PURPOSE
The aim of this study is to evaluate the clinical reliability of the whole-body Tc-99m Sestamibi scintigraphy (WBMIBI) in the pre-operative assessment of the differentiated thyroid carcinoma. This performance is based on the comparison between the scintigraphic findings and histological findings for the evaluation of primary lesions, and those from whole-body I-131 postablation scan (WBI) for the evaluation of secondary lesions.
METHODS
A descriptive transversal study was carried out, from June 2003 to April 2004, with 31 patients with differentiated histological thyroid carcinoma, 25 women and 6 men, aged between 22 and 72 years old, with an average age of 46,2 years old. All of them were submitted to thyroid ultrasonography, fine needle aspiration, WBMIBI, total thyroidectomy followed by an ablative dose of I-131 and WBI. In order to evaluate the primary lesions, the degree of agreement between the WBMIBI findings and the histological findings were calculated. In order to evaluate the secondary lesions, the degree of agreement between the WBMIBI findings and the WBI findings were calculated.
RESULTS
The findings of WBMIBI and surgical biopsy, considering the analysis of the primary lesion, were in agreement in 87.1% and discordant in 12.9% of cases, which presented thyroid nodules with less than 0,8 centimeters, and one of them was situated in the glandular isthmus. According to the analysis of secondary lesions, the WBMIBI findings showed 100% of agreement to the WBI findings, and secondary lesions were present in 9,7% of cases.
CONCLUSIONS
The WBMIBI presented as a useful tool for detection of the primary and secondary lesions to the thyroidal differentiated carcinoma. It may contribute to the clinical practice for the staging of differentiated thyroid carcinoma.