International Journal of Frontiers in Medicine, 2024, 6(7); doi: 10.25236/IJFM.2024.060707.
Jingxia Wang1, Zhijun Dai2, Jianguo Xu1, Rui Liang1, Tingyan Fu1, Yong Yang1
1Department of Nuclear Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, 750002, China
2Medical Imaging Center, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, 750002, China
Investigation of the diagnostic efficacy of 99mTc-MIBI SPECT/CT imaging combined with therapeutic iodine scan in iodine-refractory differentiated thyroid carcinoma (RAIR-DTC) patients. A total of 26 suspected RAIR-DTC patients who underwent 131I therapy from March 2019 to December 2022 were collected. All patients had completed total thyroidectomy and subsequent radioiodine ablation therapy. They underwent 99mTc-MIBI SPECT/CT imaging (on admission day 1) followed by therapeutic iodine scan (131I-WBS, on admission days 2-5). RAIR-DTC diagnosis was confirmed pathologically or by comprehensive clinical assessment. Chi-square test was used to evaluate the diagnostic performance of the two imaging methods. One patient was lost to follow-up, leaving 25 patients included in the study, with 18 diagnosed as RAIR-DTC based on pathology or clinical evaluation. Among the 25 suspected RAIR-DTC patients, 15 showed positive 99mTc-MIBI imaging and 10 showed negative imaging, with corresponding stimulated thyroglobulin (Tg) levels of 89.00 ng/ml (3.19-268.00) and 1.60 ng/ml (0.64-3.10), respectively, showing statistically significant difference (P = 0.002). Among the 18 confirmed RAIR-DTC patients, 8 showed complete lack of 131I uptake and 10 showed partial uptake, with stimulated Tg levels of 55.60 ng/ml (3.04-229.00) and 0.80 ng/ml (0.17-1.80), respectively, showing statistically significant difference (P < 0.01). When using a stimulated Tg cutoff value of 2.55 ng/ml, the sensitivity and specificity for diagnosing RAIR-DTC were 83.3% and 100%, respectively, with an area under the curve of 0.93. Among the 18 confirmed RAIR-DTC patients, 37 lymph node metastases were found, with 30 lymph nodes showing positive 99mTc-MIBI imaging and 14 lymph nodes showing positive 131I-WBS imaging, demonstrating statistical difference (P < 0.001). 99mTc-MIBI imaging combined with therapeutic 131I-WBS, along with stimulated Tg, improves the diagnostic efficacy for RAIR-DTC. 99mTc-MIBI imaging is highly valuable in identifying cervical lymph node metastases in RAIR-DTC patients.
99mTc-MIBI; Iodine-refractory differentiated thyroid cancer (RAIR-DTC); Therapeutic iodine scan; thyroglobulin
Jingxia Wang, Zhijun Dai, Jianguo Xu, Rui Liang, Tingyan Fu, Yong Yang. Value of 99mTc-MIBI SPECT-CT fusion tomography combined with therapeutic iodine scan in RAIR-DTC evaluation. International Journal of Frontiers in Medicine (2024), Vol. 6, Issue 7: 38-43. https://doi.org/10.25236/IJFM.2024.060707.
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