scholarly journals Cost-Effectiveness of The Use of 18fdg-Pet/Ct In The Detection of Recurrent Differentiated Thyroid Cancer

2015 ◽  
Vol 18 (7) ◽  
pp. A859
Author(s):  
AN Biz ◽  
LF Schluckebier ◽  
CR Bastos ◽  
RM Silva ◽  
JU Braga ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cost Effectiveness ◽  
Differentiated Thyroid Cancer ◽  
18Fdg Pet ◽  
Pet Ct

scholarly journals RADIOISOTOPE DIAGNOSTIC ALGORITHM FOR THE RELAPSE AND METASTASES DETECTION IN THE IODINE-NEGATIVE DIFFERENTIATED THYROID CANCER

2020 ◽  
Vol 25 ◽  
pp. 579-591
Author(s):  
O. Solodyannikova ◽  
◽  
Y. Kmetyuk ◽  
V. Danilenko ◽  
G. Sukach ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Ct Scan ◽  
Surgical Management ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Technetium 99M ◽  
99Mtc Pertechnetate ◽  
18Fdg Pet ◽  
Pet Ct ◽  
99Mtc Mibi

Objective. Developing of algorithm for the post-surgical management of patients with iodine-negative metastases of differentiated thyroid cancer (DTC). Materials and methods. The DTC patients with iodine-negative metastases (n = 115) were enrolled in the study. Of them the whole body scintigraphy (WBS) was performed with technetium-99m-hexakis-2-methoxyisobutylisonitrile (99mTc-MIBI) (n = 30), WBS with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) (n = 30), 18FDG PET (n = 30), and computer tomography (CT-scan) (n = 25). Complex 99mTc-pertechnetate scans including the dynamic and static scintigraphy was performed supplementary to 99mTc-MIBI WBS in 10 patients to obtain the angiographic curves from DTC metastatic foci. The non-radioiodine radiopharmaceutical technologies, namely the labeled 99mTc-MIBI, 99mTc-DMSA, 99mTc-pertechnetate, and 18FDG were applied to detect the iodine-negative DTC metastases. Radioisotopic examinations were performed at the dual-head gamma camera (Mediso Medical Imaging Systems Ltd., Hungary) and single photonemission computed tomography (SPECT) scanner «E.CAM» (Siemens, Germany). PET/CT scans were performed on the «Biograph 64 TruePoint» imaging platform (Siemens, Germany) in accordance with the European Association of Nuclear Medicine (EANM) recommendations for the Siemens imaging devices with 3D-mode data acquisition. Results. The conducted research suggested that it is feasible to use the non-radioiodine (99mTc-MIBI and 99mTc-DMSA) radiopharmaceutical technologies to detect the iodine-negative DTC metastases. 18FDG PET is a highly informative technology for the detection of iodine-negative DTC metastases in case of lung involvement in the process. Compare of the non-radioiodine radiopharmaceuticals, CT scan and 18FDG-PET/CT indicated the highest sensitivity of 18FDG PET/CT (p < 0.05). WBS with 99mTc-MIBI and 99mTc-DMSA featured the highest specificity (100 %, p < 0.05). X-ray CT is marked by the significantly lower either sensitivity, specificity, and accuracy rate (p > 0.05). Developing and application of algorithm for the post-surgical management of patients with iodine-negative forms of DTC will allow for the betimes detection of relapses and metastases with administration of adequate surgical, radiation, and targeted treatment. Conclusions. Obtained results offer the opportunity to optimize the post-surgical management of patients with iodine-negative DTC forms using the options of radionuclide diagnostics with non-radioiodine radiopharmaceuticals. The latter are readily available providing the cost-cutting of diagnostic support in these patients. Place of morphological methods of diagnosis is determined and stage of monitoring of patients with the iodine-negative metastases is established. Possibility of the 18FDG-PET tests for the early diagnosis of iodine-negative metastases in DTC for the first time have been studied and substantiated in Ukraine. A comprehensive radiation algorithm for the long-term monitoring of this category of patients will allow the timely detection of recurrences and metastases of DTC and appropriate surgery, radiation and targeted therapy administration. Data obtained as a result of the study allowed to improve the overall and recurrence-free survival rates in the able-bodied DTC patients and reduce the costs of follow-up of patients with iodine-negative forms of DTC. Key words: differentiated thyroid cancer, radioiodine-negative metastases, non-radioiodine radiopharmaceuticals, 18FDG-PET/CT.

scholarly journals Optimization of a dedicated protocol using a small-voxel PSF reconstruction for head-and-neck 18FDG PET/CT imaging in differentiated thyroid cancer

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Renaud Ciappuccini ◽  
Cédric Desmonts ◽  
Idlir Licaj ◽  
Cécile Blanc-Fournier ◽  
Stéphane Bardet ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Head And Neck ◽  
Differentiated Thyroid Cancer ◽  
Ct Imaging ◽  
18Fdg Pet ◽  
Pet Ct

Cost-Effectiveness of 18FDG-PET/CT Compared to CT Followed by 18FDG-PET/CT as a Confirmatory Test for a Positive Case in the Evaluation at the End of Treatment in Patients with Hodgkin Lymphoma

2012 ◽  
Author(s):  
Mario García Molina ◽  
Liliana Chicaíza ◽  
Alexander Moreno Calderón ◽  
Víctor Prieto Martínez ◽  
Adriana Linares Ballesteros ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hodgkin Lymphoma ◽  
Positive Case ◽  
Confirmatory Test ◽  
18Fdg Pet ◽  
End Of Treatment ◽  
Pet Ct

scholarly journals Calibration of PET/CT scanners for multicenter studies on differentiated thyroid cancer with 124I

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Jakob W. Kist ◽  
Manfred van der Vlies ◽  
Otto S. Hoekstra ◽  
Henri N. J. M. Greuter ◽  
Bart de Keizer ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Multicenter Studies ◽  
Pet Ct ◽  
Ct Scanners

Clinical applications of 124I-PET/CT in patients with differentiated thyroid cancer

2011 ◽  
Vol 38 (S1) ◽  
pp. 48-56 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Walter Jentzen ◽  
Alexander Stahl ◽  
Andreas Bockisch ◽  
Sandra J. Rosenbaum-Krumme
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Clinical Applications ◽  
Pet Ct

scholarly journals Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation

2020 ◽  
Vol 24 (2) ◽  
pp. 1-180 ◽  
Author(s):  
Nigel Fleeman ◽  
Rachel Houten ◽  
Adrian Bagust ◽  
Marty Richardson ◽  
Sophie Beale ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cost Effectiveness ◽  
Systematic Reviews ◽  
Observational Studies ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Clinical Effectiveness ◽  
Economic Evaluations ◽  
Base Case ◽  
The Cost

Background Thyroid cancer is a rare cancer, accounting for only 1% of all malignancies in England and Wales. Differentiated thyroid cancer (DTC) accounts for ≈94% of all thyroid cancers. Patients with DTC often require treatment with radioactive iodine. Treatment for DTC that is refractory to radioactive iodine [radioactive iodine-refractory DTC (RR-DTC)] is often limited to best supportive care (BSC). Objectives We aimed to assess the clinical effectiveness and cost-effectiveness of lenvatinib (Lenvima®; Eisai Ltd, Hertfordshire, UK) and sorafenib (Nexar®; Bayer HealthCare, Leverkusen, Germany) for the treatment of patients with RR-DTC. Data sources EMBASE, MEDLINE, PubMed, The Cochrane Library and EconLit were searched (date range 1999 to 10 January 2017; searched on 10 January 2017). The bibliographies of retrieved citations were also examined. Review methods We searched for randomised controlled trials (RCTs), systematic reviews, prospective observational studies and economic evaluations of lenvatinib or sorafenib. In the absence of relevant economic evaluations, we constructed a de novo economic model to compare the cost-effectiveness of lenvatinib and sorafenib with that of BSC. Results Two RCTs were identified: SELECT (Study of [E7080] LEnvatinib in 131I-refractory differentiated Cancer of the Thyroid) and DECISION (StuDy of sorafEnib in loCally advanced or metastatIc patientS with radioactive Iodine-refractory thyrOid caNcer). Lenvatinib and sorafenib were both reported to improve median progression-free survival (PFS) compared with placebo: 18.3 months (lenvatinib) vs. 3.6 months (placebo) and 10.8 months (sorafenib) vs. 5.8 months (placebo). Patient crossover was high (≥ 75%) in both trials, confounding estimates of overall survival (OS). Using OS data adjusted for crossover, trial authors reported a statistically significant improvement in OS for patients treated with lenvatinib compared with those given placebo (SELECT) but not for patients treated with sorafenib compared with those given placebo (DECISION). Both lenvatinib and sorafenib increased the incidence of adverse events (AEs), and dose reductions were required (for > 60% of patients). The results from nine prospective observational studies and 13 systematic reviews of lenvatinib or sorafenib were broadly comparable to those from the RCTs. Health-related quality-of-life (HRQoL) data were collected only in DECISION. We considered the feasibility of comparing lenvatinib with sorafenib via an indirect comparison but concluded that this would not be appropriate because of differences in trial and participant characteristics, risk profiles of the participants in the placebo arms and because the proportional hazard assumption was violated for five of the six survival outcomes available from the trials. In the base-case economic analysis, using list prices only, the cost-effectiveness comparison of lenvatinib versus BSC yields an incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained of £65,872, and the comparison of sorafenib versus BSC yields an ICER of £85,644 per QALY gained. The deterministic sensitivity analyses show that none of the variations lowered the base-case ICERs to < £50,000 per QALY gained. Limitations We consider that it is not possible to compare the clinical effectiveness or cost-effectiveness of lenvatinib and sorafenib. Conclusions Compared with placebo/BSC, treatment with lenvatinib or sorafenib results in an improvement in PFS, objective tumour response rate and possibly OS, but dose modifications were required to treat AEs. Both treatments exhibit estimated ICERs of > £50,000 per QALY gained. Further research should include examination of the effects of lenvatinib, sorafenib and BSC (including HRQoL) for both symptomatic and asymptomatic patients, and the positioning of treatments in the treatment pathway. Study registration This study is registered as PROSPERO CRD42017055516. Funding The National Institute for Health Research Health Technology Assessment programme.

scholarly journals 1921P Prognostic impact of [18F]FDG-PET/CT in differentiated thyroid cancer with bone metastasis: A French TUTHYREF study

2020 ◽  
Vol 31 ◽  
pp. S1089
Author(s):  
A. Jannin ◽  
L. Lamartina ◽  
C. Moutarde ◽  
M. Djennaoui ◽  
G. Lion ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastasis ◽  
Fdg Pet ◽  
Differentiated Thyroid Cancer ◽  
Prognostic Impact ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Lowest effective 131I activity for thyroid remnant ablation of differentiated thyroid cancer patients

2015 ◽  
Vol 54 (03) ◽  
pp. 137-143 ◽  
Author(s):  
A.-S. Moldovan ◽  
M. Ruhlmann ◽  
R. Görges ◽  
A. Bockisch ◽  
S. Rosenbaum-Krumme ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Differentiated Thyroid Cancer ◽  
Absorbed Dose ◽  
Thyroid Remnant ◽  
Remnant Ablation ◽  
Dose Threshold ◽  
131I Activity ◽  
Pet Ct ◽  
Absorbed Radiation Dose

SummaryAim: A theoretical dosimetry-based model was applied to estimate the lowest effective radioiodine activity for thyroid remnant ablation of low-risk differentiated thyroid cancer patients. Patients, methods: The model is based on the distribution of the absorbed (radiation) dose per administered radioiodine activity and the absorbed dose threshold of 300 Gy for thyroid remnants, the level believed to destroy most thyroid remnants. For this purpose, 124I PET/CT images of 49 thyroid-ectomised patients were retrospectively analysed to measure the distribution of the (average) absorbed doses to thyroid remnant per administered 131I activity. The fraction of thyroid remnants that received at least 300 Gy was determined for standard activities between 0.37 and 5.55 GBq. The lower activity was considered to be equally effective to that obtained with higher activity if the (absolute) fraction difference was below 5%. Results: A total of 62 thyroid remnants were included. The medians and ranges (in parentheses) for the absorbed dose per unit 131I activity were 359 Gy/GBq (34 to 1825 Gy/ GBq). The fractions of thyroid remnants receiving more than 300 Gy at different therapy activities (within parentheses) were 60% (1.11 GBq), 76% (1.85 GBq), 79% (2.22 GBq), and 81–82% for activities between 2.59 and 3.70 GBq. The therapy activity of 1.11 GBq is considerably less effective than that of 1.85 or 2.22 GBq; therapy activities were equally effective in the range between 2.22 to 3.70 GBq. Conclusion: On the basis of the model and the patients' data included, the lowest effective therapy activity appears to be approximately 2.2 GBq to ablate thyroid remnants. The results of this study may help to guide the design of prospective clinical studies.

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