed the suspected diagnosis of follicular thyroid cancer with multiple bone metastases. Whole-body scintigraphy performed after the following radioiodine therapy indicated disseminated osseous metastases.

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Preoperative Scintigraphic Detection of Cervical Metastases from Thyroid Carcinoma with Technetium-99m Pertechnetate

Cited by 18 publications

References 0 publications

99mTc-pertechnetate-avid metastases from differentiated thyroid cancer are prone to benefit from 131I therapy

99mTc-pertechnetate-avid metastases from differentiated thyroid cancer are prone to benefit from 131I therapy

Accumulation of technetium-99m pertechnetate in a patient with metastases of thyroid carcinoma

Unexpected Bone Metastases in 99mTc-Pertechnetate Scan of Recurrent Goiter

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