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Objectives: The aim of this study is to investigate the value of Single Photon Emission Computed Tomography/ Computed Tomography (SPECT/CT) imaging in well differentiated
thyroid cancer (DTC) after radioiodine ablation (I-131) therapy for clinical staging and
risk stratification.To determine whether SPECT/CT would change management plan or predict the clinical outcomes of DTC patients. Methods: 78 DTC patients underwent first post radioiodine therapy “Whole body iodine- 131 scintigraphy (WBS) along with SPECT/CT” at Department of Radiology and Molecular imaging, Sultan Qaboos university Hospital between January 2014 and August 2017. Differences between WBS and SPECT/CT, change in clinical staging, risk stratification and management were recorded. Clinical outcome at 6-12 months was recorded. SPSS statistical software was used for collecting and analysing the data. A generalized McNemar test was used to assess disagreement between WBS and SPECT/CT. Results: American Thyroid Association (ATA) risk stratification falls into low (35.8%), intermediate (53.8%) and high risk groups (10.2%) on WBS, which changed to 44.8%, 38.4% and 16.6% respectively on SPECT/CT imaging. Overall change in risk stratification was noted in 16.6% and TNM stage in 11.5% of patients after SPECT/CT imaging. SPECT/CT changed therapeutic plan and clinical outcome in 19.2% of patients. Conclusion: SPECT/CT allows better detection and characterization of metastatic lymph nodes and distant metastasis in DTC patients compared to WBS imaging alone. It alters TNM staging, ATA risk classification and management in significant number of patients. It is recommended that SPECT/CT should be done routinely along with WBS in well differentiated thyroid carcinoma.
Keywords: Thyroid cancer, Iodine, Ablation techniques, SPECT/CT
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