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This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Zwas, S. Articles by Rotenberg, G. PubMed Articles by Zwas, S. Articles by Rotenberg, G.

Optimizing high dose therapy (HDT) I-131 (RAI) whole body scans (WBS) in patients with DTC – Part A

¹ Nuclear Medicine; ² Endocrinology, C. Sheba Medical Center, Ramat-Gan, Israel

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Objectives: HDT-RAI WBS in DTC is considered highly efficient in demonstrating residual/recurrent disease. However, findings vary with scanning time intervals (TI) commonly up to 2w post RAI (~ 7d in our dept). The goal was to demonstrate possible WBS-TI changes to optimize WBS results.

Methods: Study group included 33 DTC pts (24F, 9M, mean age 51y) who had early & delayed TI-WBS using dual-head gamma-cameras equipped with high energy collimators. Each pt WBS were compared, and analysed for site changes.

Results: Two HDT groups were identified. Group A: 16 pts with HDT for thyroid remnants ablation (mean 99 mCi dose) who had WBS at 3.6 and 7.4 d (mean). Group B: 17 pts with HDT for disease recurrence (mean 190 mCi dose) with WBS at 3.8 and 7.3 d (mean). Finally, 85 sites were identified. Group A: 28 sites seen: 24 in the thyroid bed/pyramidal lobe; 4 in lymph nodes. Group B: 57 sites seen: 11 in the thyroid bed/pyramidal lobe. 46 in lymph nodes, lungs, bones, and others. Early and delayed WBS analyses showed no TI changes in 38.8% of lesions. Positive TI changes were seen on 7d WBS in 61.2%: decreased activity in 17.7%, increased in 34.1%, and new sites in 9.4%. Group A: No changes in 39.2%; decreased in 35.7%; increased in 10.7%; new sites in 14.4%. Group B: No difference in 38.5%; decreased in 8.8%; increased in 45.7%; new sites in 7.0%. Thyroid remnants/pyramidal lobe were seen better on early WBS while delayed scans showed significant increase/new sites in lungs, lymph node mets in 45.5%,and in group B in 52.7%.

Conclusions: WBS-TI considerations should include the imaging changes with time. Since a single TI is preferred, an intermediate (~5 days) WBS is recommended. A prospective study is currently underway to verify this concept.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Zwas, S. Articles by Rotenberg, G. PubMed Articles by Zwas, S. Articles by Rotenberg, G.