title: Thyroid remnant estimation by Tc-99m-sestamibi scanning predicts the effectiveness of rhTSH-stimulated I-131 ablation in patients with differentiated thyroid carcinoma.
abstract: OBJECTIVE
  To evaluate the relationship between postsurgical cervical Tc-99m-sestamibi scan uptake and the rate of successful remnant ablation after recombinant human-thyrotropin (rhTSH)-aided-I-131 ablation in patients with differentiated thyroid carcinoma (DTC).
  
  
  METHODS
  In all, 154 DTC patients who underwent total thyroidectomy and rhTSH-aided remnant ablation with I-131 (3.7 GBq) were enrolled. Tc-99m-sestamibi scans were performed during continuing thyroid hormone administration in all cases. Thyroid ablation was assessed after 6 to 12 months by rhTSH-stimulated I-131-whole-body scan and thyroglobulin measurement. The rate of successful ablation, occurrence of radioiodine-induced thyroiditis, and length of hospitalization were correlated with the Tc-99m-sestamibi scintigraphy results.
  
  
  RESULTS
  Tc-99m-sestamibi uptake was significantly lower in ablated versus nonablated patients (P<0.0001). A visually positive scan and a Tc-99m-sestamibi uptake greater than 0.9% predicted a high-risk of unsuccessful ablation, prolonged hospitalization, and the occurrence of radioiodine-induced thyroiditis.
  
  
  CONCLUSIONS
  Tc-99m-sestamibi scintigraphy is a simple and feasible tool to evaluate thyroid remnants and to predict radioiodine ablation results in patients with DTC.
authors.affiliation: Department of Nuclear Medicine, PET-CT Center and Thyroid Unit, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. luca.giovanella@eoc.ch
authors.forename: Luca
authors.initials: L
authors.lastname: Giovanella
authors.forename: Sergio
authors.initials: S
authors.lastname: Suriano
authors.forename: Massimo
authors.initials: M
authors.lastname: Castellani
authors.forename: Luca
authors.initials: L
authors.lastname: Ceriani
authors.forename: Frederik A
authors.initials: FA
authors.lastname: Verburg
mesh_terms: D055011:Ablation Techniques; D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D011994:Recombinant Proteins; D017256:Technetium Tc 99m Sestamibi / Q000009:adverse effects; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D013972:Thyrotropin; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011994:Recombinant Proteins; D013972:Thyrotropin; D017256:Technetium Tc 99m Sestamibi