Nuclear medicine imaging procedures in differentiated thyroid carcinoma patients with negative iodine scan

Radioiodine treatment following surgery is an effective therapy in differentiated thyroid carcinoma (DTC) patients. However, in DTC patients with metastases characterized by very low or absent iodine uptake, total thyroidectomy and radical loco-regional lymphoadenectomy is the only effective therape...

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Bibliographic Details
Published in:Biomedicine & pharmacotherapy 2000-07, Vol.54 (6), p.337-344
Main Authors: Rubello, D., Saladini, G., Carpi, A., Casara, D.
Format: Article
Language:English
Subjects:
131I scintigraphy
18FDG scintigraphy
201Tl scintigraphy
99mTc-MIBI scintigraphy
99mTc-tetrofosmin scintigraphy
Biological and medical sciences
differentiated thyroid carcinoma
Endocrine glands. Genital system. Mammary gland
Fluorodeoxyglucose F18
Humans
Investigative techniques, diagnostic techniques (general aspects)
Iodine Radioisotopes
Medical sciences
Radionuclide Imaging
Radionuclide investigations
Technetium Tc 99m Sestamibi
Thallium Radioisotopes
Thyroid Neoplasms - diagnostic imaging
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Summary:Radioiodine treatment following surgery is an effective therapy in differentiated thyroid carcinoma (DTC) patients. However, in DTC patients with metastases characterized by very low or absent iodine uptake, total thyroidectomy and radical loco-regional lymphoadenectomy is the only effective therapeutic approach. In the present article, we have discussed the most recently available nuclear medicine techniques utilized for the detection of DTC metastases that have lost the capacity to trap radioiodine. A review of the data published in the literature has been presented, and a comparative analysis made of the results obtained by other imaging modalities such as high resolution neck ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). In our experience, the most sensitive and accurate imaging procedure is represented by the combination of neck US and whole body 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) scintigraphy; this combination might be proposed as a first-line diagnostic approach in DTC patients with increased serum thyroglobulin (Tg) levels and negative high dose 131I scans.
ISSN:0753-3322
1950-6007
DOI:10.1016/S0753-3322(00)80060-8