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Last Build Date: Tue, 29 Mar 2016 16:20:32 +0100

 



Role of Nuclear Medicine in the Diagnosis of Benign Thyroid Diseases.

Thu, 24 Mar 2016 23:44:02 +0100

Authors: Garberoglio S, Testori O Abstract A deep understanding of thyroid pathophysiology is the basis for diagnosing and treating benign thyroid diseases with radioactive materials, known as radiopharmaceuticals, which are introduced into the body by injection or orally. After the radiotracer administration, the patient becomes the emitting source, and several devices have been studied to detect and capture these emissions (gamma or beta-negative) and transform them into photons, parametric images, numbers and molecular information. Thyroid scintigraphy is the only technique that allows the assessment of thyroid regional function and, therefore, the detection of areas of autonomously functioning thyroid nodules. Scintigraphy visualizes the distribution of active thyroid tissue an...

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Cytogenetic effects of radioiodine therapy: a 20-year follow-up study.

Thu, 24 Mar 2016 23:00:00 +0100

Authors: Livingston GK, Khvostunov IK, Gregoire E, Barquinero JF, Shi L, Tashiro S Abstract The purpose of this study was to compare cytogenetic data in a patient before and after treatment with radioiodine to evaluate the assays in the context of biological dosimetry. We studied a 34-year-old male patient who underwent a total thyroidectomy followed by ablation therapy with (131)I (19.28 GBq) for a papillary thyroid carcinoma. The patient provided blood samples before treatment and then serial samples at monthly intervals during the first year period and quarterly intervals for 5 years and finally 20 years after treatment. A micronucleus assay, dicentric assay, FISH method and G-banding were used to detect and measure DNA damage in circulating peripheral blood lymphocytes of th...



Cytogenetic and dosimetric effects of (131)I in patients with differentiated thyroid carcinoma: comparison between stimulation with rhTSH and thyroid hormone withdrawal treatments.

Wed, 23 Mar 2016 23:00:00 +0100

Authors: da Silva MA, Valgôde FG, Gonzalez JA, Yoriyaz H, Guimarães MI, Ribela MT, Buchpiguel CA, Bartolini P, Okazaki K Abstract A study directed to the cytogenetic and dosimetric aspects of radionuclides of medical interest is very valuable, both for an accurate evaluation of the dose received by the patients, and consequently of the genetic damage, and for the optimization of therapeutic strategies. Cytogenetic and dosimetric effects of (131)I in lymphocytes of thyroidectomized differentiated thyroid cancer (DTC) patients were evaluated through chromosome aberration (CA) technique: Euthyroid patients submitted to recombinant human thyroid-stimulating hormone (rhTSH) therapy (group A) were compared with hypothyroid patients left without levothyroxine treatment (group B). CA ana...



Anthracofibrosis Manifesting as False-Positive Iodine Accumulation in a Patient With Recent History of Thyroid Carcinoma

Thu, 10 Mar 2016 23:34:10 +0100

Abstract: A 33-year-old Indonesian woman presented for follow-up after a recent history of papillary thyroid carcinoma treated with total thyroidectomy and radioiodine therapy. A 131I whole-body scintigraphy showed an elongated iodine accumulation in the right hemithorax. On suspicion of pulmonary metastasis, further diagnostics with 124I PET/CT showed thickening of the bronchial wall and retention of secretion in a middle lobe bronchus. Bronchoscopy and histology allowed a diagnosis of stenosing anthracofibrosis with chronic inflammatory changes. (Source: Clinical Nuclear Medicine)



Calculation of Blood Dose in Patients Treated With 131I Using MIRD, Imaging, and Blood Sampling Methods

Tue, 01 Mar 2016 06:00:00 +0100

In this study, 23 patients with DTC with different administrated activities, 3.7, 4.62, and 5.55 GBq after thyroidectomy, were randomly selected. Blood dosimetry of treated patients was performed with external whole body counting using a dual-head gamma camera imaging device and also with blood sample activity measurements using a dose calibrator. Absorbed dose to the blood was measured at 2, 6, 12, 24, 48, and 96 hours after the administration of radioiodine with the 2 methods. Based on the results of whole body counting and blood sample activity dose rate measurements, 96 hours after administration of 3.7, 4.62, and 5.55 GBq of radioiodine, absorbed doses to patients’ blood were 0.65 ± 0.20, 0.67 ± 0.18, 0.79 ± 0.51 Gy, respectively. Increasing radioiodine act...



Pediatric thyroid cancer: postoperative classifications and response-to-initial-therapy as prognostic factors.

Tue, 01 Mar 2016 00:00:00 +0100

CONCLUSIONS: Our data confirm that the post-operative pediatric ATA-stratification-system and the novel "SCMCI-score" are suitable for predicting the risk of recurrent/persistent disease in this population. The "response-to-initial-therapy" classification performed 1-2 years after initial therapy may be more appropriate for guiding surveillance recommendations. PMID: 26930182 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)

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Temporary changes in neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and mean platelet volume reflecting the inflammatory process after radioiodine therapy

Thu, 25 Feb 2016 09:07:03 +0100

Conclusion: This is the first study to evaluate changes in NLR, PLR, and MPV after RAI therapy. Our findings suggest that NLR, PLR, and MPV changes indicate systemic inflammation that occurs after RAI therapy because of thyroid remnant tissue ablation. (Source: Nuclear Medicine Communications)



Dose-response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of 124I PET/CT.

Thu, 25 Feb 2016 00:00:00 +0100

CONCLUSION: In a fixed-activity approach, a statistically significant dose-response relationship for both thyroid remnants and metastases using pre-therapeutic (124)I PET/CT lesion dosimetry was found. The findings may be useful in patient management. PMID: 26917706 [PubMed - as supplied by publisher] (Source: Nuklearmedizin)



Radioiodine therapy versus antithyroid medications for Graves' disease.

Thu, 18 Feb 2016 00:00:00 +0100

CONCLUSIONS: The only antithyroid drug investigated in the two included trials was methimazole, which might limit the applicability of our findings with regard to other compounds such as propylthiouracil. Results from two RCTs suggest that radioiodine treatment is associated with an increased risk of Graves' ophthalmopathy. Our findings suggest some benefit from radioiodine treatment for recurrence of hyperthyroidism (relapse) but there is uncertainty about the magnitude of the effect size. PMID: 26891370 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)



Lingual Thyroid Ectopia: Diagnostic SPECT/CT imaging and Radioactive Iodine Treatment.

Sat, 13 Feb 2016 17:48:01 +0100

CONCLUSIONS: Ectopic lingual thyroid tissue is rarely associated with obstructive oropharyngeal symptoms due to progressive enlargement. Radioiodine therapy with 131I is an effective treatment modality for ablation of ectopic thyroid tissue as an alternative to surgery. PMID: 26864253 [PubMed - as supplied by publisher] (Source: Thyroid : official journal of the American Thyroid Association)



The impact of EANM (2013) formalism for radioiodine dosimetry in hyperthyroidism disease: A comparative evaluation of therapeutic activity

Mon, 01 Feb 2016 00:00:00 +0100

Introduction: The treatment of choice in most of hyperthyroidism cases is the radioiodine therapy. An accurate assessment of the pathological volume and an individual dosimetry procedure implementation prior to therapy are mandatory by Council Directive 97/43/Euratom. The aim of this study is to assess the differences arising in the 131I therapeutic activity depending on whether the SIE-AIMN-AIFM (2005) or EANM (2013) formalism is used. (Source: Physica Medica: European Journal of Medical Physics)

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Radiation protection impact of radioiodine therapy for hyperthyroidism after a patient specific dosimetric study

Mon, 01 Feb 2016 00:00:00 +0100

In hyperthyroid pts treatment with 131I should rapidly obtain a nonhyperthyroid status. There is a discussion about the method to determine the therapeutic activity: estimation (fixed activity) vs calculation (based on radioiodine uptake measurements), however the optimization principle states that a pt should be given the minimum activity for the clinical goal. In our Nucl Med Dept all hyperthyroid pts are submitted to a patient specific pretreatment study to calculate the minimum activity to achieve euthyroidism, for nodular autonomies, and hypothyroidism, for Graves disease. (Source: Physica Medica: European Journal of Medical Physics)



Activity estimation in patients submitted to radioiodine therapy for hyperthyroidism

Mon, 01 Feb 2016 00:00:00 +0100

Introduction: The 131I administered activities for the hyperthyroidism treatments are very high, with significant residual amounts in the following days. This paper proposes a mathematical algorithm that correlates patient activities and external measurements. The results are supported by clinical and experimental validations. (Source: Physica Medica: European Journal of Medical Physics)



DNA Damage in Peripheral Blood Lymphocytes of Thyroid Cancer Patients After Radioiodine Therapy

Mon, 01 Feb 2016 00:00:00 +0100

Conclusion: With the experimental results and model calculations presented in this work, a dose–response relationship is demonstrated, and an analytic function describing the time course of the in vivo damage response after internal irradiation of patients with 131I is established. (Source: Journal of Nuclear Medicine)



Effects of hemodialysis on iodine-131 biokinetics in thyroid carcinoma patients with end-stage chronic renal failure

Sat, 30 Jan 2016 02:04:05 +0100

In conclusion, the amount of radioiodine excreted per hemodialysis session was calculated to be 51.25%. (Source: Nuclear Medicine Communications)



Using ultrasound radio frequency technology to assess regression of the structure and function of the carotid artery by radioiodine therapy in hyperthyroidism patients.

Fri, 22 Jan 2016 09:39:02 +0100

CONCLUSIONS: Six-month (131)I treatment for patients with hyperthyroidism reverses the structural and functional damage in the carotid artery, which is sensitively evaluated by the RF data technique. PMID: 26788085 [PubMed] (Source: Archives of Medical Science)

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Evaluation of thyroid to background ratios and comparison of various scintigraphic measurements and their correlation to serum t4 in hyperthyroid cats

Tue, 19 Jan 2016 00:00:00 +0100

Thyroid‐to‐salivary ratio and percent dose uptake are the most widely recognized scintigraphic measurements. Recently, the thyroid‐to‐background ratio has been proposed as an alternate method. However, this method has not been validated. The purpose of this observational, cross‐sectional, prospective study was to determine the location of a background region of interest (ROI) that is most reflective of blood pool activity. We also hypothesized that the thyroid‐to‐background ratio using this background ROI would be a better predictor of thyroid function. Fifty‐six cats presented to the Virginia‐Maryland College of Veterinary Medicine seeking radioiodine therapy for hyperthyroidism were enrolled in this cross‐sectional study to evaluating thyroid‐to‐background ratio. ...



Quantitative Comparison of 124I PET/CT and 131I SPECT/CT Detectability

Mon, 04 Jan 2016 00:00:00 +0100

Conclusion: A relatively low 124I activity of 74 MBq (~1% of 131I activity) is sufficient to achieve similar lesion detectability between 124I PSF TOF PET/CT and 131I SPECT/CT for small spheres (≤10 mm), since the reported DEPs are close to 1%. False-negative 124I PET/CT results as compared with posttherapeutic 131I SPECT/CT may be ascribed to differences in detectability for large lesions (>10 mm) and for no-PSF no-TOF PET, since DEPs are greater than 1%. On the basis of DEPs of 3.5% for lesion diameters of up to 17 mm on no-PSF no-TOF PET, 124I activities as high as 170 MBq may be warranted to obtain equal detectability. (Source: Journal of Nuclear Medicine)



[Changes in radioiodine therapy for thyroid disorders].

Fri, 01 Jan 2016 00:00:00 +0100

Authors: Konrády A Abstract Radioiodine therapy for benign and malignant thyroid diseases was introduced about 70 years ago, however, there is still a lack of consensus regarding indications, doses and procedure. This review covers treatment results in immunogenic hyperthyroidism including the problem of orbitopathy. Radioiodine therapy for toxic and non-toxic multinodular goiter is also discussed with striking possibility of enhanching the radioiodine uptake. In this respect the recombinant human thyrotropin should be mentioned. Thyroid cancer treatment protocol has changed, too, due to ineffectivity in low-risk patients. More attention is needed to the carcinogenecity of radioiodine. The numerous problems mentioned above require large and well-designed prospective trials to reso...



Impaired immune regulation after radioiodine therapy for Graves’ disease and the protective effect of Methimazole

Wed, 23 Dec 2015 00:00:00 +0100

This study adds new highlights on immune regulation deficiencies after therapeutic interventions in thyroid autoimmunity. (Source: Endocrine)



Predictive factors for recurrence of differentiated thyroid cancer in patients under 21 years of age and a meta-analysis of the current literature

Tue, 22 Dec 2015 00:00:00 +0100

In conclusion, multifocality and presentation at diagnosis are strong predictive factors of recurrence in relation to recurrence-free survival. We recommend studies with larger sample sizes and longer follow-up to verify the influence of predictors for disease recurrence in young patients. (Source: Tumor Biology)

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Papillary thyroid carcinomas with biochemical incomplete or indeterminate responses to initial treatment: repeat stimulated thyroglobulin assay to identify disease-free patients

Mon, 14 Dec 2015 00:00:00 +0100

Abstract Papillary thyroid cancer (PTC) patients treated with thyroidectomy and radioiodine remnant ablation (RRA) often have detectable TSH-stimulated thyroglobulin (Tg) levels without localizable disease after primary treatment. To assess the value of repeat stimulated Tg assays in these patients’ follow-up, we retrospectively analyzed 86 cases followed in 5 Italian thyroid-cancer referral centers. We enrolled 86 patients with PTCs treated with total/near-total thyroidectomy plus RRA between January 1,1990 and January 31, 2006. In all cases, the initial postoperative visit revealed stimulated serum Tg ≥1 ng/mL, negative Tg antibodies, and no structural evidence of disease. None received empiric radioiodine therapy. Follow-up (median: 9.6 years) included neck ultrasound and...



Sialadenitis after radioiodine therapy. Analysis of factors that influence the response to medical treatment

Tue, 08 Dec 2015 00:00:00 +0100

Conclusion Incidence of 131I-induced sialadenitis was similar to that reported by other authors. Age, mean cumulative dose of 131I, and involvement of parotid and submaxillary glands did not condition response to CMT; however, male sex was a conditioning factor. Symptom persistence for more than 15 days makes instillation into the Stensen's duct advisable. This is an effective and safe method to avoid surgical excision of salivary glands. (Source: Endocrinologia y Nutricion)



Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma

Thu, 26 Nov 2015 00:00:00 +0100

Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility. (Source: Journal of Cancer Research and Therapeutics)



Lithium Carbonate in the Treatment of Graves' Disease with ATD-Induced Hepatic Injury or Leukopenia.

Wed, 18 Nov 2015 17:27:14 +0100

Conclusion. Lithium carbonate has effects on the treatment of mild-to-moderate hyperthyroidism caused by GD, and it is particularly suitable for patients with ATD-induced hepatic injury or leukopenia. PMID: 26576153 [PubMed - as supplied by publisher] (Source: International Journal of Endocrinology)



Radionuclide therapy using 131 I-labeled anti-epidermal growth factor receptor-targeted nanoparticles suppresses cancer cell growth caused by EGFR overexpression

Mon, 16 Nov 2015 00:00:00 +0100

Conclusion The EGFR-targeted nanoparticle EGFR–BSA–PCL demonstrated superior cellular binding and uptake compared with those of the control BSA–PCL. The EGFR-targeted radioactive nanoparticle 131I–EGFR–BSA–PCL exhibited favorable intracellular retention of 131I. Radionuclide therapy using 131I–EGFR–BSA–PCL, which showed excellent targeted cell killing, suppressed cancer cell growth caused by EGFR overexpression. (Source: Journal of Cancer Research and Clinical Oncology)

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Ectopic Subcutaneous Implantation of Thyroid Tissue after Gasless Transaxillary Robotic Thyroidectomy for Papillary Thyroid Cancer.

Sat, 14 Nov 2015 17:54:02 +0100

Authors: Espiard S, Petyt G, Lion G, Beron A, Do Cao C, Wemeau JL, Vantyghem MC, Pattou F, Caiazzo R Abstract Over the past decade, transaxillary robot-assisted thyroidectomy (TRAT) has played a growing role in the management of thyroid nodules. Despite thousands of patients being operated on in Asia for a long time, a few cases of subcutaneous thyroid tissue (STI) have recently been described in the literature, relating to new palpable mass being discovered several years after the original endoscopic thyroidectomy surgery. The high dose radioiodine therapy performed in two patients of a series of 19 patients allowed us to discover precociously microscopic SIT. STI after TRAT could be more common than it currently is, if we consider ectopic tissue uptake with high dose RIT. Despite...



Inverse Agonist of Estrogen-Related Receptor {gamma} Enhances Sodium Iodide Symporter Function Through Mitogen-Activated Protein Kinase Signaling in Anaplastic Thyroid Cancer Cells

Mon, 02 Nov 2015 00:00:00 +0100

Conclusion: These findings suggest that the inverse agonist of ERR enhances the responsiveness of radioiodine therapy by modulating NIS function in ATC cells via the regulation of ERR and the MAP kinase signaling pathway. (Source: Journal of Nuclear Medicine)



Methimazole discontinuation before radioiodine therapy in patients with Graves’ disease

Fri, 30 Oct 2015 03:11:01 +0100

Conclusion: No difference was found in the response to treatment between patients with MMI discontinuation for 24–48, 48.1–72, and 72.1–96 h before RIT. Shorter discontinuation of MMI before RIT may be preferable in most patients. Video Abstract: http://links.lww.com/NMC/A39 (Source: Nuclear Medicine Communications)



The Sonographic Features of the Thyroid Gland after Treatment with Radioiodine Therapy in Patients with Graves' Disease

Thu, 22 Oct 2015 00:00:00 +0100

The aim of the study was to describe the typical sonographic features of the thyroid gland in patients with Graves' hyperthyroidism after radioiodine therapy (RIT). Thirty patients (21 female and 9 male) with a mean age of 53 y (standard deviation [SD] ± 11.3) and with previous Graves' disease who had been successfully treated with RIT were enrolled in the study. All were hypothyroid or euthyroid after treatment. The thyroid ultrasound was carried out by a single experienced operator with an 8-MHz linear transducer. (Source: Ultrasound in Medicine and Biology)



Dose optimization in nuclear medicine therapy of benign and malignant thyroid diseases

Tue, 20 Oct 2015 00:00:00 +0100

Abstract The iodine isotope I-131 has been used in nuclear medicine for several decades to treat both benign and malignant thyroid diseases. The therapy is effective and safe and insensitive to variations in the activity dosage of I-131. Individualization of therapy in order to limit the administered activity to the lowest amount necessary to successfully treat diseased thyrocytes while minimizing exposure to healthy organs requires performing dosimetry through measurement of the individual iodine kinetics. This review discusses the concepts of dosimetry used for patients with thyroid disorders and compiles information on the present evidence for superiority of individualization of therapy by dosimetric assessments. Two main concepts of individualized treatment are used for patien...

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Effects of thyroid hormone withdrawal and recombinant human TSH on glomerular filtration rate during radioiodine therapy for well-differentiated thyroid cancer.

Sun, 11 Oct 2015 03:36:03 +0100

CONCLUSION: GFR decreases in patients with normal kidney function during THW for RIT, and rhTSH preserves GFR in these patients. This GFR impairment following thyroidectomy is related to hypothyroidism due to a significant reduction in thyroid hormone levels and is not due to a rise in the TSH level. PMID: 26446582 [PubMed - as supplied by publisher] (Source: Thyroid : official journal of the American Thyroid Association)



Thymus uptake of 131 I in patients with differentiated thyroid carcinoma: Three different case scenarios and patterns of uptake and the importance of its recognition in thyroid cancer practice

Fri, 09 Oct 2015 00:00:00 +0100

Amit Abhyankar, Sandip BasuJournal of Cancer Research and Therapeutics 2015 11(3):648-648The importance of recognizing thymic radioiodine uptake as the cause of a false-positive mediastinal focus in the whole-body 131 I scan, done for the evaluation of post-thyroidectomy cases of differentiated thyroid carcinoma, is illustrated with the corresponding clinicoradiorological correlation. The pattern of mediastinal uptake could vary based upon the pattern of thymic hyperplasia in an individual case. Three different patterns of mediastinal uptake were observed in the cases described in the present report. Recognizing the patterns and the clinical settings (where this was to be suspected by the treating physician) was important to obviate unnecessary aggressive treatment, such as, surgery or rad...



Therapy-related acute myeloid leukemia following radioactive iodine treatment for thyroid cancer

Fri, 09 Oct 2015 00:00:00 +0100

Conclusions T-AML following radioiodine therapy for thyroid cancer appears to have a shorter latency period than other types of t-AML, which is an important consideration for post-therapy surveillance. Reporting of cases and outcomes will help provide data for further research. Identifying biomarkers that help risk-stratify patients prior to therapy and specific genetic-guided therapies may help improve outcomes. (Source: Cancer Causes and Control)



Thyroid remnant ablation in differentiated thyroid cancer: searching for the most effective radioiodine activity and stimulation strategy in a real-life scenario

Wed, 30 Sep 2015 09:50:32 +0100

Conclusion: Our data demonstrate that 2220 and 3700 MBq radioiodine are more effective compared with 1110 MBq in TRA, without significant differences between 2220 and 3700 MBq or between hypothyroidism and euthyroidism. We suggest rhTSH-aided TRA with 2220 MBq iodine-131, as this approach permits efficacious treatment, thereby reducing side effects, absorbed dose to body and hospital stay. (Source: Nuclear Medicine Communications)



Modulation of thyroidal radioiodide uptake by oncological pipeline inhibitors and Apigenin.

Sat, 26 Sep 2015 05:06:06 +0100

Authors: Lakshmanan A, Scarberry D, Green JA, Zhang X, Selmi-Ruby S, Jhiang SM Abstract Targeted radioiodine therapy for thyroid cancer is based on selective stimulation of Na+/I- Symporter (NIS)-mediated radioactive iodide uptake (RAIU) in thyroid cells by thyrotropin. Patients with advanced thyroid cancer do not benefit from radioiodine therapy due to reduced or absent NIS expression. To identify inhibitors that can be readily translated into clinical care, we examined oncological pipeline inhibitors targeting Akt, MEK, PI3K, Hsp90 or BRAF in their ability to increase RAIU in thyroid cells expressing BRAFV600E or RET/PTC3 oncogene. Our data showed that (1) PI3K inhibitor GDC-0941 outperformed other inhibitors in RAIU increase mainly by decreasing iodide efflux rate to a great ext...

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Molecular profiles of cancer stem-like cell populations in aggressive thyroid cancers

Mon, 14 Sep 2015 00:00:00 +0100

Abstract A substantial proportion of patients with advanced thyroid carcinoma fail to respond to or at some point become refractory to conventional therapies. This resistance and the phenomena of thyroid cancer progression and metastasis themselves are thought to be related to tumor-cell sub-populations with stem-like properties. We isolated thyrospheres from four advanced thyroid carcinomas that were resistant to radioiodine therapy and analyzed their molecular profiles. ALDH activity and proteomic profile of main stem cell markers were used to assess stem cell properties. The TaqMan Low Density Array approach was used to evaluate the expression of several genes involved in the EMT process. The phosphorylation status of tyrosine kinase receptors (RTKs) was analyzed to identify po...



Patients with papillary thyroid carcinoma at intermediate risk of recurrence according to American Thyroid Association criteria can be reclassified as low risk when the postoperative thyroglobulin is low.

Sun, 13 Sep 2015 19:52:02 +0100

CONCLUSIONS: This study suggests that intermediate-risk patients (according to ATA criteria) with a postoperative sTg ≤ 2 ng/ml can be reclassified as low risk already at the time of initial therapy. PMID: 26359309 [PubMed - as supplied by publisher] (Source: Thyroid : official journal of the American Thyroid Association)



Intermediate and Long-term Adverse Effects of Radioiodine Therapy for Differentiated Thyroid Carcinoma - A Systematic Review

Wed, 09 Sep 2015 00:00:00 +0100

Differentiated thyroid carcinoma (DTC) is the most frequent primary endocrine-related malignancy, constituting 3.8% of all new cancer cases in the United States (incidence adults: 12.9 per 100,000 per year, incidence in children less than 10 years of age: 1 per 1,000,000 per year) [1,2]. The majority of cases are papillary and follicular thyroid cancers, which have an excellent 10-year overall survival, exceeding 90% [3]. In most cases, treatment for DTC consists of a total or near-total thyroidectomy, followed by the administration of radioactive iodine (I-131) for remnant ablation or residual disease. (Source: Cancer Treatment Reviews)



FoxP3 in papillary thyroid carcinoma induces NIS repression through activation of the TGF-β1/Smad signaling pathway

Tue, 11 Aug 2015 15:20:57 +0100

In this study, samples from 90 PTCs as well as 40 normal thyroid tissues were examined for FoxP3 and NIS by immunohistochemistry and real-time PCR. We found that FoxP3 was associated with decreased NIS expression. Lentiviral-mediated FoxP3-overexpressing cells were constructed and real-time PCR and western blotting were performed to evaluate the expression of NIS. Meanwhile, key members of the transforming growth factor-β1 (TGF-β1) pathway were explored by ELISA and immunofluorescence and a neutralizing TGF-β1 antibody was used to block activity. In vitro, FoxP3 overexpression significantly reduced NIS transcript and protein levels and the TGF-β1 pathway was activated. However, treatment with neutralizing TGF-β1 antibody partially abrogated FoxP3-induced NIS repression. These findings...



Mazabraud’s syndrome and thyroid cancer, a very rare and confusing association: a case report

Thu, 06 Aug 2015 00:00:00 +0100

Conclusion: During the evolution of a malignant disease, Mazabraud’s syndrome, known as the association of intramuscular myxoma with fibrous dysplasia, should be considered in the differential diagnosis of bone metastasis. This is the first report in the literature of Mazabraud’s syndrome occurring in a patient with thyroid cancer. (Source: BMC Endocrine Disorders)

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Clinical Association of Thyroid Stimulating Hormone Receptor Antibody Levels with Disease Severity in the Chronic Inactive Stage of Graves' Orbitopathy.

Wed, 05 Aug 2015 18:27:35 +0100

CONCLUSIONS: In chronic-inactive GO after euthyroid restoration, GO activity score did not associate with serum levels of TRAb or TBII. However, levels of the functional antibody Mc4-TSI did correlate with GO severity. Therefore, the TSI bioassay is a clinically relevant measure of disease severity even in chronic inactive GO. PMID: 26240504 [PubMed - in process] (Source: Korean Journal of Ophthalmology : KJO)



Sperm DNA fragmentation after radioiodine treatment for differentiated thyroid cancer

Sun, 02 Aug 2015 00:00:00 +0100

Conclusions Treatment with 131I induces alterations in sperm chromatin as well as in sperm parameters a short time (3 months) after a first dose of 131I with persistence of sperm alterations until 12 months after a second dose. Sperm banking should be recommended before treatment. (Source: Basic and Clinical Andrology)



Abstract 3829: DNA methylation profile in papillary thyroid cancer according to BRAF (V600E) mutation

Sun, 02 Aug 2015 00:00:00 +0100

Conclusion: This study point out putative drivers in PTC according to BRAF mutation revealing epigenetic mechanisms that contributes with cell proliferation and aggressiveness in thyroid carcinoma.Citation Format: Caroline Moraes Beltrami, Mariana Bisarro dos Reis, Mateus Camargo Barros-Filho, Fabio Albuquerque Marchi, Hellen Kuasne, Srikant Ambatipudi, Zdenko Herceg, Luiz Paulo Kowalski, Silvia Regina Rogatto. DNA methylation profile in papillary thyroid cancer according to BRAF (V600E) mutation. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3829. doi:10.1158/1538-7445.AM2015-3829 (Source: Cancer Research)



Sperm DNA fragmentation after radioiodine treatment for differentiated thyroid cancer

Sun, 02 Aug 2015 00:00:00 +0100

Conclusions: Treatment with 131 I induces alterations in sperm chromatin as well as in sperm parameters a short time (3 months) after a first dose of 131 I with persistence of sperm alterations until 12 months after a second dose. Sperm banking should be recommended before treatment. (Source: BioMed Central)



Clinical Utility of SPECT/CT Imaging Post-Radioiodine Therapy: Does It Enhance Patient Management in Thyroid Cancer?

Fri, 31 Jul 2015 10:39:03 +0100

Conclusion: In patients with thyroid cancer, 131I-SPECT/CT is a valuable addition to standard post-therapy planar imaging. SPECT/CT also improved diagnostic confidence and provided crucial clinical information leading to change of management for a significant number of these patients.Eur Thyroid J (Source: European Thyroid Journal)

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Radioiodine for patients with autonomously functioning thyroid nodules with a normal TSH level

Tue, 14 Jul 2015 00:00:00 +0100

This article is protected by copyright. All rights reserved. (Source: European Journal of Clinical Investigation)



Measurement and analysis of patient attenuation correction factor during radioiodine therapy

Mon, 13 Jul 2015 00:00:00 +0100

The calculated dose rate from the radioiodine therapy patient should normally include a factor accounting for the attenuation and scatter of patient body tissues. The attenuation factor is currently neglected, and not applied in operational radiation protection. Realistic estimation of radiation dose rate levels from radioiodine therapy patients when properly performed will reduce operational cost and optimise institutional radiation protection practice. In this work, the existence of a patient body tissue attenuation factor is verified by comparing the dose rates measured from the radioiodine capsules immediately before administration with those measured from the patient immediately after administration. The correlation between the factors suspected to influence the patient body tissue at...



Thyroid cancer radioiodine therapy: health service performance and radiation safety

Mon, 13 Jul 2015 00:00:00 +0100

Greek Atomic Energy Commission collected data related to radioiodine I-131 therapy (RAIT) delivery to differentiated thyroid carcinoma patients, for the period 2003–13, corresponding to 100 % of hospitals at national level. Radiation safety and health service performance outcome indicators were assessed. The numbers of hospitals and nuclear medicine (NM) therapy wards, as well as RAIT annual frequencies, have increased. Geographical inhomogeneous distribution of existing infrastructure is recorded. In some cases, the observed inefficient use of NM therapy wards seems to be due to lack of human resources (e.g. nurses). Regular assessment of appropriate key indicators could serve as a useful tool for radiation safety monitoring and health service performance improvement. (Source: Radia...



Systematic evaluation of salivary gland damage following I-131 therapy in differentiated thyroid cancer patients by quantitative scintigraphy and clinical follow-up

Fri, 03 Jul 2015 18:00:32 +0100

Conclusion: Although the side effects associated with radioiodine treatment were apparent, they were usually small and temporary. Nevertheless, more consideration should be placed on careful dosing of I-131. (Source: Nuclear Medicine Communications)



TSH Threshold Related to Lower Bone Mineral Density in Postmenopausal Patients Under TSH Suppression Therapy for Differentiated Thyroid Carcinoma

Wed, 01 Jul 2015 00:00:00 +0100

TSH suppression with supraphysiological doses of levothyroxine aims to reduce risk of recurrence in the treatment of patients with differentiated thyroid carcinoma (DTC) after surgery and radioiodine therapy. Exogenous subclinical thyrotoxicosis (EST), with suppressed TSH and normal T4 levels probably has a negative effect on bone metabolism, but there is no definition of the magnitude of the effect on bone mineral density (BMD). (Source: Journal of Clinical Densitometry)

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Histamine receptor 1 and 2 antagonists alter biodistribution of radioiodine.

Sun, 28 Jun 2015 00:27:25 +0100

CONCLUSION: H1 and H2 blockers alter the biodistribution of radioiodine in the rat. While the findings remain to be confirmed in humans, these drugs could increase radiation exposure to non-target tissues, particularly the stomach and salivary tissue, during (131)I therapy. Although these studies remain to be confirmed in humans, consideration should be given to avoidance of the elective use of these drugs during radioiodine therapy. PMID: 26111706 [PubMed - as supplied by publisher] (Source: Journal of Nuclear Medicine Technology)



Impact of high (131)I-activities on quantitative (124)I-PET.

Sat, 27 Jun 2015 02:32:10 +0100

Authors: Braad PE, Hansen SB, Høilund-Carlsen PF Abstract Peri-therapeutic [Formula: see text]I-PET/CT is of interest as guidance for radioiodine therapy. Unfortunately, image quality is complicated by dead time effects and increased random coincidence rates from high [Formula: see text]I-activities. A series of phantom experiments with clinically relevant [Formula: see text]I/[Formula: see text]I-activities were performed on a clinical PET/CT-system. Noise equivalent count rate (NECR) curves and quantitation accuracy were determined from repeated scans performed over several weeks on a decaying NEMA NU-2 1994 cylinder phantom initially filled with 25 MBq [Formula: see text]I and 1250 MBq [Formula: see text]I. Six spherical inserts with diameters 10-37 mm were filled with [Formu...



131 I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study

Fri, 26 Jun 2015 22:10:05 +0100

Conclusion 131I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between 131I treatment and KCS development. (Source: European Journal of Nuclear Medicine and Molecular Imaging)



Predictors of incomplete response to therapy among Filipino patients with papillary thyroid cancer in a tertiary hospital

Wed, 03 Jun 2015 00:00:00 +0100

Conclusion A significant fraction of PTC patients experienced incomplete response to therapy. Our data suggest that male gender, lateral or mediastinal lymph node involvement, class III extent of disease by De Groot and multifocality with concurrent tumour or tumours more than 1 cm are major predictors of incomplete response. Not all predictors of recurrence and mortality are consistent predictors of treatment response which may be equally important in a disease with low mortality but significant morbidity like PTC. (Source: Journal of Endocrinological Investigation)



Assessment of Simplified Blood Dose Protocols for the Estimation of the Maximum Tolerable Activity in Thyroid Cancer Patients Undergoing Radioiodine Therapy Using 124I

Mon, 01 Jun 2015 00:00:00 +0100

Conclusion: The pretherapy blood dosimetry protocol can be substantially shortened and may be beneficial to patients and patient management while reducing the radiation exposure to medical staff. (Source: Journal of Nuclear Medicine)

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Comparative Efficacy of Four Treatments in Patients with Graves’ Disease: a Network Meta-analysis

Tue, 19 May 2015 00:00:00 +0100

Conclusions: Radioiodine+prednisone therapy might have the least probability of leading to an exacerbation or new appearance of ophthalmopathy, and radioiodine therapy might have the least probability of causing a recurrence.[...]© Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: Experimental and Clinical Endocrinology and Diabetes)



The Use of 123I in Diagnostic Radioactive Iodine Uptake Scans in Children with Differentiated Thyroid Carcinoma.

Sat, 16 May 2015 23:26:04 +0100

CONCLUSIONS: 123I is effective for use in diagnostic radioactive iodine scans in children with differentiated thyroid cancer. The primary advantages of using 123I include decreased radiation exposure and avoidance of stunning, however, in children there is a possibility of missed detection of metastatic pulmonary disease. PMID: 25978106 [PubMed - as supplied by publisher] (Source: Thyroid : official journal of the American Thyroid Association)



Thyroid Cancer Presentation and Treatment in the United States

Sun, 10 May 2015 06:47:04 +0100

Conclusions This study provides insight into the patterns of papillary thyroid cancer care in the general population. The findings from this study indicate adherence to guideline recommendations in that family history of thyroid disease/cancer, in addition to tumor characteristics, does appear to inform treatment practices, especially among low-risk patients. (Source: Annals of Surgical Oncology)



Effect of sodium/iodide symporter (NIS)-mediated radioiodine therapy on estrogen receptor-negative breast cancer.

Sat, 09 May 2015 10:42:03 +0100

Authors: Yao C, Pan Y, Li Y, Xu X, Lin Y, Wang W, Wang S Abstract Since the sodium/iodide symporter (NIS) stimulates the iodine uptake in normal lactating breast, our study aimed to study the effect of NIS-mediated radioiodide therapy on ER-negative breast cancers. A recombinant lentivirus plasmid encoding the human NIS (hNIS) gene and firefly luciferase (Fluc) was constructed. MDA-MB-231 cells were transfected with the recombinant lentivirus, and the hNIS gene expression was identified by western blot analysis and real-time PCR. Tissue-specific expression of the NIS gene was confirmed by immunohistochemical (IHC) staining. Functional NIS activity in the MDA-hNIS cells was confirmed by the uptake of 131I and cytotoxicity assays. The relative expression level of hNIS mRNA exhibited ...



Inhibition of miR-146b expression increases Radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression.

Thu, 07 May 2015 00:00:00 +0100

Authors: Li L, Lv B, Chen B, Guan M, Sun Y, Li H, Zhang B, Ding C, He S, Zeng Q Abstract Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, was ...

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Intermediate‐risk differentiated thyroid carcinoma patients who were surgically ablated do not need adjuvant radioiodine therapy: long‐term outcome study

Thu, 07 May 2015 00:00:00 +0100

ConclusionIntermediate‐risk surgically ablated patients do not need adjuvant RAI therapy and patients who failed to achieve ablation with first dose of 131I may be dynamically risk stratified as high‐risk category and managed aggressively. (Source: Clinical Endocrinology)



Radioiodine therapy for Graves' disease - retrospective analysis of efficacy factors.

Mon, 04 May 2015 15:24:02 +0100

CONCLUSIONS: The absorbed dose of 131I and the volume of the thyroid gland are two parameters that have a significant influence on the efficacy of radioiodine therapy for Graves' disease. 150 Gy is the optimal dose for glands < 50 mL. A goitre > 50 mL requires an absorbed dose of 200 Gy in order to minimise the risk of recurrent hyperthyroidism. (Endokrynol Pol 2015; 66 (2): 126-131). PMID: 25931042 [PubMed - in process] (Source: Endokrynologia Polska)



Radioiodine therapy increases the risk of cerebrovascular events in hyperthyroid and euthyroid patients.

Sat, 02 May 2015 12:26:04 +0100

CONCLUSIONS: We report an increased risk of cerebrovascular events in hyperthyroid as well as euthyroid patients treated with radioiodine for benign thyroid disorders. That these patient groups have similar risks suggests the possibility that radiation from radioiodine contributes to cerebrovascular morbidity via acceleration or initiation of atherosclerosis. PMID: 25920711 [PubMed - in process] (Source: European Journal of Endocrinology)



Health Care Utilization And Cost Associated With Radioiodine Refractory (Rai-R) Differentiated Thyroid Cancer (DTC)

Fri, 01 May 2015 00:00:00 +0100

Thyroid cancer (TC) constitutes ~1% of all diagnosed cancers. DTC is the most common type of TC, accounting for about 95% of all cases. Most patients with DTC respond well to surgery and/or radioiodine therapy (I-131). However, (Source: Value in Health)



Abstract P6-03-13: Inhibition of Src increases radioiodide uptake in breast cancer cells by inhibiting phosphorylation of pituitary tumor transforming gene binding factor (PBF)

Thu, 30 Apr 2015 00:00:00 +0100

Although not detectable in normal breast tissue, the sodium iodide symporter (NIS) has been found to be expressed in 70-80% of breast cancers. However, the majority of NIS is intracellular, leaving only 20-30% functional at the plasma membrane. Whilst radioiodine therapy has been proposed as a potential treatment for breast cancer, effective therapy would require increased levels of membranous NIS localisation in tumours. Previous work revealed that overexpression of pituitary tumor transforming gene binding factor (PBF) in thyroid cells leads to the redistribution of NIS from the plasma membrane into intracellular vesicles, thereby reducing radioiodide uptake, a process modulated by Src phosphorylation of PBF. Here we show that PBF and NIS have a consistent relationship in breast cancer, ...

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Influence of prior carbimazole on the outcome of radioiodine therapy in pediatric and adolescent Graves’ disease

Tue, 28 Apr 2015 05:35:33 +0100

Conclusion: Prior carbimazole treatment does not alter the outcome of radioiodine therapy in PGD. (Source: Nuclear Medicine Communications)



Factors influencing the success of radioiodine therapy in patients with Graves’ disease

Tue, 28 Apr 2015 05:35:32 +0100

Objective: The first dose of radioiodine (131I) does not always cure hyperthyroidism in patients with Graves’ disease (GD). Our aim was to evaluate the factors influencing the success of 131I therapy. Patients and methods: We reviewed the medical records of 724 patients who were first diagnosed with GD between 2005 and 2009 and were subsequently treated with 131I in a fixed-dose manner considering the thyroid volume (TV). TSH, fT4, and fT3 were measured. TV was measured by means of ultrasonography. Successful therapy was followed by euthyroidism or hypothyroidism. Results: Out of 724 patients, 656 (90.5%) were successfully (Group 1) and 69 (9.5%) were unsuccessfully (Group 2) treated with the first dose of 131I. In Group 1, the applied dose of 131I was lower than that in Group 2 [626±10...



FDG PET Performed at Thyroid Remnant Ablation Has a Higher Predictive Value for Long-Term Survival of High-Risk Patients With Well-Differentiated Thyroid Cancer Than Radioiodine Uptake

Wed, 15 Apr 2015 11:40:24 +0100

Conclusions: At thyroid remnant ablation, FDG PET is more predictive for long-term survival, whereas radioiodine uptake is more important for short-term response. FDG PET performed at thyroid remnant ablation might represent a useful tool for management of high-risk patients with differentiated thyroid cancer. (Source: Clinical Nuclear Medicine)



Thiamazole pretreatment lowers the (131)I activity needed to cure hyperthyroidism in patients with nodular goiter.

Mon, 13 Apr 2015 00:00:00 +0100

CONCLUSIONS: Thiamazole treatment prior to (131)I therapy resulted in an average 2-fold increase in thyroid RAIU and enhanced the efficiency of radioiodine therapy assessed at 12 months. Thiamazole pretreatment is therefore a safe, easily accessible alternative to rhTSH stimulation and a more effective option than low iodine diet. PMID: 25867812 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)



Mesenchymal Stem Cell-Mediated, Tumor Stroma-Targeted Radioiodine Therapy of Metastatic Colon Cancer Using the Sodium Iodide Symporter as Theranostic Gene

Wed, 01 Apr 2015 00:00:00 +0100

Conclusion: This novel gene therapy approach opens the prospect of NIS-mediated radionuclide therapy of metastatic cancer after MSC-mediated gene delivery. (Source: Journal of Nuclear Medicine)

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A Novel hNIS/tdTomato Fusion Reporter for Visualizing the Relationship Between the Cellular Localization of Sodium Iodide Symporter and Its Iodine Uptake Function Under Heat Shock Treatment.

Fri, 20 Mar 2015 00:02:04 +0100

Authors: Yeom CJ, Chung T, Youn H, Kang KW, Lee DS, Chung JK Abstract AbstractThe function of membrane-localized sodium iodide symporter (NIS) determines the efficacy of radioiodine therapy in thyroid cancer. Here, we describe a dual mode reporter fused with human NIS (hNIS) and a red fluorescent protein named tandem dimeric Tomato (tdTomato) for the in vitro and in vivo imaging of hNIS protein expression, localization, and iodide uptake function. Human cervical epithelial adenocarcinoma cell line (HeLa)-hNIS/tdTomato cells were established by transducing a fusion gene expressing hNIS/tdTomato under the control of a cytomegalovirus promoter. Fluorescence imaging, confocal microscopy, and an 125I uptake assay were performed to validate the integrity of the fusion protein. Actinomyci...



Value of sentinel lymph node biopsy in papillary thyroid cancer: initial results of a prospective trial

Thu, 19 Mar 2015 22:15:52 +0100

The objectives of the study were to evaluate the performance of sentinel lymph node biopsy (SLNB) in detecting occult metastases in papillary thyroid carcinoma (PTC) and to correlate their presence to tumor and patient characteristics. Twenty-three clinically node-negative PTC patients (21 females, mean age 48.4 years) were prospectively enrolled. Patients were submitted to sentinel lymph node (SLN) lymphoscintigraphy prior to total thyroidectomy. Ultrasound-guided peritumoral injections of 99mTc-phytate (7.4 MBq) were performed. Cervical single-photon emission computed tomography and computed tomography (SPECT/CT) images were acquired 15 min after radiotracer injection and 2 h prior to surgery. Intra-operatively, SLNs were located with a gamma probe and removed along with non-SLNs loc...



The NUKDOS software for treatment planning in molecular radiotherapy.

Tue, 17 Mar 2015 00:00:00 +0100

Authors: Kletting P, Schimmel S, Hänscheid H, Luster M, Fernández M, Nosske D, Lassmann M, Glatting G Abstract The aim of this work was the development of a software tool for treatment planning prior to molecular radiotherapy, which comprises all functionality to objectively determine the activity to administer and the pertaining absorbed doses (including the corresponding error) based on a series of gamma camera images and one SPECT/CT or probe data. NUKDOS was developed in MATLAB. The workflow is based on the MIRD formalism For determination of the tissue or organ pharmacokinetics, gamma camera images as well as probe, urine, serum and blood activity data can be processed. To estimate the time-integrated activity coefficients (TIAC), sums of exponentials are fitted to the time ...



Radioiodine remnant ablation in low‐risk differentiated thyroid cancer patients who had R0 dissection is an over treatment

Mon, 09 Mar 2015 00:00:00 +0100

This study aims to evaluate the long‐term outcome in these two groups of patients. Retrospective cohort study conducted from January 1991 to December 2012. Based on extent of surgical resection and histopathology, LR DTC patients were classified as Gr‐1: 169 patients, who were surgically ablated; Gr‐2: 153 patients, who had significant remnant in thyroid bed. Basal parameters were comparable between two groups except pretherapy 24 h radioiodine uptake (0.16 ± 0.01% vs. 5.64 ± 0.46%; P < 0.001). No patient received RRA in Gr‐1; Gr‐2 patients were administered 30 mCi 131I. Total number of events (recurrence, persistent, and progression of disease), with median follow up of 10.3 years, was observed in 10/322 (3.1%) of LR DTC patients. Only one patient had disease recur...



Serum 25-hydroxyvitamin D predict prognosis in radioiodine therapy of Graves’ disease

Wed, 04 Mar 2015 00:00:00 +0100

Conclusions Serum 25(OH)D levels were lower in patients who failed than in those who succeeded in RIT of GD. Therefore, serum 25(OH)D < 20 ng/ml might be an independent risk factor for predicting failure of RIT in GD patients. (Source: Journal of Endocrinological Investigation)

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Preablation 131-I scans with SPECT/CT contribute to thyroid cancer risk stratification and131-I therapy planning.

Tue, 03 Mar 2015 00:00:00 +0100

Conclusions: Both imaging data and stimulated thyroglobulin levels acquired at the time of Dx 131-I scans are consequential for 131-I therapy planning, providing information that changes risk stratification in 15% of patients as compared to recurrence risk estimation based on histopathology alone. Dx 131-I scans contribute to risk stratification by defining residual nodal and distant metastatic disease, changing clinical management in 29.4% of patients. PMID: 25734251 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)



The RET oncogene in papillary thyroid carcinoma

Mon, 02 Mar 2015 00:00:00 +0100

Papillary thyroid carcinoma (PTC) is the most common form of thyroid cancer, accounting for greater than 80% of cases. Surgical resection, with or without postoperative radioiodine therapy, remains the standard of care for patients with PTC, and the prognosis is generally excellent with appropriate treatment. Despite this, significant numbers of patients will not respond to maximal surgical and medical therapy and ultimately will die from the disease. This mortality reflects an incomplete understanding of the oncogenic mechanisms that initiate, drive, and promote PTC. Nonetheless, significant insights into the pathologic subcellular events underlying PTC have been discovered over the last 2 decades, and this remains an area of significant research interest. Chromosomal rearrangements resul...



Non-contrast-enhanced computed tomography attenuation in the parotid glands before radioiodine therapy for thyroid carcinoma could be a predictor of radiovulnerability

Thu, 26 Feb 2015 09:10:28 +0100

This study aimed to determine a predictive factor for the effect of radioiodine therapy (RIT) on salivary gland dysfunction through a multiple regression analysis. Methods: We retrospectively assessed 40 patients with thyroid carcinoma, including 13 men (age range, 21–80 years) and 27 women (age range, 28–75 years), who underwent total thyroidectomy and were treated with RIT. We used multiple regression analysis to evaluate whether factors such as age, sex, dose number, prescintigraphy grade, computed tomography (CT) attenuation, and CT volume of the salivary glands affected the postscintigraphy grade. Receiver operating characteristics analysis was performed for predicting worsening scintigraphy grade of the parotid glands in 20 patients after RIT. Results: The postscintigraphy grade ...



Systemic Oxidative Stress to Nucleic Acids Is Unaltered Following Radioiodine Therapy of Patients with Benign Nodular Goiter

Tue, 10 Feb 2015 23:44:04 +0100

Conclusion: Systemic oxidative stress, as detected by nucleic acids metabolites in the urine, is not increased after thyroid stimulation with 0.1 mg of rhTSH, or after 131I therapy. Our method cannot quantify the oxidative stress induced locally in the thyroid gland, but the study supports that 131I therapy of benign nodular goiter carries no or only a minute risk of developing subsequent malignancies. It remains to be explored whether our findings also apply to hyperthyroid disorders.Eur Thyroid J (Source: European Thyroid Journal)



Radioprotective Effect of Ginseng and Fucoidan on Salivary Gland after Radioiodine Therapy In Mice

Fri, 06 Feb 2015 18:44:15 +0100

To investigate the morphometric and functional changes of salivary gland(SG) after antioxidants(ginseng, fucoidan and amifostine) supplement preceding to radioiodine(RI) therapy in a murine model. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)

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miR-339-5p modulates NIS-mediated RAIU

Mon, 26 Jan 2015 12:00:00 +0100

Na+/I− symporter (NIS)-mediated radioiodide uptake (RAIU) serves as the basis for targeted ablation of thyroid cancer remnants. However, many thyroid cancer patients have reduced NIS expression/function. microRNAs (miRs) have emerged as a promising therapeutic method; Lakshmanan and colleagues make the first report to demonstrate that hNIS-mediated RAIU can be modulated by miRs, and that the same miRs may also play roles in thyroid malignancy. Accordingly, miRs may serve to halt the progression of thyroid cancer and to enhance the efficacy of radioiodine therapy. Read the full article at Lakshmanan et al. (2015) Endocrine-Related Cancer 22 11–21 DOI:10.1530/ERC-14-0439 (Source: Society for Endocrinology)



Quality of life in patients with benign non-toxic goiter: impact of disease, treatment response, and comparison with the general population.

Wed, 21 Jan 2015 19:45:04 +0100

Conclusions Compared with the general population, patients with NTG had greatest HRQoL impairment at baseline on the Goiter Symptoms and Anxiety scales, which also demonstrated the largest post-treatment improvements. However, both disease-specific and generic HRQoL deficits persisted 6 months after treatment. In order to improve individualized care, future studies should focus on identifying risk factors for persistent HRQoL deficits and compare HRQoL effects of the various goiter treatment modalities in relation to thyroid phenotype. PMID: 25602312 [PubMed - as supplied by publisher] (Source: Thyroid : official journal of the American Thyroid Association)



Radioiodine Uptake in an Ovarian Mature Teratoma Detected With SPECT/CT

Mon, 19 Jan 2015 19:42:59 +0100

Abstract: A 28-year-old woman underwent a near-total thyroidectomy for papillary carcinoma. Before radioiodine therapy, the serum thyroid-stimulating hormone level was 50 μIU/mL, the thyroglobulin level was 1 μg/L, and the antithyroglobulin was negative. She received 100 mCi of 131I for ablation of residual thyroid tissue. After therapy, 131I whole-body scan demonstrated focal uptake in the right pelvic area, which localized to the right ovary on SPECT/CT fusion images. The ovarian cyst was resected, and histopathological examination revealed a mature teratoma without thyroid tissue component. At 6-month follow-up, the whole-body radioiodine scan was normal, and serum thyroglobulin was undetectable. (Source: Clinical Nuclear Medicine)



Prognostic Role of 18F-FDG PET/CT in the Postoperative Evaluation of Differentiated Thyroid Cancer Patients

Mon, 19 Jan 2015 19:42:37 +0100

Conclusions: FDG PET/CT was abnormal in 17% of patients. Moreover, FDG PET/CT has an independent prognostic role, with a better PFS in patients with a negative scan. (Source: Clinical Nuclear Medicine)

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Fetus dose estimation in thyroid cancer post-surgical radioiodine therapy

Mon, 19 Jan 2015 00:00:00 +0100

Unrecognised pregnancy during radioisotope therapy of thyroid cancer results in hardly definable embryo/fetus exposures, particularly when the thyroid gland is already removed. Sources of such difficulty include uncertainty in data like pregnancy commencing time, amount and distribution of metastasized thyroid cells in body, effect of the thyroidectomy on the fetus dose coefficient etc. Despite all these uncertainties, estimation of the order of the fetus dose in most cases is enough for medical and legal decision-making purposes. A model for adapting the dose coefficients recommended by the well-known methods to the problem of fetus dose assessment in athyrotic patients is proposed. The model defines a correction factor for the problem and ensures that the fetus dose in athyrotic pregnant...



Combination of ultrasound guided percutaneous microwave ablation and radioiodine therapy in benign thyroid diseases. A suitable method to reduce the 131I activity and hospitalization time?

Wed, 14 Jan 2015 00:00:00 +0100

Conclusion: Depending on ablated volume by MWA, RIT-monotherapy requires on average 31.2% more 131I-activity than the combined therapy. The combined therapy remarkably decreases 131I-dose and hospitalization time. The combined MWA and RIT therapy is a considerable, effective and safer alternative to surgery for the treatment of very large benign nodular goiters. PMID: 25586901 [PubMed - as supplied by publisher] (Source: Nuklearmedizin)



Age and body composition influence TSH concentrations after administration of rhTSH.

Thu, 08 Jan 2015 00:00:00 +0100

Conclusion: Age and anthropometric parameters have significant independent influence on TSH concentrations after rhTSH injection in both groups. Anthropometric parameters (BSA, LBM) and demographic parameters (female gender) show strong influence on TSH concentrations. Further research should be conducted to examine the influence of body compartments on TSH levels through measuring total body water. PMID: 25566749 [PubMed - as supplied by publisher] (Source: Nuklearmedizin)



Discrepant salivary gland response after radio iodine and MIBG therapies.

Thu, 08 Jan 2015 00:00:00 +0100

CONCLUSION: The discrepant salivary gland responses in MIBG and radio iodine therapies suggest a different radiotherapeutical distribution on microscopic scale within the glandular tissue and prove the clinical relevance of a microdosimetric analysis. PMID: 25566809 [PubMed - as supplied by publisher] (Source: Nuklearmedizin)



Salivary Gland Dysfunction after Radioactive Iodine (I-131) Therapy in Patients following Total Thyroidectomy: Emphasis on Radioactive Iodine Therapy dose

Tue, 06 Jan 2015 00:00:00 +0100

The purpose of this study was to retrospectively evaluate symptoms, images of salivary gland dysfunction, and related clinical factors in thyroid cancer patients with total thyroidectomy followed by radioiodine therapy (RIT). (Source: Clinical Imaging)

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Codon-optimized Human Sodium Iodide Symporter (opt-hNIS) as a Sensitive Reporter and Efficient Therapeutic Gene

Fri, 02 Jan 2015 04:00:21 +0100

To generate a more efficient in vivo reporter and therapeutic gene, we optimized the coding sequence of the human sodium/iodide symporter (NIS) gene by replacing NIS DNA codons from wild type to new codons having the highest usage in human gene translation. The Codon Adaptation Index (CAI), representing the number of codons effective for human expression, was much improved (0.79 for hNIS, 0.97 for opt-hNIS). Both wild-type (hNIS) and optimized human NIS (opt-hNIS) were cloned into pcDNA3.1 and pMSCV vectors for transfection. Various cancer cell lines such as thyroid (TPC-1, FRO, B-CPAP), breast (MDA-MB-231), liver (Hep3B), cervical (HeLa), and glioma (U87MG) were transfected with pcDNA3.1/hNIS or pcDNA3.1/opt-hNIS. 125I uptake by opt-hNIS-expressing cells was 1.6 ~ 2.1 times higher th...



Estimation of patient attenuation factor for iodine-131 based on direct dose rate measurements from radioiodine therapy patients

Fri, 19 Dec 2014 23:57:09 +0100

The aim of the study was to measure the actual dose at 1 m from the patients per unit activity with the aim of providing a more accurate prediction of the dose levels around radioiodine patients in the hospital, as well as to compare our results with the literature. In this work the demonstration of a patient body tissue attenuation factor is verified by comparing the dose rates measured from the patients with those measured from the unshielded radioiodine capsules immediately after administration of the radioactivity. The normalized dose rate per unit activity is therefore proposed as an operational quantity that can be used to predict exposure rates to staff and patients’ relatives. The average dose rate measured from our patient per unit activity was 38.4±11.8 μSv/h/GBq. The cal...



microRNA-339-5p modulates Na+/I- symporter-mediated radioiodide uptake

Wed, 17 Dec 2014 00:00:00 +0100

Na+/I– symporter (NIS)-mediated radioiodide uptake (RAIU) serves as the basis for targeted ablation of thyroid cancer remnants. However, many patients with thyroid cancer have reduced NIS expression/function and hence do not benefit from radioiodine therapy. microRNA (miR) has emerged as a promising therapeutic target in many diseases; yet, the role of miRs in NIS-mediated RAIU has not been investigated. In silico analysis was used to identify miRs that may bind to the 3'UTR of human NIS (hNIS). The top candidate miR-339-5p directly bound to the 3'UTR of hNIS. miR-339-5p overexpression decreased NIS-mediated RAIU in HEK293 cells expressing exogenous hNIS, decreased the levels of NIS mRNA, and RAIU in transretinoic acid/hydrocortisone (tRA/H)-treated MCF-7 human breast cancer cells as...



The Evolving Use of Radioiodine Therapy in Differentiated Thyroid Cancer

Thu, 11 Dec 2014 09:43:43 +0100

The incidence of differentiated thyroid cancer has increased worldwide over the last three decades, but thyroid cancer-related mortality remains stable. Until recently, the standard treatment for most thyroid cancers has been near-total thyroidectomy followed by radioiodine remnant ablation. Observational data support lower recurrence rates and improved survival after radioiodine ablation in patients with high-risk cancers; however, a similar benefit has not been established for all patients with thyroid cancer. Risk stratification should be used to identify patients who are likely to benefit from radioiodine ablation and guide therapeutic decisions. For most patients who need radioiodine remnant ablation, preparation for therapy with recombinant human thyroid-stimulating hormone stimulati...



The Evolving Use of Radioiodine Therapy in Differentiated Thyroid Cancer.

Thu, 11 Dec 2014 00:00:00 +0100

Authors: Mayson SE, Yoo DC, Gopalakrishnan G Abstract The incidence of differentiated thyroid cancer has increased worldwide over the last three decades, but thyroid cancer-related mortality remains stable. Until recently, the standard treatment for most thyroid cancers has been near-total thyroidectomy followed by radioiodine remnant ablation. Observational data support lower recurrence rates and improved survival after radioiodine ablation in patients with high-risk cancers; however, a similar benefit has not been established for all patients with thyroid cancer. Risk stratification should be used to identify patients who are likely to benefit from radioiodine ablation and guide therapeutic decisions. For most patients who need radioiodine remnant ablation, preparation for therap...

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Retrospective Analysis of 255 Papillary Thyroid Carcinomas ≤2 cm: Clinicohistological Features and Prognostic Factors

Sat, 06 Dec 2014 10:20:52 +0100

Conclusions: In the setting of small PTCs, vascular invasion, extrathyroidal extension and lymph node and/or systemic metastases may confer worse prognosis, perhaps justifying more aggressive therapeutic and follow-up approaches in such cases. (Source: European Thyroid Journal)



Chewing-gum stimulation did not reduce the absorbed dose to salivary glands during radioiodine treatment of thyroid cancer as inferred from pre-therapy 124 I PET/CT imaging

Sat, 06 Dec 2014 00:00:00 +0100

Background: The goal of this prospective study was to estimate the absorbed (radiation) doses to salivary glands in radioiodine therapy of thyroid cancer under chewing-gum stimulation using 124I positron emission tomography (PET)/computed tomography (CT) imaging. Methods: Duplex ultrasonography was conducted in three test persons for visual comparison of the glandular blood flow with three different stimulation types (no stimulation, chewing tasteless gum base, sucking on lemon slices). Ten patients with newly diagnosed differentiated thyroid cancer received 124I PET/CT dosimetry after thyroidectomy and prior to radioiodine therapy. Patients underwent a series of three 124I PET/CT scans (4, 24, and ≥96 h after administration of 23 MBq 124I). They were instructed to chew gum base (taste...



Internal dosimetry of nuclear medicine workers through the analysis of (131)I in aerosols.

Wed, 03 Dec 2014 00:00:00 +0100

Authors: Carneiro LG, de Lucena EA, Sampaio CD, Dantas AL, Sousa WO, Santos MS, Dantas BM Abstract (131)I is widely used in nuclear medicine for diagnostic and therapy of thyroid diseases. Depending of workplace safety conditions, routine handling of this radionuclide may result in a significant risk of exposure of the workers subject to chronic intake by inhalation of aerosols. A previous study including in vivo and in vitro measurements performed recently among nuclear medicine personnel in Brazil showed the occurrence of (131)I incorporation by workers involved in the handling of solutions used for radioiodine therapy. The present work describes the development, optimization and application of a methodology to collect and analyze aerosol samples aiming to assess internal doses b...



Recombinant human thyrotropin-aided radioiodine therapy in patients with metastatic differentiated thyroid carcinoma.

Tue, 02 Dec 2014 06:39:31 +0100

Authors: Zagar I, Schwarzbartl-Pevec AA, Vidergar-Kralj B, Horvat R, Besic N Abstract Our aim was to test the efficacy of 131-I therapy (RIT) using recombinant human TSH (rhTSH) in patients with differentiated thyroid carcinoma (DTC) in whom endogenous TSH stimulation was not an option due to the poor patient's physical condition or due to the disease progression during L-thyroxin withdrawal. The study comprised 18 patients, who already have undergone total or near-total thyroidectomy and radioiodine ablation and 0-12 (median 5) RITs after L-thyroxin withdrawal. Our patients received altogether 44 RITs using rhTSH while on L-thyroxin. Six to 12 months after the first rhTSH-aided RIT, PR and SD was achieved in 3/18 (17%) and 4/18 patients (22%), respectively. In most patients (n = 1...



Papillary Thyroid Carcinoma with Exclusive Involvement of a Functioning Recurrent Laryngeal Nerve May Be Treated with Shaving Technique

Tue, 02 Dec 2014 00:00:00 +0100

Conclusions Patients with locally invasive PTC with exclusive involvement of a functioning RLN may be treated by nerve shaving followed by treatment of the macroscopic residual tumor with high-dose RAI therapy. (Source: World Journal of Surgery)

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