Iodine Radioisotope Diagnostic Scanning With SPECT/CT After Thyroidectomy for Thyroid Cancer: Essential Data or Unnecessary Investigation?

Journal of Clinical Endocrinology and Metabolism

In the clinical management of patients with differentiated
thyroid cancer after total thyroidectomy, there is controversy on the utility of postsurgical iodine radioisotop diagnostic imaging (using 131-I or 123-I), with or without SPECT)/computed tomography (CT). Some arguments supporting the use of postsurgical radioactive iodine (RAI) diagnostic scans, with or without SPECT/CT, include beliefs that this
procedure may optimize postoperative risk classification by ascertaining disease status/staging, optimize selection of patients with RAI-avid disease for RAI therapy, optimize RAI therapeutic dose activity selection, and identify patients who may benefit from additional surgical therapy
(such as debulking of distant metastases or resection of a large thyroid remnant).