News | January 04, 2009

SPECT-CT Enables Earlier, Individualized Treatment of Thyroid Cancer, Says Study

January 5, 2009 — In a study to determine the diagnostic value of molecular imaging in nodal staging of patients with thyroid cancer, researchers were able to accurately distinguish between cancerous cells in regional lymph nodes and normal residual thyroid tissue directly after surgery for the first time.

Researchers from the University of Erlangen-Nürnberg, Germany, reported in an article in the January issue of The Journal of Nuclear Medicine on the results of a study using a hybrid single photon emission computed tomography-computed tomography (SPECT-CT) camera to determine and locate the spread of cancer cells to nearby lymph nodes.

According to the researchers, the demonstration or exclusion of cancer spread (metastasis) in regional lymph nodes plays a major role in treating the disease since all patients with lymph node metastases are considered to be at high risk for recurrence.

Currently, patients with differentiated thyroid carcinoma (DTC) who have had their thyroid removed are treated with radioactive iodine, which effectively zeros in on and kills any remaining cancerous thyroid cells. Because one of the functions of the thyroid gland is to absorb iodine from the blood, radioiodine is taken up by any thyroid tissue not removed by surgery, including cancerous cells spreading to other body parts, such as lymph nodes. In addition to emitting electrons that destroy the tissue harboring the radionuclide, radioactive iodine emits photons suitable for imaging.

“Normal thyroid tissue as well as residual cancer cells concentrate radioiodine. Performed after ingestion of radioiodine, SPECT-CT provides three-dimensional images of the distribution of the radionuclide in the human body and is therefore used for staging this type of cancer,” said Torsten Kuwert, M.D., co-author of the article. “Incorporated at first treatment, SPECT-CT allows us to better stratify patients into treatment groups.”

In the study, 57 patients received radioiodine therapy. Afterwards, a SPECT-CT camera was rotated around the patients at a variety of angles to capture where the radioactivity was occurring. SPECT imaging can locate cells in the body that are not behaving normally, but does not provide the detailed, X-ray-like images that CT imaging can. The hybrid camera, however, is able to reveal both the malignant cell activity and the exact anatomical location.

“With SPECT-CT imaging, we were able to determine tumor spread much earlier than before,” said Daniela Schmidt, M.D., another co-author of the article. “Earlier detection will lead to earlier individualized treatment of this potentially deadly cancer.”

The researchers also reported that this information led to a revision of the original diagnosis in 35 percent of the study participants. The images reclassified as benign six of 11 lesions that had been considered lymph node metastases and 11 of 15 lesions considered to be indeterminate.

“Our data suggest that SPECT-CT should be used as a routine procedure in DTC patients at the first radioiodine treatment,” said Dr. Kuwert. “By upstaging or downstaging disease, this hybrid imaging tool may alter the management of more than one-third of patients with the disease.”

According to the American Cancer Society, DTC is the most common form of thyroid cancer and one of the success stories in the war on cancer. Since the advent of radioiodine therapy, it has been considered one of the more curable cancers. In 2009, about 37,340 new cases of thyroid cancer will be diagnosed in the United States. Of the new cases, about 28,410 will occur in women, and 8,930 in men.

Co-authors of “Impact of I-131-SPECT/Spiral-CT on Nodal Staging of Differentiated Thyroid Carcinoma at First Radioablation” include Daniela Schmidt, Attila Szikszai, Rainer Linke, Torsten Kuwert, Clinic of Nuclear Medicine; and Werner Bautz, Institute of Radiology, all from the University of Erlangen-Nürnberg in Erlangen, Germany.

For more information: www.snm.org

Related Content

Siemens Healthineers Announces FDA Clearance of syngo.via VB30 Molecular Imaging Software
Technology | Nuclear Imaging | July 16, 2018
At the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), June 23-26 in Philadelphia...
Cardiac MRI being performed at the DeBakey Heart Hospital.

Cardiac MRI being performed at the DeBakey Heart Hospital.

Feature | Cardiac Imaging | May 03, 2018 | By Jeff Zagoudis
Magnetic resonance imaging (MRI) for cardiac assessment provides a radiation-free alternative to other commonly used...
The Chalk River nuclear reactor license has been renewed, but will be decommissioned by 2028.

The Chalk River nuclear isotope reactor license has been renewed, but will be decommissioned by 2028. The reactor supplies about 50 percent of the world's supply of Tc99m.

Feature | Nuclear Imaging | April 02, 2018 | Dave Fornell
April 2, 2018 – The Canadian Nuclear Safety Commission (CNSC) announced March 29 that it renewed Canadian Nuclear Lab
A Tc99m SPECT cardiac exam showing myocardial perfusion in the heart.

Technetium-99m is primarily used for the detection of cancer and to assess perfusion defects in the heart caused by heart attacks or other conditions.

Feature | Radiopharmaceuticals and Tracers | February 08, 2018 | Dave Fornell
February 8, 2018 — The U.S.
Videos | Nuclear Imaging | August 24, 2017
Prem Soman, M.D., director of nuclear cardiology at the Heart and Vascular Institute, University of Pittsburgh, and p
GE Healthcare SPECT/CT and PET/CT Systems Enhance Personalized Patient Care
News | Nuclear Imaging | June 10, 2017
GE Healthcare showcased positron emission tomography (PET) and single photon emission computed tomography/computed...
advanced visualization
News | Molecular Imaging | June 09, 2017
The Food and Drug Administration (FDA) has cleared syngo.via VB20 for Molecular Imaging (MI) from Siemens Healthineers...
News | SPECT-CT | June 08, 2017
Siemens Healthineers debuts Symbia Intevo Bold at the 2017 annual meeting of the Society of Nuclear Medicine &...
Videos | Nuclear Imaging | April 28, 2017
David Wolinsky, M.D., director of nuclear cardiology at Cleveland Clinic Florida and past-president of the American S
xSPECT Quant technology, SPECT/CT, Symbia Intevo, Siemens Healthineers, RSNA 2016
News | SPECT Imaging | December 06, 2016
December 6, 2016 — At the 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America (
Overlay Init