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Aim: The aim of the present study was to evaluate the diagnostic sensitivity of [(99m)Tc]methoxyisobutylisonitrile ([(99m)Tc]MIBI) in a large series of patients with metastatic differentiated thyroid carcinoma (DTC), as compared with (131)I-whole body scan (WBS) and other diagnostic imaging techniques., Methods: Eighty-four patients with known metastases from DTC where recruited during the course of replacement thyroxine therapy and undergone [(99m)Tc]MIBI scan. All patients previously performed a (131)I-WBS with thyroglobulin (Tg) measurement and neck ultrasound or computerized tomography, or magnetic resonance imaging, or bone scan or positron emission tomography (PET) scan., Results: Patients were divided in two groups: group A (n=50) with known metastases and positive at a previous (131)I-WBS and group B (n=34) with known metastases, but negative at (131)I-WBS. All patients had elevated serum Tg level in absence of replacement therapy. Technetium-99m-MIBI scan showed 76.2% sensitivity in detecting metastases, Tg during opotherapy 64.3%, and the other imaging techniques combined 86.9%. Sensitivity of [(99m)Tc]MIBI was greater in metastases without (131)I uptake than in metastases with (131)I uptake, although the difference was not statistically significant., Conclusion: Technetium-99m-MIBI scan improves sensitivity of Tg measurement in patients with suspected metastases from DTC during the course of opotherapy and is a useful alternative to fluorodeoxyglucose-PET or other imaging techniques in patients with elevated serum Tg and negative (131)I-WBS.

Aim: Retrospective studies have been carried out to estimate the survival of 96 patients with lung metastases from differentiated thyroid carcinoma, observed from 1958 to 2000., Methods: All patients had undergone total thyroidectomy. Case histories were analysed with respect to age at diagnosis, sex, histology, local lymph node involvement, size of lung metastases and 131I uptake by metastases. Survival functions were calculated. Cox regression was performed., Results: There was no statistically significant difference in histological type and lymph node involvement, whereas a significantly longer survival time was observed in patients under 45 years of age at diagnosis (p= or <0.0001), in those with metastases concentrating 131I (p= or <0.0001) and in those with fine miliaric metastases (p=0.0037). Multi-variate analysis revealed that the risk of death increases about 5.4-fold in patients over 45 years old, whereas 131I treatment is likely to reduce this risk to nearly 1/6. Conclusion. In conclusion, in patients with lung metastases from differentiated thyroid carcinoma, young age at diagnosis and 131I uptake by metastases are the most important factors positively affecting survival time. Radioiodine therapy, also with high cumulative 131I activity, can lead to longer survival time or complete recovery.