SPECT/CT guides postop management of thyroid cancer

Share this article:

Information obtained from single positron emission computed tomography (SPECT)/computed tomography (CT) scans helps determine the need for radioiodine therapy in persons with thyroid cancer and influences the long-term follow-up strategy for such patients, according to research presented in The Journal of Nuclear Medicine (2012;53:754-764).

“The new technology of SPECT/CT has substantially improved the interpretation of planar studies and can be implemented in the postoperative management protocols of thyroid cancer patients,” affirmed report author Anca M. Avram, MD, of the Division of Nuclear Medicine/Radiology at University of Michigan Medical Center in Ann Arbor, in a statement issued by the Society of Nuclear Medicine (SNM).

For many years, postoperative management of persons with thyroid cancer included radioiodine administration followed by a post-therapy scan, explained Avram in her research paper. However, this approach has been challenged by evidence that remnant ablation does not improve survival in low-risk patients.

As noted in the SNM statement, SPECT/CT can determine lymph node status following radioiodine therapy more accurately than can planar imaging in persons with thyroid cancer, and SPECT/CT also improves anatomical localization of activity foci seen on planar imaging. In her report, Avram cited studies that speak to the high diagnostic value of radioiodine SPECT/CT: Such information resulted in changes in risk stratification and clinical management in a substantial number of patients.

Specifically, in various studies of persons with thyroid cancer, SPECT/CT imaging:

  • changed postsurgical staging in 21% of patients
  • modified the treatment approach in 36% of patients
  • altered the recommended radioiodine 131I therapy in 58% of patients compared with therapy based on histopathologic risk stratification alone, due to findings on preablation scans
  • accurately characterized 85% of foci considered inconclusive on planar imaging, resulting in altered management for 47% of patients
  • led to the avoidance of unnecessary 131I therapy in 20% of patients without disease.

Avram also noted that SPECT/CT is very useful in evaluating unusual radioactivity distributions in persons with thyroid cancer and in confirming metastases to unexpected sites.

Share this article:
You must be a registered member of ONA to post a comment.
close

Next Article in Web Exclusives

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs

More in Web Exclusives

Improved tyrosine kinase inhibitor (TKI) selectively activates in tumor tissue, minimizing side ...

A new strategy developed by an interdisciplinary team of researchers aims to reduce the side effects connected to use of tyrosine kinase inhibitors (TKIs).

Prior cancer exclusion criteria may stymie potential of lung cancer clinical trials

A history of prior cancer can exclude many individuals from participation in clinical trails related to lung cancer, even when the prior cancer is unlikely to interfere with treatment outcomes.

Better adherence to guidelines for safe handling of antineoplastic drugs is needed

Recommended safe handling practices for workers who administer antineoplastic drugs in health care settings are not always followed, according to a new study.