Novel Approaches to Thyroid Cancer Treatment and Response Assessment

Grewal, Ravinder K.; Ho, Alan L.; Schöder, Heiko

doi:10.1053/j.semnuclmed.2015.10.010

Cited by 35 publications

(49 citation statements)

References 76 publications

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“…Most of the orally ingested iodine is rapidly cancer by helping to determine the presence of nodal or distant metastases before radioiodine treatment. After thyroidectomy with or without lymph node dissection, radioiodine is also used for thyroid remnant ablation, for adjuvant treatment, and for the treatment of distant metastases (3)(4)(5). Posttherapy scintigraphy, which is typically performed 5-9 days after treatment, has a higher sensitivity for distant metastases than pretreatment scintigraphy because of the improved target-to-background ratio (5).…”

Section: Radioiodine Physiology and Biodistributionmentioning

confidence: 99%

mentioning

confidence: 99%

“…the presence of lymph node metastasis (4). These factors are important to determine the intent of radioiodine treatment and the appropriate dose, as well as to aid interpretation of the scintigrams (4,5). Any unusual finding, particularly with lessaggressive tumor histopathologic findings and/ or a low serum thyroglobulin level, should be interpreted with caution, and potential causes for physiologic and nonthyroid pathologic variants should be explored.…”

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confidence: 99%

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Pictorial Review of False-Positive Results on Radioiodine Scintigrams of Patients with Differentiated Thyroid Cancer

Chudgar¹,

Shah²

2017

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Radioiodine has served an important role in the diagnostic workup and treatment of patients with differentiated thyroid cancer for more than 6 decades. The interpretation of radioiodine scintigraphic studies should be performed in conjunction with a comprehensive history, histopathologic correlation, and pertinent laboratory values, as well as correlation with available anatomic images and the findings from physical examination. A thorough understanding of the physiology and biodistribution of radioiodine is critical when interpreting radioiodine scintigraphic studies to avoid misinterpretation of physiologic and nonthyroid pathologic variants as thyroid cancer metastases. Differentiating a false-positive finding from a true metastasis on pretherapy radioiodine scintigrams is important to determine the appropriate radioiodine treatment dose. The correct interpretation of posttherapy radioiodine scintigraphic studies is also important to determine if repeat radioiodine treatment will be necessary and for the future clinical and imaging followup of the patient. A variety of different factors, such as the presence of the sodium-iodide symporter and the passive diffusion or retention of radioiodine in normal and pathologic structures, can result in false-positive results on radioiodine scintigrams. Numerous false-positive findings have been reported in the literature and are further demonstrated with the increasing availability of single photon emission computed tomography (SPECT) integrated with computed tomography (CT) as true dual-modality imaging (SPECT/CT). SPECT/CT has been documented to be of incremental value in the accurate anatomic localization and characterization of radioiodine uptake as false-positive findings, particularly in cases with discordant findings of a low serum thyroglobulin level but positive findings on radioiodine whole-body planar scintigrams. The objectives of this review are to describe the physiology and biodistribution of radioiodine and to provide examples of false-positive results on radioiodine scintigrams, with clinical and anatomic correlation, in the following categories of radioiodine uptake: functional uptake secondary to sodium-iodide symporter expression, radioiodine retention, nonthyroid neoplasms, inflammatory or infectious uptake, contamination, and other causes. RSNA, 2017.

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Section: Radioiodine Physiology and Biodistributionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Pictorial Review of False-Positive Results on Radioiodine Scintigrams of Patients with Differentiated Thyroid Cancer

Chudgar¹,

Shah²

2017

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“…The most common treatment for TC without metastasis is surgery. Chemotherapy and radioactive iodine treatment are also medical treatment options in addition to surgery [3]. However, the prognosis of recurrent TC is not good with the above treatments [4].…”

Section: Introductionmentioning

confidence: 99%

Long Non-Coding RNAs in Thyroid Cancer: Implications for Pathogenesis, Diagnosis, and Therapy

et al. 2019

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Thyroid cancer is a rare malignancy and accounts for less than 1% of malignant neoplasms in humans; however, it is the most common cancer of the endocrine system and responsible for most deaths from endocrine cancer. Long non-coding (Lnc)RNAs are defined as non-coding transcripts that are more than 200 nucleotides in length. Their expression deregulation plays an important role in the progress of cancer. These molecules are involved in physiologic cellular processes, genomic imprinting, inactivation of chromosome X, maintenance of pluripotency, and the formation of different organs via changes in chromatin, transcription, and translation. LncRNAs can act as a tumor suppressor genes or oncogenes. Several studies have shown that these molecules can interact with microRNAs and prevent their binding to messenger RNAs. Research has shown that these molecules play an important role in tumorigenicity, angiogenesis, proliferation, migration, apoptosis, and differentiation. In thyroid cancer, several lncRNAs (MALAT1, H19, BANCR, HOTAIR) have been identified as contributing factors to cancer development, and can be used as novel biomarkers for early diagnosis or even treatment. In this article, we study the newest lncRNAs and their role in thyroid cancer.

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“…A metaanalysis of seven prospective controlled clinical trials indicated that FDG-PET under TSH stimulation either by thyroid hormone withdrawal or by rhTSH had slightly improved diagnostic performance in detecting Tg-positive and WBS-negative DTC lesions. FDG-PET/CT is useful in staging, response assessment after chemotherapy, targeted therapies, or radiotherapy and prognostic assessment for patients with cancer [55]. Therefore, PET/ CT imaging should be performed as first-line, with empiric 131 I treatment being considered only for those patients with no detectable FDG uptake [51].…”

Section: (3) 18 F-fdg-pet/ct or Pet/mrimentioning

confidence: 99%

Differentiated Thyroid Carcinoma with Elevated Thyroglobulin and Negative Radioiodine Whole-Body Scan Metastases

Ma¹

2016

Thyroid Cancer - Advances in Diagnosis and Therapy

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Serum thyroglobulin Tg and Tg antibody Tg"b levels, together with neck ultrasonography and I whole-body scintigraphy W"S , are diagnostic tools for postoperative follow-up of patients with differentiated thyroid carcinoma DTC . Generally, good correlation is seen between Tg and W"S in follow-up studies for DTC after thyroid remnant ablation. Undetectable serum Tg with negative W"S results suggests complete remission, whereas detectable, or elevated, serum Tg is associated with radioiodine uptake in local or distant metastases. Patients with thyroid cancer cells lacking radioiodine uptake despite an elevated serum Tg level have been referred to as W"S-negative, Tg-positive patients, who represent % of cases. F-FDG PET FDG-PET scanning should be considered in high-risk DTC patients with negative W"S and positive Tg. The preferred therapeutic hierarchy for Tg-positive and W"Snegative metastases is surgical excision of loco-regional disease, I therapy for radioiodine-responsive disease, external beam radiation, TSH suppression, and systemic therapy with kinase inhibitors. If FDG-PET diagnostic results are negative, one course of I treatment may be considered in high-risk patients and individualized. No further I therapy is indicated for patients with a negative post-therapy W"S.

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Novel Approaches to Thyroid Cancer Treatment and Response Assessment

Cited by 35 publications

References 76 publications

Pictorial Review of False-Positive Results on Radioiodine Scintigrams of Patients with Differentiated Thyroid Cancer

Pictorial Review of False-Positive Results on Radioiodine Scintigrams of Patients with Differentiated Thyroid Cancer

Long Non-Coding RNAs in Thyroid Cancer: Implications for Pathogenesis, Diagnosis, and Therapy

Differentiated Thyroid Carcinoma with Elevated Thyroglobulin and Negative Radioiodine Whole-Body Scan Metastases

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