Comparative analysis and evaluation of the diagnostic effectiveness of scintigraphic, morphological and metabolic imaging for the detection of iodine-negative metastases and recurrences of differentiated thyroid cancer
Solodyannуkova O.I.1, Danilenko V.V. 1, Kmetiuk Ya.V.2
- 1Nonprofit Organization National Cancer Institute Kyiv, Ukraine
- 2All-Ukrainian Center of Radiosurgery, Clinical Hospital «Feofaniya», Kyiv, Ukraine
Summary. Aim. To develop an algorithm for postoperative management of patients with iodine-negative metastases of differentiated thyroid cancer (DTC). Materials and methods. We examined 115 patients with iodine-negative metastases of DTC, of whom 30 underwent SPECT with Technetium-99m sestamibi (MIBI) (99mTc-MIBI) — 30, SPECT with Technetium-99m-dimercaptosuccinic acid (99mTc-DMCA) — 30, positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) — 30, computed tomography (CT) — 25. 10 patients from the group undergoing SPECT with 99mTc-MIBI additionally underwent a comprehensive scintigraphic examination with 99mTc-pertechnetate, which included dynamic and static scintigraphy to obtain angiographic curves with metastatic foci of PTC. The following methods using non-iodine RPS, namely 99mTc-MIBI, 99mTc-DMCA and 99mTc-pertechnetate, were used to diagnose iodine-negative metastases of PTC. Results. A comparative evaluation of iodine-negative RPS, CT and PET / CT with 18F-FDG revealed the highest percentage of sensitivity and specificity of scintigraphic imaging with PET / CT with 18F-FDG, which were 92.8±11.2 and 89.4±9.2, respectively. Conclusions. It has been proven that the creation and use of an algorithm for postoperative management of patients with iodine-negative forms of DTC will allow timely detection of recurrence and metastasis and appropriate treatment, namely surgical, radiation and targeted therapy.
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