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Radioiodine therapy

Lars Stegger, Kambiz Rahbar, Christoph Schülke, Sebastian Huss, Christian Wenning
PET using the radiotracer F-fluorodeoxyglucose (FDG) was performed in a patient who presented with elevated thyroglobulin (Tg) levels several years after initial therapy of follicular thyroid carcinoma (oncocytic variant) and in whom high-dose radioiodine (I) failed to locate recurrent tumor or to decrease Tg levels. A focal fluorodeoxyglucose uptake in the apical septum of the heart did not have a discernible correlate in echocardiography or MRI for more than 12 months. Finally, a metastasis of the follicular thyroid carcinoma with partly squamous cell differentiation was confirmed and treated by resection and stereotactic body radiotherapy...
October 15, 2018: Clinical Nuclear Medicine
Robin Bacher, Melanie Hohberg, Markus Dietlein, Markus Wild, Carsten Kobe, Alexander Drzezga, Matthias C Schmidt
Adjuvant radioiodine therapy (RITh) for differentiated thyroid carcinoma is performed either with thyroid hormone withdrawal or with administration of recombinant human thyroid-stimulating hormone (rhTSH). Heterogeneous results have been obtained on the impact of the method of patient preparation on thyroid uptake and whole-body effective half-life. A higher radiation exposure using thyroid hormone withdrawal for several weeks compared to rhTSH was reported in prior studies. It was the aim to examine if these findings are reproducible in a modern protocol with a short interval between surgery and RITh...
October 12, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Guohua Shen, Ying Kou, Bin Liu, Rui Huang, Anren Kuang
OBJECTIVES: Preclinical studies showed that BRAF mutation significantly reduced radioiodine uptake and decreased the sensitivity to radioactive iodine (RAI) therapy. However, clinical data regarding its role in therapeutic decision making with respect to RAI therapy are currently insufficient. Thus, this study aimed to evaluate the effect of BRAF mutation on the clinical response to RAI therapy for papillary thyroid microcarcinoma (PTMC) with intermediate-risk to high-risk features. PATIENTS AND METHODS: From January 2012 and October 2015, consecutive patients with PTMC with intermediate-risk to high-risk features who underwent RAI therapy were retrospectively included...
October 11, 2018: Nuclear Medicine Communications
Adam Maciejewski, Rafał Czepczyński, Marek Ruchała
Patients affected by differentiated thyroid cancer are treated surgically and by ablative radioiodine therapy. Post-therapy whole body scan allows detecting thyroid remnants or local and distant metastases, although false-positive findings may be observed. We report a case of 75-year-old woman with follicular thyroid cancer, who underwent ablative radioiodine treatment. On post-therapy whole body scan, abnormal uptake in the left upper abdomen was found, although stimulated thyroglobulin level was not suggestive for distant metastases of differentiated thyroid carcinoma...
October 11, 2018: Endokrynologia Polska
V R Agrawal, G Jodon, R Mushtaq, D W Bowles
Curative therapies for radioiodine-refractory differentiated thyroid cancer remain lacking. However, oral multikinase inhibitors often allow for disease control and improved progression-free survival. Two agents, lenvatinib and sorafenib, have been approved for radioiodine-refractory differentiated thyroid cancer on the basis of phase III clinical trials showing marked response rates and improved progression-free survival over placebo. Several other multikinase inhibitors, including apatinib, axitinib, cabozantinib, pazopanib, sunitinib and vandetanib, have also been studied in phase II clinical trials, with varying response rates and comparable progression-free survival...
September 2018: Drugs of Today
Sebastian Hoberück, Enrico Michler, Danilo Seppelt, Jörg Kotzerke, Claudia Brogsitter
A 68-year-old woman who underwent a thyroidectomy for bilateral goiter 20 years ago was referred to our department. The examination revealed a newly occurred thyroid nodule in the right central lobe. Unexpectedly the Tc-pertechnetate scan revealed several extrathyroidal foci right-sided supraclavicular, beside a cold thyroid nodule in the right lower lobe. Consecutive surgery and histology confirmed the suspected diagnosis of follicular thyroid cancer with multiple bone metastases. Whole-body scintigraphy performed after the following radioiodine therapy indicated disseminated osseous metastases...
October 8, 2018: Clinical Nuclear Medicine
Mohammad Abuqbeitah, Mustafa Demir, İffet Çavdar, Handan Tanyildizi, Nami Yeyin, Lebriz Uslu-Beşli, Levent Kabasakal, Nazenin İpek Işıkcı, Kerim Sönmezoğlu
The aim of the present study was to review the available models developed for calculating red bone marrow dose in radioiodine therapy using clinical data. The study includes 18 patients (12 females and six males) with metastatic differentiated thyroid cancer. Radioiodine tracer of 73 ± 16 MBq 131 I was orally administered, followed by blood sampling (2 ml) and whole-body scans (WBSs) done at several time points (2, 6, 24, 48, 72, and ≥ 96 h). Red bone marrow dose was estimated using the OLINDA/EXM 1...
October 8, 2018: Radiation and Environmental Biophysics
Ei Thuzar Aung, Nicola N Zammitt, Anna R Dover, Mark Wj Strachan, Jonathan R Seckl, Fraser W Gibb
OBJECTIVE: Radioiodine (RAI) is an effective treatment for Graves' thyrotoxicosis but is associated with a failure rate of 15% and may be a risk factor for thyroid eye disease (TED) and weight gain. We sought to examine predictors of RAI failure, weight gain, TED and patient satisfaction. DESIGN: Retrospective cohort study. PATIENTS: 655 episodes of RAI in Graves' thyrotoxicosis patients (2006 - 2015). MEASUREMENTS: Biochemical assessment, including TFTs and thyrotropin receptor antibodies (TRAb), clinical features (e...
October 6, 2018: Clinical Endocrinology
Ali S Alzahrani, Meshael Alswailem, Yosra Moria, Reem Almutairi, Metib Alotaibi, Avaniyapuram Kannan Murugan, Ebtesam Qasem, Balgees AlGhamdi, Hindi Al-Handi
Context: Lung metastases are common in pediatric thyroid cancer. We present an analysis of a series of lung metastasis in pediatric TC. Patients and methods: Data on 20 patients (16 females, 4 males, median age 14.5 years, range 10-18) were analyzed. The tumors include differentiated thyroid cancer in 19 patients and a single case of poorly differentiated thyroid cancer. Results: Lung metastasis presented with 3 distinct radiological patterns: lung uptake on diagnostic radioiodine whole body scan (DxWBS) only in 3 patients (15%), on DxWBS and CT scan as micro metastases (≤ 1 cm) in 16 patients (80%) and on DxWBS and CT scan as macrometastases (>1 cm) in 1 patient (5%)...
September 28, 2018: Journal of Clinical Endocrinology and Metabolism
Partha Choudhury, Manoj Gupta
The term theranostics is the combination of a diagnostic tool that helps to define the right therapeutic tool for specific disease. It signifies the "we know which sites require treatment (diagnostic scan) and confirm that those sites have been treated (post therapy scan)" demonstrating the achievable tumor dose concept. This term was first used by John Funkhouser at the beginning of the 90's at the same time the concept of personalized medicine appeared. In nuclear medicine theranostics is easy to apply and understand because of an easy switch from diagnosis to therapy with the same vector...
September 27, 2018: British Journal of Radiology
Jacobo Guiu-Souto, Sara Neira Castro, Manuel Sánchez-García, Oscar López-Pouso, Miguel Pombar, Juan Pardo-Montero
Nowadays therapies involving radioiodine (I-131) represents 84% of the total metabolic treatments in Europe, according to the last report of the European Association of Nuclear Medicine (EANM) in relation to treatment planning for molecular radiotherapy. Last recommendations of the European Council, i.e. 2013/59/Euroatom, mandates that metabolic treatments should be planned according to the radiation doses delivered to individual patients, analogous to external beam radiotherapy. In this work, we present a novel biokinetic model for I-131 that allows obtaining realistic activity distributions for particular patients with thyroid cancer in absence of metastasis...
September 26, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Nikola Besic, Marta Dremelj, Gasper Pilko
Background Locoregional recurrence is common in patients with locally advanced differentiated thyroid carcinoma (DTC). Our aim was to find out the rate of locoregional control of the disease after external beam radiotherapy (EBRT) of the neck and mediastinum in patients with DTC and pT4 tumor. Patients and methods Altogether 91 patients (47 males, 44 females, median age 61 years) with DTC had EBRT of the neck and mediastinum as part of the multimodal treatment of pT4 tumor (63 cases pT4a, 28 cases pT4b) from the year 1973 to 2015...
September 22, 2018: Radiology and Oncology
Christina Schug, Aayush Gupta, Sarah Urnauer, Katja Steiger, Phyllis Fung-Yi Cheung, Christian Neander, Konstantinos Savvatakis, Kathrin A Schmohl, Marija Trajkovic-Arsic, Nathalie Schwenk, Markus Schwaiger, Peter J Nelson, Jens T Siveke, Christine Spitzweg
The sodium iodide symporter ( SLC5A5/NIS ) as theranostic gene would allow for non-invasive imaging of functional NIS expression and therapeutic radioiodine application. Genetically engineered mesenchymal stem cells (MSC), based on their tumor-homing abilities, show great promise as tumor-selective NIS gene delivery vehicles for non-thyroidal tumors. As a next step towards clinical application, tumor specificity and efficacy of MSCs were investigated in an advanced genetically engineered mouse model of pancreatic ductal adenocarcinoma (PDAC)...
September 17, 2018: Molecular Cancer Research: MCR
Lin Qui, Hui Tan, Hongyan Yin, Jun Zhou, Dengfeng Cheng, Hongcheng Shi
BACKGROUND: The aim was to compare the detect ability of 3 sequential 131I whole-body scans (tri-WBS) on the second, third, and fourth day after 131I therapy for metastatic thyroid cancer. METHODS: Differentiated thyroid cancer patients who received oral high-dose 131I therapy underwent routinely tri-WBS on the second, third, and fourth day after total or near-total thyroidectomy in our hospital. We enrolled 137 patients with 261 tri-WBSs in this study between January 2015 and November 2017...
September 13, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Ewelina Szczepanek-Parulska, Magdalena Wojewoda-Korbelak, Martyna Borowczyk, Malgorzata Kaluzna, Barbara Brominska, Katarzyna Ziemnicka, Rafal Czepczynski, Maciej Baczyk, Marek Ruchala
BACKGROUND: Although differentiated thyroid cancer (DTC) has relatively favorable course, factors predicting the course of the disease are intensively searched. The aim of the study was to identify the clinical factors determining incomplete response to radioiodine therapy in patients with differentiated thyroid cancer. METHODS: We retrospectively analyzed 385 consecutive patients with DTC treated and followed-up at a single tertiary reference center. We investigated clinical factors detectable during first hospitalization 3-6 months following total thyroidectomy due to DTC, which may serve as prognostic factors determining response to DTC therapy in a long-term follow-up...
September 13, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Lindsay Brammen, Philipp Riss, Julius Lukas, Alois Gessl, Daniela Dunkler, Shuren Li, Asha Leisser, Sandra Rezar-Dreindl, Katharina Eibenberger, Andreas Selberherr, Christian Scheuba, Andrea Papp
BACKGROUND: Graves' disease (GD) is characterized by thyrotoxicosis and goiter and arises through circulating autoantibodies that bind to, and stimulate, the thyroid hormone receptor (TSHR). A temporal relation between the onset of hyperthyroidism and the onset of ophthalmopathy, a common extrathyroidal manifestation, has been demonstrated. Graves' ophthalmopathy (GO) is typically characterized by an inflammation and expansion of the extraocular muscles and an increase in retroorbital fat...
September 15, 2018: Trials
Mohammad Abuqbeitah, Mustafa Demir, Levent Kabasakal, İffet Çavdar, Lebriz Uslu-Beşli, Nami Yeyin, SayedBaresh Razavikhosroshahi, Kerim Sönmezoğlu
AIM: The development of reliable dosimetry models promotes the individualized therapy concept toward more success and less complications. This paper evaluates the traditional maximum empirical activity (250 mCi) and the benefit of joining two dosimetry approaches to optimize the therapeutic activity and radioiodine efficacy in metastatic differentiated thyroid cancer. MATERIALS AND METHODS: Nineteen (12 females and seven males) patients with metastatic differentiated thyroid cancer were included in the present study...
September 1, 2018: Nuclear Medicine Communications
Alessio Rizzo, Luca Zagaria, Germano Perotti, Salvatore Annunziata, Massimo Salvatori
A 72-year-old man underwent total thyroidectomy and radioiodine remnant ablation for papillary thyroid cancer in 2016. The posttherapy whole-body scan showed uptake in the neck, classified as residual thyroid tissue. Two years later, the patient came to our observation to perform a second radioiodine therapy for high levels of thyroglobulin. The planar posttherapy scan showed a focal radioiodine area in the neck. SPECT/CT diagnosed a voluminous esophageal diverticulum located in the upper third of the esophagus...
November 2018: Clinical Nuclear Medicine
Jooyeon Cho, Jung Hee Shin, Soo Yeon Hahn, Young Lyun Oh
Objective: To evaluate the ultrasonography (US) features and clinical characteristics of columnar cell variant of papillary thyroid carcinoma (CCV-PTC) that can predict disease progression. Materials and Methods: Six cases of CCV-PTC were identified via surgical pathology analysis at our institution from 1994 to 2016. The histological, architectural, and cytological features met the diagnostic criteria of CCV-PTC. We reviewed the US features and clinicopathological findings in the six cases...
September 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Hong Song, Camila Mosci, Haruko Akatsu, Marina Basina, Chrysoula Dosiou, Andrei Iagaru
OBJECTIVES: The use of I whole body scintigraphy (WBS) before I radioiodine ablation (RIA) of the post-surgical thyroid remnant in patients with papillary thyroid cancer (PTC) remains debated. The American Thyroid Association's guidelines state that WBS may be useful before RIA (rating C-expert opinion). Some institutions do not use I WBS before RIA in their routine clinical protocol. We were therefore prompted to evaluate the impact of I WBS prior to ablation of thyroid remnant in patients with PTC...
October 2018: Clinical Nuclear Medicine
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