Technetium-99m-furifosmin in the follow-up of differentiated thyroid carcinoma.

Abstract

UNLABELLED:

Tumor scintigraphy with flow tracers, such as 201TI-chloride, has an established role in the follow-up of differentiated thyroid cancer. We investigated a new tracer, 99mTc-furifosmin (Technescan Q12, Mallinckrodt Diagnostika, Hennef, Germany), in patients with elevated thyroglobulin levels or sonographic suspicion of lymph node metastases or recurrent disease.

METHODS:

In a prospective study, we examined 20 patients with 99mTc-furifosmin. All patients underwent a 18F-fluorodeoxyglucose (FDG) PET scan of the neck and chest. Positive 99mTc-furifosmin findings were validated by biopsy, (131)I scan, CT or 18F-FDG PET examinations.

RESULTS:

In three patients with cervical lymph node metastases detected on a planar 99mTc-furifosmin scan, we found a rapid tracer accumulation in the tumor (maximum < 2 min) and a significant washout in 2 of 3 patients after 4 hr. The visual contrast and the tumor-to-nontumor ratio was rather poor (average 1.2:1). In 3 additional patients, 3 pulmonary and 2 mediastinal lymph node metastases were detected by the 99mTc-furifosmin SPECT scan. Two patients were true-negative, and in 13 of 18 patients, the tumor could be localized by 18F-FDG PET (10 cervical, 6 mediastinal, 4 pulmonary metastases, 1 bone metastasis); 5 patients were false-negative. In 3 of these false-negative cases we could not localize the tumor with other diagnostic methods. Two patients had a true-negative PET examination.

CONCLUSION:

The statistical analysis of our data on 99mTc-furifosmin reveals that the sensitivity and 95% confidence interval of 33% (11%-56%) on a patient-by-patient basis and of 34% (17%-57%) for the lesion-by-lesion analysis is significantly lower than the sensitivity and 95% confidence interval of 72% (50%-89%) on a patient-by-patient basis and of 91% (78%-100%) on lesion-by-lesion basis for 18F-FDG. The sensitivity of 99mTc-furifosmin appears to be poor, even for cervical and mediastinal tumor manifestations where the value of 201TI-chloride is established.

• Authors: K Brandt-Mainz, S P Müller, W Sonnenschein, A Bockisch
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 39 Issue 9 Pg. 1536-41 (Sep 1998) ISSN: 0161-5505 [Print] United States
• PMID: 9744338 (Publication Type: Journal Article)

Chemical References

• Fluorine Radioisotopes
• Organophosphorus Compounds
• Organotechnetium Compounds
• Radiopharmaceuticals
• technescan Q12
• Fluorodeoxyglucose F18

Topics

• Carcinoma, Papillary (diagnostic imaging)
• Female
• Fluorine Radioisotopes
• Fluorodeoxyglucose F18
• Humans
• Lymphatic Metastasis
• Male
• Neoplasm Recurrence, Local (diagnostic imaging)
• Organophosphorus Compounds
• Organotechnetium Compounds
• Prospective Studies
• Radiopharmaceuticals
• Sensitivity and Specificity
• Thyroid Neoplasms (diagnostic imaging)
• Tomography, Emission-Computed
• Tomography, Emission-Computed, Single-Photon