scholarly journals Thyroid remnant volume and Radioiodine ablation in Differentiated thyroid carcinoma

2015 ◽  
Vol 17 (1) ◽  
pp. 55-60
Author(s):  
Md Sayedur Rahman Miah ◽  
Md Reajul Islam ◽  
Tanjim Siddika
Keyword(s):  
Thyroid Carcinoma ◽  
Atomic Energy Commission ◽  
Thyroid Volume ◽  
Differentiated Thyroid Carcinoma ◽  
High Dose ◽  
Thyroid Remnant ◽  
Complete Ablation ◽  
Successful Ablation ◽  
Remnant Thyroid ◽  
Radioiodine Ablation

Aims: The aims of the study were to determine the thyroid remnant volume and to see the effect of radioiodine ablation on thyroid remnant volume. Methods: A retrospective analysis of seventy-one differentiated thyroid carcinoma patients treated with high dose radioiodine (I-131) for post surgical ablation of thyroid remnants were done in Institute of Nuclear Medicine & Allied Sciences, Comilla of Bangladesh Atomic Energy Commission. Female were 60 and male were 11 with female-male ration of 5.5:1. All patients enrolled during the period from January 2001 to December 2011. The age range of the patients was 15 years to 90 years. The thyroid remnant volumes were determined by SPECT scintigraphy. High dose radioiodine (I-131) ablations were done with doses ranged from 2.77 GBq (75mCi) to 5.55 GBq (175 mCi). A successful ablation was defined as the absence of activity in the thyroid bed on subsequent imaging studies. Results: Fifty-nine patients (83.1%) showed complete ablation and twelve (16.9%) showed partial ablation of thyroid remnants after radioiodine therapy. The remnant thyroid volume as determined from scintigraphic images was significantly different (p = 0.048) between them who were completely ablated and them who were partially ablated. It was also observed that in complete ablation, 52.5% had thyroid remnant volume <1.0 gm, 40.7% had 1.1 to 2.0 gm, 5.1% had 2.1 to 3.0 gm and 1.7% had > 3.0 gm. i.e., The smaller the volume of thyroid remnant, better the response and larger the volume, the poorer the response to radioiodine. Conclusions: Successful ablation of thyroid remnants significantly depends on their volume and the successful ablation is inversely related with thyroid remnant volume. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22492 Bangladesh J. Nuclear Med. 17(1): 55-60, January 2014

scholarly journals Radioiodine in Differentiated Thyroid Carcinoma: Do We Need Diagnostic Pre-Ablation Iodine-123 Scintigraphy to Optimize Treatment?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 553
Author(s):  
Elizabeth de Koster ◽  
Taban Sulaiman ◽  
Jaap Hamming ◽  
Abbey Schepers ◽  
Marieke Snel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Treatment Success ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Thyroid Remnant ◽  
Node Metastasis ◽  
Unsuccessful Treatment

Changing insights regarding radioiodine (I-131) administration in differentiated thyroid carcinoma (DTC) stir up discussions on the utility of pre-ablation diagnostic scintigraphy (DxWBS). Our retrospective study qualitatively and semi-quantitatively assessed posttherapy I-131 whole-body scintigraphy (TxWBS) data for thyroid remnant size and metastasis. Findings were associated with initial treatment success after nine months, as well as clinical, histopathological, and surgical parameters. Possible management changes were addressed. A thyroid remnant was reported in 89 of 97 (92%) patients, suspicion of lymph node metastasis in 26 (27%) and distant metastasis in 6 (6%). Surgery with oncological intent and surgery by two dedicated thyroid surgeons were independently associated with a smaller remnant. Surgery at a community hospital, aggressive tumor histopathology, histopathological lymph node metastasis (pN1) and suspicion of new lymph node metastasis on TxWBS were independently associated with an unsuccessful treatment. Thyroid remnant size was unrelated to treatment success. All 13 pN1 patients with suspected in situ lymph node metastases on TxWBS had an unsuccessful treatment, opposite 19/31 (61%) pN1 patients without (p = 0.009). Pre-ablative knowledge of these TxWBS findings had likely influenced management in 48 (50%) patients. Additional pre-ablative diagnostics could optimize patient-tailored I-131 administration. DxWBS should be considered, especially in patients with pN1 stage or suspected in situ lymph node metastasis. Dependent on local surgical expertise, DxWBS is not recommended to evaluate thyroid remnant size.

Circulating epithelial cells in patients with thyroid carcinoma

2013 ◽  
Vol 52 (01) ◽  
pp. 7-13 ◽  
Author(s):  
T. Winkens ◽  
K. Pachmann ◽  
M. Freesmeyer
Keyword(s):  
Epithelial Cells ◽  
Thyroid Carcinoma ◽  
Statistical Significance ◽  
Surgical Excision ◽  
Differentiated Thyroid Carcinoma ◽  
Serum Thyroglobulin ◽  
Thyroid Cells ◽  
Potential Marker ◽  
Radioiodine Ablation ◽  
Circulating Epithelial Cells

Summary Goal: To investigate whether circulating epithelial cells (CEC) recognized via the epithelial cell adhesion molecule (EpCAM) can be identified in the blood of patients with thyroid carcinoma, given that CEC have already been detected in other types of carcinoma and are considered a potential marker of tumour dissemination. Patients, methods: Blood samples of patients with active differentiated thyroid carcinoma (DTC) (n = 50) were compared to samples of patients with: a) recent surgical excision of a thyroid carcinoma (postOP-DTC) (n = 16); b) athyreotic, tumour-free status after radioiodine ablation (AT-DTC) (n= 33); and c) benign thyroid diseases (BTD) (n = 51). Samples of volunteers with normal thyroid parameters (NT) (n = 12) were also investigated. Cells from EDTAblood were subjected to erythrocyte lysis, isolated by centrifugation, and incubated with a fluorescence-labeled antibody against EpCAM. The numbers of vital cells were counted via fluorescence microscopy. Results: CEC were identified in all groups, with the postOP-DTC group showing the highest mean CEC numbers of all groups. The DTC group had significantly higher CEC numbers than the NT group, and numerically higher numbers than the other groups, although not reaching statistical significance. Within the DTC group there was a correlation between levels of serum thyroglobulin and numbers of CEC (r = 0.409, p = 0.003). Conclusions: High CEC numbers were not specific to thyroid carcinoma. The methodology used here, based on a single measurement does not allow to identify severe forms of DTC, emphasizing the need of longitudinal measurements throughout therapy. Detection and characterization of tumour thyroid cells in circulation should be based on additiona l consideration of tissue-specific characteristics.

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