<sup>124</sup>I PET/CT in Patients with Differentiated Thyroid Cancer: Clinical and Quantitative Image Analysis

Güleç, Seza A.; Kuker, Russ; Goryawala, Mohammed; Fernández, Carolina; Perez, Rudolfo; Khan-Ghany, Alina; Apaza, Ana; Harja, Evis; Harrell, Mack

doi:10.1089/thy.2015.0482

Cited by 39 publications

(22 citation statements)

References 23 publications

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“…There were four studies that were prospective (Phan et al ., Capocetti et al ., Gulec et al . and Kist et al …”

Section: Resultsmentioning

confidence: 94%

“…Eight studies were initially identified in the systematic review as potentially qualified for inclusion in the meta‐analysis . On further assessment, three of these studies were excluded .…”

Section: Resultsmentioning

confidence: 99%

“…The use of I‐124, a positron emitting tomography tracer, in combination with computed tomography (PET/CT) has made it possible to detect and image thyroid cancer lesions with high sensitivity and resolution, providing data for 3‐D radiobiology and dosimetry . Several studies have shown I‐124 PET/CT to be a highly effective imaging modality compared with I‐131 in diagnosing DTC‐related metastatic disease . However, it is less clear what proportion of I‐124 PET/CT‐identified lesions are sufficiently RAI avid for them to prove responsive to I‐131 therapy.…”

Section: Introductionmentioning

confidence: 99%

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Utility of I‐124 PET/CT in identifying radioiodine avid lesions in differentiated thyroid cancer: a systematic review and meta‐analysis

Santhanam

Taïeb

Solnes

et al. 2017

Clinical Endocrinology

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SummaryIntroduction Diagnostic I-123 scans have been shown to underestimate the disease burden in differentiated thyroid cancer (DTC) when compared to I-131 post-treatment scans, especially in children and patients who have had prior radioiodine (RAI) therapy and/or distant metastasis. I-124 PET/CT has been shown to be highly effective in imaging DTC-related metastatic disease. Methods We performed a systematic review and meta-analysis of studies investigating the sensitivity and specificity of I-124 PET/CT in identifying lesions amenable to RAI therapy as confirmed by I-131 post-treatment scanning. Results There were 141 patients and 415 lesions of DTC identified altogether. There was significant heterogeneity in the individual studies. The pooled sensitivity of the I-124 PET/CT in detecting lesions of differentiated thyroid cancer amenable to I-131 therapy was 94Á2% (91Á3-96Á4% CI, P < 0Á01), and the pooled specificity was 49Á0% (34Á8-63Á4% CI, P < 0Á01). The pooled positive likelihood ratio (LR) was 1Á43 (1Á05-1Á94 CI), and the pooled negative LR was 0Á28 (0Á15-0Á53 CI). Overall, the diagnostic odds ratio was 7Á90 (3Á39-18Á48 CI). There were a small but increased number of lesions identified by I-124 PET/CT that was not detected on post-treatment scan. Conclusion I-124 PET/CT is a sensitive tool to diagnose RAI avid DTC lesions, but also detects some new lesions that are not visualized on the post-treatment I-131 scan. Further, carefully designed dosimetric studies may be required to fully establish the role of I-124 PET CT for identifying potential lesions for I-131 therapy. I-124 PET/CT in patients with DTC may have other applications in specific clinical situations.

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“…There were four studies that were prospective (Phan et al ., Capocetti et al ., Gulec et al . and Kist et al …”

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utility of I‐124 PET/CT in identifying radioiodine avid lesions in differentiated thyroid cancer: a systematic review and meta‐analysis

Santhanam

Taïeb

Solnes

et al. 2017

Clinical Endocrinology

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“…The use of I-124 in clinical practice in a patient with DTC was first described in 1960 ( 1 ), and the first PET-based dosimetry study based on serial measurements in DTC patients was published in 1999 ( 2 ) after phantom studies demonstrated that quantification was feasible ( 3 ). Since then, there have been several key articles demonstrating the clinical utility of I-124 and its role in the detection of residual thyroid tissue and/or metastasis in patients with DTC ( 4 , 5 , 6 , 7 , 8 ); and the following are some more recent highlights.…”

Section: History Of I-124 In Clinical Practicementioning

confidence: 99%

I-124 Imaging and Dosimetry

Kuker¹,

Sztejnberg²,

Güleç³

2017

Mirt

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Although radioactive iodine imaging and therapy are one of the earliest applications of theranostics, there still remain a number of unresolved clinical questions as to the optimization of diagnostic techniques and dosimetry protocols. I-124 as a positron emission tomography (PET) radiotracer has the potential to improve the current clinical practice in the diagnosis and treatment of differentiated thyroid cancer. The higher sensitivity and spatial resolution of PET/computed tomography (CT) compared to standard gamma scintigraphy can aid in the detection of recurrent or metastatic disease and provide more accurate measurements of metabolic tumor volumes. However the complex decay schema of I-124 poses challenges to quantitative PET imaging. More prospective studies are needed to define optimal dosimetry protocols and to improve patient-specific treatment planning strategies, taking into account not only the absorbed dose to tumors but also methods to avoid toxicity to normal organs. A historical perspective of I-124 imaging and dosimetry as well as future concepts are discussed.

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“…Additionally TKI-PET tracers have shown encouraging results [63] . Finally, 124 I-PET has demonstrated clinical and functional value in the analysis of DTC metastases [64,65] .…”

Section: Molecular Imagingmentioning

confidence: 99%

Nodular Thyroid Disease and Thyroid Cancer in the Era of Precision Medicine

et al. 2017

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The management of thyroid nodules, one of the main clinical challenges in endocrine clinical practice, is usually straightforward. Although the most important concern is ruling out malignancy, there are grey areas where uncertainty is frequently present: the nodules labelled as indeterminate by cytology and the extent of therapy when thyroid cancer is diagnosed pathologically. There is evidence that the current available precision medicine tools (from all the “-omics” to molecular analysis, fine-tuning imaging or artificial intelligence) may help to fill present gaps in the future. We present here a commentary on some of the current challenges faced by endocrinologists in the field of thyroid nodules and cancer, and illustrate how precision medicine may improve their diagnostic and therapeutic capabilities in the future.

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¹²⁴I PET/CT in Patients with Differentiated Thyroid Cancer: Clinical and Quantitative Image Analysis

Abstract: (124)I PET/CT is a valuable clinical imaging tool/agent, both in determining the extent of disease in the setting of metastatic DTC and in the functional volumetric and kinetic evaluation of target lesions.

Cited by 39 publications

References 23 publications

Utility of I‐124 PET/CT in identifying radioiodine avid lesions in differentiated thyroid cancer: a systematic review and meta‐analysis

Utility of I‐124 PET/CT in identifying radioiodine avid lesions in differentiated thyroid cancer: a systematic review and meta‐analysis

I-124 Imaging and Dosimetry

Nodular Thyroid Disease and Thyroid Cancer in the Era of Precision Medicine

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124I PET/CT in Patients with Differentiated Thyroid Cancer: Clinical and Quantitative Image Analysis

Abstract: (124)I PET/CT is a valuable clinical imaging tool/agent, both in determining the extent of disease in the setting of metastatic DTC and in the functional volumetric and kinetic evaluation of target lesions.

Cited by 39 publications

References 23 publications

Utility of I‐124 PET/CT in identifying radioiodine avid lesions in differentiated thyroid cancer: a systematic review and meta‐analysis

Utility of I‐124 PET/CT in identifying radioiodine avid lesions in differentiated thyroid cancer: a systematic review and meta‐analysis

I-124 Imaging and Dosimetry

Nodular Thyroid Disease and Thyroid Cancer in the Era of Precision Medicine

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Product

Resources

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¹²⁴I PET/CT in Patients with Differentiated Thyroid Cancer: Clinical and Quantitative Image Analysis