Comparison of whole body retention of I-131 in case humans thyroid cancer between model prediction and measurement

Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insights regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients’ clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable among patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I.

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Abstract #53: False-Positive 131I Whole-Body Scan Due to a Lactating Breast in a Patient with Thyroid Cancer

Endocrine Practice ◽

10.1016/s1530-891x(20)43901-1 ◽

2003 ◽

Vol 9 ◽

pp. 21

Author(s):

Puneet S. Arora ◽

Manfred Blum

Keyword(s):

Thyroid Cancer ◽

False Positive ◽

Whole Body ◽

Whole Body Scan ◽

Body Scan ◽

Lactating Breast

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Radioimmunszintigraphie mit SPECT: Methodik, Probleme und klinische Erfahrungen

Nuklearmedizin ◽

10.1055/s-0038-1628889 ◽

1987 ◽

Vol 26 (05) ◽

pp. 202-205 ◽

Cited By ~ 1

Author(s):

J. Fass ◽

S. Truong ◽

U. Büll ◽

V. Schumpelick ◽

R. Bares

Keyword(s):

Clinical Practice ◽

The Other ◽

Whole Body ◽

Blood Clearance ◽

Planar Scintigraphy ◽

Gastrointestinal Carcinomas ◽

Body Regions ◽

Other Hand ◽

Body Retention ◽

Klinische Erfahrungen

Radioimmunoscintigraphy (RIS) with 111ln- and 131 I-labelled monoclonal anti bodies (MAbs) against CEA and/or CA 19-9 was performed in 83 patients with various gastrointestinal carcinomas. A total of 276 body regions could be examined. The results of planar scintigraphy and SPECT were compared intraindividually. Using 111 In-labelled MAbs the sensitivity of RIS was significantly improved by SPECT (88.9 vs. 52.4% with planar scintigraphy, p <0.01). For131 l-labelled MAbs the effect was smaller (83.9 vs. 65.6% with planar scintigraphy, n.s.). This finding can be explained by different kinetics and biodistribution of the used MAb preparations.111 In-labelled MAbs with long whole-body retention and rapid blood clearance reveal ideal qualities for SPECT; on the other hand, the short whole-body retention of131 l-labelled MAbs leads to small count rates and therefore long counting times that make delayed SPECT unsuitable in clinical practice

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Malignant Struma Ovarii with Concurrent Thyroid Cancer: Outcomes during and after Pregnancy

European Thyroid Journal ◽

10.1159/000512735 ◽

2021 ◽

pp. 1-5

Author(s):

Sara Donato ◽

Helder Simões ◽

Valeriano Leite

Keyword(s):

Thyroid Cancer ◽

Thyroid Tissue ◽

Pelvic Mass ◽

Pregnant Patient ◽

Whole Body ◽

Ovarian Teratoma ◽

Struma Ovarii ◽

Pelvic Mri ◽

Biochemical Evidence

Introduction: Struma ovarii (SO) is a rare ovarian teratoma characterized by the presence of thyroid tissue in more than 50% of the tumor. Malignant transformation is rare and the most common associated malignancy is papillary thyroid carcinoma (PTC). Pregnancy may represent a stimulus to differentiated thyroid cancer (DTC) growth in patients with known structural or biochemical evidence of disease, but data about malignant SO evolution during pregnancy are rare. We present the first reported case of a pregnant patient with malignant SO and biochemical evidence of disease. Case Presentation: A previously healthy 35-year-old female diagnosed with a suspicious left pelvic mass on routine ultrasound was submitted to laparoscopic oophorectomy which revealed a malignant SO with areas of PTC. A 15-mm thyroid nodule (Bethesda V in the fine-needle aspiration cytology) was detected by palpation and total thyroidectomy was performed. Histology revealed a 15 mm follicular variant of PTC (T1bNxMx). Subsequently, she received 100 mCi of radioactive iodine therapy (RAIT) with the whole-body scan showing only moderate neck uptake. Her suppressed thyroglobulin (Tg) before RAI was 1.1 ng/mL. She maintained biochemical evidence of disease, with serum Tg levels of 7.6 ng/mL. She got pregnant 14 months after RAIT, and during pregnancy, Tg increased to 21.5 ng/mL. After delivery, Tg decreased to 14 ng/mL but, 6 months later, rose again and reached 31.9 ng/mL on the last follow-up visit. TSH was always suppressed during follow-up. At the time of SO diagnosis, a chest computed tomography scan showed 4 bilateral lung micronodules in the upper lobes which were nonspecific, and 9 months after diagnosis, a pelvic MRI revealed a suspicious cystic nodule located on the oophorectomy bed. These lung and pelvic nodules remained stable during follow-up. Neck ultrasonography, abdominal MRI, and fluorodeoxyglucose-positron emission tomography showed no suspicious lesions. Discussion/Conclusion: As for DTC, pregnancy seems to represent a stimulus to malignant SO growth. This can be caused by the high levels of estrogen during pregnancy that may bind to receptors in malignant cells and/or by the high levels of hCG which is known to stimulate TSH receptors.

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Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

Endocrine ◽

10.1007/s12020-020-02418-x ◽

2020 ◽

Vol 70 (2) ◽

pp. 280-291

Author(s):

Alfredo Campennì ◽

Daniele Barbaro ◽

Marco Guzzo ◽

Francesca Capoccetti ◽

Luca Giovanella

Keyword(s):

Nuclear Medicine ◽

Thyroid Cancer ◽

Clinical Practice ◽

Molecular Imaging ◽

Routine Clinical Practice ◽

Whole Body ◽

Neck Ultrasound ◽

Long Term Follow Up

Abstract Purpose The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine therapy (RaIT), individualized thyroid hormone therapy, and follow-up for detection of patients with persistent or recurrent disease. In 2019, the nine Martinique Principles for managing thyroid cancer were developed by the American Thyroid Association, European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and European Thyroid Association. In this review, we present our clinical practice recommendations with regard to implementing these principles in the diagnosis, treatment, and long-term follow-up of patients with DTC. Methods A multidisciplinary panel of five thyroid cancer experts addressed the implementation of the Martinique Principles in routine clinical practice based on clinical experience and evidence from the literature. Results We provide a suggested approach for the assessment and diagnosis of DTC in routine clinical practice, including the use of neck ultrasound, measurement of serum thyroid-stimulating hormone and calcitonin, fine-needle aspiration, cytology, and molecular imaging. Recommendations for the use of surgery (lobectomy vs. total thyroidectomy) and postoperative RaIT are also provided. Long-term follow-up with neck ultrasound and measurement of serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin is standard, with 123/131I radioiodine diagnostic whole-body scans and 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography suggested in selected patients. Management of metastatic DTC should involve a multidisciplinary team. Conclusions In routine clinical practice, the Martinique Principles should be implemented in order to optimize clinical management/outcomes of patients with DTC.

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Improved zinc and iron absorption from breakfast meals containing malted oats with reduced phytate content

British Journal Of Nutrition ◽

10.1079/bjn19960075 ◽

1996 ◽

Vol 76 (5) ◽

pp. 677-688 ◽

Cited By ~ 57

Author(s):

Marie Larsson ◽

Lena Rossander-Hulthén ◽

Brittmarie Sandström ◽

Ann-Sofie Sandberg

Keyword(s):

Iron Absorption ◽

Human Subjects ◽

Vulnerable Groups ◽

Whole Body ◽

Absolute Amount ◽

Average Increase ◽

Mineral Deficiency ◽

Breakfast Meal ◽

Body Retention ◽

Phytate Content

The absorption of Zn or Fe from breakfast meals containing oat porridge prepared from malted and soaked oats and a control porridge made from untreated oats was measured in human subjects. The effect on Zn and Fe absorption of reducing the phytate content of oat-porridge meals was examined in each subject by extrinsic labelling of porridge with 65Zn and of bread rolls with 55Fe and 59Fe, and measuring whole-body retention and the erythrocyte uptake of isotopes. Each experiment comprised nine to ten subjects. The absorption of Zn from malted-oat porridge with a phytate (inositol hexaphosphate) content of 107 μmol was 18·3%, and significantly higher (P < 0·05) than from the control porridge containing 432 μmol phytate (11·8%). Fe absorption from the meal containing malted-oat porridge with 107 μmol phytate (Expt 2) was also significantly improved (P < 0·05) compared with that from the meal containing control porridge with 437 μmol phytate. The average increase in Fe absorption was 47%, or from 4·4 to 6·0%. In the breakfast meal containing malted porridge with 198 μmol phytate (Expt 3) the increase in Fe absorption was not significantly improved. Even though the phytate content was reduced to a greater extent in Expt 3 than Expt 2, the average increase in Fe absorption in Expt 3 was only 25% more than that from the meal containing control porridge (with 599 μmol phytate), depending on the higher absolute amount of phytate. In conclusion, an improvement in Zn and Fe absorption from oat products can be achieved by practising malting and soaking in the processing of oats. This may be of importance in the prevention of mineral deficiency in vulnerable groups.

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Combined Treatment with Laser Ablation and Tyrosine-Kinase Inhibitor as a Novel Multimodality Approach to Locally Advanced Thyroid Cancer: a Case Report

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530321666210830093522 ◽

2021 ◽

Vol 21 ◽

Author(s):

Agnese Persichetti ◽

Salvatore Monti ◽

Carmela Coccaro ◽

Federica Presciuttini ◽

Maria Grazia Deiana ◽

...

Keyword(s):

Thyroid Cancer ◽

Laser Ablation ◽

Tyrosine Kinase ◽

Combined Treatment ◽

Locally Advanced ◽

Tumor Burden ◽

Whole Body ◽

Laser Source ◽

Thyroid Tumors ◽

Multimodality Approach

Background: Direct locoregional treatments were recently proposed for the local control of cervical and distant metastasis of thyroid cancer, but data on their use as part of a multimodality approach for primary thyroid tumors are poor. In this feasibility study, laser ablation (LTA) was successfully used for the initial debulking of unresectable radioiodine-refractory thyroid cancer in sequential therapy with tyrosine-kinase inhibitors (TKI). Clinical case: A 69-year-old woman underwent partial resection of papillary thyroid cancer with extensive tracheal infiltration. Post-treatment whole-body scan (131I, 8140 MBq) showed the absence of cervical thyroid uptake. The patient experienced a rapid increase in her cervical mass associated with dysphonia, dyspnea, and dysphagia. Due to a concomitant severe hypertensive state and cardiac failure, the patient was treated with LTA after a multidisciplinary consultation. After local anesthesia, two 300 nm optic fibers were inserted into the lesion through 21G spinal needles. Two illuminations with 4-watt output power and 3600 Joules energy delivery were performed with a diode-laser source. LTA resulted in rapid cancer debulking, and mass volume decreased from 23.9 to 7.5 mL resulting in significant improvement of pressure symptoms. Three months later, the patient was started on lenvatinib due to the initial regrowth of the tumor mass. The cervical tumor burden was controlled by TKI for 20 months when a rapid disease progression occurred, and the patient died. Discussion: Locally advanced, unresectable, and radioiodine-refractory thyroid tumors can be managed with a novel multimodality approach. The initial debulking with LTA of the locally aggressive disease results in rapid control of the tumor burden threatening patients’ life and is effectively followed by long-term control with TKI treatment. Conclusion: Based on this experience, sequential multimodality treatment with an initial locally directed laser ablation procedure followed by TKI therapy may be considered as a salvage option in patients with unresectable and rapidly progressive RR thyroid tumors.

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