The use of SPECT-CT in differentiated thyroid cancer: A review of the literature

1008 Learning Objectives 1. To review the literature regarding the clinical utility of Single Photon Emission Computer Tomography combined with radiographic computer tomography (SPECT-CT) in differentiated thyroid cancer and its potential impact on patient management, 2. To list the various SPECT-CT cameras available and their differences, 3. To list the advantages and disadvantages of SPECT-CT relative to conventional nuclear medicine imaging techniques such as planar whole body imaging and pinhole collimator imaging, and 4. To present an atlas of SPECT-CT images demonstrating some of the clinical utility of SPECT-CT in imaging of differentiated thyroid cancer. SPECT in combination with CT allows integration of the functional and anatomic information and is playing an increasingly important role in imaging differentiated thyroid cancer. This educational exhibit will review the new important publications involving radioiodine SPECT-CT with emphasis on altering the management of differentiated thyroid cancer (e.g. potential impact on staging of disease, altering therapeutic management, and follow-up) and the time of imaging (e.g. pre-131I therapy, post-131I therapy, and radioiodine surveillance scanning). The various SPECT-CT cameras that are commercially available will also be briefly discussed, and the advantages and disadvantages of SPECT-CT will be summarized with particular attention to its incremental role in better anatomical localization and characterization of areas of radioiodine uptake over planar imaging. Selected images demonstrating the utility of SPECT-CT in anatomical localization of distant metastases, distinguishing regional nodal metastases from thyroid remnants, and distinguishing physiological uptake from pathological lesions will be presented. With the information presented, the nuclear medicine physicians, radiologists, endocrinologists and the residents will be able to optimize the use of SPECT-CT in imaging of patients with differentiated thyroid cancer