RAI thyroid bed uptake after total thyroidectomy: A novel SPECT-CT anatomic classification system
| Autor: | Dipti Kamani, R. Michael Tuttle, Ravinder K. Grewal, Rebecca Zeuren, Ashok R. Shaha, Agnese Biagini, Gregory W. Randolph, Mona M. Sabra |
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| Rok vydání: | 2014 |
| Předmět: |
Ablation Techniques
Adult Male medicine.medical_treatment Thyroid Gland Remnant ablation Article Iodine Radioisotopes medicine Humans Postoperative Period Thyroid Neoplasms Thyroid cancer Total thyroidectomy Tomography Emission-Computed Single-Photon business.industry Thyroid Thyroidectomy Middle Aged medicine.disease medicine.anatomical_structure Otorhinolaryngology Thyroglobulin Female Radioactive iodine business Nuclear medicine Tomography X-Ray Computed Hormone |
| Zdroj: | The Laryngoscope. 125(10) |
| ISSN: | 1531-4995 |
| Popis: | Objective Recent, more selective use of radioactive iodine (RAI) has led to reevaluation of the clinical importance of achieving complete total thyroidectomy with minimal residual normal thyroid tissue. We utilize the improved localization by post-RAI remnant ablation, single photon emission computerized tomography-computed tomography (SPECT-CT) to define specific anatomic sites of residual RAI-uptake foci after total thyroidectomy for differentiated thyroid cancer (DTC) and to provide a novel classification system relating uptake to thyroid anatomy and preservation of adjacent neural structures. Study Design Retrospective. Method Radioactive iodine-uptake foci in thyroid bed were localized by SPECT/CT imaging at the time of RAI remnant ablation in 141 DTC patients undergoing total thyroidectomy. Results Minimal residual RAI uptake (median 0.32% at 24 hours) in the thyroid bed was detected by diagnostic planar whole body scans in 93% and by posttherapy SPECT/CT imaging in 99% of subjects. Discrete RAI uptake foci were identified on the SPECT/CT imaging at Berry's ligament (87%), at superior thyroid poles (79%), in paratracheal-lobar regions (67%), in isthmus-region (54%), and in pyramidal lobe (46%). Despite the residual foci, the nonstimulated thyroglobulin (Tg) prior to remnant ablation (with a median thyroid-stimulating hormone of 0.36 m IU/L) was |
| Databáze: | OpenAIRE |
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