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J Nucl Med. 2008; 49 (Supplement 1):356P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

I-124 versus I-131 in the identification of suspected residual thyroid tissue or metastasis in patients with well-differentiated thyroid cancer (WDTC)

Douglas Van Nostrand1, Shari Moreau1, Francis Atkins1, Young-Rok Shin1, Kenneth Burman2 and Leonard Wartofsky2

1 Div Nucl Med; 2 Div Endo, Wash Hosp Ctr, Washington, District of Columbia

1507

Objectives: To compare the ability of I-124 PET imaging vs diagnostic I-131 planar imaging in detecting metastatic WDTC.

Methods: Prospectively, patients (pts) were selected for I-124 imaging who (1) had histologically proven WDTC, (2) were suspected of having metastatic WDTC (e.g. {uparrow} Tg levels, + recent FNA, suspicious enlarging mass), and (3) were referred for I-131 whole body dosimetry (DM). The prescribed activity was 1-2 mCi and 1.7 mCi for I-131 and I-124, respectively. Pts who were prepared with withdrawal (WD) had I-131 DM performed first (n=5). Those prepared with rh-TSH injections were randomized to receive I-131 or I-124 first (n=9). For each image, 1 reader (DVN) categorized every focus of I-131 and I-124 radioiodine uptake (RAIU) as 1=definite physiological uptake/artifact, 2=most likely physiological uptake/artifact, 3=indeterminate, 4=residual thyroid tissue/metastases (mets) in the neck/bed, 5=most likely distant mets, or 6=definite distant mets. Categories 4, 5 and 6 were considered positive (+). When available, foci were correlated with other diagnostic studies.

Results: Of the 14 pts, 5 pts (33%) had more + foci on I-124 than on I-131, of which 3 (60%) had mets confirmed by CT in 1 or more of the additional + I-124 foci. I-124 images were identical to I-131 in 8 pts (7 with no + foci; 1 with 2 + foci each). A total of 89 + foci were identified on either I-124 or I-131. I-124 identified 40 + foci not seen on I-131; one pt had one + focus on I-131 not seen on I-124, which has not yet been confirmed as a met.

Conclusions: Relative to I-131 planar imaging, I-124 PET imaging identified significantly more foci of RAIU suggestive of residual tissue or metastatic WDTC.

Research Support: Grants from Genzyme and Latham Fund





This Article
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Google Scholar
Right arrow Articles by Van Nostrand, D.
Right arrow Articles by Wartofsky, L.
PubMed
Right arrow Articles by Van Nostrand, D.
Right arrow Articles by Wartofsky, L.