technetium-tc-99m-tetrofosmin and Carcinoma--Papillary--Follicular

The effectiveness of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) and technetium-99m tetrofosmin (Tc-99m TF) single photon emission computed tomography (SPECT) of neck and chest was evaluated to detect metastatic lesions in well-differentiated thyroid carcinoma after nearly total thyroidectomy and radioiodine (I-131) treatment who present with elevated serum human thyroglobulin levels but negative I-131 whole body scan.. Twenty-three patients with differentiated thyroid carcinoma who underwent nearly total thyroidectomy and I-131 treatments were included in this study.. All of the 23 patients had negative I-131 whole body scan and elevated human thyroglobulin levels under thyroid-stimulating hormone stimulation. Metastatic lesions were detected by FDG-PET in 20 patients, while Tc-99m TF SPECT revealed metastatic lesions in only 11 of the 20 patients. Both FDG-PET and Tc-99m TF SPECT failed to demonstrate miliary pulmonary metastases in two of the remaining three patients. The other patient did not show any lesion on FDG-PET, Tc-99m TF SPECT, chest computed tomography, or other imaging techniques.. This study demonstrated that FDG-PET is more sensitive than Tc-99m TF SPECT to detect metastatic lesions in differentiated thyroid carcinoma with elevated human thyroglobulin but negative I-131 whole body scan. However, miliary pulmonary metastases could be missed by the both techniques.

Topics: Adult; Aged; Carcinoma, Papillary, Follicular; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Iodine Radioisotopes; Male; Middle Aged; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Sensitivity and Specificity; Thyroid Neoplasms; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon

This report describes the accurate localization of metastatic lesions in a patient with differentiated mixed thyroid cancer using 99mTc-tetrofosmin imaging. A 66-yr-old women with a cytological diagnosis of follicular thyroid cancer associated with a large amount of goiter changes was studied by 99mTc-tetrofosmin total-body scintigraphy. No significant tetrofosmin uptake was observed in the thyroid nodules, which mainly showed goiter abnormalities. Abnormal increased tetrofosmin uptake, however, was found in metastatic tumor lesions located in the cervical and dorsal spine as well as in the left lower chest wall and lungs. In conclusion, 99mTc-tetrofosmin, a new radiopharmaceutical proposed for myocardial perfusion imaging, may be useful in patients with thyroid cancer.

Topics: Aged; Carcinoma, Papillary, Follicular; Female; Humans; Lung Neoplasms; Organophosphorus Compounds; Organotechnetium Compounds; Radionuclide Imaging; Spinal Neoplasms; Thoracic Neoplasms; Thyroid Neoplasms