scholarly journals RADTHYR: an open-label, single-arm, prospective multicenter phase II trial of Radium-223 for the treatment of bone metastases from radioactive iodine refractory differentiated thyroid cancer

2021 ◽  
Author(s):  
Désirée Deandreis ◽  
Aline Maillard ◽  
Slimane Zerdoud ◽  
Claire Bournaud ◽  
Lavinia Vija ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastases ◽  
Fdg Pet ◽  
Radioactive Iodine ◽  
Phase Ii Trial ◽  
Radium 223 ◽  
Pet Ct ◽  
Clinical Benefits ◽  
Fdg Pet Ct ◽  
Skeletal Event

Abstract Purpose This is the first prospective trial evaluating the efficacy of alpha emitter Radium-223 in patients with bone metastases from radioactive iodine (RAI) refractory (RAIR) differentiated thyroid cancer. Methods RADTHYR is a multicenter, single-arm prospective Simon two-stage phase II trial (NCT02390934). The primary objective was to establish the efficacy of three administrations of 55 kBq/kg of Radium-223 by 18F-FDG PET/CT according to PERCIST criteria. Secondary objectives were to establish the efficacy of six administrations of Radium-223 by 18F-FDG PET/CT, 99mTc-HMDP bone scan and 18FNa PET/CT, clinical benefits, changes in serum bone markers, thyroglobulin levels, and safety. Results Ten patients were enrolled between July 2015 and December 2017 (4 M; median age 74 years). Prior to Radium-223 administration, patients received a median RAI cumulative activity of 15 GBq (7.4–35.6), external radiation therapy (n = 9), bone surgery (n = 8), cimentoplasty (n = 5), and cryoablation (n = 2). 18F-FDG PET/CT showed stable disease (SD) in 4/10 and progressive disease (PD) in 6/10 cases after three administrations and SD in 4/10, PD in 5/10 cases, and 1/10 non-evaluable (NE) case after six administrations. After six injections, 99mTc-HMDP bone scan showed SD in 9 cases and was NE in 1 case; 18FNa PET/CT showed SD in 8 cases, partial response (PR) in 1 case, and was NE in 1 case. No significant clinical benefits were reported during the study. A skeletal event occurred in 6 patients (median time without skeletal event of 12.1 months). Seventy-seven adverse events were reported during treatment (7 of grade 3–4). Three patients developed an acute myeloid, a promyelocytic, and a chronic myeloid leukemia after the last Radium-223 administration considered as drug-related. Conclusion The trial was stopped after interim analysis for lack of response of bone metastases from RAIR thyroid cancer to Radium-223. Severe hematological toxicity was observed in patients heavily pretreated with RAI and external radiation. Trial registration number NCT02390934. Registration date 18.03.2015.

scholarly journals Early Predictive Response to Multi-Tyrosine Kinase Inhibitors in Advanced Refractory Radioactive-Iodine Differentiated Thyroid Cancer: A New Challenge for [18F]FDG PET/CT

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1417
Author(s):  
Cristina Ferrari ◽  
Giulia Santo ◽  
Rossella Ruta ◽  
Valentina Lavelli ◽  
Dino Rubini ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Tyrosine Kinase ◽  
Fdg Pet ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Early Recognition ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Predictive Response

Differentiated thyroid cancer (DTC) represents the most common thyroid cancer histotype. Generally, it exhibits a good prognosis after conventional treatments; nevertheless, about 20% of patients can develop a local recurrence and/or distant metastasis. In one-third of advanced DTC, the metastatic lesions lose the ability to take up iodine and become radioactive iodine-refractory (RAI-R) DTC. In this set of patients, the possibility to perform localized treatments should always be taken into consideration before the initiation of systemic therapy. In the last decade, some multi-tyrosine kinase inhibitor (MKI) drugs were approved for advanced DTC, impacting on patient’s survival rate, but at the same time, these therapies have been associated with several adverse events. In this clinical context, the role of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) in the early treatment response to these innovative therapies was investigated, in order to assess the potentiality of this diagnostic tool in the early recognition of non-responders, avoiding unnecessary therapy. Herein, we aimed to present a critical overview about the reliability of [18F]FDG PET/CT in the early predictive response to MKIs in advanced differentiated thyroid cancer.

scholarly journals PET response assessment in apatinib-treated radioactive iodine-refractory thyroid cancer

2018 ◽  
Vol 25 (6) ◽  
pp. 653-663 ◽  
Author(s):  
Chen Wang ◽  
Xin Zhang ◽  
Xue Yang ◽  
Hui Li ◽  
Ruixue Cui ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fdg Pet ◽  
Radioactive Iodine ◽  
Tumour Response ◽  
Progression Free Survival ◽  
Metabolic Tumour Volume ◽  
Early Assessment ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

This work evaluated the use of the positron emission tomography (PET)/computed tomography (CT) technique to assess the early therapeutic response and predict the prognosis of patients with radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) who underwent apatinib therapy. Standardised uptake value (SUV), metabolic tumour volume (MTV) and total lesion glycolysis (TLG), derived from18F-FDG PET/CT and SUV from68Ga-NOTA-PRGD2 PET/CT were evaluated. Tumour response was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Sixteen of 20 patients achieved partial response (PR) and four of 20 had stable disease (SD) after apatinib therapy. Six progression-free survival (PFS) events occurred. A strong correlation was observed between the best change in the sum of the longest diameters of target lesions (ΔCT%) and18F-FDG PET/CT indices after the completion of the first treatment cycle (ΔMTV% (P = 0.0019), ΔTLG% (P = 0.0021) and ΔSUVmax% (P = 0.0443)). A significant difference in PFS was observed between patients with ΔMTV% <−45% and ≥−45% (P = 0.0019) and between patients with ΔTLG% <−80% and ≥−80% (P = 0.0065). Ten of 11 patients presented a decrease in SUVmax on68Ga-NOTA-PRGD2 PET/CT after two cycles of apatinib therapy and showed PR, whereas one patient presenting an increase in SUVmax only showed SD as the best response. When a cut-off value of the target/background ratio at −20% was used, two PFS curves showed a significant difference (P = 0.0016). Hence, early assessment by18F-FDG and68Ga-NOTA-PRGD2 PET/CT was effective in the prediction and evaluation of RAIR-DTC treated with apatinib.

scholarly journals Comparison of the Relative Diagnostic Performance of [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT for the Detection of Bone Metastasis in Patients With Different Cancers

2021 ◽  
Vol 11 ◽  
Author(s):  
Junhao Wu ◽  
Yingwei Wang ◽  
Taiping Liao ◽  
Zijuan Rao ◽  
Weidong Gong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thyroid Cancer ◽  
Liver Cancer ◽  
Bone Metastases ◽  
False Positive ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Metastatic Lesions ◽  
Pet Ct ◽  
Fdg Pet Ct

PurposeThe present retrospective analysis sought to compare the relative diagnostic efficacy of [68Ga]Ga-DOTA-FAPI-04 to that of [18F]FDG PET/CT as a means of detecting bone metastases in patients with a range of cancer types.MaterialsIn total, 30 patients with bone metastases associated with different underlying malignancies were retrospectively enrolled. All patients had undergone [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT, and the McNemar test was used to compare the relative diagnostic performance of these two imaging modalities. The maximum standard uptake value (SUVmax) was used to quantify radiotracer uptake by metastatic lesions, with the relative uptake associated with these two imaging strategies being compared via the Mann-Whitney U test. The cohort was further respectively divided into two (osteolytic and osteoblastic bone metastases) and three clinical subgroups (lung cancer, thyroid cancer, and liver cancer).Results[68Ga]Ga-DOTA-FAPI-04 PET/CT was found to be significantly more sensitive as a means of diagnosing bone metastases relative to [18F]FDG PET/CT ([109/109] 100% vs [89/109] 81.7%; P&lt; 0.01), consistent with the significantly increased uptake of [68Ga]Ga-DOTA-FAPI-04 by these metastatic lesions relative to that of [18F]FDG (n=109, median SUVmax, 9.1 vs. 4.5; P&lt; 0.01). [68Ga]Ga-DOTA-FAPI-04 accumulation was significantly higher than that of [18F]FDG in both osteolytic (n=66, median SUVmax, 10.6 vs 6.1; P &lt; 0.01), and osteoblastic metastases (n=43, median SUVmax, 7.7 vs 3.7; P &lt; 0.01). [68Ga]Ga-DOTA-FAPI-04 uptakes were significantly higher than that of [18F]FDG in bone metastases from lung cancer (n = 62, median SUVmax, 10.7 vs 5.2; P &lt; 0.01), thyroid cancer (n = 18, median SUVmax, 5.65 vs 2.1; P &lt; 0.01) and liver cancer (n = 12, median SUVmax, 5.65 vs 3.05; P &lt; 0.01). However, [68Ga]Ga-DOTA-FAPI-04 detected 10 false-positive lesions, while only 5 false-positive were visualized by [18F]FDG PET/CT.Conclusion[68Ga]Ga-DOTA-FAPI-04 PET/CT exhibits excellent diagnostic performance as a means of detecting bone metastases, and is superior to [18F]FDG PET/CT in this diagnostic context. Furthermore, [68Ga]Ga-DOTA-FAPI-04 tracer uptake levels are higher than those of [18F]FDG for most bone metastases. However, owing to the potential for false-positive bone lesions, it is critical that physicians interpret all CT findings with caution to ensure diagnostic accuracy.

scholarly journals Rebound Thymic Hyperplasia Detected by 18F-FDG PET/CT After Radioactive Iodine Ablation Therapy for Thyroid Cancer

Thyroid ◽  
2014 ◽  
Vol 24 (11) ◽  
pp. 1636-1641 ◽  
Author(s):  
Tae Joo Jeon ◽  
Yong Sang Lee ◽  
Jae-Hoon Lee ◽  
Hang Seok Chang ◽  
Young Hoon Ryu
Keyword(s):  
Thyroid Cancer ◽  
Fdg Pet ◽  
Radioactive Iodine ◽  
Thymic Hyperplasia ◽  
Ablation Therapy ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Radioactive Iodine Ablation

Detection of Papillary Thyroid Cancer Brain Metastasis With FDG-PET/CT

2010 ◽  
Vol 35 (5) ◽  
pp. 357-359 ◽  
Author(s):  
Josephine N. Rini ◽  
Vinh T. Nguyen ◽  
Eran Ben-Levi ◽  
Jason J. Naidich ◽  
Jian Yi Li ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Brain Metastasis ◽  
Papillary Thyroid Cancer ◽  
Fdg Pet ◽  
Papillary Thyroid ◽  
Pet Ct ◽  
Fdg Pet Ct
Sign in / Sign up

Export Citation Format

Share Document