Clinical Significance of Observation without Repeated Radioiodine Therapy in Differentiated Thyroid Carcinoma Patients with Positive Surveillance Whole-Body Scans and Negative Thyroglobulin

The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy.

Download Full-text

Efficacy of radioiodine therapy in the treatment of elevated serum thyroglobulin in patients with differentiated thyroid carcinoma and negative whole-body iodine scan

Nuclear Medicine Communications ◽

10.1097/00006231-200607000-00004 ◽

2006 ◽

Vol 27 (7) ◽

pp. 567-572 ◽

Cited By ~ 12

Author(s):

Mohsen Saghari ◽

Ali Gholamrezanezhad ◽

Sahar Mirpour ◽

Mohammad Eftekhari ◽

Abbas Takavar ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Radioiodine Therapy ◽

Elevated Serum ◽

Differentiated Thyroid Carcinoma ◽

Whole Body ◽

Serum Thyroglobulin ◽

Iodine Scan

Download Full-text

Guidelines on radioiodine therapy for differentiated thyroid carcinoma

Nuklearmedizin ◽

10.1055/s-0038-1625319 ◽

2005 ◽

Vol 44 (06) ◽

pp. 229-237 ◽

Cited By ~ 3

Author(s):

M. K. Pixberg ◽

U. Dörr ◽

M. Dietlein ◽

H. Schlemmer ◽

J. Grimm ◽

...

Keyword(s):

Clinical Practice ◽

Thyroid Carcinoma ◽

Radioiodine Therapy ◽

External Beam Radiotherapy ◽

German Society ◽

Differentiated Thyroid Carcinoma ◽

Whole Body ◽

131I Activity ◽

Treatment Data ◽

The Impact

SummaryAim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing Multicenter Study Differentiated Thyroid Carcinoma (MSDS) were analyzed. Patients, methods: Patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pN0/1/x M0/x (UICC, 5th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4–6 weeks), in 33% and 84% with regard to 131I activity for RIT (1-3 vs. 1-4 GBq; ± 10%), and in 16% and 60% with regard to 131I activity for WBS (15319-300 vs. 15319-400 MBq; ± 10%). Conclusions: The 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes.

Download Full-text

Advantages of surgical extirpation in addition to radioiodine therapy in differentiated thyroid carcinoma patients with a solitary large-volume skeletal metastasis with small-volume oligometastatic disease in the rest of the whole body

Journal of Cancer Research and Therapeutics ◽

10.4103/0973-1482.106595 ◽

2012 ◽

Vol 8 (4) ◽

pp. 656 ◽

Cited By ~ 1

Author(s):

Sandip Basu ◽

ChaitanyaR Borde ◽

Amit Abhyankar

Keyword(s):

Thyroid Carcinoma ◽

Large Volume ◽

Small Volume ◽

Radioiodine Therapy ◽

Skeletal Metastasis ◽

Differentiated Thyroid Carcinoma ◽

Whole Body ◽

Oligometastatic Disease ◽

Surgical Extirpation

Download Full-text

Clinical significance of extra-thyroid 99mTc-pertechnetate uptake before initial radioiodine therapy for differentiated thyroid carcinoma

Journal of International Medical Research ◽

10.1177/03000605211012667 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110126

Author(s):

Bin Long ◽

Li-Fang Yao ◽

Shou-Cong Chen ◽

Jin Shui ◽

Xue-Mei Ye ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Clinical Significance ◽

Clinical Features ◽

Uptake Rate ◽

Radioactive Iodine ◽

Differentiated Thyroid Carcinoma ◽

Whole Body ◽

Iodine Uptake ◽

Uptake Rates ◽

Post Therapy

Objective To analyse the clinical characteristics of extra-thyroid 99mTc-pertechnetate uptake in order to explore the effect of the phenomenon on radioactive iodine (RAI) therapy for differentiated thyroid carcinoma (DTC) and its clinical significance. Methods This study retrospectively selected patients with DTC and extra-thyroid 99mTc-pertechnetate uptake. The clinical features, location, location count and extra-thyroid 99mTc-pertechnetate uptake distribution were analysed, combined with the uptake rate, stimulated thyroglobulin (sTg) level, post-therapy whole-body scan and curative effect. Results A total of 38 patients were enrolled in the study and 65 extra-thyroid 99mTc-pertechnetate foci were detected. Thirty-four patients showed abnormal 99mTc-pertechnetate uptake in the lymph nodes (26 of 38; 68.4%), lungs (four of 38; 10.5%) and bones (four of 38; 10.5%). The corresponding uptake rates were 0.2%, 0.2% and 0.8%, respectively. The uptake rate and sTg were significantly positively correlated ( r = 0.36). 131I uptake was found in 36 patients at the 99mTc-pertechnetate uptake site. The number of iodine uptake foci was significantly higher than that of 99mTc-pertechnetate uptake foci. The sTg value and pathological staging significantly differed between the excellent and nonexcellent response groups (Z = –2.947 and Z = –2.348, respectively). Conclusion Extra-thyroid 99mTc-pertechnetate uptake mostly indicated metastases with specific clinical features, which may have prognostic value for the judgment of iodine uptake function and the RAI therapy plan.

Download Full-text

Differentiated thyroid carcinoma: Incremental diagnostic value of 131I SPECT/CT over planar whole body scan after radioiodine therapy

Endocrine ◽

10.1007/s12020-016-1086-3 ◽

2016 ◽

Vol 56 (3) ◽

pp. 551-559 ◽

Cited By ~ 10

Author(s):

Valentina Zilioli ◽

Alessia Peli ◽

Maria Beatrice Panarotto ◽

Giancarlo Magri ◽

Ahmed Alkraisheh ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Radioiodine Therapy ◽

Diagnostic Value ◽

Differentiated Thyroid Carcinoma ◽

Whole Body ◽

Whole Body Scan ◽

Body Scan

Download Full-text

Impact of treatment guidelines on radioiodine therapy for differentiated thyroid carcinoma in German-speaking Europe

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2005-862905 ◽

2005 ◽

Vol 113 (S 1) ◽

Author(s):

M Biermann ◽

M Pixberg ◽

O Schober

Keyword(s):

Thyroid Carcinoma ◽

Treatment Guidelines ◽

Radioiodine Therapy ◽

Differentiated Thyroid Carcinoma ◽

German Speaking

Download Full-text

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

Diagnostics ◽

10.3390/diagnostics11030553 ◽

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.

Download Full-text