Usefulness of 99mTc-pertechnetate whole body scan with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer patients

Chantadisai, Maythinee; Kingpetch, Kanaungnit

doi:10.1007/s12149-014-0864-3

Cited by 14 publications

(19 citation statements)

References 18 publications

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“…This correlation makes sense as reasoned by the authors, who explained that greater uptake of therapeutic 131 I would be expected in 99m Tc-pertechnetate-avid lesions (125). These results were confirmed in an observational cohort of 56 patients (128). In this perpatient analysis, there was overall concordance of 96.4% between TcWBS with SPECT/CT of the neck and chest and findings on posttherapy scans.…”

Section: Clinical Scenarios and Auc Scoressupporting

confidence: 66%

“…It was approved by the FDA for imaging breast cancer, and many reports in the 1980s and 1990s demonstrated the utility of 99m Tc-sestamibi in patients with DTC, elevated Tg (63) or anti-TgAb levels, and negative results of radioiodine scans (Tg1/scan-). Although the widespread implementation of 18 F-FDG PET replaced the routine use of 99m Tc-sestamibi imaging in these patients (128), the original publications and, most important, the different uptake mechanisms of 99m Tc-sestamibi and 18 F-FDG, offer support for selected use of 99m Tc-sestamibi in difficult patients with suspected residual thyroid neoplasm and no other imaging evidence of disease (e.g., negative RAI, ultrasound, 18 F-FDG PET/CT, and CT scan results).…”

Section: Methoxyisobutylisonitrile (Mibi) Imaging In Dtc Introductionmentioning

confidence: 99%

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Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

Donohoe

Aloff

Avram³

et al. 2020

J Nucl Med

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of Recommendations 99m Tc-pertechnetate imaging of a suspected thyroid remnant after total or near-total thyroidectomy may be appropriate if 123 I or 131 I are not available or otherwise contraindicated. Imaging of suspected residual or recurrent DTC after total or near-total thyroidectomy may be appropriate as well; however, 123 I or 131 I is preferred. Imaging of thyroid cancer before total or near-total thyroidectomy is rarely appropriate. Imaging with 99m Tc-pertechnetate in the pregnant or lactating patient is rarely appropriate.

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Section: Clinical Scenarios and Auc Scoressupporting

confidence: 66%

Section: Methoxyisobutylisonitrile (Mibi) Imaging In Dtc Introductionmentioning

confidence: 99%

Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

Donohoe

Aloff

Avram³

et al. 2020

J Nucl Med

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“…Our findings on the diagnostic value of 99m Tc-pertechnetate scan are inconsistent with study by Chantadisai et al, which demonstrated that preablative 99m Tc-pertechnetate planar scan with neck and chest SPECT/CT has good correlation with post-therapeutic 131 I planar scan with SPECT/CT per-patient basis. [ 20 ] However, our group reports a relatively lower overall patient-based or lesion-based percentage of concordance. The possible explanation is that our study focused mainly on metastatic lesions, but Chantadisai et al cared mainly about thyroid remnant (92.2%).…”

Section: Discussionmentioning

confidence: 73%

“…[ 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%

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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“…The hyperfunctioning metastases of DTC generally are well differentiated, displaying excellent 99m Tc-pertechnetate and 131 I uptake (Chantadisai & Kingpetch 2014). As we have demonstrated previously, 99m Tc-pertechnetate whole-body scan should be recommended for diagnoses as well as predicting the efficacy of 131 I therapy (Liu et al 2017).…”

Section: Diagnosismentioning

confidence: 99%

Thyrotoxicosis with concomitant thyroid cancer

Cheng

Jin

et al. 2019

Endocrine-Related Cancer

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Thyrotoxicosis with concomitant thyroid cancer is rare and poorly recognized, which may result in delayed diagnosis, inappropriate treatment and even poor prognosis. To provide a comprehensive guidance for clinicians, the etiology, pathogenesis, diagnosis and treatment of this challenging setting were systematically reviewed. According to literatures available, the etiologies of thyrotoxicosis with concomitant thyroid cancer were categorized into Graves’ disease with concurrent differentiated thyroid cancer (DTC) or medullary thyroid cancer, Marine–Lenhart Syndrome with coexisting DTC, Plummer’s disease with concomitant DTC, amiodarone-induced thyrotoxicosis with concomitant DTC, central hyperthyroidism with coexisting DTC, hyperfunctioning metastases of DTC and others. The underlying causal mechanisms linking thyrotoxicosis and thyroid cancer were elucidated. Medical history, biochemical assessments, radioiodine uptake, anatomic and metabolic imaging and ultrasonography-guided fine-needle aspiration combined with pathological examinations were found to be critical for precise diagnosis. Surgery remains a mainstay in both tumor elimination and control of thyrotoxicosis, while anti-thyroid drugs, beta-blockers, 131I, glucocorticoids, plasmapheresis, somatostatin analogs, dopamine agonists, radiation therapy, chemotherapy and tyrosine kinase inhibitors should also be appropriately utilized as needed.

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Usefulness of 99mTc-pertechnetate whole body scan with neck and chest SPECT/CT for detection of post-surgical thyroid remnant and metastasis in differentiated thyroid cancer patients

Cited by 14 publications

References 18 publications

Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

Appropriate Use Criteria for Nuclear Medicine in the Evaluation and Treatment of Differentiated Thyroid Cancer

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

Thyrotoxicosis with concomitant thyroid cancer

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