I-131, I-123, and F-18 FDG-PET imaging in a patient with diffuse sclerosing variant of papillary thyroid cancer.
OBJECTIVE
To compare the sensitivity of I-123 total body iodine (TBI) scan, I-131 TBI, and PET scanning with 2-deoxy-2[F-18]fluoro-D-glucose (FDG-PET) scans for detection of residual/recurrent disease in patients with diffuse sclerosing variant of papillary thyroid cancer.


METHODS
A 45-year-old woman with status post-thyroidectomy and modified neck dissection showed papillary thyroid carcinoma with a diffuse sclerosing variant and positive lymph nodes. Six weeks after surgery, I-131 TBI and FDG-PET scans showed no residual or metastatic disease. However, clinical suspicion for disease remained, and an I-123 TBI scan was performed.


RESULTS
I-123 TBI showed a tiny residual focus in the left thyroid bed. The patient was treated with 150 mCi oral I-131 sodium iodide; posttreatment scan confirmed the presence of residual disease. Follow-up I-123 TBI scans up to 2 1/2 years posttreatment were negative.


CONCLUSIONS
Total body imaging with I-123 was more sensitive than I-131 TBI scanning for detecting residual or recurrent disease in patients with well-differentiated thyroid cancer presenting with low preoperative thyroglobulin levels.
Wong
Terence Z
TZ
Division of Nuclear Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. wong0015@mc.duke.edu
Jain
Manoj K
MK
Spratt
Susan E
SE
D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007457:Iodine Radioisotopes; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
D005462:Fluorine Radioisotopes; D007457:Iodine Radioisotopes; D019788:Fluorodeoxyglucose F18