Single photon emission computed tomography (SPECT)/computed tomography using Iodine-123 in patients with differentiated thyroid cancer: additional value over whole body planar imaging and SPECT

ObjectiveThe aim of the study was to assess the diagnostic performance of co-registered single photon emission computed tomography (SPECT)/computed tomography (CT) compared to Iodine-123 whole body gamma camera (WBGC) imaging and to SPECT alone in patients with differentiated thyroid cancer.MethodsW...

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Veröffentlicht in:European journal of endocrinology 2010-06, Vol.162 (6), p.1131-1139
Hauptverfasser: Barwick, Tara, Murray, Iain, Megadmi, Hakim, Drake, William M, Plowman, P Nick, Akker, Scott A, Chew, Shern L, Grossman, Ashley B, Avril, Norbert
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container_issue 6
container_start_page 1131
container_title European journal of endocrinology
container_volume 162
creator Barwick, Tara
Murray, Iain
Megadmi, Hakim
Drake, William M
Plowman, P Nick
Akker, Scott A
Chew, Shern L
Grossman, Ashley B
Avril, Norbert
description ObjectiveThe aim of the study was to assess the diagnostic performance of co-registered single photon emission computed tomography (SPECT)/computed tomography (CT) compared to Iodine-123 whole body gamma camera (WBGC) imaging and to SPECT alone in patients with differentiated thyroid cancer.MethodsWBGC and SPECT/CT (n=85) imaging of the neck and thorax was performed in 79 consecutive patients. Three experienced observers reviewed: i) WBGC images followed by ii) SPECT alone, and iii) co-registered SPECT/CT. Foci of increased radioiodine uptake were classified on a five-point scale. Biopsy, other imaging modalities, and clinical follow-up served as the reference standard.ResultsTwenty-two patients had local recurrence or metastatic thyroid cancer (11 were radioiodine negative), 9 had remnant thyroid tissue, and 54 had no evidence of disease. When classifying equivocal, probably, and definitely malignant findings as positive for malignancy, the sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 41, 68, 31, and 77% for WBGC imaging; 45, 89, 59, and 82% for WBGC plus SPECT imaging; and 50, 100, 100, and 85% for WBGC plus SPECT/CT imaging respectively. The specificity was improved by the addition of SPECT (P=0.0002) and SPECT/CT (P
doi_str_mv 10.1530/EJE-09-1023
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Three experienced observers reviewed: i) WBGC images followed by ii) SPECT alone, and iii) co-registered SPECT/CT. Foci of increased radioiodine uptake were classified on a five-point scale. Biopsy, other imaging modalities, and clinical follow-up served as the reference standard.ResultsTwenty-two patients had local recurrence or metastatic thyroid cancer (11 were radioiodine negative), 9 had remnant thyroid tissue, and 54 had no evidence of disease. When classifying equivocal, probably, and definitely malignant findings as positive for malignancy, the sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 41, 68, 31, and 77% for WBGC imaging; 45, 89, 59, and 82% for WBGC plus SPECT imaging; and 50, 100, 100, and 85% for WBGC plus SPECT/CT imaging respectively. The specificity was improved by the addition of SPECT (P=0.0002) and SPECT/CT (P&lt;0.0001) than to WBGC imaging. SPECT/CT was also more specific than WBGC plus SPECT imaging (P=0.016). In a study-based analysis, SPECT/CT provided additional diagnostic information in 42% (36/85) of cases. SPECT/CT provided further characterization in 70% (63/90) of foci and improved the diagnostic confidence of all three observers.ConclusionThe addition of SPECT/CT significantly improved the diagnostic information over Iodine-123 WBGC imaging and WBGC plus SPECT imaging alone.</description><identifier>ISSN: 0804-4643</identifier><identifier>EISSN: 1479-683X</identifier><identifier>DOI: 10.1530/EJE-09-1023</identifier><identifier>PMID: 20212015</identifier><language>eng</language><publisher>Bristol: BioScientifica</publisher><subject>Adenocarcinoma, Follicular - diagnostic imaging ; Adenocarcinoma, Papillary - diagnostic imaging ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Clinical Study ; Endocrinopathies ; Female ; Fundamental and applied biological sciences. Psychology ; Humans ; Iodine Radioisotopes ; Male ; Malignant tumors ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - diagnostic imaging ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; ROC Curve ; Sensitivity and Specificity ; Thyroid Neoplasms - diagnostic imaging ; Thyroid. 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Three experienced observers reviewed: i) WBGC images followed by ii) SPECT alone, and iii) co-registered SPECT/CT. Foci of increased radioiodine uptake were classified on a five-point scale. Biopsy, other imaging modalities, and clinical follow-up served as the reference standard.ResultsTwenty-two patients had local recurrence or metastatic thyroid cancer (11 were radioiodine negative), 9 had remnant thyroid tissue, and 54 had no evidence of disease. When classifying equivocal, probably, and definitely malignant findings as positive for malignancy, the sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 41, 68, 31, and 77% for WBGC imaging; 45, 89, 59, and 82% for WBGC plus SPECT imaging; and 50, 100, 100, and 85% for WBGC plus SPECT/CT imaging respectively. The specificity was improved by the addition of SPECT (P=0.0002) and SPECT/CT (P&lt;0.0001) than to WBGC imaging. SPECT/CT was also more specific than WBGC plus SPECT imaging (P=0.016). In a study-based analysis, SPECT/CT provided additional diagnostic information in 42% (36/85) of cases. SPECT/CT provided further characterization in 70% (63/90) of foci and improved the diagnostic confidence of all three observers.ConclusionThe addition of SPECT/CT significantly improved the diagnostic information over Iodine-123 WBGC imaging and WBGC plus SPECT imaging alone.</description><subject>Adenocarcinoma, Follicular - diagnostic imaging</subject><subject>Adenocarcinoma, Papillary - diagnostic imaging</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Clinical Study</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Iodine Radioisotopes</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - diagnostic imaging</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Vertebrates: endocrinology</subject><subject>Whole Body Imaging</subject><issn>0804-4643</issn><issn>1479-683X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl1rFDEUhoNY7Fq98l5yIyoyNslkPuKdLKu2FBRawbvhTD52IjOTaZLpsj_Pf2a2u61FxKuckOec8_K-QegFJe9pkZPT1fkqIyKjhOWP0ILySmRlnf94jBakJjzjJc-P0dMQfhJCU02eoGNGGGWEFgv069KO617jqXPRjVgPNgSbCumGaY5a4egGt_YwdVv85vLbann19vRfb3NIc_CZU3bUGWU5tiOeIFo9xoA3NnZYWWO0T3cLt73d1jursIRRav8Bg1I2ps3Q4xvoZ43djfZ407kkrnVqi6ceRvDYDrDerYJR4Vs9z9CRgT7o54fzBH3_tLpafskuvn4-W368yFrOScxkrUFXQkhoW8FKWpUSeLLBkKI1wFVNFCtYpYRRShScMSOUEMyUbVEVORf5CXq9nzt5dz3rEJvkldR9kqXdHJoqz3mRjCeJfLcnpXcheG2aySfZfttQ0uwia1JkDRHNLrJEvzzMndtBq3v2LqMEvDoAECT0xifHbPjDsbqsS8ESx_ZcZ9fdxnrdtNYFuYvAGivh4fa7D5Oa6L7pL_Z_in8DzzbB6Q</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Barwick, Tara</creator><creator>Murray, Iain</creator><creator>Megadmi, Hakim</creator><creator>Drake, William M</creator><creator>Plowman, P Nick</creator><creator>Akker, Scott A</creator><creator>Chew, Shern L</creator><creator>Grossman, Ashley B</creator><creator>Avril, Norbert</creator><general>BioScientifica</general><general>European Society of Endocrinology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Single photon emission computed tomography (SPECT)/computed tomography using Iodine-123 in patients with differentiated thyroid cancer: additional value over whole body planar imaging and SPECT</title><author>Barwick, Tara ; Murray, Iain ; Megadmi, Hakim ; Drake, William M ; Plowman, P Nick ; Akker, Scott A ; Chew, Shern L ; Grossman, Ashley B ; Avril, Norbert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b440t-c8eae799cabb926176ca4021f05bfa4d80d2527d9fdd95422f9d992f6b5753493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adenocarcinoma, Follicular - diagnostic imaging</topic><topic>Adenocarcinoma, Papillary - diagnostic imaging</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Clinical Study</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Iodine Radioisotopes</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - diagnostic imaging</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Thyroid Neoplasms - diagnostic imaging</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Vertebrates: endocrinology</topic><topic>Whole Body Imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barwick, Tara</creatorcontrib><creatorcontrib>Murray, Iain</creatorcontrib><creatorcontrib>Megadmi, Hakim</creatorcontrib><creatorcontrib>Drake, William M</creatorcontrib><creatorcontrib>Plowman, P Nick</creatorcontrib><creatorcontrib>Akker, Scott A</creatorcontrib><creatorcontrib>Chew, Shern L</creatorcontrib><creatorcontrib>Grossman, Ashley B</creatorcontrib><creatorcontrib>Avril, Norbert</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barwick, Tara</au><au>Murray, Iain</au><au>Megadmi, Hakim</au><au>Drake, William M</au><au>Plowman, P Nick</au><au>Akker, Scott A</au><au>Chew, Shern L</au><au>Grossman, Ashley B</au><au>Avril, Norbert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Single photon emission computed tomography (SPECT)/computed tomography using Iodine-123 in patients with differentiated thyroid cancer: additional value over whole body planar imaging and SPECT</atitle><jtitle>European journal of endocrinology</jtitle><addtitle>Eur J Endocrinol</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>162</volume><issue>6</issue><spage>1131</spage><epage>1139</epage><pages>1131-1139</pages><issn>0804-4643</issn><eissn>1479-683X</eissn><abstract>ObjectiveThe aim of the study was to assess the diagnostic performance of co-registered single photon emission computed tomography (SPECT)/computed tomography (CT) compared to Iodine-123 whole body gamma camera (WBGC) imaging and to SPECT alone in patients with differentiated thyroid cancer.MethodsWBGC and SPECT/CT (n=85) imaging of the neck and thorax was performed in 79 consecutive patients. Three experienced observers reviewed: i) WBGC images followed by ii) SPECT alone, and iii) co-registered SPECT/CT. Foci of increased radioiodine uptake were classified on a five-point scale. Biopsy, other imaging modalities, and clinical follow-up served as the reference standard.ResultsTwenty-two patients had local recurrence or metastatic thyroid cancer (11 were radioiodine negative), 9 had remnant thyroid tissue, and 54 had no evidence of disease. When classifying equivocal, probably, and definitely malignant findings as positive for malignancy, the sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 41, 68, 31, and 77% for WBGC imaging; 45, 89, 59, and 82% for WBGC plus SPECT imaging; and 50, 100, 100, and 85% for WBGC plus SPECT/CT imaging respectively. The specificity was improved by the addition of SPECT (P=0.0002) and SPECT/CT (P&lt;0.0001) than to WBGC imaging. SPECT/CT was also more specific than WBGC plus SPECT imaging (P=0.016). In a study-based analysis, SPECT/CT provided additional diagnostic information in 42% (36/85) of cases. SPECT/CT provided further characterization in 70% (63/90) of foci and improved the diagnostic confidence of all three observers.ConclusionThe addition of SPECT/CT significantly improved the diagnostic information over Iodine-123 WBGC imaging and WBGC plus SPECT imaging alone.</abstract><cop>Bristol</cop><pub>BioScientifica</pub><pmid>20212015</pmid><doi>10.1530/EJE-09-1023</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Oxford University Press Journals All Titles (1996-Current)
subjects Adenocarcinoma, Follicular - diagnostic imaging
Adenocarcinoma, Papillary - diagnostic imaging
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Clinical Study
Endocrinopathies
Female
Fundamental and applied biological sciences. Psychology
Humans
Iodine Radioisotopes
Male
Malignant tumors
Medical sciences
Middle Aged
Neoplasm Recurrence, Local - diagnostic imaging
Non tumoral diseases. Target tissue resistance. Benign neoplasms
ROC Curve
Sensitivity and Specificity
Thyroid Neoplasms - diagnostic imaging
Thyroid. Thyroid axis (diseases)
Tomography, Emission-Computed, Single-Photon
Vertebrates: endocrinology
Whole Body Imaging
title Single photon emission computed tomography (SPECT)/computed tomography using Iodine-123 in patients with differentiated thyroid cancer: additional value over whole body planar imaging and SPECT
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