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29.10.2018 | Original Article

Negative remnant 99mTc-pertechnetate uptake predicts excellent response to radioactive iodine therapy in low- to intermediate-risk differentiated thyroid cancer patients who have undergone total thyroidectomy

verfasst von: Wei Lan, Zhao Gege, Lv Ningning, Wen Qiang, Bai Lin, Ma Qingjie, Ji Bin

Erschienen in: Annals of Nuclear Medicine

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Abstract

Objective

Negative 99mTc-pertechnetate uptake of the thyroid bed indicates the absence or a small volume of remnant thyroid tissue (RTT) after total thyroidectomy (TT). The aim of this study is to evaluate the predictive value of negative 99mTc-pertechnetate scintigraphy for excellent response (ER) to radioactive iodine therapy (RIT) in low- to intermediate-risk differentiated thyroid cancer (DTC) patients.

Patients

One-hundred and eighty-nine low- to intermediate-risk DTC patients who underwent TT, RIT with a single dose of 30 mCi and suppressive therapy with thyroid-stimulating hormone (TSH) from July 2015 to February 2016 in our hospital were retrospectively evaluated. 99mTc-pertechnetate thyroid scintigraphy was performed just before RIT and images were reported dichotomously as negative or positive. The response of patients was assessed for 23.2 ± 3.8 months after RIT and dichotomized as excellent response (ER) or non-excellent response (NER). 99mTc-pertechnetate uptake, age at diagnosis, gender, multifocality, T stage, N stage, preablative stimulated thyroglobulin (ps-Tg), and TSH were explored as potential predictors for ER.

Results

80.68% (71/88) of patients with negative 99mTc-pertechnetate uptake achieved ER. When patients were evaluated according to different ps-Tg levels, we found that 94.83% (55/58) of patients with ps-Tg < 1 ng/ml and negative 99mTc-pertechnetate uptake achieved ER. Multivariate Cox regression analysis revealed that ps-Tg (P = 0.0001) and 99mTc-pertechnetate uptake (P = 0.0473) were independent predictors for ER.

Conclusions

In addition to ps-Tg, negative 99mTc-pertechnetate uptake is also a significant independent predictor for an excellent response in low- to intermediate-risk patients. It may be possible to omit RIT in patients with ps-Tg < 1 ng/ml and concurrent negative 99mTc-pertechnetate uptake.
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Metadaten
Titel
Negative remnant 99mTc-pertechnetate uptake predicts excellent response to radioactive iodine therapy in low- to intermediate-risk differentiated thyroid cancer patients who have undergone total thyroidectomy
verfasst von
Wei Lan
Zhao Gege
Lv Ningning
Wen Qiang
Bai Lin
Ma Qingjie
Ji Bin
Publikationsdatum
29.10.2018
Verlag
Springer Singapore
Erschienen in
Annals of Nuclear Medicine
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-018-1314-4