Diagnostic value of [۹۹mTc]Tc-HYNIC-TOC scintigraphy in the management of differentiated thyroid cancer with elevated thyroglobulin and negative radioiodine whole-body scan

Mohammad Esmatinia; Emran Askari; Athena Aghaee; Parinaz Jahanpanah; Narjess Ayati; Susan Shafiei; Kamran Aryana

Diagnostic value of [۹۹mTc]Tc-HYNIC-TOC scintigraphy in the management of differentiated thyroid cancer with elevated thyroglobulin and negative radioiodine whole-body scan

محل انتشار: مجله پزشکی هسته ای ایران، دوره: 30، شماره: 2

سال انتشار: 1401

نوع سند: مقاله ژورنالی

زبان: انگلیسی

مشاهده: 185

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علوم پزشکی > سرطان

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لینک ثابت به این مقاله:

https://civilica.com/doc/1476794

شناسه ملی سند علمی:

JR_IRJNM-30-2_007

تاریخ نمایه سازی: 8 تیر 1401

چکیده مقاله:

Introduction: Negative radioiodine (۱۳۱I) whole-body scan with elevated serum thyroglobulin (Tg) level are found in ۲۰% of patients with differentiated thyroid cancer (DTC), which can be a diagnostic challenge. We evaluated the efficacy of Technetium-۹۹m-Hydrazinonicotinyl-Tyr۳-Octreotide ([۹۹mTc]Tc-HYNIC-TOC) somatostatin receptor scintigraphy (SRS) for detection of non-iodine-avid metastases and its impact on staging and management of these patients. Methods: The study population consisted of ۳۵ DTC patients (۲۵ females; PTC = ۸۸.۲%, FTC = ۱۱.۸%) who had elevated serum Tg levels despite negative post-ablation radioiodine whole-body scan. All patients underwent whole body SRS ۳-۴ hours after intravenous injection of ۲۰mCi (۷۴۰ MBq) of [۹۹mTc]Tc-HYNIC-TOC. Sites of suspected radiotracer accumulation were confirmed with anatomic imaging. Ultimately, corresponding changes in the staging and management were recorded.Results: SRS was positive in ۲۷ (۷۷.۱%) cases. Patients with positive scan had significantly higher Tg levels at the time of scan, compared to those with negative scans (۱۵۴.۵±۱۸۸.۶ vs. ۲۸.۲±۳۲.۷ ng/mL, p-value = ۰.۰۰۵). Interestingly, previous history of neck external beam radiation therapy (EBRT) was significantly correlated with [۹۹mTc]Tc-HYNIC-TOC avidity (Likelihood ratio = ۱۱.۲, p = ۰.۰۰۵). Addition of SSTR scintigraphy changed overall staging and management in ۱۱% and ۳۲.۴% of the patients, respectively.Conclusion: SRS can be a useful diagnostic adjunct in DTC patients with highly elevated Tg and negative radioiodine whole-body scan. The likelihood of positive findings on [۹۹mTc]Tc‑HYNIC‑TOC was higher in cases with previous history of EBRT or high Tg levels (i.e. suppressed-Tg >۸۰ ng/mL) at the time of scan.

کلیدواژه ها:

[۹۹mTc]Tc-HYNIC-TOC ، Somatostatin receptor scintigraphy ، Differentiated thyroid carcinoma ، TENIS syndrome

نویسندگان

Mohammad Esmatinia