Nuklearmedizin Nuklearmedizin nuk de-de http://www.schattauer.de/rss.html Wed, 22 Feb 17 19:01:37 +0100 http://www.schattauer.de/uploads/pics/rss.jpg Ahead of print: Incremental value of 99mTc-HYNIC-TOC SPECT/CT over whole-body planar scintigraphy... http://nuk.schattauer.de/t3page/1214.html?manuscript=27128 Aim: The aim of this study was to evaluate the additional value of 99mTc-HYNIC-TOC SPECT/CT over planar whole-body (WB) scintigraphy and SPECT alone in the detection and accurate localisation of neuroendocrine tumour (NET) lesions. Methods: This study included 65 patients with a definitive histological diagnosis of NET prior to scintigraphy. Planar WB scintigraphy, SPECT, and SPECT/CT images were acquired at 4 h post-administration of 670&thinsp;MBq 99mTc-HYNIC-TOC. Additional SPECT images at 10 min after tracer administration were also acquired. Clinical and imaging follow-up findings were considered as the reference standards (minimum follow-up period, 15 months). Patient and lesion-based analyses of the efficacies of the imaging modalities were performed. Results: While 38 patients exhibited metastasis of NETs, 27 presented no evidence of metastasis. Upon patient-based analysis, the sensitivity and specificity of SPECT/CT were found to be 88.9 and 79.3&thinsp;%, respectively. The diagnostic accuracies of WB scintigraphy, 4h-SPECT, and SPECT/CT were 72.3, 73.8, and 84.6&thinsp;%, respectively. The area under curve (AUC) value for SPECT/CT (0.84) was the highest, followed by those for 4h-SPECT (0.75) and WB scintigraphy (0.74). The accuracy and AUC values of SPECT/CT were significantly better compared to those of WB scintigraphy (p&thinsp;&lt;&thinsp;0.001), 10 min-SPECT (p&thinsp;&lt;&thinsp;0.001), and 4 h-SPECT (p&thinsp;=&thinsp;0.001). The findings of SPECT/CT led to the change in treatment plan of 11 patients (16.9&thinsp;%). Conclusion: The sensitivity and diagnostic accuracy of SPECT/CT in the evaluation of NET lesions outperforms planar WB imaging or SPECT alone.... M. Trogrlic (1), S. Težak (1) 27128 2017-02-06 08:16:32 Ahead of print: 18F-FDG PET/CT in the detection of asymptomatic malignant melanoma recurrence http://nuk.schattauer.de/t3page/1214.html?manuscript=27127 Aim: To evaluate the diagnostic accuracy of FDG PET/CT in the detection of asymptomatic recurrence in patients with malignant melanoma who have had resection of their primary lesion. We also aimed to determine the pattern and factors predisposing to disease recurrence. Methods: Patients with malignant melanoma who have had surgical resection of their disease and without any clinical evidence of disease recurrence were followed-up with FDG PET/CT. The diagnostic accuracy of FDG PET/CT, pattern of recurrence and factors predictive of disease recurrence were determined. Results: A total of 144 patients were followed-up for a median period of 50.50 months. Asymptomatic recurrence was seen in 37 patients (25.7&thinsp;%) with a median time to recurrence of 20 months. Lymph node was the commonest site of asymptomatic recurrence. Sex, tumour depth, histology type and presence of nodal metastasis were significant predictors of tumour recurrence. Age, race, site of primary lesion, type of lymph node resection were not significant predictors of disease recurrence. Race has a significant effect on the histological subtype of tumour (nodular maligna was more common in Caucasian while acral lentiginous was more prevalent in the Blacks) and the site of the primary lesion (lower limb in Blacks and trunk in Caucasians). Sensitivity, specificity and accuracy of FDG PET/CT for the detection of disease recurrence were 94.5&thinsp;%, 87.6&thinsp;% and 89.6&thinsp;% respectively. Conclusion: FDG PET/CT is a suitable modality for early detection of asymptomatic recurrence of malignant melanoma. Asymptomatic recurrence most commonly occurs in lymph nodes. Sex, nodal metastasis and tumour pathologic features are predictors of recurrence.... I. Lawal (1), T. Lengana (1), K. Ololade (1), T. Boshomane (1), F. Reyneke (1), M. Modiselle (1), M. Vorster (1), M. Sathekge (1) 27127 2017-02-03 09:18:31 Twins in spirit part IV – [177Lu] high affinity DOTATATE http://nuk.schattauer.de/t3page/1214.html?manuscript=27099 Aim: Besides the use of somatostatin analogues, small molecules like sunitinib and everolimus as well as conventional chemotherapy, peptide receptor radiotherapy (PRRT) using radiolabelled somatostatin analogues has gained an important role in the treatment of inoperable, metastasized neuroendocrine tumours (NET). There are various radiotracers in use. Based on our experience with the PET tracer [68Ga]DOTA-3-iodo-Tyr3-octreotate ([68Ga]HA-DOTATATE), a DOTATATE derivative with an increased binding affinity to hsst5, the current retrospective analysis is exploring the therapeutic potential of [177Lu]HA-DOTATATE. Methods: Eighteen patients with metastatic NET (G1/G2) were treated using [177Lu]DOTATATE and/or [177Lu]HA-DOTATATE, and dosimetric results of both tracers were compared. Results: Using [177Lu]HA-DOTATATE, a mean tumour dose of 5.34 Gy/GBq (median 2.53 Gy/GBq; range 0.89–33.3 Gy/GBq) was achieved, while [177Lu]DOTATATE delivered a tumour dose of 5.53 Gy/GBq (median 2.70 Gy/GBq; range 0.44–15.3 Gy/GBq). Organ doses for [177Lu]HA-DOTATATE vs. [177Lu]DOTATATE were as follows: kidney 2.31 ± 0.85 vs. 2.03 ± 0.96 Gy/GBq, liver 1.06 ± 0.79 vs. 1.67 ± 1.73 Gy/GBq, spleen 3.89 ± 4.04 vs. 4.50 ± 3.69 Gy/GBq and whole body 0.16 ± 0.10 Gy/GBq vs. 0.15 ± 0.08 Gy/GBq. Tumour-to-kidney dose ratio was slightly higher for [177Lu]DOTATATE (2.4 ± 5.6) compared to [177Lu]HA-DOTATATE (1.5 ± 3.6). Conclusion: Both tracers showed marked inter-patient variation in their dosimetry, and no significant differences in dosimetry of [177Lu]HA-DOTATATE and [177Lu]DOTATATE were observed when taking all patients into account. Thus, [177Lu]HA-DOTATATE appears viable for PRRT, although it was marginally inferior regarding kidney dose and tumour-to-kidney dose ratio compared to the established [177Lu]DOTATATE.... C. Brogsitter (1), H. Hartmann (1), G. Wunderlich (1), M. Schottelius (2), H.-J. Wester (2), J. Kotzerke (1) 27099 2017-01-31 08:45:54 Prevalence of thyroid disorders in elderly people in Germany http://nuk.schattauer.de/t3page/1214.html?manuscript=27092 Aim: In a screening study on people of working age the prevalence of morphological thyroid disorders was 33.1 %. It is not known precisely whether this further increases after retirement. The present study aimed to establish whether the increase in the prevalence of morphological and functional thyroid disorders continues beyond working age in elderly citizens. Methods: 223 participants were recruited in an institute for geriatric rehabilitative medicine. All patients were screened by thyroid ultrasound, measurement of serum levels of thyroid hormones and thyroid related autoantibodies as well as measurement of urinary iodine excretion. Results: The median thyroid volume was 17 ml (range 4–41 ml) in men and 16 ml (range 0.4–73 ml) in women. 27/59 (46 %) of the men (median age [range]: 77 [58–87] years) and 85/139 (61 %) of the women (median age [range]: 77 [52–97] years), or a total of 112/198 (57 %) residents, showed morphological thyroid abnormalities. There was no clear increase with age. 85 % of the participants without a history of thyroid treatment were euthyroid. 12 % showed a subclinical hyperthyroidism whereas 1 % showed a biochemically manifest hyperthyroidism. 2 % were biochemically hypothyroid. Tg-antibodies was elevated in 10 (5 %) and TPO-antibodies in 18 (9 %) of the patients. Median iodine excretion was 129 µg/l. 41.5 % of the patients showed iodine excretion values below 100 µg/l whereas only 7 % of the patients showed a severe iodine deficiency with an excretion below 50 µg/l. Conclusion: Compared to a previously described population of working age, the prevalence of morphological thyroid disorders does not further increase above the age of 65; thyroid function abnormalities in this iodine sufficient screening population were relatively rare.... F. A. Verburg (1, 2), I. Grelle (1), K. Tatschner (3), C. Reiners (1), M. Luster (2) 27092 2017-01-26 08:29:12 Diagnostic value of additional 68Ga-PSMA-PET before 223Ra-dichloride therapy in patients with... http://nuk.schattauer.de/t3page/1214.html?manuscript=27035 Purpose: Medical imaging plays an important role in selecting patients with metastatic castration-resistant prostate cancer for 223Ra-dichloride therapy of bone metastases. The purpose of this study was to investigate whether 68Ga-PSMA-PET has incremental value over conventional imaging for selecting patients suitable for 223Ra-dichloride therapy. Methods: In 27 consecutive patients referred for 223Ra-dichloride therapy additional 68Ga-PSMA-PET/CT was performed and tracer distribution was evaluated systematically with respect to the detection of visceral metastases and bone metastases with inadequate uptake on bone scintigraphy. Results: In 4 patients (15 %) 68Ga-PSMA-PET revealed previously unknown visceral metastases (3 liver, 1 adrenal gland), which changed the therapeutic decision in 2 cases. PET revealed more extended tumour involvement in the bone compared to bone scintigraphy in 9 patients (33 %). In 3 of these, the mismatch was extensive enough to question suitability for 223Ra-dichloride therapy. Conclusions: Additional 68Ga-PSMA-PET as a gatekeeper between conventional staging and 223Ra-dichloride therapy can provide valuable additional information with regard to visceral metastases and tumour manifestations without adequate bone mineral turnover. It may lead to a change in therapeutic management in a significant number of patients and should therefore be considered in future clinical trials.... A. Bräuer (1), K. Rahbar (1), J. Konnert (1), M. Bögemann (2), L. Stegger (1) 27035 2017-01-11 09:15:26 Polymyalgia rheumatica detected by SPECT/CT using 99mTc-labeled monoclonal antibody Fab'-fragments http://nuk.schattauer.de/t3page/1214.html?manuscript=27027 A. Fr&ouml;lich (1), I. Schwarze (2), C. Neumann (1) 27027 2016-12-22 13:20:32 Fragen zum Beitrag „Radioiodtherapie bei benignen Schilddrüsenerkrankungen“ http://nuk.schattauer.de/t3page/1214.html?manuscript=26966 26966 2016-12-06 10:28:56 Erratum to: Li B, Zhang M, Jin J. Unusual FDG uptakes of mesenteric brown adipose tissue in a... http://nuk.schattauer.de/t3page/1214.html?manuscript=26964 26964 2016-12-06 09:52:58 Erratum zu: Schütze C et al. Kons tanzprüfung der Systemlinearität von Aktivimetern mittels 99mTc.... http://nuk.schattauer.de/t3page/1214.html?manuscript=26965 26965 2016-12-06 09:52:58 Metastatic epithelioid sarcoma revealed with 18F-FDG PET/CT imaging http://nuk.schattauer.de/t3page/1214.html?manuscript=26963 B. Dirlik Serim (1), B. Vatankulu (2), M. Hala&ccedil; (2), S. Dikici (3), F. Kantarcı (3), K. S&ouml;nmezoğlu (2) 26963 2016-12-06 09:52:58 Radioiodtherapie bei benignen Schilddrüsenerkrankungen (Version 5) http://nuk.schattauer.de/t3page/1214.html?manuscript=26961 Die Version 5 der Leitlinie zur Radioiodtherapie bei benignen Schilddr&uuml;senerkrankungen ist ein Update der Version 4, die im Jahr 2007 durch die Deutsche Gesellschaft f&uuml;r Nuklearmedizin (DGN) in Abstimmung mit der Deutschen Gesellschaft f&uuml;r Endokrinologie (DGE, Sektion Schilddr&uuml;se) und der Deutschen Gesellschaft f&uuml;r Allgemein- und Viszeralchirurgie (DGAV) publiziert worden war. Die Leitlinie ist mit den Empfehlungen der European Association of Nuclear Medicine (EANM) harmonisiert worden. Nach der &bdquo;Richtlinie Strahlenschutz in der Medizin&ldquo; ist die &bdquo;rechtfertigende Indikation&ldquo; zur Radioiodtherapie durch einen fachkundigen Arzt (&bdquo;Fachkunde in der Therapie mit offenen radioaktiven Stoffen&ldquo;) zu stellen. Daher werden Indikationen zur Radioiodtherapie und alternative Behandlungsm&ouml;glichkeiten in dieser Leitlinie diskutiert. Die Leitlinie wurde von einer repr&auml;sentativen Expertengruppe im informellen Konsens verabschiedet und entspricht damit einer Verfahrensanweisung der ersten Stufe (S1) nach den Kriterien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).... M. Dietlein (1), F. Gr&uuml;nwald (2), M. Schmidt (1), P. Schneider (3), F. A. Verburg (4), M. Luster (5) 26961 2016-12-06 09:52:58 Der hoch-normale fT4-Spiegel ist mit Vorhofflimmern assoziiert http://nuk.schattauer.de/t3page/1214.html?manuscript=26962 M. Dietlein (1), A. Drzezga (1) 26962 2016-12-06 09:52:58 Diagnosis of chronic osteomyelitis by combined 99mTc-bone and 99mTc-anti-granulocyte scintigraphy http://nuk.schattauer.de/t3page/1214.html?manuscript=26960 A. Fr&ouml;lich (1), G. Knoll (2), M. B&auml;hre (3), C. Neumann (1) 26960 2016-12-06 09:52:57 [68Ga]PSMA-HBED-CC PET/CT to differentiate between diffuse bone metastases of prostate cancer and... http://nuk.schattauer.de/t3page/1214.html?manuscript=26959 F. Behrendt (1), T. Krohn (1), F. Mottaghy (1), F. A. Verburg (1) 26959 2016-12-06 09:52:57 Open Access: Myocardial perfusion SPECT 2015 in Germany http://nuk.schattauer.de/t3page/1214.html?manuscript=26956 Aim: The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine presents the results of the 7th survey of myocardial perfusion SPECT (MPS) of the reporting year 2015. Method: 268 questionnaires (173 practices [PR], 67 hospitals [HO], 28 university hospitals [UH]) were evaluated. Results of the last survey from 2012 are set in squared brackets. Results: MPS of 121 939 [105 941] patients were reported. 98 % [95 %] of all MPS were performed with Tc-99m radiopharmaceuticals and 2 % [5 %] with Tl-201. 78 % [79 %] of all patients were studied in PR, 14 % [15 %] in HO, and 8 % [6 %] in UH. A pharmacological stress test was performed in 43 % [39 %] (22 % [24 %] adenosine, 20 % [9 %] regadenoson, 1 % [6 %] dipyridamole or dobutamine). Attenuation correction was applied in 25 % [2009: 10 %] of MPS. Gated SPECT was performed in 78 % [70 %] of all rest MPS, in 80 % [73 %] of all stress and in 76 % [67 %] of all stress and rest MPS. 53 % [33 %] of all nuclear medicine departments performed MPS scoring by default, whereas 24 % [41 %] did not apply any quantification. 31 % [26 %] of all departments noticed an increase in their counted MPS and 29 % [29 %] no changes. Data from 89 departments which participated in all surveys showed an increase in MPS count of 11.1 % (PR: 12.2 %, HO: 4.8 %, UH: 18.4 %). 70 % [60 %] of the MPS were requested by ambulatory care cardiologists. Conclusion: The 2015 MPS survey reveals a high-grade adherence of routine MPS practice to current guidelines. The positive trend in MPS performance and number of MPS already observed in 2012 continues. Educational training remains necessary in the field of SPECT scoring.... O. Lindner (1), W. Burchert (1), W. Schäfer (2), M. Hacker (3) 26956 2016-12-02 09:40:05 Treatment planning in PRRT based on simulated PET data and a PBPK model http://nuk.schattauer.de/t3page/1214.html?manuscript=26922 Aim: To investigate the accuracy of treatment planning in peptide-receptor radionuclide therapy (PRRT) based on simulated PET data (using a PET noise model) and a physiologically based pharmacokinetic (PBPK) model. Methods: The parameters of a PBPK model were fitted to the biokinetic data of 15 patients. True mathematical phantoms of patients (MPPs) were the PBPK model with the fitted parameters. PET measurements after bolus injection of 150 MBq 68Ga-DOTATATE were simulated for the true MPPs. PET noise with typical noise levels was added to the data (i.e. c = 0.3 [low], 3, 30 and 300 [high]). Organ activity data in the kidneys, tumour, liver and spleen were simulated at 0.5, 1 and 4 h p.i. PBPK model parameters were fitted to the simulated noisy PET data to derive the PET-predicted MPPs. Therapy was simulated assuming an infusion of 3.3 GBq of 90Y-DOTATATE over 30 min. Time-integrated activity coefficients (TIACs) of simulated therapy in tumour, kidneys, liver, spleen and remainder were calculated from both, true MPPs (true TIACs) and predicted MPPs (predicted TIACs). Variability v between true TIACs and predicted TIACs were calculated and analysed. Variability ≤ 10 % was considered to be an accurate prediction. Results: For all noise level, variabilities for the kidneys, liver, and spleen showed an accurate prediction for TIACs, e.g. c = 300: vkidney = (5 ± 2)%, vliver = (5 ± 2)%, vspleen = (4 ± 2)%. However, tumour TIAC predictions were not accurate for all noise levels, e.g. c = 0.3: vtumour = (8 ± 5)%. Conclusion: PET-based treatment planning with kidneys as the dose limiting organ seems possible for all reported noise levels using an adequate PBPK model and previous knowledge about the individual patient.... D. Hardiansyah (1, 2), W. Guo (1), A. A. Attarwala (1, 2), P. Kletting (3), F. M. Mottaghy (4, 5), G. Glatting (1, 3) 26922 2016-11-25 09:19:53 Comparison of clonogenic cell survival and DNA damage induced by 188Re and X-rays in rat thyroid... http://nuk.schattauer.de/t3page/1214.html?manuscript=26744 Aim: Ionizing radiation produces DNA lesions among which DNA double strand breaks (DSB) are the most critical events. Radiation of various energy types might differ in their biological effectiveness. Here, we compared cell survival and DNA damage induced by 188Re and X-rays using γH2AX foci as a measure of DSB. The correlation between survival and residual foci was also analyzed. Methods: PCCl3 cells were irradiated with 200 kV X-rays (1.2 Gy/min) or 0.5–25 MBq/ml 188Re (1 h irradiation) achieving doses up to 10 Gy. By blocking of sodium iodide symporter (NIS) essentially extracellular activity could be guaranteed. Survival fractions (SF) were detected by colony forming assay. Initial and residual γH2AX foci (15 min and 24 h after irradiation) were assessed by immunostaining. The relationship between SF and residual radiation induced γH2AX foci (RIF) was evaluated by Spearman and Pearson correlation tests. Results: We did not find significant differences between the survival curves in terms of the radiation quality. The D37 values were 4.6 Gy and 4.2 Gy for 188Re or X-ray, respectively. The initial foci numbers were in the same range for 188Re and X-ray, but higher levels of residual foci persisted after X-rays in comparison to 188Re (1 GyX-ray 6.5 ± 0.2; 1 GyRe-188 4.8 ± 0.2 RIF). Accordingly, for 188Re a higher extent of DSB repair was found. The Spearman test revealed a significant (p ... R. Runge (1), J. Arlt (1), L. Oehme (1), R. Freudenberg (1), J. Kotzerke (1) 26744 2016-10-26 09:56:12 Detection of obstructive uropathy and assessment of differential renal function using two functional... http://nuk.schattauer.de/t3page/1214.html?manuscript=26641 Aim: After detection of obstructive uropathy (OU), the indication for or against surgery is primarily based on the differential renal function (DRF). This is to compare functional magnetic resonance urography (fMRU) with dynamic renal scintigraphy (DRS) to assess OU and DRF in infants and children. Patients, methods: Retrospective analysis in 30 patients (female: 16; male: 14; median age: 5.5 years [0.2–16.5]), divided into subgroup A (age: 0–2 years; n = 16) and B (> 2–17 years; n = 14). fMRU was assessed by measuring renal transit time (RTT) and volumetric DRF with CHOP fMRU tool (CT) and ImageJ MRU plug-in (IJ). OU detection by fMRU was compared with DRS (standard of reference) using areas under the curves (AUC) in ROC analyses. Concordant DRF was assumed if absolute deviation between fMRU and DRS was ≤ 5 %. Results: DRS confirmed fixed OU in 4/31 kidneys (12.9 %) in subgroup A. AUC of CT was 0.94 compared with 0.93 by IJ. Subgroup B showed fixed OU in 1/21 kidneys (4.8 %) with AUCs of 0.98 each. RTT measured neither by CT nor by IJ in confirmed fixed OU was... P. Genseke (1), J. M. M. Rogasch (1), I. G. Steffen (1), G. Neumann (1), I. Apostolova (1), J. Ruf (2), A. Rißmann (3), D. Wiemann (4), U.-B. Liehr (5), M. Schostak (5), H. Amthauer (1, 6), C. Furth (1, 6) 26641 2016-09-29 13:00:29 Fragen zum Thema "Radionuklidtherapie von Knochenmetastasen mittels Radium-223" http://nuk.schattauer.de/t3page/1214.html?manuscript=26623 26623 2016-09-26 09:40:43 Primary lymphoma involving cranial nerves and cauda equina detected by 18F-FDG PET/CT and MRI http://nuk.schattauer.de/t3page/1214.html?manuscript=26620 G. Wang (1), Y. Liu (1), F. He (1) 26620 2016-09-26 09:38:34 Strong [68Ga]PSMA-HBED-CC accumulation in non-cancerous prostate tissue surrounding a PSMA-negative... http://nuk.schattauer.de/t3page/1214.html?manuscript=26621 F. A. Verburg (1, 2), F. F. Behrendt (1), F. M. Mottaghy (1, 2), D. Pfister (3), F. Steib (4), R. Knuechel (4) 26621 2016-09-26 09:38:34 Devitalized bone in a multi-fragment femoral shaft fracture detected by 18F-NaF PET-CT http://nuk.schattauer.de/t3page/1214.html?manuscript=26622 P. Seifert (1), V. K&ouml;nig (2), G. O. Hofmann (2), M. Freesmeyer (1) 26622 2016-09-26 09:38:34 The role of 18F-FDG PET/CT in diagnosis and therapeutic approach in small child with MSMD http://nuk.schattauer.de/t3page/1214.html?manuscript=26619 D. Chroustov&aacute; (1), M. Bloomfield (2), J. Bene&scaron; Jr (3), J. Trnka (1) 26619 2016-09-26 09:38:33 18F-FDG-PET/CT in unexplained elevated inflammatory markers http://nuk.schattauer.de/t3page/1214.html?manuscript=26549 The diagnostic strategy in patients with fever or inflammation of unknown origin remains a major clinical challenge. The aim of this study was to evaluate the role of 18F-FDG-PET/CT in patients with unexplained elevated C-reactive protein with or without fever. Contribution of 18F-FDG-PET/CT to the final diagnosis was evaluated. In addition we determined whether a differentiation between patients with or without fever is clinically reasonable. Patients, methods: We retrospectively analysed 72 consecutive patients with unexplained elevated C-reactive protein levels (above 8mg/l) that underwent 18F-FDG-PET/CT in our facility between 10/2009 and 11/2012. 18F-FDG-PET/CT was considered a so-called diagnostic scan when results decisively led to a final diagnosis and adequate therapy with a response of symptoms was initiated due to the PET/CT result. Results: In 60/72 patients (83%) a final diagnosis was established. Diagnoses included infections (58%), non-infectious inflammatory diseases (29%) and malignancies (8%). 18F-FDG-PET/CT was true positive in 47 cases (65%) and the diagnostic scan in 29 patients (40%). Sensitivity of 18F-FDG-PET/CT was 81% and specificity was 86%. Diagnostics, final diagnoses, 18F-FDG-PET/CT results, SUVmax, C-reactive protein levels and the diagnostic scan did not differ significantly between patients with fever and patients without fever. Conclusion: 18F-FDG-PET/CT is a useful method in the diagnostic workup of patients with inflammation of unknown origin. In our series there was no significant difference between patients with or without fever. Regarding 18F-FDG-PET/CT-imaging inflammation of unknown origin and unexplained fever can be joined to one entity.... C. Bouter (1), I. Braune (1), B. Meller (1), C. Sahlmann (1), C. Ritter (2), J. Meller (1) 26549 2016-09-12 11:23:47 Rate of elimination of radioiodine-avid lymph node metastases of differentiated thyroid carcinoma by... http://nuk.schattauer.de/t3page/1214.html?manuscript=26524 SPECT/CT detects radioiodine-positive cervical lymph node metastases (LNMs) of differentiated thyroid carcinoma (DTC) at the time of postsurgical radioablation (RA). Preliminary evidence indicates that the majority of LNMs are successfully treated by RA. The aim of this study was to confirm this evidence in a bicentric setting and to evaluate whether size is a predictor for successful elimination. Patients and methods: Since 01/2007 and 05/2008, respectively, SPECT/spiral-CT is performed routinely in all patients with DTC at RA in two University Clinics. The outcome of iodine-positive LNMs identified by SPECT/CT until 12/2012 was analyzed by follow-up diagnostic 131I scans and serum thyreoglobulin (Tg) values. LNM volume and short-axis diameter were evaluated as prognostic factors by a receiver-operating characteristic (ROC) analysis. Results: 79 patients with 97 iodine-positive LNMs were included. Surgery was carried out in 8 patients with 13 LNMs due to the presence of additional iodine-negative lesions. Of the remaining 84 LNMs, 74 (88%) were successfully treated as demonstrated by radioiodine scans at follow-up. 10 LNMs persisted. 67/70 LNMs smaller than 0.9 ml were treated successfully, whereas this was the case of only 6/14 exceeding this threshold. Using this cut-off level to predict treatment success, sensitivity, specificity, positive and negative predictive value were 92%, 73%, 96%, and 57%. Results for short-axis diameter (cut-off level < 1cm) were 90%, 69%, 94% and 56%. Conclusion: RA is effective in the treatment of the majority of 131I-positive LNMs identified in SPECT/CT images. In this study, 88% of iodine-positive LNM in DTC were successfully treated by radioiodine given at RA. Both LNM volume and diameter are reliable predictors of treatment success.... H. Ilhan (1), M. Mustafa (1, 2), P. Bartenstein (1), T. Kuwert (3), D. Schmidt (3) 26524 2016-09-02 10:26:16