Predicting thyroid cancer ablation success: Pre-ablative 99mTc-Pertechnetate and post-ablative 131I scan comparison Prédiction du succès de l'ablation dans le cancer de la thyroïde : une comparaison de la scintigraphie pré-ablative à la 99mTc-pertechnétate et de la scintigraphie post-ablative au 131I


MÜTEVELİZADE G., PARLAK Y., BOZDEMİR B. Ç., Sezgin C., Gumuser G., Sayit E.

Medecine Nucleaire, cilt.49, sa.3, ss.179-186, 2025 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 49 Sayı: 3
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.mednuc.2024.05.001
  • Dergi Adı: Medecine Nucleaire
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.179-186
  • Anahtar Kelimeler: 131I scan, 99mTc-Pertechnetate, Ablation, Differentiated thyroid carcinoma, Scintigraphy, Success
  • Manisa Celal Bayar Üniversitesi Adresli: Evet

Özet

Introduction: The purpose of this study was to evaluate the relationship between pre-ablative 99mTc-pertechnetate scintigraphy, and therapeutic iodine-131 (131I) whole-body scan (TxWBS), with ablation status and to investigate the possible predictive factors for successful ablation in differentiated thyroid carcinoma (DTC) patients. Materials and methods: A total of 330 DTC patients underwent 99mTc-pertechnetate scintigraphy after thyroidectomy. Uptake values were determined using the region-of-interest technique. All patients had neck ultrasonography and TxWBS. Both scintigraphic scans were interpreted visually and qualitatively. The ablation status was evaluated with a diagnostic 131I whole-body scan. Results: The success rate for residual thyroid ablation was 88.8%. The sensitivity, specificity, accuracy, PPV, and NPV of 99mTc-Pertechnetate scintigraphy were 82.4%, 87.5%, 82.7%, 99.2%, and 20.2%, respectively. Pre-ablative TG values and 99mTc uptake (%) were significantly lower in successfully ablated patients. The 99mTc uptake was determined as a significant predictive factor for ablation success (P = 0.000). The optimal 99mTc uptake cut-off value of 0.75% was demonstrated for successful ablation. There were significant positive correlations between the visual and the calculated uptake (%) of residual tissues on both scintigraphic scans, Considering the number of remnant tissue foci, significant positive correlations were found between 99mTc-Pertechnetate scintigraphy, TxWBS, and USG. Conclusion: Pre-ablative 99mTc-Pertechnetate uptake (%) value of the remnant tissue can predict the ablation status in DTC patients. 99mTc-Pertechnetate scintigraphy, which is an easily applicable and accessible imaging method, has maintained its place in the postoperative and pre-ablative period in DTC patients over the years and has not lost any of its value.