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Molecular Imaging and Radionuclide Therapy

William Makis, Anthony Ciarallo
OBJECTIVE: The aim of this study was to evaluate the clinical significance of incidental focal uptake of (18)F-fluorodeoxyglucose ((18)F-FDG) on positron emission tomography/computed tomography (PET/CT) in the prostate glands of cancer patients. METHODS: A retrospective review of 3122 consecutive male patients who underwent (18)F-FDG PET/CT studies with an oncologic indication, over the course of four years, was performed. Studies with incidental (18)F-FDG uptake in the prostate gland were further analyzed...
June 1, 2017: Molecular Imaging and Radionuclide Therapy
Ali Ozan Öner, Evrim Sürer Budak, Funda Aydın, Ozan Salim, Orhan Kemal Yücel, Bahar Akkaya, Tayfur Toptaş, Adil Boz, Akın Yıldız, Fırat Güngör, Levent Undar
OBJECTIVE: Currently (18)F-2-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography/computerized tomography (PET/CT) is being successfully used for staging and follow-up of Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). Various studies have demonstrated that PET/CT effectively detects bone marrow involvement (BMI) and is concordant with bone marrow biopsy (BMB) findings, thus it is deemed as a complementary method. This study was aimed to evaluate(18)F-FDG-PET/CT efficiency for detection of BMI in HL and NHL...
June 1, 2017: Molecular Imaging and Radionuclide Therapy
Levent Kabasakal, Türkay Toklu, Nami Yeyin, Emre Demirci, Mohammad Abuqbeitah, Meltem Ocak, Aslan Aygün, Emre Karayel, Hüseyin Pehlivanoğlu, Nalan Alan Selçuk
OBJECTIVE: The aim of the study was to estimate the radiation-absorbed doses and to study the in vivo and in vitro stability as well as pharmacokinetic characteristics of lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA)-617. METHODS: For this purpose, 7 patients who underwent Lu-177-PSMA therapy were included into the study. The injected Lu-177-PSMA-617 activity ranged from 3.6 to 7.4 GBq with a mean of 5.2±1.8 GBq. The stability of radiotracer in saline was calculated up to 48 h...
June 1, 2017: Molecular Imaging and Radionuclide Therapy
Berrin Çavuşoğlu, Selda Sucu, Hatice Durak, Kadir Akgüngör, Hakan Epik, Türkan Ertay
OBJECTIVE: The behavior of beta particles under the magnetic field was investigated both theoretically and experimentally based on the assumption of reducing the damage to the normal tissues created by using magnetic field in radionuclide therapy. METHODS: A water-filled spherical medium and a beta particle source was formed by using Geant4 simulation software for the theoretical study. After applying a homogenous magnetic field, the volume of points at which the particles interact with the medium was calculated by determining particle range...
June 1, 2017: Molecular Imaging and Radionuclide Therapy
Türkan Ertay, Mine Sencan Eren, Meral Karaman, Gülgün Oktay, Hatice Durak
OBJECTIVE: Detection/localization of infection and inflammation is important for the initiation of correct treatment as well as its maintenance. Nuclear medicine imaging methods play an important role in determining infection and inflammation. (18)F-2'-deoxy-2-fluoro-d-glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) is highly sensitive in such cases when used with tomographic cross-sections. In this study, the development and progression of infection and inflammation were monitored on rats by using (18)F-FDG via PET/CT...
June 1, 2017: Molecular Imaging and Radionuclide Therapy
Jorge Alsina, Raul Alsina, Seza Gulec
The next-generation sequencing technology allows high out-put genomic analysis. An innovative assay in thyroid cancer, ThyroSeq® was developed for targeted mutation detection by next generation sequencing technology in fine needle aspiration and tissue samples. ThyroSeq v.2 next generation sequencing panel offers simultaneous sequencing and detection in >1000 hotspots of 14 thyroid cancer-related genes and for 42 types of gene fusions known to occur in thyroid cancer. ThyroSeq is being increasingly used to further narrow the indeterminate category defined by cytology for thyroid nodules...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Hani Alotaibi, Merve Tuzlakoğlu-Öztürk, Uygar Halis Tazebay
Iodide (I-) is an essential constituent of the thyroid hormones triiodothyronine (T3) and thyroxine (T4), and the iodide concentrating mechanism of the thyroid gland is essential for the synthesis of these hormones. In addition, differential uptake of iodine isotopes (radioiodine) is a key modality for the diagnosis and therapy of thyroid cancer. The sodium dependent iodide transport activity of the thyroid gland is mainly attributed to the functional expression of the Na+/I- Symporter (NIS) localized at the basolateral membrane of thyrocytes...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Murat Tuncel
Thyroid stimulating hormone receptor (TSHR) plays a pivotal role in thyroid hormone metabolism. It is a major controller of thyroid cell function and growth. Mutations in TSHR may lead to several thyroid diseases, most commonly hyperthyroidism. Although its genetic and epigenetic alterations do not directly lead to carcinogenesis, it has a crucial role in tumor growth, which is initiated by several oncogenes. This article will provide a brief review of TSHR and related diseases.
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Steven M Larson, Joseph R Osborne, Ravinder K Grewal, R Michael Tuttle
In a recent article, we reported a restorative therapeutic intervention that turned individual thyroid cancer lesions into more efficient tissues for taking up radioactive iodine (RAI), resulting in clinically significant and durable responses. A group of Iodine-131 refractory thyroid cancer patients were treated with the MEK tyrosine kinase inhibitor (TKI) selumetinib, and RAI uptake was restored in a subset of patients. We employed Iodine-124 positron emission tomography to measure radiation absorbed dose, on a lesion by lesion basis...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Stanley J Goldsmith
Radioactive iodine therapy has evolved over the past 70 years from treatment of known metastatic thyroid carcinoma to include adjuvant use to decrease the incidence of recurrent disease and to ablation of normal remnant tissue following thyroidectomy, even for minimal tumor involvement. Advances in laboratory testing, development of drugs useful in radioiodine treatment, as well as advances in radiation detection and imaging instrumentation, have progressively improved the utility of radioiodine therapy of differentiated thyroid carcinoma...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Russ Kuker, Manuel Sztejnberg, Seza Gulec
Although radioactive iodine imaging and therapy are one of the earliest applications of theranostics, there still remain a number of unresolved clinical questions as to the optimization of diagnostic techniques and dosimetry protocols. I-124 as a positron emission tomography (PET) radiotracer has the potential to improve the current clinical practice in the diagnosis and treatment of differentiated thyroid cancer. The higher sensitivity and spatial resolution of PET/computed tomography (CT) compared to standard gamma scintigraphy can aid in the detection of recurrent or metastatic disease and provide more accurate measurements of metabolic tumor volumes...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Arif Sheikh, Berna Polack, Yvette Rodriguez, Russ Kuker
Traditional nuclear medicine is rapidly being transformed by the evolving concepts in molecular imaging and theranostics. The utility of new approaches in differentiated thyroid cancer (DTC) diagnostics and therapy has not been fully appreciated. The clinical information, relevant to disease management and patient care, obtained by scintigraphy is still being underestimated. There has been a trend towards moving away from the use of radioactive iodine (RAI) imaging in the management of the disease. This paradigm shift is supported by the 2015 American Thyroid Association Guidelines (1)...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Richard T Kloos
Thyroid fine-needle aspiration biopsy results are cytologically indeterminate in 15-30% of cases. When these nodules undergo diagnostic surgery, approximately three-quarters are histologically benign. These unnecessary surgeries diminish quality of life, generate complications, and increase healthcare costs. The Afirma gene expression classifier (GEC) is validated to pre-operatively identify cytologically indeterminate nodules likely to be truly benign so that surgery can be avoided. Its performance is supported by robust multicenter prospective and blinded clinical validation studies, and supported by extensive independent clinical utility publications which show a marked reduction in surgery among patients with benign Afirma GEC results...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Atil Y Kargi, Marcela Perez Bustamante, Seza Gulec
In recent years there has been an increased awareness of the genetic alterations underlying both benign and malignant neoplasms of the thyroid. Next-generation sequencing (NGS) is an emerging technology that allows for rapid detection of a large number of genetic mutations in thyroid fine-needle aspiration (FNA) specimens. NGS for targeted mutational analysis in thyroid tumors has been proposed as a tool to assist in the diagnosis of thyroid nodules with indeterminate FNA cytology. Results of genomic testing of thyroid nodules and thyroid cancers could also have prognostic implications and play a role in determining optimal treatment strategies including targeted therapies...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Seza Gulec, Russ Kuker
The rationale and objectives for radioactive iodine (RAI) ablation remain perplexing to many. This review addresses the meaning, clinical context and the goals of "ablation": the RAI treatment after a total thyroidectomy. This article also aims to clarify the definition of a total thyroidectomy and how a thyroid remnant can introduce a confounding factor in the postoperative management of patients with differentiated thyroid cancer. The implications of an existing thyroid remnant on RAI diagnostic imaging and serum thyroglobulin levels are discussed...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Aviram Mizrachi, Ashok R Shaha
Lymph node metastases in differentiated thyroid cancer (DTC) have a wide spectrum of clinical significance. Several variables are taken under consideration when trying to decide on the optimal management of patients with DTC. Routine prophylactic central and/or lateral lymph node dissection is not advocated with exception of central neck dissection for locally advanced tumors. When regarding recurrent disease, foundations have been laid for clinicians to make accurate decisions as to when to perform surgery and when to continue maintaining the patient's disease under observation...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Seza Gulec
Cancer is a disorder of the genome. The thyroid cancer genome is being decoded. Recent studies have identified a mutation or a genetic alteration in 95% of thyroid cancers. The National Cancer Institute initiated the Cancer Genome Atlas project in 2006 to catalogue genetic mutations associated with cancer, using genome sequencing and bioinformatics. The project has expanded to carry out genomic characterization and sequence analysis of thyroid cancer. The concept of risk stratification based on traditional parameters will soon vacate their role for clear molecular markers of non-invasive/focal, invasive/metastatic and systemic stages/phases of neoplastic disorder...
February 9, 2017: Molecular Imaging and Radionuclide Therapy
Selin Soyluoğlu Demir, Gül Ege Aktaş, Ahmet Polat, Ali Sarıkaya
A 25-year-old woman had total thyroidectomy and iodine-131 ablation therapy for papillary thyroid carcinoma. Whole body imaging on the 7(th) day of therapeutic activity demonstrated radioiodine uptake in the remnant tissue and intense heterogeneous uptake at the sacral region prominently in the posterior image. Initial interpretation was suspicious for sacral metastasis. Technetium-99m-methylene diphosphonate bone scan demonstrated normal bone uptake and the absence of left kidney. On blood-pool phase of bone scan, the absence of left renal activity and an extra area of uptake in the sacral region suggestive of pelvic kidney were noticed...
February 5, 2017: Molecular Imaging and Radionuclide Therapy
Pelin Arıcan, Berna Okudan Tekin, Seniha Naldöken, Rıza Şefizade, Dilek Berker
Von Hippel-Lindau syndrome (VHLS) is an autosomal dominant hereditary familial disorder characterized by development of malignant and benign neoplasms. Differential diagnosis of the adrenal and pancreatic masses are difficult in patients with VHLS. Iodine-123 metaiodobenzylguanidine (I-123 MIBG) and indium-111 somatostatin receptor scintigraphies (In-111 SRS) have important roles in the differential diagnosis of adrenal and pancreatic masses in those patients. In this case report, we present the findings of I-123 MIBG single-photon emission computerized tomography (SPECT/CT) and In-111 SRS SPECT/CT in three members of a family with VHLS...
February 5, 2017: Molecular Imaging and Radionuclide Therapy
Sulaiman Mohammed Al-Mayouf, Nora Almutairi, Khalid Alismail
OBJECTIVE: Camptodactyly-arthropathy-coxa-vara-pericarditis (CACP) syndrome is an autosomal recessive disorder caused by mutations in PRG4 gene that encodes for proteoglycan 4, the main lubricant for joints and tendon surfaces. It is a non-inflammatory arthropathy, characterized by joint effusions and synovial hypertrophy. So far, there is no effective treatment for this disorder. To evaluate the effectiveness of yttrium-90 radiosynovectomy in arthropathy of patients with CACP syndrome...
February 5, 2017: Molecular Imaging and Radionuclide Therapy
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