Tc-99m MIBI SPECT in detecting metastatic papillary thyroid carcinoma in patients with elevated human serum thyroglobulin levels but negative I-131 whole body scan

Chung-Huei Hsu, Feng Yuan Liu, Ruoh Fang Yen, Chia Hung Kao

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Papillary carcinomas are the most common thyroid malignancies. They invade the regional lymphatics and metastasize frequently to local lymph nodes in the neck. Distant metastasis, generally to the lungs, is also common. The aim of this study is to evaluate the effectiveness of single photon emission computed tomography (SPECT) with technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) in detecting metastatic lesions in patients with papillary thyroid carcinoma (PTC) after nearly total thyroidectomy and radioiodine (I-131) treatment who present with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). Methods. Twenty patients of PTC who underwent nearly total thyroidectomy and I-131 treatments were included in this study. All of the 20 patients had negative I-131 WBS results and elevated hTg levels (hTg > 20 μIU/mL) under thyroid-stimulating hormone (TSH) stimulation (TSH > 30 μIU/mL). Technetium-99m MIBI SPECT was performed to detect metastatic lesions. Results. Technetium-99m MIBI SPECT demonstrated lesions in 10 patients. Technetium-99m MIBI SPECT failed to demonstrate lesions in nine patients including small lymph node and lung metastases. Conclusions. This study showed that Tc-99m MIBI SPECT is a useful tool to detect metastatic lesions in PTC with elevated hTg but negative I-131 WBS. However, small lymph node and lung metastases may be missed in Tc-99m MIBI SPECT. In the latter circumstance, other imaging studies should be included in the follow-up protocol.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalEndocrine Research
Volume29
Issue number1
DOIs
Publication statusPublished - 2003

Fingerprint

Whole Body Imaging
Thyroglobulin
Single-Photon Emission-Computed Tomography
Technetium
Serum
Lymph Nodes
Thyroidectomy
Thyrotropin
Neoplasm Metastasis
Lung
Papillary Carcinoma
Papillary Thyroid cancer
technetium 99m methoxyisobutylisonitrile
Thyroid Gland
Neck
Therapeutics
Neoplasms

Keywords

  • Papillary thyroid carcinoma (PTC)
  • Single photon emission computed tomography (SPECT)
  • Technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI)

ASJC Scopus subject areas

  • Endocrinology

Cite this

Tc-99m MIBI SPECT in detecting metastatic papillary thyroid carcinoma in patients with elevated human serum thyroglobulin levels but negative I-131 whole body scan. / Hsu, Chung-Huei; Liu, Feng Yuan; Yen, Ruoh Fang; Kao, Chia Hung.

In: Endocrine Research, Vol. 29, No. 1, 2003, p. 9-15.

Research output: Contribution to journalArticle

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abstract = "Papillary carcinomas are the most common thyroid malignancies. They invade the regional lymphatics and metastasize frequently to local lymph nodes in the neck. Distant metastasis, generally to the lungs, is also common. The aim of this study is to evaluate the effectiveness of single photon emission computed tomography (SPECT) with technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) in detecting metastatic lesions in patients with papillary thyroid carcinoma (PTC) after nearly total thyroidectomy and radioiodine (I-131) treatment who present with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). Methods. Twenty patients of PTC who underwent nearly total thyroidectomy and I-131 treatments were included in this study. All of the 20 patients had negative I-131 WBS results and elevated hTg levels (hTg > 20 μIU/mL) under thyroid-stimulating hormone (TSH) stimulation (TSH > 30 μIU/mL). Technetium-99m MIBI SPECT was performed to detect metastatic lesions. Results. Technetium-99m MIBI SPECT demonstrated lesions in 10 patients. Technetium-99m MIBI SPECT failed to demonstrate lesions in nine patients including small lymph node and lung metastases. Conclusions. This study showed that Tc-99m MIBI SPECT is a useful tool to detect metastatic lesions in PTC with elevated hTg but negative I-131 WBS. However, small lymph node and lung metastases may be missed in Tc-99m MIBI SPECT. In the latter circumstance, other imaging studies should be included in the follow-up protocol.",
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N2 - Papillary carcinomas are the most common thyroid malignancies. They invade the regional lymphatics and metastasize frequently to local lymph nodes in the neck. Distant metastasis, generally to the lungs, is also common. The aim of this study is to evaluate the effectiveness of single photon emission computed tomography (SPECT) with technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) in detecting metastatic lesions in patients with papillary thyroid carcinoma (PTC) after nearly total thyroidectomy and radioiodine (I-131) treatment who present with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). Methods. Twenty patients of PTC who underwent nearly total thyroidectomy and I-131 treatments were included in this study. All of the 20 patients had negative I-131 WBS results and elevated hTg levels (hTg > 20 μIU/mL) under thyroid-stimulating hormone (TSH) stimulation (TSH > 30 μIU/mL). Technetium-99m MIBI SPECT was performed to detect metastatic lesions. Results. Technetium-99m MIBI SPECT demonstrated lesions in 10 patients. Technetium-99m MIBI SPECT failed to demonstrate lesions in nine patients including small lymph node and lung metastases. Conclusions. This study showed that Tc-99m MIBI SPECT is a useful tool to detect metastatic lesions in PTC with elevated hTg but negative I-131 WBS. However, small lymph node and lung metastases may be missed in Tc-99m MIBI SPECT. In the latter circumstance, other imaging studies should be included in the follow-up protocol.

AB - Papillary carcinomas are the most common thyroid malignancies. They invade the regional lymphatics and metastasize frequently to local lymph nodes in the neck. Distant metastasis, generally to the lungs, is also common. The aim of this study is to evaluate the effectiveness of single photon emission computed tomography (SPECT) with technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) in detecting metastatic lesions in patients with papillary thyroid carcinoma (PTC) after nearly total thyroidectomy and radioiodine (I-131) treatment who present with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). Methods. Twenty patients of PTC who underwent nearly total thyroidectomy and I-131 treatments were included in this study. All of the 20 patients had negative I-131 WBS results and elevated hTg levels (hTg > 20 μIU/mL) under thyroid-stimulating hormone (TSH) stimulation (TSH > 30 μIU/mL). Technetium-99m MIBI SPECT was performed to detect metastatic lesions. Results. Technetium-99m MIBI SPECT demonstrated lesions in 10 patients. Technetium-99m MIBI SPECT failed to demonstrate lesions in nine patients including small lymph node and lung metastases. Conclusions. This study showed that Tc-99m MIBI SPECT is a useful tool to detect metastatic lesions in PTC with elevated hTg but negative I-131 WBS. However, small lymph node and lung metastases may be missed in Tc-99m MIBI SPECT. In the latter circumstance, other imaging studies should be included in the follow-up protocol.

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