Thyroid pathologies in nuclear medicine

2021 ◽  
pp. 6-28
Author(s):  
Barone Sebastiano ◽  
Pagliuso Luana
Keyword(s):  
Gamma Camera ◽  
Whole Body ◽  
Radioiodine Treatment ◽  
Equal Distribution ◽  
Radioiodine Uptake ◽  
Medical Diagnostic ◽  
High Emission ◽  
Risk Patients ◽  
Iodine 131 ◽  
Metabolic Radiotherapy

The presented work describes the thyroid pathologies and the nuclear-medical diagnostic approach, in order to obtain a differential diagnosis and the monitoring of various neoplasms; specifically, it describes the importance of radiometabolic treatment with iodine 131, after thyroidectomy surgery. Through a study conducted in patients suffering from thyroid disease, undergoing metabolic radiotherapy, it is shown that, with equal distribution of radioiodine, uptake with at least 3700 MBq of therapeutic dose is obtained. All this can be seen through the whole body scintigraphic framework, obtained through the use of the double-headed gamma camera with collimators for high emission energies. Radiometabolic treatment is effective in patients with a high risk of relapse, while radioiodine treatment is not recommended in low-risk patients.

scholarly journals Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients

2009 ◽  
Vol 160 (3) ◽  
pp. 431-436 ◽  
Author(s):  
M Chianelli ◽  
V Todino ◽  
F M Graziano ◽  
C Panunzi ◽  
D Pace ◽  
...  
Keyword(s):  
Ablation Rate ◽  
Low Risk ◽  
Whole Body ◽  
Radioiodine Uptake ◽  
Ablation Therapy ◽  
Risk Patients ◽  
Group A ◽  
Group B ◽  
Low Activity

Objective(a) To compare the efficacy of low-activity (2 GBq; 54 mCi) 131I ablation using l-thyroxine withdrawal or rhTSH stimulation, and (b) to assess the influence of thyroid remnants volume on the ablation rate.DesignPatients underwent neck ultrasound, 131I neck scintigraphy and radioiodine uptake. Post-therapy whole body scan (WBS) was acquired after 4–6 days. Ablation was assessed after 6–12 months by WBS, Tg and TgAb following l-thyroxine withdrawal.MethodsGroup A: preparation by L-T4 withdrawal (37 days); 21 patients received 131I (2.02±0.22 GBq; 54.6±5.9 mCi) and on the day of treatment, TSH, Tg, TgAb were measured; Group B: stimulation by rhTSH; 21 patients received 131I (1.97±0.18 GBq; 53.2±4.9 mCi) 24 h after the second injection of rhTSH (0.9 mg) and TSH, Tg and TgAb were measured after 2 days.ResultsAt follow-up, 90.0% of patients from group A and 85.0% of patients from group B had Tg levels <1 ng/ml; no uptake was observed in 95.2% and in 90.5% of patients from group A or B respectively, with no statistical differences for both ablation criteria. Before 131I treatment, small thyroid remnants (<1 ml) were detected by US in <25% of all patients.ConclusionsThe use of rhTSH for the preparation of low-risk patients to ablation therapy with low activities of 131I (2 GBq; 54 mCi) is safe and effective and avoids hypothyroidism. The presence of thyroid remnants smaller than 1 ml at US evaluation had no effect on the ablation rate.

Radioiodine treatment of feline hyperthyroidism in Germany

2002 ◽  
Vol 41 (06) ◽  
pp. 245-251 ◽  
Author(s):  
M. Knietsch ◽  
T. Spillmann ◽  
E.-G. Grünbaum ◽  
R. Bauer ◽  
M. Puille
Keyword(s):  
Radiation Exposure ◽  
Radiation Protection ◽  
Thyroid Function ◽  
Radioiodine Therapy ◽  
Whole Body ◽  
Radioiodine Treatment ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Body Activity ◽  
Thyroid Uptake

SummaryAim: Establishment of radioiodine treatment of feline hyperthyroidism in veterinary routine in accordance with German radiation protection regulations. Patients and methods: 35 cats with proven hyperthyroidism were treated with 131I in a special ward. Thyroid uptake and effective halflife were determined using gammacamera dosimetry. Patients were released when measured whole body activity was below the limit defined in the German “Strahlenschutzverordnung”. Results: 17/20 cats treated with 150 MBq radioiodine and 15/15 cats treated with 250 MBq had normal thyroid function after therapy, normal values for FT3 and FT4 were reached after two and normal TSH levels after three weeks. In 14 cats normal thyroid function was confirmed by controls 3-6 months later. Thyroidal iodine uptake was 24 ± 10%, effective halflife 2.5 ± 0.7 days. Whole body activity <1 MBq was reached 13 ± 4 days after application of 131I. Radiation exposure of cat owners was estimated as 1.97 Sv/MBq for adults. Conclusion: Radioiodine therapy of feline hyper-thyroidism is highly effective and safe. It can easily be performed in accordance with German radiation protection regulations, although this requires hospitalisation for approximately two weeks. Practical considerations on radiation exposure of cat owners do not justify this long interval. Regulations for the veterinary use of radioactive substances similar to existing regulations for medical use in humans are higly desirable.

Hematologic Toxicity of High-Dose Iodine-131–Metaiodobenzylguanidine Therapy for Advanced Neuroblastoma

2004 ◽  
Vol 22 (12) ◽  
pp. 2452-2460 ◽  
Author(s):  
Steven G. DuBois ◽  
Julia Messina ◽  
John M. Maris ◽  
John Huberty ◽  
David V. Glidden ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Radiation Dose ◽  
Red Cells ◽  
Whole Body ◽  
High Dose ◽  
Hematologic Toxicity ◽  
Severe Thrombocytopenia ◽  
Hematopoietic Stem ◽  
Iodine 131 ◽  
Mibg Therapy

Purpose Iodine-131–metaiodobenzylguanidine (131I-MIBG) has been shown to be active against refractory neuroblastoma. The primary toxicity of 131I-MIBG is myelosuppression, which might necessitate autologous hematopoietic stem-cell transplantation (AHSCT). The goal of this study was to determine risk factors for myelosuppression and the need for AHSCT after 131I-MIBG treatment. Patients and Methods Fifty-three patients with refractory or relapsed neuroblastoma were treated with 18 mCi/kg 131I-MIBG on a phase I/II protocol. The median whole-body radiation dose was 2.92 Gy. Results Almost all patients required at least one platelet (96%) or red cell (91%) transfusion and most patients (79%) developed neutropenia (< 0.5 × 103/μL). Patients reached platelet nadir earlier than neutrophil nadir (P < .0001). Earlier platelet nadir correlated with bone marrow tumor, more extensive bone involvement, higher whole-body radiation dose, and longer time from diagnosis to 131I-MIBG therapy (P ≤ .04). In patients who did not require AHSCT, bone marrow disease predicted longer periods of neutropenia and platelet transfusion dependence (P ≤ .03). Nineteen patients (36%) received AHSCT for prolonged myelosuppression. Of patients who received AHSCT, 100% recovered neutrophils, 73% recovered red cells, and 60% recovered platelets. Failure to recover red cells or platelets correlated with higher whole-body radiation dose (P ≤ .04). Conclusion These results demonstrate the substantial hematotoxicity associated with high-dose 131I-MIBG therapy, with severe thrombocytopenia an early and nearly universal finding. Bone marrow tumor at time of treatment was the most useful predictor of hematotoxicity, whereas whole-body radiation dose was the most useful predictor of failure to recover platelets after AHSCT.

scholarly journals Metabolic radiotherapy with iodine-131 in cholangiocarcinoma: In vitro studies

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e204
Author(s):  
A.F. Brito ◽  
A.C. Ribeiro ◽  
A.I. Fernandes ◽  
A.M. Abrantes ◽  
M. Laranjo ◽  
...  
Keyword(s):  
In Vitro Studies ◽  
Iodine 131 ◽  
Metabolic Radiotherapy

scholarly journals Labeling of Salmonella Typhymurium with iodine-131 to study phagocytic function in rats

1989 ◽  
Vol 31 (3) ◽  
pp. 135-138
Author(s):  
Maria K. Sato ◽  
Aldo J. Rodrigues Junior ◽  
Edwaldo E. Camargo
Keyword(s):  
Whole Body ◽  
Large Field ◽  
Scintillation Camera ◽  
Functional Evaluation ◽  
Body Images ◽  
System A ◽  
Carrier Free ◽  
Free Iodine ◽  
Iodine 131 ◽  
Reticulo Endothelial System

The present study describes a method for labeling Salmonella typhymurium with iodine-131 to evaluate both the morphological and the functional characteristics of the reticulo-endothelial system. A suspension containing 2 x 10(9) bacteria per ml was labeled with carrier-free Na131I without reductor, with a labeling yield of 46.5 ± 3% and 3.5 ± 1.3% of free Iodine-131. The biodistribution of the labeled bacteria in rats was studied with a large field-of-view scintillation camera equiped with a pinhole collimator. Whole body images were obtained 15 and 30 minutes after intravenous injection of the labeled microorganisms. Images showed accumulation of bacteria in the liver and both normal and transplanted spleens of the animals. Autoradiographs of liver and spleen demonstrated labeled bacteria within the cells of the reticulo-endothelial system. The method described is easy to perform, has a good labeling yield and allows the functional evaluation of the reticulo-monophagocytic system, including transplanted spleens.

Iodine-131-anti-B1 radioimmunotherapy for B-cell lymphoma.

1996 ◽  
Vol 14 (7) ◽  
pp. 1974-1981 ◽  
Author(s):  
M S Kaminski ◽  
K R Zasadny ◽  
I R Francis ◽  
M C Fenner ◽  
C W Ross ◽  
...  
Keyword(s):  
Complete Remission ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Rate ◽  
Whole Body ◽  
Hematologic Toxicity ◽  
Low Grade ◽  
Tracer Dose ◽  
Iodine 131

PURPOSE The CD20 B-lymphocyte surface antigen expressed by B-cell lymphomas is an attractive target for radioimmunotherapy, treatment using radiolabeled antibodies. We conducted a phase I dose-escalation trial to assess the toxicity, tumor targeting, and efficacy of nonmyeloablative doses of an anti-CD20 monoclonal antibody (anti-B1) labeled with iodine-131 (131I) in 34 patients with B-cell lymphoma who had failed chemotherapy. PATIENTS AND METHODS Patients were first given tracelabeled doses of 131I-labeled anti-B1 (15 to 20 mg, 5 mCi) to assess radiolabeled antibody biodistribution, and then a radioimmunotherapeutic dose (15 to 20 mg) labeled with a quantity of 131I that would deliver a specified centigray dose of whole-body radiation predicted by the tracer dose. Whole-body radiation doses were escalated from 25 to 85 cGy in sequential groups of patients in 10-cGy increments. To evaluate if radiolabeled antibody biodistribution could be optimized, initial patients were given one or two additional tracer doses on successive weeks, each dose preceded by an infusion of 135 mg of unlabeled anti-B1 one week and 685 mg the next. The unlabeled antibody dose resulting in the most optimal tracer biodistribution was also given before the radioimmunotherapeutic dose. Later patients were given a single tracer dose and radioimmunotherapeutic dose preceded by infusion of 685 mg of unlabeled anti-B1. RESULTS Treatment was well tolerated. Hematologic toxicity was dose-limiting, and 75 cGy was established as the maximally tolerated whole-body radiation dose. Twenty-eight patients received radioimmunotherapeutic doses of 34 to 161 mCi, resulting in complete remission in 14 patients and a partial response in eight. All 13 patients with low-grade lymphoma responded, and 10 achieved a complete remission. Six of eight patients with transformed lymphoma responded. Thirteen of 19 patients whose disease was resistant to their last course of chemotherapy and all patients with chemotherapy-sensitive disease responded. The median duration of complete remission exceeds 16.5 months. Six patients remain in complete remission 16 to 31 months after treatment. CONCLUSION Nonmyeloablative radioimmunotherapy with 131I-anti-B1 is associated with a high rate of durable remissions in patients with B-cell lymphoma refractory to chemotherapy.

Multicenter Phase II Clinical Study of Iodine-131–Rituximab Radioimmunotherapy in Relapsed or Refractory Indolent Non-Hodgkin’s Lymphoma

2006 ◽  
Vol 24 (27) ◽  
pp. 4418-4425 ◽  
Author(s):  
Michael F. Leahy ◽  
John F. Seymour ◽  
Rodney J. Hicks ◽  
J. Harvey Turner
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Progression Free Survival ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
Whole Body ◽  
Actuarial Survival ◽  
Entire Cohort ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Iodine 131

Purpose To evaluate efficacy and safety of iodine-131 (131I) –rituximab chimeric anti-CD20 antibody radioimmunotherapy in patients with relapsed or refractory indolent non-Hodgkin's lymphoma (NHL). Patients and Methods After a standard loading dose of rituximab 375 mg/m2, individualized dosimetry was performed by whole-body gamma imaging of a tracer activity of 131I-rituximab followed by administration of a therapeutic activity of 131I-rituximab to deliver an estimated whole-body radiation absorbed dose of 0.75 Gy. Results Ninety-one patients were entered onto the trial: 78 patients (86%) had follicular lymphoma, six patients (7%) had mucosa-associated lymphoid tissue/marginal zone lymphoma, and seven patients (8%) had small lymphocytic lymphoma. The objective overall response rate (ORR) was 76%, with 53% attaining a complete response (CR) or CR unconfirmed (CRu). Median duration of response for patients achieving CR/CRu was 20 v 7 months for those with a partial response (P = .0121). Median progression-free survival for the entire cohort was 13 months, with 14% remaining relapse free beyond 4 years. Median follow-up was 23 months, with a 4-year actuarial survival rate of 59% ± 10%. Toxicity was principally hematologic; grade 4 thrombocytopenia occurred in 4% and neutropenia occurred in 16% of patients, with nadirs at 6 to 7 weeks after treatment. Conclusion 131I-rituximab radioimmunotherapy of relapsed or refractory indolent NHL achieves high ORR and CR rates with minimal toxicity.

From Whole-body Counting to Imaging: The Computer Aided Collimation Gamma Camera Project (CACAO)

2000 ◽  
Vol 89 (3) ◽  
pp. 349-352
Author(s):  
C. Jeanguillaume ◽  
S. Begot ◽  
M. Quartuccio ◽  
A. Douiri ◽  
P. Ballongue
Keyword(s):  
Gamma Camera ◽  
Whole Body ◽  
Computer Aided ◽  
Body Counting ◽  
Whole Body Counting
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