Korean J Nucl Med.
2000 Aug;34(4):285-293.
The Usefulness of Diagnostic Scan Using Technetium-99m Pertechnetate Scintigraphy prior to the First Ablative Radioiodine Treatment in Patients with Well Differentiated Thyroid Carcinoma: A Comparative Study with Iodine-131
Abstract
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PURPOSE: A prospective comparison was made between imaging with Tc-99m pertechnetate
(Tc-99m) and Ioine-131 (I-131) for the detection of residual and metastatic tissue after
total thyroidectomy in patients with well-differentiated thyroid carcinoma.
MATERALS AND METHODS: Initially our patients had imaging with Tc-99m, followed by I-131
within 3 days. The study included 21 patients who had ablation with high dose of I-131
ranging from 100 mCi to 150 mCi. Planar and pinhole images were acquired for both Tc-99m
and I-131. Diagnostic images of Tc-99m and I-131 were compared with post-therapy images.
Degree of uptake on Tc-99m and I-131 images was scored by four point scale and compared.
RESULTS
The results of the Tc-99m study were: 16 of 19 studies (84%) were positive on simple planar images, but 19 of 20 studies (95%) were positive on pinhole images. Conventional I-131 diagnostic imaging on the other hand showed that all studies (100%) were positive on both planar and pinhole images. There was a significant difference in degree of uptake between Tc-99m and I-131 planar images (p<0.05). Only one case of Tc-99m scintigraphy was negative on both planar and pinhole studies (false negative). There was no distant metastasis on the therapeutic I-131 images.
CONCLUSION
Tc-99m scan using pinhole in certain clinical situations is an alternative to the I-131 scan in detecting thyroid or lymph node metastasis prior to the first ablative treatment after thyroidectomy for well-differentiated thyroid carcinoma.
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