Radioactive Iodine Therapy in Differentiated Thyroid Cancer: 2020 Update

Ciarallo, Anthony; Rivera, Juan

doi:10.2214/ajr.19.22626

Cited by 56 publications

(59 citation statements)

References 29 publications

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“…A recent article outlining the importance of patient risk restratification and the utility it has for patient management describes a risk stratification system based on the 8 th Edition of the American Joint Committee on Cancer tumor node metastases (TNM) staging system. [ 11 ] This system would better reflect the biological nature of thyroid cancer with the most important prognostic risk factors being the age at diagnosis, presence of distant metastasis, and extrathyroid extension. There is increasing clinical support for a patient risk restratification scheme with RAI treatment which better captures the patient-specific disease state and is reflected in improved outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Clinical predictors of I-131 therapy failure in differentiated thyroid cancer by machine learning: A single-center experience

Lubin

Tsetse

Khorasani³

et al. 2021

World J Nucl Med

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Well-differentiated thyroid carcinoma is predominantly a slow-growing malignancy, amendable to treatment, and has an excellent prognosis following thyroidectomy and radioiodine (RAI) therapy. However, patients who fail the initial RAI treatment attempt may require repeated RAI or other treatments and with this, comes an associated impact on patient quality of life. Therefore, the anticipation of patients in whom there is a higher risk of RAI failure may help in patient risk stratification and subsequent management. We conducted a retrospective review to determine the factors associated with initial RAI therapy failure in well-differentiated thyroid cancer patients. Using scikit-learn from Python, we implemented a machine-learning algorithm to determine the clinical patient factors associated with a higher likelihood of treatment resistance. We found that clinical factors such as tumor focality ( P = 0.026) and lymph node invasion at surgical resection ( P = 0.0135) were significantly associated with initial treatment failure following RAI. Elevated serum thyroglobulin (Tg) and Tg antibody levels following surgery but before RAI were also associated with treatment resistance ( P < 0.0001 and P = 0.011 respectively). Less expected factors such as decreased time from surgery to RAI were also associated with treatment failure, however not to a statistically significant degree ( P > 0.064). Clinical outcomes following RAI can be stratified by identifying factors that are associated with initial treatment failure. These findings can help restratify patients for RAI treatment and change patient management in certain cases. Such stratification will ultimately help to optimize successful treatment outcomes and improve patient quality of life.

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Section: Discussionmentioning

confidence: 99%

“…There is increasing clinical support for a patient risk restratification scheme with RAI treatment which better captures the patient-specific disease state and is reflected in improved outcomes. [ 11 ] In light of these proposed patient restratification systems, the factors we determined for treatment resistance can be utilized clinically.…”

Section: Discussionmentioning

confidence: 99%

Clinical predictors of I-131 therapy failure in differentiated thyroid cancer by machine learning: A single-center experience

Lubin

Tsetse

Khorasani³

et al. 2021

World J Nucl Med

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“…Some studies have performed diagnostic I-131 scan before RAI therapy, while others did not. 27 , 28 Other studies have performed SPECT/CT only in equivocal cases, while some studies did not include low-risk patients, as these patients were not treated with RAI. 14 , 29 There were differences in study samples and type of analyses (lesion-based vs patient-based).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Diagnostic Value of SPECT/CT Imaging in Post-radioiodine Therapy in Thyroid Cancer

Hatmi

Jain

Mittal

et al. 2022

Sultan Qaboos Univ Med J

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Objectives: The aim of this study is to investigate the value of Single Photon Emission Computed Tomography/ Computed Tomography (SPECT/CT) imaging in well differentiated thyroid cancer (DTC) after radioiodine ablation (I-131) therapy for clinical staging and risk stratification.To determine whether SPECT/CT would change management plan or predict the clinical outcomes of DTC patients. Methods: 78 DTC patients underwent first post radioiodine therapy “Whole body iodine- 131 scintigraphy (WBS) along with SPECT/CT” at Department of Radiology and Molecular imaging, Sultan Qaboos university Hospital between January 2014 and August 2017. Differences between WBS and SPECT/CT, change in clinical staging, risk stratification and management were recorded. Clinical outcome at 6-12 months was recorded. SPSS statistical software was used for collecting and analysing the data. A generalized McNemar test was used to assess disagreement between WBS and SPECT/CT. Results: American Thyroid Association (ATA) risk stratification falls into low (35.8%), intermediate (53.8%) and high risk groups (10.2%) on WBS, which changed to 44.8%, 38.4% and 16.6% respectively on SPECT/CT imaging. Overall change in risk stratification was noted in 16.6% and TNM stage in 11.5% of patients after SPECT/CT imaging. SPECT/CT changed therapeutic plan and clinical outcome in 19.2% of patients. Conclusion: SPECT/CT allows better detection and characterization of metastatic lymph nodes and distant metastasis in DTC patients compared to WBS imaging alone. It alters TNM staging, ATA risk classification and management in significant number of patients. It is recommended that SPECT/CT should be done routinely along with WBS in well differentiated thyroid carcinoma. Keywords: Thyroid cancer, Iodine, Ablation techniques, SPECT/CT

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“…Many clinical studies have confirmed that 131 I radiotherapy is an effective strategy for the treatment of patients with DTC. 20 However, the secondary radiation resistance of DTC cells to 131 I accelerates the proliferation and metastasis of tumor cells, resulting in 131 I implantation therapy, not delivering the expected therapeutic effect, or even resulting in failure. In the present study, our data showed that knockdown of circ_NEK6 reduced 131 I resistance of DTC in vitro and in vivo .…”

Section: Discussionmentioning

confidence: 99%

Knockdown of circ_NEK6 Decreased ¹³¹I Resistance of Differentiated Thyroid Carcinoma via Regulating miR-370-3p/MYH9 Axis

Chen

Yin

Feng

et al. 2021

Technol Cancer Res Treat

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Radioresistance is a crucial factor for the failure of iodine 131 (131I)-based radiotherapy for differentiated thyroid carcinoma (DTC). This study aimed to explore the effect of circ_NEK6 on the development of 131I resistance in DTC and its potential mechanism. In this study, we demonstrated that circ_NEK6 expression was significantly elevated in 131I-resistant DTC tissues and cell lines. Knockdown of circ_NEK6 significantly repressed 131I resistance via inhibiting cell proliferation, migration, invasion abilities, and inducing cell apoptosis and DNA damage in 131I-resistant DTC cells. Mechanistically, knockdown of circ_NEK6 suppressed 131I resistance in DTC by upregulating the inhibitory effect of miR-370-3p on the expression of myosin heavy chain 9 (MYH9). In vivo experiments showed that circ_NEK6 inhibition aggravated 131I radiation-induced inhibition of xenograft tumor growth. Taken together, knockdown of circ_NEK6 repressed 131I resistance in DTC cells by regulating the miR-370-3p/MYH9 axis, indicating that circ_NEK6 may act as a potential biomarker and therapeutic target for DTC patients with 131I resistance.

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Radioactive Iodine Therapy in Differentiated Thyroid Cancer: 2020 Update

Cited by 56 publications

References 29 publications

Clinical predictors of I-131 therapy failure in differentiated thyroid cancer by machine learning: A single-center experience

Clinical predictors of I-131 therapy failure in differentiated thyroid cancer by machine learning: A single-center experience

Evaluation of Diagnostic Value of SPECT/CT Imaging in Post-radioiodine Therapy in Thyroid Cancer

Knockdown of circ_NEK6 Decreased ¹³¹I Resistance of Differentiated Thyroid Carcinoma via Regulating miR-370-3p/MYH9 Axis

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Radioactive Iodine Therapy in Differentiated Thyroid Cancer: 2020 Update

Cited by 56 publications

References 29 publications

Clinical predictors of I-131 therapy failure in differentiated thyroid cancer by machine learning: A single-center experience

Clinical predictors of I-131 therapy failure in differentiated thyroid cancer by machine learning: A single-center experience

Evaluation of Diagnostic Value of SPECT/CT Imaging in Post-radioiodine Therapy in Thyroid Cancer

Knockdown of circ_NEK6 Decreased 131I Resistance of Differentiated Thyroid Carcinoma via Regulating miR-370-3p/MYH9 Axis

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Knockdown of circ_NEK6 Decreased ¹³¹I Resistance of Differentiated Thyroid Carcinoma via Regulating miR-370-3p/MYH9 Axis