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Indium-111 octreotide scintigraphy for the detection of non-functioning metastases from differentiated thyroid cancer: diagnostic and prognostic value.

Abstract
In this prospective study, we evaluated the diagnostic and prognostic value of (111)In-octreotide scintigraphy (SRS) in papillary and follicular thyroid carcinoma (DTC) with increasing thyroglobulin (Tg) levels but no response to treatment with (131)I. Twenty-three consecutive patients (13 female, 10 male; mean age 55 years, range 13-81 years) with progressive DTC were selected for the study. All patients had non-functioning metastases, defined by no or slight uptake of (131)I in metastases. Diagnosis of tumour progression was based on rising Tg levels during follow-up and was confirmed by radiological examination. Uptake on SRS was scored from 0 to 4. Data on initial tumour stage, histology, age, gender, Tg values, TSH levels, (131)I treatment doses, intervals and survival were gathered. Seven patients died during follow-up. The overall sensitivity for the detection of metastases was 74%. The sensitivity was better in patients in whom (131)I whole-body scintigraphy did not show any abnormal uptake (82%; 14/17) than in patients with faint (131)I uptake (50%; 3/6). The 10-year survival rate was significantly different between patients with an uptake score of 0 or 1 (100%) and those with an uptake score of 2, 3 or 4 (33%) ( P=0.001). Gender, log Tg and uptake on SRS significantly correlated with survival, but in stepwise analysis, (111)In-octreotide uptake was selected as the most prognostic independent variable (hazard rate 6.25, P=0.006). We conclude that (111)In-octreotide scintigraphy is a valuable clinical tool for the detection of non-functioning DTC metastases. The uptake seems to correlate with prognosis and survival.
AuthorsMarcel P M Stokkel, Robbert B Verkooijen, Jan W A Smit
JournalEuropean journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 31 Issue 7 Pg. 950-7 (Jul 2004) ISSN: 1619-7070 [Print] Germany
PMID14991244 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • indium-111-octreotide
  • Octreotide
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma (diagnostic imaging, mortality, radiotherapy, secondary)
  • Female
  • Humans
  • Iodine Radioisotopes (therapeutic use)
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Netherlands (epidemiology)
  • Octreotide (analogs & derivatives)
  • Prognosis
  • Radionuclide Imaging
  • Radiopharmaceuticals (therapeutic use)
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Survival Analysis
  • Thyroid Neoplasms (diagnostic imaging, mortality, radiotherapy)
  • Treatment Outcome
  • Whole-Body Counting (methods, statistics & numerical data)

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