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Nuklearmedizin 1996; 35(06): 230-265
DOI: 10.1055/s-0038-1629781
Original Article
Schattauer GmbH

Tc-99m-Tetrofosmin Scintigraphy: An Alternative Scintigraphic Method for Following up Differentiated Thyroid Carcinoma

Preliminary ResultsTc-99m-Tetrofosminszintigraphie: Ein alternatives szintigraphisches Verfahren in der Nachsorge des differenzierten SchilddrüsenkarzinomsVorläufige Ergebnisse
H. J. Gallowitsch
1   From the Department of Nuclear Medicine and Special Endocrinology, LKH Klagenfurt, Austria
,
E. Kresnik
1   From the Department of Nuclear Medicine and Special Endocrinology, LKH Klagenfurt, Austria
,
P. Mikosch
1   From the Department of Nuclear Medicine and Special Endocrinology, LKH Klagenfurt, Austria
,
W. Pipam
1   From the Department of Nuclear Medicine and Special Endocrinology, LKH Klagenfurt, Austria
,
Iris Gomez
1   From the Department of Nuclear Medicine and Special Endocrinology, LKH Klagenfurt, Austria
,
P. Lind
1   From the Department of Nuclear Medicine and Special Endocrinology, LKH Klagenfurt, Austria
› Author Affiliations
Further Information

Publication History

Received: 11 March 1996

in revised form: 10 April 1996

Publication Date:
02 February 2018 (online)

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Summary

Aim: The usefulness of the myocardial perfusion agent, Tc-99m-tetrofosmin (Myoview®) in the follow-up of differentiated thyroid carcinoma was evaluated in a clinical study of 15 patients, primary treated with thyroidectomy and high-dose I-131-therapy (2960-3700 MBq), 12 with suspected recurrence and metastases and three patients without any suspicion and compared with other non-specific tracers like TI-201 and Tc-99m-sestamibi. Method: Twelve patients with elevated thyroglobulin (Tg) levels of more than 10 ng/ml (group A), four of these had negative I-131 scans, and three patients with Tg levels less than 10 ng/ml (group B) were examined under TSH suppressive L-Thyroxine treatment. Whole body scans were taken with TI-201 (74 MBq; 20 min post injection), Tc-99m-sestamibi (370 MBq; 20-60 min post injection) and Tc-99m-tetrofosmin (370 MBq; 20-60 min post injection). Tumor/background ratios and optional time/activity analyses (up to 150 min post injection) were evaluated using the region of interest approach. Results: Compared with TI-201 (T/BG: 1.59, ± 0.396), Tc-99m-tetrofosmin showed slightly but not significant better T/BG ratios and detection rates (T/BG: 1.76, ± 0.345).Tc-99m-sestamibi (1.51, ± 0.31 p = 0.05) showea significantly lower values than Tc-99m-tetrofosmin. Conclusion: In the light of these results, scintigraphy with Tc-99m-tetrofosmin seems to be a possibly sensitive imaging modality in the follow-up of DTC with possible advantages concerning T/Bg ratio, background clearance, detection rate and dosimetry compared with TI-201 and Tc-99m-sestamibi, especially in patients with elevated Tg level and no iodine uptake , but further investigations are needed to confirm our preliminary results.

Zusammenfassung

Ziel: Die Verwendbarkeit des myokardialen Perfusionstracers Tc-99m-Tetrofosmin (Myoview®) für die Nachsorge des differenzierten Schilddrüsenkarzinoms wurde in einer Pilotstudie an primär operierten und ra-diojodtherapierten Patienten (12 Patienten mit Tg >10 ng/ml, 3 Patienten <10 ng/ml) evaluiert und der TI-201 und Tc-99m-Sestamibiszintigra-phie gegenübergestellt. Methoden: Nach Durchführung von Ganzkör-perszintigrammen mit Tc-99m-Tetrofosmin (370 MBq), Tc-99m-Sestamibi (370 MBq) und TI-201 (74 MBq) wurden mit Hilfe der ROI Methode T/Bg Ratios errechnet und optionale Zeit/Aktivitätsanalysen durchgeführt. Ergebnisse: Tc-99m-Tetrofosmin zeigt nach unseren vorläufigen Ergebnissen geringe Vorteile hinsichtlich Detektionsrate sowie T/Bg Ratio (T/BG: 1.76, ± 0.345) gegenüber TI-201 (T/BG: 1.59, ± 0.396) und Tc-99m-Sestamibi (1.51, ± 0.31 p = 0.05). Schlußfolgerung: Die Ganz-körperszintigraphie mit Tc-99m-Tetrofosmin stellt somit eine potentielle Alternative mit möglichen Vorteilen gegenüber anderen unspezifischen Tracern in der Nachsorge des differenzierten Schilddrüsenkarzinoms dar, speziell bei Patienten mit erhöhtem Tg-Spiegel und fehlender J-131 -Speicherung.

Keywords

Differentiated thyroid carcinoma - TI-201 - Tc-99m-sestamibi - Tc-99m-tetrofosmin

Schlüsselwörter

Differenziertes Schilddrüsenkarzinom - TI-201 - Tc-99m-Tetrofosmin - Tc-99m-Sestamibi
 

  • References

  • 1 Balachandran S, Sayle BA. Value of thyroid carcinoma imaging after therapeutic doses of radioiodine. Clin Nucl Med 1981; 6: 162-7.
    CrossrefPubMedSearch in Google Scholar
  • 2 Biedermann M, Bares R, Grün B. et al. Follow-up of thyroid cancer by MRI and Tc-99m-MIBI oncoscintigraphy. Nuklearmedizin 1995; 34: 87-91.
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Brendel AJ, Guyot M, Jeandot R. et al. Thallium-201 imaging in the follow-up of differentiated thyroid carcinoma. J Nucl Med 1988; 29: 1515-20.
    PubMedSearch in Google Scholar
  • 4 Brendel AJ, Guyot M, Jeandot R. et al. Tc-99m MIBI imaging in the follow-up of differentiated thyroid carcinoma. 36th Annual Meeting. J Nucl Med 1989; 30: 904-5.
    Search in Google Scholar
  • 5 Briele B, Hotze A, Kropp J. et al. Comparison of TI-201 and Tc-99m MIBI in the follow-up of differentiated thyroid carcinomas. Nuklearmedizin 1991; 30: 115-24.
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Burman KD, Anderson JH, Wartofsky L. et al. Management of patients with thyroid carcinoma: Application of Thallium-201 scintigraphy and magnetic resonance imaging. J Nucl Med 1990; 31: 1958-64.
    PubMedSearch in Google Scholar
  • 7 Charkes ND, Vitti RA, Brooks K. Thallium-201 SPECT increases detectabitlity of thyroid cancer metastases. J Nucl Med 1990; 31: 147-53.
    PubMedSearch in Google Scholar
  • 8 Chiu Ml, Kronauge JF, Piwinca-Worms D. Effect of mitochondrial and plasma membrane potentials on accumulation of hexakis (2-methoxyisobutyl isonitrile) technetium in cultured mouse fibroblasts. J Nucl Med 1990; 31: 1646-53.
    PubMedSearch in Google Scholar
  • 9 Civelek AC, Durski K, Shafique I. et al. Failure of Perchlorate to inhibit Tc-99m isonitrile binding by the thyroid during myocardial perfusion studies. Clin Nucl Med 1991; 16: 358-61.
    CrossrefPubMedSearch in Google Scholar
  • 10 Highley B, Smith FW, Smith T. et al. Techne-tium-99m-l,2-bis[bis(2-Ethoxy-ethyl)Phos-phino]Ethane: Human biodistribution, dosimetry and safety of a new myocardial perfusion imaging agent. J Nucl Med 1993; 34: 30-8.
    PubMedSearch in Google Scholar
  • 11 Hoefnagel BA, Delprat CC, Marcuse HR, de Vijlder JJM. Role of Thallium-201 total-body scintigraphy in follow-up of thyroid carcinoma. J Nucl Med 1986; 27: 1854-7.
    PubMedSearch in Google Scholar
  • 12 Kelly D, Forster A, Highley B. et al. Techne-tium-99m-Tc-99m-tetrofosmin as a new radiopharmaceutical for myocardial perfusion imaging. J Nucl Med 1993; 34: 222-7.
    PubMedSearch in Google Scholar
  • 13 Lebouthillier G, Morais J, Picard M. et al. Tc-99m-sestamibi and other agents in the detection of metastatic medullary carcinoma of the thyroid. Clin Nucl Med 1993; 18 (Suppl. 08) 657-61.
    CrossrefPubMedSearch in Google Scholar
  • 14 Leide S, Diemer H, Ahlgren L, Mattsson S. In vivo distribution and dosimetry of Tc-99m MIBI in man. In: Proceedings of 5th international radiopharmaceutical dosimetry symposium. Watson EE, Schlafke-Stelson AT. (eds). Oak Ridge Associated Universities. CONF 910529 1992: 483-49.
    Search in Google Scholar
  • 15 Muller S, Guth-Tougelidis B, Creutzig H. Imaging of malignant tumors with Tc-99m-MIBI SPECT. J Nucl Med 1987; 28: 562.
    Search in Google Scholar
  • 16 Nemec J, Nyvltova O, Preiningerova M. et al. Positive thyroid cancer scintigraphy using Tc-99m-tetrofosmin (Myoview): A preliminary report. Nucl Med Comm 1995; 16: 694-7.
    CrossrefPubMedSearch in Google Scholar
  • 17 Pacini F, Lippi F, Formica N. et al. Therapeutic doses of iodine-131 reveal un-diagnosed metastases in thyroid cancer patients with detectable serum thyroglobulin levels. J Nucl Med 1987; 28: 1888-91.
    PubMedSearch in Google Scholar
  • 18 Ramanna L, Waxman A, Braunstein G. Thallium-201 scintigraphy in differentiated thyroid cancer: Comparison with radioiodine scintigraphy and serum thyroglobulin determinations. J Nucl Med 1991; 32: 441-6.
    PubMedSearch in Google Scholar
  • 19 Sundram FX, Goh AS, Ang ES. Role of technetium-99mTc-99m-sestamibi in localization of thyroid cancer metastases. Ann Acad Med Singapore 1993; 22 (Suppl. 04) 557-9.
    PubMedSearch in Google Scholar
  • 20 van Sorge-Van Boxtel AJ, van Eck-Smit BL, Goslings M. Comparison of serum thyroglobulin, I-131 and TI-201 scintigraphy in the postoperative follow-up of differentiated thyroid cancer. Nucl Med Comm 1993; 14: 365-72.
    CrossrefPubMedSearch in Google Scholar
  • 21 Wackers FHT, Berman DS, Maddahi J. et al. Technetium-99m hexakis 2-methoxy-isobu-tyl isonitrile: Human biodistribution, dosimetry, safety, and preliminary comparison to Thallium-201 for myocardial perfusion imaging. J Nucl Med 1989; 30: 301-11.
    PubMedSearch in Google Scholar
  • 22 Wawschinek O, Eber O, Petek W. et al. Determination of urine iodine excretion with a modified cer-arsenite method. Report of ÒGKG 1985; 8: 13-156.
    Search in Google Scholar
  • 23 Waxman AD, Ramanna L, Chapman N. et al. The significance of I-131 scan doses in patients with thyroid cancer: determination of ablation: concise communication. J Nucl Med 1981; 22: 861.
    PubMedSearch in Google Scholar
  • 24 Yen TC, Lin HD, Lee CH. et al. The role of Tc-99m-sestamibi whole-body scans in diagnosing metastatic Huerthle cell carcinoma of the thyroid gland after total thyroidectomy: a comparison with iodine-131 and TI-201 whole body scans. Eur J Nucl 1994; 21: 980-3.
    Search in Google Scholar