Contribution of different scintigraphic techniques to the management of medullary thyroid carcinoma
We compared three different scintigraphic techniques for the localization of neck recurrences and metastases in seven patients with medullary thyroid carcinoma one month to eight years after the first surgical intervention. Three successive scintigraphic studies were performed in five patients (6 x 3 studies) within two weeks using 201Tl chloride, 111In-labeled F(ab')2 fragments of the anti-carcinoembryonic antigen (anti-CEA) monoclonal antibody (MoAb) BW 431/31, and 131I meta-iodo-benzylguanidine (MIBG). Additionally, 11 studies were performed with the 111In-labeled MoAb fragment BW 431/31 (seven studies) or the 99mTc-labeled intact anti-CEA MoAb BW 431/26 (four studies). The gold standards for classifying scintigraphic results were biopsy, histology, surgery, and cytology. Six regions were classified as positive or negative in each study: thyroid region, four quadrants (lymph node regions) around the thyroid, and the region of the upper mediastinum. Of 36 sites, 201Tl was true positive (TP) in seven sites, false-positive (FP) in one site, true negative (TN) in 22 sites, and false-negative (FN) in six sites, resulting in a sensitivity of 54% and a specificity of 96%. 131I MIBG was TP in four sites, FP in none of the sites, TN in 23 sites, and FN in nine sites, with a sensitivity of 31% and a specificity of 100%. Immunoscintigraphy (102 sites overall) was TP in 16 sites, FP in five sites, TN in 77 sites, and FN in four sites, resulting in a sensitivity of 80% and a specificity of 94%. Immunoscintigraphy with 111In/99mTc anti-CEA F(ab')2 fragment/intact antibody is superior to scintigraphy with 201Tl and 131I MIBG.
- OSTI ID:
- 6872931
- Journal Information:
- Henry Ford Hospital Medical Journal; (USA), Vol. 37:3-4; ISSN 0018-0416
- Country of Publication:
- United States
- Language:
- English
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METASTASES
BIOLOGICAL LOCALIZATION
SCINTISCANNING
SENSITIVITY ANALYSIS
THYROID
CARCINOMAS
CEA
COMPARATIVE EVALUATIONS
INDIUM 111
IODINE 131
ISOMERIC NUCLEI
MONOCLONAL ANTIBODIES
NECK
PATIENTS
RADIOIMMUNOSCINTIGRAPHY
SPECIFICITY
TECHNETIUM 99
THALLIUM 201
ANTIBODIES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
BODY AREAS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE GLANDS
FRENCH ORGANIZATIONS
GLANDS
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
IODINE ISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
MINUTES LIVING RADIOISOTOPES
NATIONAL ORGANIZATIONS
NEOPLASMS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOIMMUNODETECTION
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
TECHNETIUM ISOTOPES
THALLIUM ISOTOPES
TRACER TECHNIQUES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics