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Radioiodine therapy

Shanmuga S Palaniswamy, Padma Subramanyam
Introduction: Differentiated thyroid carcinoma (DTC) is the most common pathological type of thyroid carcinoma, which includes papillary and follicular subtypes. DTC is usually indolent, characterized by good prognosis, and long-term survival. Total thyroidectomy is the mainstay of treatment in DTC which is followed by diagnostic whole body 131I (WBI) scan. Like other primary malignancies of the head and neck, DTC follows a consistent pattern of spread in the cervical LNs. The central compartment, level VI and VII, is the first sentinel node followed by spread to the lateral compartments levels II-V, followed by the contralateral side...
November 2018: Indian Journal of Endocrinology and Metabolism
Steven P Weitzman, Steven I Sherman
Systemic therapy options have emerged for treatment of progressive, radioiodine-refractory differentiated thyroid carcinoma. Approved therapies that target tumor angiogenesis, lenvatinib and sorafenib, improve progression-free survival and, in an older subset, lenvatinib can prolong overall survival. Treatments based on targeting specific somatic genetic alterations are also available, which potentially also may prolong progression-free survival but are not yet approved for use by the Food and Drug Administration for this specific disease...
March 2019: Endocrinology and Metabolism Clinics of North America
Prasanna Santhanam, Paul W Ladenson
Serum thyroglobulin monitoring along with anatomic and functional imaging play key roles in the surveillance of patients with differentiated thyroid cancer after initial treatment. Among patients with a disease stage justifying thyroid remnant ablation or with suspected metastatic disease, radioiodine whole-body scans are essential in the months after surgery. For patients with low to moderate-risk cancers, ultrasonography of the neck (with measurement of serum thyroglobulin on thyroid hormone replacement) are the best initial diagnostic modalities, and are often the only tests required...
March 2019: Endocrinology and Metabolism Clinics of North America
Dorina Ylli, Douglas Van Nostrand, Leonard Wartofsky
This article presents an overview of the use of radioactive iodine (131-I) in the treatment of patients with differentiated thyroid cancer. Topics reviewed include definitions; staging; the 2 principal methods for selection of 131-I dosage; the indications for ablation, adjuvant treatment, and treatment; the recommendations for the use of 131-I contained in the guidelines of the American Thyroid Association and the Society of Nuclear Medicine and Molecular Imaging; the dosage recommendations and selection of dosage approach for 131-I by these organizations; the use of recombinant human thyrotropin for radioiodine ablation, adjuvant therapy, or treatment; and the MedStar Washington Hospital Center approach...
March 2019: Endocrinology and Metabolism Clinics of North America
Chidambaram Natrajan Balasubramanian Harisankar, Ramakrishnan Vijayabhaskar, Selva Muthukumaran, Kirushna Kumar
Occipital condyle syndrome is a rare cause of pain in the head which is characterized by severe and persistent unilateral suboccipital headache with unilateral hypoglossal nerve palsy. We report an elderly female who presented with dysarthria and suboccipital headache. On further evaluation, she was found to have a solitary bone metastases from thyroid cancer. She was treated with local radiation therapy for pain relief, total thyroidectomy, and high-dose radioiodine therapy. The patient is presently free of pain with very good control of the thyroid cancer status...
January 2019: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Y S Lin
Radioiodine-131((131)I) therapy as one of the post-surgical targeted therapies has been proven as an effective treatment modality in reducing the risk of recurrence and mortality in intermediate and high risk differentiated thyroid cancer (DTC). With increasing evidence over recent years, improvements in the management of DTC have been observed. In this review, several points and their influences on DTC decision making are discussed, including the purpose of (131)I therapy, evaluating system for risks and on-going response to therapy, as well as the significance of molecular features such as thyroglobulin, molecular pathology and nuclear medicine molecular imaging...
January 7, 2019: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Stephanie Allelein, Matthias Schott
DIAGNOSIS:  Also accordingly to the recent European Thyroid Association Guidelines 2018, TSH receptor antibody (TRAb) measurement is highly sensitive and specific for the detection of Graves' disease (GD) and to distinguish from autoimmune thyroiditis (AIT). Bioassays are used for distinguishing stimulating from blocking antibodies and are used for scientific questions. THERAPY:  According to the current guidelines - and with exception for pregnant women - the use of thiamazol/carbimazole is generally favored from propylthiouracil (PTU)...
February 2019: Deutsche Medizinische Wochenschrift
Maria E Cabanillas, Shunji Takahashi
Lenvatinib is a multikinase inhibitor of vascular endothelial growth factor (VEGF) receptors 1-3, fibroblast growth factor receptors 1-4, RET, KIT, and platelet-derived growth factor receptor-α. Lenvatinib is approved as a monotherapy for the treatment of radioiodine-refractory differentiated thyroid cancer and in combination with everolimus for the second-line treatment of advanced renal cell carcinoma. Lenvatinib is also under investigation for the treatment of several malignancies including unresectable hepatocellular carcinoma...
December 21, 2018: Seminars in Oncology
Enrico Gabriele Piersanti, Luigi Sgattone, Luciano Di Stefano, Giacomo Migliorati
Radionuclides are increasingly used in hospitals for diagnostic and therapeutic purposes, such as functional research, diagnostic imaging, and in the performance of radioiodine therapy. Their use produces radioactive waste, and risks environmental contamination. The present study involves 486 samples of radioactive waste produced in hospitals in Abruzzo, Italy, during 2000 - 2015. Measurements were carried out with the gamma spectrometry technique: Germanium detector (PTG) with 8000 acquisition channels, power range 59 - 1836 keV, resolution 1 keV, overall efficiency 30%, measurement time 60000 Seconds...
December 31, 2018: Veterinaria Italiana
Wei-Jun Wei, Heather Hardin, Quan-Yong Luo
Thyroid cancer is one of the most common endocrine malignancies. Although the prognosis for the majority of thyroid cancers is relatively good, patients with metastatic, radioiodine-refractory or anaplastic thyroid cancers have an unfavorable outcome. With the gradual understanding of the oncogenic events in thyroid cancers, molecularly targeted therapy using tyrosine kinase inhibitors (TKIs) is greatly changing the therapeutic landscape of radioiodine-refractory differentiated thyroid cancers (RR-DTCs), but intrinsic and acquired drug resistance, as well as adverse effects, may limit their clinical efficacy and use...
January 1, 2019: Endocrine-related Cancer
Ove Törring, Torquil Watt, Gabriel Sjölin, Kristina Byström, Mirna Abraham-Nordling, Jan Calissendorff, Per Cramon, Helena Filipsson Nyström, Bengt Hallengren, Mats Holmberg, Selwan Khamisi, Mikael Lantz, Göran Wallin
BACKGROUND: Hyperthyroidism is known to have a significant impact on the quality of life (QoL) at least in the short term. The purpose of the present study was to assess QoL in patients at 6-10 years after treatment for Graves´ disease (GD) with radioiodine (RAI) to those treated with thyroidectomy or antithyroid drugs (ATD) as assessed with both a thyroid-specific (ThyPRO) and general (SF-36) QoL surveys. METHODS: We evaluated 1186 GD patients in a sub-cohort from an incidence study 2003-2005 which had been treated according to routine clinical practice at seven participating centers...
January 22, 2019: Thyroid: Official Journal of the American Thyroid Association
Rosa Cervelli, Salvatore Mazzeo, Giuseppe Boni, Antonio Boccuzzi, Francesca Bianchi, Federica Brozzi, Pierina Santini, Paolo Vitti, Roberto Cioni, Davide Caramella
OBJECTIVE: To compare the efficacy of Radioiodine (RI) and Radiofrequency ablation (RFA) in the treatment of autonomously functioning thyroid nodules (AFTNs). END POINTS: nodule volume reduction (NVR) and thyroid function normalization. DESIGN, PATIENTS AND MEASUREMENTS: Twenty-two patients (2:20 M:F; 51.9±13.9 years) affected by 25 AFTNs, treated by RFA were retrospectively compared with 25 patients (8:17 M:F; 57.2±12.8 years) affected by a single AFTN treated by RI...
January 18, 2019: Clinical Endocrinology
Jina Kim, Jaeyoung Song, Hyun Dong Ji, Eun Kyung Yoo, Jae-Eon Lee, Sang Bong Lee, Ji Min Oh, Seungmi Lee, Ji Sun Hwang, Heeseok Yoon, Dong-Su Kim, Su-Jeong Lee, Minseon Jeong, Sungwoo Lee, Kyung-Hee Kim, Hueng-Sik Choi, Sang Woo Lee, Keun-Gyu Park, In-Kyu Lee, Seong Heon Kim, Hayoung Hwang, Yong Hyun Jeon, Jungwook Chin, Sung Jin Cho
An inverse agonist of estrogen-related receptor-γ (ERRγ), an orphan nuclear receptor encoded by E srrg, enhances sodium iodide symporter-mediated radioiodine uptake in anaplastic thyroid cancer (ATC) cells, thereby facilitating responsiveness to radioiodine therapy in vitro. We synthesized potent, selective, and orally bioavailable ERRγ-inverse agonists and evaluated their activity by analyzing in vitro pharmacology and absorption, distribution, metabolism, excretion, and toxicity profiles. X-ray crystallographic analysis of the ligand and ERRγ complex showed that 35 completely binds to the target protein (PDB 6A6K )...
February 4, 2019: Journal of Medicinal Chemistry
Zachary Hurst, Sandya Liyanarachchi, Huiling He, Pamela Brock, Jennifer A Sipos, Fadi Nabhan, Electron Kebebew, Patience Green, Gilbert J Cote, Steven I Sherman, Christopher J Walker, Yi Seok Chang, Shuai Xue, Brynn Hollingsworth, Wei Li, Luke Genutis, Eric Menq, Albert de la Chapelle, Sissy M Jhiang
BACKGROUND: Thyroid cancer patients with radioiodine refractory (RAI-R) disease, resulting from insufficient RAI delivery and/or RAI resistance, have increased mortality and limited treatment options. To date, studies have largely focused on tumor mutations associated with different stages of disease, which could provide prognostic value for RAI-R disease. We hypothesize that germline variants contributing to intrinsic differences in iodine metabolism, tumor microenvironment and/or immune surveillance are associated with RAI-R disease...
January 18, 2019: Thyroid: Official Journal of the American Thyroid Association
Hye-Ji Shin, Kyung-A Hwang, Kyung-Chul Choi
Thyroid cancers developed from the tissues of the thyroid gland are classified into papillary (PTC), follicular (FTC), medullary (MTC), and anaplastic thyroid cancer (ATC). Although thyroid cancers have been generally known as mild forms of cancer, undifferentiated MTC and ATC have a more unfavorable prognosis than differentiated PTC and FTC because they are more aggressive and early metastatic. A variety of therapies such as surgery, radiotherapy, and chemotherapy have been currently used to treat thyroid cancer, but they still have limitations including drug resistance or unfavorable side effects...
January 9, 2019: Nutrients
Fuqiang Shao, Jiali Tang, Xiaoli Lan
Various etiologies could cause focal I accumulation. Hepatic cyst is one of these etiologies. Here we present a 59-year-old man with a history of papillary thyroid cancer resection who received radioiodine therapy for three times. The images after the I therapy of the second and third time showed variable activity uptake in the same hepatic cysts.
January 4, 2019: Clinical Nuclear Medicine
Christian Happel, Wolfgang Tilman Kranert, Hanns Ackermann, Ina Binse, Benjamin Bockisch, Daniel Gröner, Ken Herrmann, Frank Grünwald
PURPOSE: Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid stunning in benign thyroid diseases caused by the radioiodine uptake test (RIUT). Therefore, the influence of pre-therapeutic tracer radiation dose on therapeutic iodine-131 uptake was evaluated retrospectively...
December 31, 2018: Endocrine
George Sgouros
Radiopharmaceutical therapy involves the use of radionuclides that are either conjugated to tumor-targeting agents (e.g., nanoscale constructs, antibodies, peptides, and small molecules) or that concentrate in tumors through natural physiological mechanisms that occur predominantly in neoplastic cells. In the latter category, radioiodine therapy of thyroid cancer is the prototypical and most widely implemented radiopharmaceutical therapy. In the category of radionuclide-ligand conjugates, antibody and peptide conjugates have been studied extensively...
February 2019: Health Physics
Y Gong, J Yang, F Liu, Z Li, R Gong, T Wei
Given the pathological incidence of metastases or radioiodine-refractory papillary thyroid carcinoma (PTC) is increasing worldwide, patients have little alternatives when choosing effective drugs. Therefore, it is necessary to develop new therapeutic targets for PTC treatment. CDK7 is a member of the cyclindependent protein kinase (CDK) family, which plays an important role in various types of cancers. In this study, we found CDK7 were upregulated in PTC cell lines compared to normal thyroid cells using qRT-PCR and Western blot...
November 2018: Journal of Biological Regulators and Homeostatic Agents
Yi Cui, Katharina Heuser, Natali Bauer, Reto Neiger
OBJECTIVES: The aim of the study was to describe the coagulatory state of hyperthyroid cats before and after successful radioiodine therapy (RIT) compared with healthy age-matched controls, using classical coagulation parameters and thromboelastogram (TEG) as a global assessment method. The differences in coagulation activity after RIT, depending on the thyroid hormone (normal vs low total thyroxine [T4]) state, were also evaluated. METHODS: Fifteen hyperthyroid cats and 10 healthy age-matched controls were recruited...
December 20, 2018: Journal of Feline Medicine and Surgery
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