Diagnostic capabilities of I-131, Tl-201, and Tc-99m-MIBI scintigraphy for metastatic differentiated thyroid carcinoma after total thyroidectomy

Shunji Fujie, Yoshihiro Okumura, Shuhei Sato, Shiro Akaki, Kuniaki Katsui, Kengo Himei, Mitsuhiro Takemoto, Susumu Kanazawa

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We investigated the diagnostic capabilities of I-131, Tl-201, and Tc-99m-MIBI (hexakis-2-methoxyisobutyl-isonitrile) scintigraphy for thyroid cancer metastases after total thyroidectomy over the entire body and for every locus before and after thyroid bed ablation. After total thyroidectomy of thyroid cancer, 36 cases were subjected to I-131 treatment 64 times. They consisted of 17 men and 19 women with 31 papillary carcinomas and 5 follicular carcinomas. Their ages were 22-75 (an average of 60.5 ± 12.3) years. I-131 scintigraphy (I-131), Tl-201 scintigraphy (Tl-201), and Tc-99m-MIBI scintigraphy (Tc-99m-MIBI) were performed. We defined the metastases as those cases in which serum thyroglobulin (Tg) increased significantly or in which we were able to prove the lesions on CT (computed tomography), MRI (magnetic resonance imaging) or bone scintigram. Three radiology medical specialists visually evaluated each scintigram and calculated the sensitivity, specificity, and likelihood ratio. For whole-body sensitivity, both Tl-201 and Tc-99m-MIBI were high before ablation and I-131 was high after ablation. Before ablation, the negative likelihood ratio was less than 0.1 for Tl-201 and Tc-99m-MIBI, while the positive likelihood ratio was more than 10 for Tl-201. After ablation, the positive likelihood ratio for I-131, Tl-201, and Tc-99m-MIBI was more than 10. The sensitivity of the mediastinum was appropriate, except for I-131 before ablation, and the sensitivity of the lung before and after ablation was inferior for either tracer. The specificity of the cervix for I-131 before ablation was markedly deteriorated, but it increased after ablation. Copyright

Original languageEnglish
Pages (from-to)99-107
Number of pages9
JournalActa medica Okayama
Volume59
Issue number3
Publication statusPublished - Jun 1 2005

Keywords

  • I-131 scintigraphy
  • Tc-99m-MIBI scintigraphy
  • Thyroid cancer metastases
  • Tl-201 scintigraphy

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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