Radionuclide monitoring and diagnostic algorithm for detection of relevance and metastasis in patients with iodine-negative forms of differentiated thyroid cancer
Solodiannykova O.I., Danylenko V.V., Bankovska N.V.
Summary. The aim of the work is to develop an algorithm for postoperative management of patients with iodine-negative metastases of differentiated thyroid cancer. Materials and methods. The object of the study is 115 patients with iodine-negative metastases of DTC. Research methods and equipment are whole-body scintigraphy (WBS) with 99mTc-MIBI; WBS with 99mTc-DMCA; X-ray computed tomography (CT); positron emission tomography (PET) with 18F-FDG; methods of statistical processing of results; two-detector gamma camera of the company «Mediso» (Hungary), single-photon emission computed tomography (SPECT) «E. CAM 180». Results. The study group consisted of 115 patients with iodine-negative metastases of the thyroid gland, of which 30 patients underwent WBS with 99mTc-MIBI, WBS with 99mTc-DMCA — 30 patients, PET with 18F-FDG — 30 patients, CT — 25 patients. Ten patients from the group in which WBS with 99mTc-MIBI was performed additionally underwent a complex scintigraphic study with 99mTc-pertechnetate, which included dynamic and static scintigraphy in order to obtain angiographic curves with metastatic foci of the thyroid gland. Conclusions. Two information sheets have been prepared and approved — «Algorithm for diagnostic support of patients with iodine-negative metastases of differentiated thyroid cancer» and «Method of treatment of patients with metastatic, progressive differentiated thyroid cancer refractory to radioactive iodine treatment».
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