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

Objectives: The aim of this study is to investigate the value of Single Photon Emission Computed Tomography/ Computed Tomography (SPECT/CT) imaging in well differentiated thyroid cancer (DTC) after radioiodine ablation (I-131) therapy for clinical staging and risk stratification.To determine whether SPECT/CT would change management plan or predict the clinical outcomes of DTC patients. Methods: 78 DTC patients underwent first post radioiodine therapy “Whole body iodine- 131 scintigraphy (WBS) along with SPECT/CT” at Department of Radiology and Molecular imaging, Sultan Qaboos university Hospital between January 2014 and August 2017. Differences between WBS and SPECT/CT, change in clinical staging, risk stratification and management were recorded. Clinical outcome at 6-12 months was recorded. SPSS statistical software was used for collecting and analysing the data. A generalized McNemar test was used to assess disagreement between WBS and SPECT/CT. Results: American Thyroid Association (ATA) risk stratification falls into low (35.8%), intermediate (53.8%) and high risk groups (10.2%) on WBS, which changed to 44.8%, 38.4% and 16.6% respectively on SPECT/CT imaging. Overall change in risk stratification was noted in 16.6% and TNM stage in 11.5% of patients after SPECT/CT imaging. SPECT/CT changed therapeutic plan and clinical outcome in 19.2% of patients. Conclusion: SPECT/CT allows better detection and characterization of metastatic lymph nodes and distant metastasis in DTC patients compared to WBS imaging alone. It alters TNM staging, ATA risk classification and management in significant number of patients. It is recommended that SPECT/CT should be done routinely along with WBS in well differentiated thyroid carcinoma. Keywords: Thyroid cancer, Iodine, Ablation techniques, SPECT/CT

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Pre-Ablation rhTSH-Stimulated F-18 FDG PET/CT Changes Patient Management in Increased-Risk Thyroid Cancer

Hormone and Metabolic Research ◽

10.1055/a-1111-8927 ◽

2020 ◽

Vol 52 (03) ◽

pp. 158-167 ◽

Cited By ~ 1

Author(s):

Gundula Rendl ◽

Lukas Rettenbacher ◽

Gregor Schweighofer-Zwink ◽

Lukas Hehenwarter ◽

Christian Pirich

Keyword(s):

Thyroid Cancer ◽

High Risk ◽

Fdg Pet ◽

Patient Management ◽

Treatment Plan ◽

Ct Imaging ◽

Whole Body ◽

Increased Risk ◽

Pet Ct ◽

Fdg Pet Ct

AbstractThe aim of the study was to evaluate the clinical impact of pre-ablation rhTSH-stimulated fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT in addition to post-therapeutic whole body radioiodine scanning in patients with intermediate to high risk differentiated thyroid carcinoma (DTC). This was a retrospective single center study including 73 patients with thyroid cancer (44 females, mean age 43.2±16.2 years, 62% papillary, 31% follicular, 7% poorly differentiated). All patients underwent ablative radioiodine treatment (mean activity: 3661±673 MBq I-131) using rhTSH after thyroidectomy and lymph node (LN) dissection (01/2013–10/2016) and TSH-stimulated F-18 FDG PET/CT (4 MBq/kg body weight, low dose CT). Post-treatment I-131 whole body scan (I-131 WBS) was obtained 9 days afterwards in planar technique and in case of equivocal or abnormal findings using SPECT/CT. Thirty-one patients (42%) showed F-18 FDG avid lesions, 14 patients showed more FDG than iodine positive lesions and 5 patients more iodine positive lesions in I-131 WBS, respectively. Fifty-three patients showed identical F-18 FDG PET/CT and I-131 WBS. The initial treatment plan was changed from follow-up to therapy (surgery, systemic therapy using tyrosine-kinase inhibition) in 11 patients (15%) on the basis of F-18 FDG PET/CT imaging. Six of these 11 patients had papillary thyroid cancer. Three patients with histologically proven LN metastases had stimulated thyroglobulin-levels<2.0 ng/ml. Our study demonstrated a clinical benefit of pre-ablation rhTSH-stimulated F-18 FDG PET/CT imaging in about 20% of patients with intermediate to high risk DTC, leading to change in patient management in 15%.

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The influence of saliva flow stimulation on the absorbed radiation dose to the salivary glands during radioiodine therapy of thyroid cancer using 124I PET(/CT) imaging

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-010-1532-z ◽

2010 ◽

Vol 37 (12) ◽

pp. 2298-2306 ◽

Cited By ~ 38

Author(s):

Walter Jentzen ◽

Dorothee Balschuweit ◽

Jochen Schmitz ◽

Lutz Freudenberg ◽

Ernst Eising ◽

...

Keyword(s):

Thyroid Cancer ◽

Radiation Dose ◽

Salivary Glands ◽

Radioiodine Therapy ◽

Ct Imaging ◽

Pet Ct ◽

Absorbed Radiation Dose ◽

Flow Stimulation ◽

Saliva Flow

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Predictive factors determining incomplete response to radioiodine therapy in patients with differentiated thyroid cancer

The Quarterly Journal of Nuclear Medicine and Molecular Imaging ◽

10.23736/s1824-4785.18.03026-1 ◽

2020 ◽

Vol 64 (1) ◽

Author(s):

Ewelina Szczepanek-Parulska ◽

Magdalena Wojewoda-Korbelak ◽

Martyna Borowczyk ◽

Malgorzata Kaluzna ◽

Barbara Brominska ◽

...

Keyword(s):

Thyroid Cancer ◽

Predictive Factors ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Incomplete Response

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T2Candida for the Diagnosis and Management of Invasive Candida Infections

Journal of Fungi ◽

10.3390/jof7030178 ◽

2021 ◽

Vol 7 (3) ◽

pp. 178

Author(s):

Lea M Monday ◽

Tommy Parraga Acosta ◽

George Alangaden

Keyword(s):

Clinical Utility ◽

Patient Management ◽

Diagnostic Methods ◽

Healthcare Associated Infection ◽

Antifungal Stewardship ◽

Candida Sp ◽

Candida Infections ◽

Blood Specimens ◽

Healthcare Associated ◽

Preclinical And Clinical Studies

Invasive candidiasis is a common healthcare-associated infection with high mortality and is difficult to diagnose due to nonspecific symptoms and limitations of culture based diagnostic methods. T2Candida, based on T2 magnetic resonance technology, is FDA approved for the diagnosis of candidemia and can rapidly detect the five most commonly isolated Candida sp. in approximately 5 h directly from whole blood. We discuss the preclinical and clinical studies of T2Candida for the diagnosis of candidemia and review the current literature on its use in deep-seated candidiasis, its role in patient management and prognosis, clinical utility in unique populations and non-blood specimens, and as an antifungal stewardship tool. Lastly, we summarize the strengths and limitations of this promising nonculture-based diagnostic test.

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Radioiodine therapy reduces the frequency of circulating tumour cells in patients with differentiated thyroid cancer

Clinical Endocrinology ◽

10.1111/cen.14419 ◽

2021 ◽

Author(s):

Mathias Schmidt ◽

Christina Antke ◽

Katalin Mattes‐György ◽

Hubertus Hautzel ◽

Stephanie Allelein ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Tumour Cells ◽

Circulating Tumour Cells

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Nuclear medical inpatient treatment in Germany

Nuklearmedizin ◽

10.3413/nukmed-0296 ◽

2010 ◽

Vol 49 (02) ◽

pp. 49-57 ◽

Cited By ~ 10

Author(s):

M. Dietlein ◽

C. Reiners ◽

R. Lorenz

Keyword(s):

Nuclear Medicine ◽

Thyroid Cancer ◽

Inpatient Treatment ◽

Radioiodine Therapy ◽

Main Diagnosis ◽

Medical Inpatient ◽

Iodine Prophylaxis ◽

Iodine Supply ◽

Quality Report ◽

Quality Reports

SummaryAll public licensed hospitals of Germany are obligated since 2004 to establish and to publish a structured biennial quality report. The aim of this study was to analyse the quality reports from 2008 of clinics with nuclear-medicine therapy ward and to investigate developments for the inpatient nuclear-medicine therapy by comparing the results with the quality reports of the years 2004 and 2006. Methods: All available structured quality reports of clinics with a nuclear-medicine therapy ward of the years 2004, 2006 and 2008 were evaluated. Results: The total number of inpatient treatment cases in 2008 amounted to 54 190 (2006: 54 884; 2004: 57 366). This corresponds to a decrease of 5.5% in comparison to 2004. The number of the therapy wards decreased at the same time to currently 117 (2006: 120; 2004: 124). Remarkable changes were found in the spectrum of the main diagnosis. Thus, the most frequent diagnosis with the ICD-code E05 (hyperthyroidism) decreased continuously from 37 747 treatments in 2004 and 34 764 in 2006 to 31 756 in the year 2008. In contrast, the ICD-diagnoses for thyroid cancer (C73, Z08) with 14 761 cases in 2008 increased with time (2006: 13 426; 2004: 12 581). Conclusions: In analogy to the observations from Europe after introduction of an iodine prophylaxis the improved iodine supply in Germany has led to a decline of the radioiodine therapy due to hyperthyroidism.

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