KMID : 1148920100440040273
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Nuclear Medicine and Molecular Imaging 2010 Volume.44 No. 4 p.273 ~ p.281
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Improved Detection of Lung or Bone Metastases with an I-131 Whole Body Scan on the 7th Day After High-Dose I-131 Therapy in Patients with Thyroid Cancer
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Chong A-Ri
Song Ho-Chun Min Jung-Joon Jeong Shin-Young Ha Jung-Min Kim Ja-Hae Yoo Su-Ung Oh Jong-Ryool Bom Hee-Seung
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Abstract
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Purpose: The purpose of this study is to compare post-therapy third day and seventh day I-131 whole body scans (3DWBS and 7DWBS) in detecting lung or bone metastasis from well-differentiated thyroid cancer.
Materials and Methods: We enrolled 52 patients with lung or bone metastasis out of 1,152 patients who were treated with high-dose I-131 therapy from January 2008 to June 2009. All patients underwent 3DWBS and 7DWBS. I-131 avidity was classified into three grades: no uptake, suspicious for uptake, and definite uptake. We compared the presence and grades of metastatic lesions on each scan. We categorized all cases into three groups based on I-131 uptake on each scan and compared several clinical parameters including FDG uptake and thyroglobulin (Tg) level among the groups.
Results: Sixty metastatic cases from 52 patients (45 lung and 15 bone metastases) were included. In 35 cases, I-131-avid metastatic lesions were detected by both 3DWBS and 7DWBS (group A). In 15 cases, metastatic lesions were missed on 3DWBS but detected on 7DWBS (group B). In 10 cases, I-131 uptake was not detected on either 3DWBS or 7DWBS (group C). Ten of 45 cases (22.2%) of lung metastasis that were negative on 3DWBS were detected on 7DWBS (p?=?0.002). Five of 15 cases (33.3%) of bone metastasis that were negative on 3DWBS were detected on 7DWBS (p?=?0.0625). The serum Tg level (TSH stimulated) was significantly different among groups A, B, and C (p?=?0.0030). However, after exclusion of cases without a history of I-131 therapy, there was no significant difference in serum Tg level among the groups (p?=?0.2330). The number of cases with a prior history of metastasis was higher in group A than in group B (p?=?0.0069). However, there was no significant difference in prior history of metastasis between groups A and C (p?=?0.8107).
Conclusion: 7DWBS showed more lung or bone metastatic lesions than 3DWBS. After high-dose I-131 therapy, 7DWBS should be considered regardless of the results of the 3DWBS for the diagnosis of lung or bone metastasis from well-differentiated thyroid cancer.
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KEYWORD
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Thyroid cancer, Distant metastasis, I-131, Post-therapy scan, Scan time
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