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Comparison of 131I whole-body imaging, 131I SPECT/CT, and 18F-FDG PET/CT in the detection of metastatic thyroid cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to compare 131I whole-body scintigraphy (WBS), WBS with 131I single photon emission computed tomography/computed tomography (SPECT/CT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the detection of distant metastases of differentiated thyroid cancer (DTC).

Methods

A total of 140 patients with 258 foci of suspected distant metastases were evaluated. 131I WBS, 131I SPECT/CT, and 18F-FDG PET/CT images were interpreted separately. The final diagnosis was obtained from histopathologic study, serum thyroglobulin level, other imaging modalities, and/or clinical follow-up.

Results

Of the 140 patients with 258 foci, 46 patients with 166 foci were diagnosed as positive for distant metastasis. The sensitivity, specificity, and diagnostic accuracy of each imaging modality were 65, 55, and 59%, respectively, for 131I WBS; 65, 95, and 85% for 131I SPECT/CT, respectively; and 61, 98, and 86%, respectively, for 18F-FDG PET/CT in patient-based analyses. Lesion-based analyses demonstrated that both SPECT/CT and PET/CT were superior to WBS (p<0.001) in all patient groups. SPECT/CT was superior to WBS and PET/CT (p<0.001) in patients who received a single challenge of radioiodine therapy, whereas PET/CT was superior to WBS (p=0.005) and SPECT/CT (p=0.013) in patients who received multiple challenges.

Conclusion

Both SPECT/CT and PET/CT demonstrated high diagnostic performance in detecting metastatic thyroid cancer. SPECT/CT was highly accurate in patients who underwent a single challenge of radioiodine therapy. In contrast, 18F-FDG PET/CT presented the highest diagnostic performance in patients who underwent multiple challenges of radioiodine therapy.

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Acknowledgement

This research was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (No. 2010-0028751), Republic of Korea, and in part by the Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University.

Conflicts of interest

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Authors and Affiliations

  1. Department of Nuclear Medicine, Clinical Medicine Research Center, Chonnam National University Hospital, 671 Jebongno, Gwangju, 501-757, Republic of Korea

    Jong-Ryool Oh, Ari Chong, Jahae Kim, Sae-Ryung Kang, Dong-Yeon Kim, Ho-Chun Song & Hee-Seung Bom

  2. Department of Nuclear Medicine, Clinical Medicine Research Center, Chonnam National University Hwasun Hospital, 160 Ilsimri, Hwasun, Jeonnam, 519-809, Republic of Korea

    Byung-Hyun Byun, Sun-Pyo Hong, Su-Woong Yoo & Jung-Joon Min

  3. Department of Chemistry, Dongguk University, Seoul, Republic of Korea

    Dong-Yeon Kim

  4. Center for Biomedical Human Resources at Chonnam National University, Brain Korea 21 Project, Gwangju, Republic of Korea

    Jung-Joon Min

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  1. Jong-Ryool Oh
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Oh, JR., Byun, BH., Hong, SP. et al. Comparison of 131I whole-body imaging, 131I SPECT/CT, and 18F-FDG PET/CT in the detection of metastatic thyroid cancer. Eur J Nucl Med Mol Imaging 38, 1459–1468 (2011). https://doi.org/10.1007/s00259-011-1809-x

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  • DOI: https://doi.org/10.1007/s00259-011-1809-x

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