Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck

Nagarajah, James; Jentzen, Walter; Hartung, Verena; Rosenbaum-Krumme, Sandra; Mikat, Christian; Heusner, Till A.; Antoch, Gerald; Bockisch, Andreas; Stahl, Alexander

doi:10.1007/s00259-011-1866-1

Cited by 37 publications

(23 citation statements)

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“…Despite the improved volume segmentation technique, for most lesions only the minimum lesion AD could be calculated. In the future, further developments in PET/MRI might contribute to additional improvements of the dosimetry in smallvolume disease (29).…”

Section: Cervical High 4 -mentioning

confidence: 99%

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of ¹²⁴I PET/CT

et al. 2016

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The dose-response relationship in a fixed-activity approach generally applied in the treatment of differentiated thyroid cancer was assessed using 124 I PET/CT. Methods: Pretherapeutic 124 I PET/ CT images of 47 patients scheduled for radioiodine therapy were retrospectively analyzed. 124 I PET/CT images were acquired 24 and 96 h after oral administration of approximately 28 MBq of 124 I-sodium iodide. Lesions were identified as thyroid remnants or metastases (lymph node, lung, bone). After a neoteric segmentation technique allowing accurate volume estimation down to the 124 I PET spatial resolution of 0.15 mL was applied, lesions were divided into a known-volume group and a small-volume group. For the known-volume group, average lesion-absorbed dose (AD) values were calculated, whereas for the small-volume group a minimum lesion AD was estimated. Lesion response was determined on the basis of 124 I PET/CT and 131 I SPECT/CT follow-up images. A lesion not detectable on any of the follow-up images was considered a completely responding lesion. Differences in lesion AD estimations between completely and incompletely responding lesions were evaluated by Mann-Whitney U test. Moreover, receiver-operating-characteristic curves were used to test the performance of pretherapeutic 124 I PET/CT lesion AD for prediction of complete lesion response. Results: In the approach of fixed radioiodine activity (3.0 ± 1.0 GBq), 89% of thyroid remnants and 69% of metastases responded completely. Except for the small-volume groups, the lesion AD of completely responding lesions was significantly higher than that of incompletely responding lesions. Using receiver-operating-characteristic curve analysis, it was shown that for the known-volume group, pretherapeutic 124 I PET/CT lesion dosimetry can be used as a prognostic tool to predict lesion-based 131 I therapy response with an area under the curve of 0.76 for remnants and 0.97 for metastases. The corresponding lesion AD threshold value maximizing correct complete response prediction was 90 Gy for remnants and 40 Gy for metastases. Conclusion: In a fixed-activity approach, a statistically significant dose-response relationship for both thyroid remnants and metastases using pretherapeutic 124 I PET/CT lesion dosimetry was found. The findings may be useful in patient management. Radi oiodine therapy is the standard adjuvant therapy after total thyroidectomy in patients with differentiated thyroid cancer (DTC) (1,2). The purpose of radioiodine therapy is 2-fold: ablation of thyroid remnants and treatment of radioiodine-avid metastases.The generally accepted threshold for lesion-absorbed dose (AD) to achieve high therapy response is 85 Gy for metastases and 300 Gy for thyroid remnants (3,4). To predict therapy response, a reliable AD estimation requires, inter alia, accurate lesion volume determination, which is hampered by the often small lesion volumes with respect to the spatial resolution of 131 I scintigraphy and lesion segmentation difficulties encountered in ultrasonography, CT, ...

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Section: Cervical High 4 -mentioning

confidence: 99%

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of ¹²⁴I PET/CT

et al. 2016

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“…Iodine 124 PET/MRI has also been used for lesion detection and dosimetry in high-risk thyroid cancer patients with lymph nodes metastases. The authors reported that MRI was superior to CT for identifying pathological lymph nodes, especially those smaller than 10 mm (125), but this issue requires further study.…”

Section: Other Radiopharmaceuticalsmentioning

confidence: 99%

ENDOCRINE TUMOURS: Imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach

Lamartina¹,

Deandreis

Durante³

et al. 2016

European Journal of Endocrinology

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The clinical and epidemiological profiles of differentiated thyroid cancers (DTCs) have changed in the last three decades. Today's DTCs are more likely to be small, localized, asymptomatic papillary forms. Current practice is, though, moving toward more conservative approaches (e.g. lobectomy instead of total thyroidectomy, selective use of radioiodine). This evolution has been paralleled and partly driven by rapid technological advances in the field of diagnostic imaging. The challenge of contemporary DTCs follow-up is to tailor a risk-of-recurrence-based management, taking into account the dynamic nature of these risks, which evolve over time, spontaneously and in response to treatments. This review provides a closer look at the evolving evidence-based views on the use and utility of imaging technology in the post-treatment staging and the short-and long-term surveillance of patients with DTCs. The studies considered range from cervical US with Doppler flow analysis to an expanding palette of increasingly sophisticated second-line studies (cross-sectional, functional, combined-modality approaches), which can be used to detect disease that has spread beyond the neck and, in some cases, shed light on its probable outcome.

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“…18 F-FDOPA PET/MRI fusion provides precise anatomical localization of tracer uptake in patients with gliomas, with PET data capable of identifying tumors not visible on MRI [84]. In high-risk differentiated thyroid cancer patients, fused 124-iodine PET/MRI has proven to be superior to 124-iodine PET/CT in detecting lesions, particularly those \10 mm [85]. Both modalities were performed after thyroidectomy but before radioiodine therapy, and data provided by fused PET/MRI imaging provided more precise and tailored dosimetry [85].…”

Section: Non-fdg Tracersmentioning

confidence: 99%

“…In high-risk differentiated thyroid cancer patients, fused 124-iodine PET/MRI has proven to be superior to 124-iodine PET/CT in detecting lesions, particularly those \10 mm [85]. Both modalities were performed after thyroidectomy but before radioiodine therapy, and data provided by fused PET/MRI imaging provided more precise and tailored dosimetry [85]. MRI and fMRI (spectroscopy) is used to localize, stage, and obtain functional information in prostate cancer patients [86].…”

Section: Non-fdg Tracersmentioning

confidence: 99%

Whole-body PET/MRI in oncology: current status and clinical applications

Pace

Nicolai

Aiello

et al. 2013

Clin Transl Imaging

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In oncology, diagnostic imaging plays a major role in staging, therapy assessment and in the evaluation of tumor biology. Multimodality imaging, and more specifically positron emission tomography/computed tomography (PET/CT), has matured into an important imaging tool. The recent introduction of the integrated whole-body PET/ magnetic resonance imaging (MRI) represents the addition of a promising methodology in clinical practice. Combining the metabolic data of PET with the anatomical and functional information provided by MRI and fMRI may further improve the diagnostic value of each method alone. Although the literature is still limited, data indicate a potential advantage of PET/MRI over PET/CT in all the indications where MRI is superior to CT, as well as in the evaluation of tumor biology. Integrated PET/MRI might be performed in addition to the existing imaging modality in specific regions. Moreover, integrated PET/MRI is an alternative to PET/CT when a low radiation dose is required, i.e. in children and in repeated imaging. In the rapidly evolving field of diagnostic imaging, the role of a new modality should be accurately evaluated. Further studies are needed to test the diagnostic accuracy of PET/MRI in different oncology indications. Whether PET/MRI will replace PET/CT or be a complementary methodology and whether it represents true diagnostic progress remains to be evaluated, also taking into account economic considerations.

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Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck

Abstract: PET/MRI is superior to PET/CT in terms of tracing back a PET focus to a morphological correlate. For this reason PET/MRI enhances diagnostic certainty for lesions<10 mm and improves pretherapeutic lesion dosimetry in DTC.

Cited by 37 publications

References 15 publications

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of ¹²⁴I PET/CT

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of ¹²⁴I PET/CT

ENDOCRINE TUMOURS: Imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach

Whole-body PET/MRI in oncology: current status and clinical applications

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Diagnosis and dosimetry in differentiated thyroid carcinoma using 124I PET: comparison of PET/MRI vs PET/CT of the neck

Abstract: PET/MRI is superior to PET/CT in terms of tracing back a PET focus to a morphological correlate. For this reason PET/MRI enhances diagnostic certainty for lesions<10 mm and improves pretherapeutic lesion dosimetry in DTC.

Cited by 37 publications

References 15 publications

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of 124I PET/CT

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of 124I PET/CT

ENDOCRINE TUMOURS: Imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach

Whole-body PET/MRI in oncology: current status and clinical applications

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Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of ¹²⁴I PET/CT

Dose–Response Relationship in Differentiated Thyroid Cancer Patients Undergoing Radioiodine Treatment Assessed by Means of ¹²⁴I PET/CT