Comparative Study of Initial Post-Therapeutic 131I Single-Photon Emission Computed Tomography/Computed Tomography and Reoperation for the Detection of Residual Lymph Node Metastasis in Patients With Papillary Thyroid Cancer
Authors' conclusion
131I SPECT/CT has high specificity but relatively low sensitivity in detecting all residual LNMs. Approximately 80% of patients were rendered structurally disease free after reoperation.
Study context
- Population
- Patients with PTC with iodine-avid lymph node metastasis (LNM) on initial post-therapeutic 131I SPECT/CT who underwent reoperative dissection within 6 months
- Participants
- 53 patients
- Comparison
- Initial post-therapeutic 131I SPECT/CT vs reoperation for detecting residual LNM
- Outcome
- Diagnostic performance of 131I SPECT/CT vs reoperation in detecting residual LNM (numbers and locations)
Performance
As reported in the abstract
Detection of residual LNM
| Test or model | Value | Sensitivity | Specificity | Patients with LNM confirmed |
|---|---|---|---|---|
| 131I SPECT/CT | 95 events | 44.8% (95/212) | 91.6% (87/95) | |
| Reoperation | 212 events | 51 (96.2%) |
Value
131I SPECT/CT95 events
Reoperation212 events
Sensitivity
131I SPECT/CT44.8% (95/212)
Reoperation— not stated in the abstract
Specificity
131I SPECT/CT91.6% (87/95)
Reoperation— not stated in the abstract
Patients with LNM confirmed
131I SPECT/CT— not stated in the abstract
Reoperation51 (96.2%)
- Between 131I SPECT/CT and Reoperation: P = 0.004
Further findings
| Outcome | P value |
|---|---|
| Location frequency of residual LNMs | P = 0.057 |
Location frequency of residual LNMs
- Location frequency by 131I SPECT/CT similar to reoperation
Residual iodine-avid LNM on SPECT/CT after second RAI treatment
- Received second RAI treatment
- 32 patients
- Still had residual iodine-avid LNM
- 6 (18.8%)
Therapeutic response by ATA dynamic risk stratification (16 patients)
- Structural incomplete response
- 4 (23.5%)
- Biochemical incomplete response
- 4 (23.5%)
- Indeterminate response
- 5 (29.4%)
- Excellent response
- 3 (17.6%)
Original publication
Comparative Study of Initial Post-Therapeutic 131I Single-Photon Emission Computed Tomography/Computed Tomography and Reoperation for the Detection of Residual Lymph Node Metastasis in Patients With Papillary Thyroid Cancer. Endocr Pract. Published 8 November 2022. doi:10.
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