scholarly journals False Positive Findings on I-131 WBS and SPECT/CT in Patients with History of Thyroid Cancer: Case Series

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Zeina C. Hannoush ◽  
Juan D. Palacios ◽  
Russ A. Kuker ◽  
Sabina Casula
Keyword(s):  
Computed Tomography ◽  
Thyroid Cancer ◽  
False Positive ◽  
Photon Emission ◽  
Thyroid Tissue ◽  
Case Series ◽  
Whole Body ◽  
Cancer Case ◽  
Emission Computed Tomography ◽  
Thyroglobulin Level

Introduction. Although whole body scan (WBS) with I-131 is a highly sensitive tool for detecting normal thyroid tissue and metastasis of differentiated thyroid cancer (DTC), it is not specific. Additional information, provided by single photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) and by the serum thyroglobulin level, is extremely useful for the interpretation of findings. Case Presentation. We report four cases of false positive WBS in patients with DTC: ovarian uptake corresponding to an endometrioma, scrotal uptake due to a spermatocele, rib-cage uptake due to an old fracture, and hepatic and renal uptake secondary to a granuloma and simple cyst, respectively. Conclusions. Trapping, organification, and storage of iodine are more prominent in thyroid tissue but not specific. Physiologic sodium-iodine symporter expression in other tissues explains some, but not all, of the WBS false positive cases. Other proposed etiologies are accumulation of radioiodine in inflamed organs, metabolism of radiodinated thyroid hormone, presence of radioiodine in body fluids, and contamination. In our cases nonthyroidal pathologies were suspected since the imaging findings were not corroborated by an elevated thyroglobulin level, which is considered a reliable tumor marker for most well-differentiated thyroid cancers. Clinicians should be aware of the potential pitfalls of WBS in DTC to avoid incorrect management.

scholarly journals Incidental finding of ovarian teratoma on post-therapy scan for papillary thyroid cancer and impact of SPECT/CT imaging

2011 ◽  
Vol 55 (7) ◽  
pp. 490-493 ◽  
Author(s):  
Anwar Ali Jammah ◽  
Albert Driedger ◽  
Irina Rachinsky
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Photon Emission ◽  
Thyroid Tissue ◽  
Cystic Teratoma ◽  
Whole Body ◽  
Ovarian Teratoma ◽  
Emission Computed Tomography ◽  
Papillary Thyroid

A 41-year old woman post thyroidectomy and neck dissection is presented in this case. She initially presented goiter and an enlarged cervical lymph node. She had no family history of cancer or radiation therapy. She had total thyroidectomy and found to have papillary thyroid cancer (T4N1M0). Histopathology report revealed multifocal classical papillary thyroid carcinoma with lympho-vascular invasion, extra-thyroidal extension, and positive lymph nodes. She was treated with 6.5 Gigabecquerel (GBq) of 131Iodine. Whole-body scan showed uptake in the neck and large focus in the left lower abdomen. Single-photon emission computed tomography SPECT/CT demonstrated a round shaped mass in the left pelvis. Pathology revealed cystic teratoma with benign thyroid tissue (struma ovarii), and no malignancy. Two months later, she had the second treatment with 5.5 GBq 131Iodine. Her follow-up stimulated and non-stimulated thyroglobulin levels were significantly lower, and there was no abnormal uptake in the follow-up scan.

scholarly journals Single photon emission computed tomography (SPECT)/computed tomography using Iodine-123 in patients with differentiated thyroid cancer: additional value over whole body planar imaging and SPECT

2010 ◽  
Vol 162 (6) ◽  
pp. 1131-1139 ◽  
Author(s):  
Tara Barwick ◽  
Iain Murray ◽  
Hakim Megadmi ◽  
William M Drake ◽  
P Nick Plowman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Thyroid Cancer ◽  
Single Photon ◽  
Photon Emission ◽  
Spect Imaging ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
Iodine 123 ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

ObjectiveThe aim of the study was to assess the diagnostic performance of co-registered single photon emission computed tomography (SPECT)/computed tomography (CT) compared to Iodine-123 whole body gamma camera (WBGC) imaging and to SPECT alone in patients with differentiated thyroid cancer.MethodsWBGC and SPECT/CT (n=85) imaging of the neck and thorax was performed in 79 consecutive patients. Three experienced observers reviewed: i) WBGC images followed by ii) SPECT alone, and iii) co-registered SPECT/CT. Foci of increased radioiodine uptake were classified on a five-point scale. Biopsy, other imaging modalities, and clinical follow-up served as the reference standard.ResultsTwenty-two patients had local recurrence or metastatic thyroid cancer (11 were radioiodine negative), 9 had remnant thyroid tissue, and 54 had no evidence of disease. When classifying equivocal, probably, and definitely malignant findings as positive for malignancy, the sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 41, 68, 31, and 77% for WBGC imaging; 45, 89, 59, and 82% for WBGC plus SPECT imaging; and 50, 100, 100, and 85% for WBGC plus SPECT/CT imaging respectively. The specificity was improved by the addition of SPECT (P=0.0002) and SPECT/CT (P<0.0001) than to WBGC imaging. SPECT/CT was also more specific than WBGC plus SPECT imaging (P=0.016). In a study-based analysis, SPECT/CT provided additional diagnostic information in 42% (36/85) of cases. SPECT/CT provided further characterization in 70% (63/90) of foci and improved the diagnostic confidence of all three observers.ConclusionThe addition of SPECT/CT significantly improved the diagnostic information over Iodine-123 WBGC imaging and WBGC plus SPECT imaging alone.

scholarly journals Tc-99m HYNIC-TOC scintigraphy in dedifferentiated thyroid cancer

2019 ◽  
Vol 12 (4) ◽  
pp. e227910
Author(s):  
Kanhaiyalal Agrawal ◽  
P Sai Sradha Patro ◽  
C Preetam
Keyword(s):  
Thyroid Cancer ◽  
Single Photon ◽  
Somatostatin Receptor ◽  
Photon Emission ◽  
Peptide Receptor Radionuclide Therapy ◽  
Ct Imaging ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
Serum Thyroglobulin ◽  
Pet Ct

There is literature evidence showing utility of somatostatin receptor (SSTR) positron emission tomography-CT (PET-CT) imaging in differentiated thyroid cancer with Thyroglobulin Elevated and Negative Iodine Scan (TENIS). These patients are less benefited with I-131 therapy and surgery remains only curable option if disease could be localised. If surgery is not feasible, other therapeutic options are not promising. However, if these patients show strongly positive SSTR imaging, then possibility of peptide receptor radionuclide therapy may be explored. As SSTR PET-CT imaging is expensive and not widely available, Technetium-99m (Tc-99m) hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC), which is a Single photon emission computed tomography (SPECT) tracer, can be used. We are documenting a case of raised serum thyroglobulin antibody and negative I-131 whole body scan with disease recurrence localised on Tc-99m HYNIC-TOC scan.

scholarly journals The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastoma

2021 ◽  
Vol 20 (4) ◽  
pp. 22-32
Author(s):  
E. D. Kireeva ◽  
. Kailash ◽  
T. V. Shamanskaya ◽  
M. Ya. Yadgarov ◽  
D. Yu. Kachanov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
Planar Imaging ◽  
Single Photon Emission ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

The value of single-photon emission computed tomography combined with computed tomography imaging in ¹²³I-Metaiodobenzylguanidine scintigraphy in children with neuroblastomaWhole body scintigraphy with ¹²³I-Metaiodobenzylguanidine (¹²³I-MIBG) is an important imaging modality for evaluation of patients with neuroblastoma (NB). As the intrinsic nuclear scintigraphic characteristics, the assessment of conventional planar ¹²³I-MIBG images presents some difficulties. The limited resolution of planar images can induce false-negative results for small lesions, whereas the presence of physiologic MIBG uptake is not always easily differentiable from pathologic uptake and can induce false-positive results. Single-photon emission computed tomography combined with computed tomography (SPECT/ CT) hybrid imaging technique, allowing the direct fusion of morphologic and functional information, has been suggested to be more accurate. However, SPECT/CT imaging renders slightly more radiation to patients from CT portion of the study and is time consuming. The aim of our study was to investigate how much SPECT/CT can have additional diagnostic value over planar imaging in NB patients at initial staging. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. A total of 251 SPECT/CT scans following by planar ¹²³I-MIBG imaging scans performed in 251 patients with NB were retrospectively analyzed. In 72.1% of the studies, the whole-body planar images and SPECT/CT images showed the same result. In 27.9% of studies, however, SPECT/CT images provided additional very important information. In our study, the diagnosis reached by planar imaging was revised or specified by SPECT/CT in 70 of the 251 patients and was clinically significant. 

scholarly journals Primary accessory thyroid carcinoma with negative 99mTcO4− SPECT/CTimaging: a case report and literature review

2019 ◽  
Vol 47 (8) ◽  
pp. 3934-3939
Author(s):  
Yibo Ma ◽  
Feng Qian ◽  
Jianfeng Wang ◽  
Yanping Liu ◽  
Shuiqing Liu
Keyword(s):  
Computed Tomography ◽  
Thyroid Carcinoma ◽  
Single Photon ◽  
Thyroid Cartilage ◽  
Photon Emission ◽  
Thyroid Tissue ◽  
Punch Biopsy ◽  
Pathological Examination ◽  
Emission Computed Tomography ◽  
Accessory Thyroid

Introduction In contrast to orthotopic thyroid carcinoma, primary accessory thyroid carcinoma is very rare. We herein report a case involving primary accessory thyroid carcinoma in a patient with normal ultrasonography of the orthotopic thyroid and negative 99mTcO4− single-photon emission computed tomography (SPECT) scintigraphy. Case presentation: A computed tomography (CT) scan showed soft tissue nodules at the left anterior edge of the thyroid cartilage. To determine whether the mass was accessory thyroid tissue, 99mTcO4− SPECT/CT was performed, and the findings were negative. However, pathological examination after resection showed that mass was a primary accessory thyroid papillary carcinoma. The 1-year follow-up ultrasound showed no lesion at the orthotropic thyroid and neck incision sites. Conclusions This case suggests that negative 99mTcO4− SPECT/CT imaging may not completely exclude the possibility of thyroid carcinoma. A punch biopsy or postoperative pathological examination is necessary for the diagnosis.

Compton-camera-based SPECT for thyroid cancer imaging

2020 ◽  
pp. 1-14
Author(s):  
Hengyong Yu ◽  
Ge Wang
Keyword(s):  
Computed Tomography ◽  
Thyroid Cancer ◽  
Detection Efficiency ◽  
Single Photon ◽  
Photon Emission ◽  
Resolution Enhancement ◽  
Spect Imaging ◽  
Emission Computed Tomography ◽  
Compton Camera ◽  
Study Results

Thyroid cancer is the most common type of endocrine-related cancer and the most common cancer in young women. Currently, single photon emission computed tomography (SPECT) and computed tomography (CT) are used with radioiodine scintigraphy to evaluate patients with thyroid cancer. The gamma camera for SPECT contains a mechanical collimator that greatly compromises dose efficiency and limits diagnostic sensitivity. Fortunately, the Compton camera is emerging as an ideal approach for mapping the distribution of radiopharmaceuticals inside the thyroid. In this preliminary study, based on the state-of-the-art readout chip Timepix3, we investigate the feasibility of using Compton camera for radiotracer SPECT imaging in thyroid cancer. A thyroid phantom is designed to mimic human neck, the mechanism of Compton camera-based event detection is simulated to generate realistic list-mode data, and a weighted back-projection method is developed to reconstruction the original distribution of the emission source. Study results show that the Compton camera can improve the detection efficiency for two or higher orders of magnitude comparing with the conventional gamma cameras. The thyroid gland regions can be reconstructed from the Compton camera measurements in terms of radiotracer distribution. This makes the Compton-camera-based SPECT imaging a promising modality for future clinical applications with significant benefits for dose reduction, scattering artifact reduction, temporal resolution enhancement, scan throughput increment, and others.

Nuclear Medicine Applications in Pediatric Musculoskeletal Diseases: The Added Value of Hybrid Imaging

2018 ◽  
Vol 22 (01) ◽  
pp. 025-045 ◽  
Author(s):  
Ramesh Iyer ◽  
A. Stanescu ◽  
Marguerite Parisi
Keyword(s):  
Computed Tomography ◽  
Nuclear Medicine ◽  
Single Photon ◽  
Musculoskeletal Diseases ◽  
Photon Emission ◽  
Added Value ◽  
Whole Body ◽  
Response Monitoring ◽  
Emission Computed Tomography ◽  
Nuclear Medicine Procedures

AbstractThe introduction of diphosphonates in the 1970s revolutionized not only nuclear medicine but musculoskeletal imaging as well, providing functional assessment of entities such as osteomyelitis, trauma, and osseous metastatic disease. Although rarely the first-line imaging modality used today, nuclear medicine procedures continue to play a pivotal role in the evaluation of musculoskeletal diseases in children, providing whole-body assessment of disease involvement. More recently, the introduction of technologies such as single-photon emission computed tomography/computed tomography (SPECT/CT), as well as newer positron-emitting tracers such as 18fluorine-fluorodeoxyglucose and sodium 18F-fluorine, particularly when combined with CT (positron emission tomography/CT), have injected new life into the older established techniques and expanded the application of nuclear medicine imaging into new arenas. This article discusses the utility of standard nuclear medicine procedures as they apply to children with musculoskeletal disorders, focusing on the added value of and indications for SPECT/CT. Subsequently, we discuss the expanding role of positron-emitting agents in infection, trauma, and for the diagnosis, staging, and therapeutic response monitoring of children with malignant bone and soft tissue tumors. Differences between disease processes encountered in children as compared with adults are discussed; developmental variants that can, but should not, be confused with disease are illustrated. The need for pediatric-specific protocols is addressed.

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