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Staging and risk stratification of thyroid cancer improved with SPECT/CT
Date:5/3/2012

ion SPECT/CT scans can be used in addition to histopathology information to complete staging and risk stratification prior to radioablation. The pre-ablation scans can reveal unsuspected regional and distant metastatic lesions, resulting in changes in the prescribed I-131 activity, either by adjusting empiric I-131 doses or performing dosimetry calculations.

The article reports that SPECT/CT changed post-surgical staging in 21 percent patients, modified the treatment approach in 36 percent patient with disease, and led to avoidance of unnecessary I-131 therapy in 20 percent patients without disease. The findings on pre-ablation scans altered the recommended I-131 therapy in 58 percent patients as compared to therapy based on histopathologic risk stratification alone, by appropriately prescribing higher activities for treatment of regional and distant metastases and minimizing the activity prescribed for thyroid remnant ablation.

SPECT/CT is also very useful for evaluating unusual radioactivity distributions in thyroid cancer patients; accurate anatomic localization of radioactivity foci permits rapid exclusion of physiologic mimics of disease, or confirmation of metastatic lesions to unexpected sites.

"Diagnostic radioiodine scintigraphy with SPECT/CT provides a clear advantage for the management of patients with thyroid cancer," said Avram. "By integrating clinical, pathology and imaging information, the nuclear medicine physicians are able to offer an individualized treatment plan, bringing the nuclear medicine community a step closer to the goal of personalized medicine."

The incidence of thyroid cancer has increased 2.4 times since 1975. The U.S. National Cancer Institute estimates that in 2012 more than 56,000 cases of thyroid cancer will be diagnosed and nearly 1,800 individuals will die from the disease.


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Contact: Susan Martonik
smartonik@snm.org
703-652-6773
Society of Nuclear Medicine
Source:Eurekalert

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