Comparison of 124Iodine PET with Iodine-131 Whole Body Gamma Scintigraphy and 18FDG PET in Differentiated Thyroid Carcinoma: A Prospective Clinical Trial

Despite expert surgery, a small amount of normal thyroid tissue is commonly left in the thyroid bed following removal of a thyroid cancer. Patients are often treated with 131I after surgery to destroy the remaining thyroid. About six months later, a diagnostic whole body scan (DWBS) is done with 131I to see whether any tumor is left that still can pick up some iodine. If the scan is positive, it confirms that there is still tumor present. Unfortunately, thyroid cancer does not pick up iodine very well and so a negative test does not mean there is no thyroid tumor left. The poor resolution with 131I can mean a diagnostic whole body will not detect the tumor. Another test is becoming more widely used to detect recurrent or persistent disease. It involves injecting TSH and measuring the serum thyroglobulin level: if the level rises more than 2 ug/ml, there is a high likelihood that tumor is present. PET scanning can detect a different isotope of iodine 124I. Recent studies indicate that when a 124I PET scan is combined with a CT scan, the detection and localization of residual thyroid tumors is improved. We wish to study the CT/124I PET method for finding the spread of thyroid cancer, for estimating the size of tumors, and for calculating the dose of 131I required to eliminate the cancer.

The isotope 131I has been used for 50 years to treat thyroid cancer, even though 131I scans do not provide very good picture of where the isotope is located. The purpose of this study is to determine whether using the iodine isotope [124I] and doing a combined CT and PET scan would be better way to detect the spread of thyroid cancer, to study tumor size, and to study iodine metabolism in normal thyroid and thyroid cancer.

Reimbursement

None

Investigator

Hani A. Nabi, M.D., Ph.D.

Contact Information

Name: Debra Erb
Phone: 716 838-5889