FDG PET Performed at Thyroid Remnant Ablation Has a Higher Predictive Value for Long-Term Survival of High-Risk Patients With Well-Differentiated Thyroid Cancer Than Radioiodine Uptake

2015 ◽  
Vol 40 (5) ◽  
pp. 378-383 ◽  
Author(s):  
Florian C. Gaertner ◽  
Shozo Okamoto ◽  
Tohru Shiga ◽  
Yoichi M. Ito ◽  
Yuko Uchiyama ◽  
...  
Thyroid ◽  
2014 ◽  
Vol 24 (3) ◽  
pp. 480-487 ◽  
Author(s):  
Peter Bartenstein ◽  
Elisa Caballero Calabuig ◽  
Carlo Ludovico Maini ◽  
Renzo Mazzarotto ◽  
M. Angustias Muros de Fuentes ◽  
...  

Author(s):  
Michele Klain ◽  
Carmela Nappi ◽  
Emilia Zampella ◽  
Valeria Cantoni ◽  
Roberta Green ◽  
...  

Abstract Purpose We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. Methods A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. Results The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation. Conclusion In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control.


2021 ◽  
Author(s):  
Evert F.s. van Velsen ◽  
Robin P. Peeters ◽  
Merel T. Stegenga ◽  
F.j. van Kemenade ◽  
Tessa M. van Ginhoven ◽  
...  

Objective Recent research suggests that the addition of age improves the 2015 American Thyroid Association (ATA) Risk Stratification System for differentiated thyroid cancer (DTC). The aim of our study was to investigate the influence of age on disease outcome in ATA High Risk patients with a focus on differences between patients with papillary (PTC) and follicular thyroid cancer (FTC). Methods We retrospectively studied adult patients with High Risk DTC from a Dutch university hospital. Logistic regression and Cox proportional hazards models were used to estimate the effects of age (at diagnosis) and several age cutoffs (per five years increment between 20 and 80 years) on (i) response to therapy, (ii) developing no evidence of disease (NED), (iii) recurrence, and (iv) disease specific mortality (DSM). Results We included 236 ATA High Risk patients (32% FTC) with a median follow-up of 6 years. Age, either continuously or dichotomously, had a significant influence on having an excellent response after initial therapy, developing NED, recurrence, and DSM for PTC and FTC. For FTC, an age cutoff of 65 or 70 years showed the best statistical model performance, while this was 50 or 60 years for PTC. Conclusions In a population of patients with High Risk DTC, older age has a significant negative influence on disease outcomes. Slightly different optimal age cutoffs were identified for the different outcomes, and these cutoffs differed between PTC and FTC. Therefore, the ATA Risk Stratification System may further improve should age be incorporated as an additional risk factor.


2015 ◽  
Vol 54 (03) ◽  
pp. 137-143 ◽  
Author(s):  
A.-S. Moldovan ◽  
M. Ruhlmann ◽  
R. Görges ◽  
A. Bockisch ◽  
S. Rosenbaum-Krumme ◽  
...  

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.


2015 ◽  
Vol 36 (11) ◽  
pp. 1100-1106 ◽  
Author(s):  
Alfredo Campennì ◽  
Luca Giovanella ◽  
Salvatore A. Pignata ◽  
Maria A. Violi ◽  
Massimiliano Siracusa ◽  
...  

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