Diagnostic 123I Whole Body Scan Prior to Ablation of Thyroid Remnant in Patients With Papillary Thyroid Cancer

Song, Hong; Mosci, Camila; Akatsu, Haruko; Basina, Marina; Dosiou, Chrysoula; Iagaru, Andrei

doi:10.1097/rlu.0000000000002246

Cited by 16 publications

(9 citation statements)

References 19 publications

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“…Better spatial resolution of pretreatment SPECT/CT imaging with a potential impact on institutional treatment planning or clinical decision making was also reported in other reports (23)(24)(25). A consistent finding in most studies is an overall rate of *6% for detection of extracervical metastatic disease.…”

Section: Current Standards: Clinical and Technical Considerations In Rai Imagingsupporting

confidence: 73%

A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer

Güleç

Ahuja

Avram

et al. 2021

Thyroid

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Background: The American Thyroid Association (ATA), the European Association of Nuclear Medicine, the European Thyroid Association, and the Society of Nuclear Medicine and Molecular Imaging have established an intersocietal working group to address the current controversies and evolving concepts in thyroid cancer management and therapy. The working group annually identifies topics that may significantly impact clinical practice and publishes expert opinion articles reflecting intersocietal collaboration, consensus, and suggestions for further research to address these important management issues. Summary: In 2019, the intersocietal working group identified the following topics for review and interdisciplinary discussion: (i) perioperative risk stratification, (ii) the role of diagnostic radioactive iodine (RAI) imaging in initial staging, and (iii) indicators of response to RAI therapy. Conclusions: The intersocietal working group agreed that (i) initial patient management decisions should be guided by perioperative risk stratification that should include the eighth edition American Joint Committee on Cancer staging system to predict disease specific mortality, the modified 2009 ATA risk stratification system to

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Section: Current Standards: Clinical and Technical Considerations In Rai Imagingsupporting

confidence: 73%

A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer

Güleç

Ahuja

Avram

et al. 2021

Thyroid

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“…First, the small dose of RAI used in diagnostic scans may not be sufficient to identify all remnant tissue. 24,25 The prevalence of residual tissue would be greater than the reported 90.51%, supporting the use of empiric treatment. Our decision tree also assumes that those patients with negative DxWBS findings are truly disease free.…”

Section: Discussionmentioning

confidence: 86%

Preablation Diagnostic Whole‐Body Scan vs Empiric Radioactive Iodine Ablation in Differentiated Thyroid Cancer: Cost‐effectiveness Analysis

Arjani

Quinn

2020

Otolaryngol.--head neck surg.

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Objective To perform a comparative analysis of postthyroidectomy radioactive iodine ablation dosing with or without the implementation of a diagnostic whole-body scan in patients with well-differentiated thyroid cancer. Study Design Decision analysis model. Setting Hospital or ambulatory center. Methods A decision tree model was created to determine the cost-effectiveness of radioactive iodine ablation dosed with diagnostic whole-body scans versus empiric radioactive iodine ablation in patients with differentiated thyroid cancer undergoing postthyroidectomy ablation. The decision tree was populated with values from the published literature. Costs were represented by 2020 Medicare reimbursement rates (US dollars), and morbidity and survival data were used to calculate quality-adjusted life-years. The incremental cost-effectiveness ratio was the primary outcome. Results Empiric radioactive iodine dosing was the dominant economic strategy, producing 0.94 more quality-adjusted life-years while costing $1250.07 less than management with a diagnostic whole-body scan. Sensitivity analyses upheld these results except in cases involving a large discrepancy in successful ablation rates between the diagnostic and empiric treatment arms. Conclusion For patients with differentiated thyroid cancer requiring postthyroidectomy ablation, it is more cost-effective to administer radioactive iodine empirically.

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“…Other authors also demonstrated that the information gained by [ 123 I] DxWBS changed the applied [ 131 I] activity in 49% of cases [ 35 ]. Santhanam and colleagues, in a recent meta-analysis, described a 94% sensitivity of [ 124 I] PET/CT in postoperative detection of metastatic lesions amenable to RAI [ 36 ].…”

Section: Differentiated Thyroid Cancersmentioning

confidence: 99%

Molecular Imaging and Theragnostics of Thyroid Cancers

Giovanella

Deandreis

Vrachims³

et al. 2022

Cancers

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Molecular imaging plays an important role in the evaluation and management of different thyroid cancer histotypes. The existing risk stratification models can be refined, by incorporation of tumor-specific molecular markers that have theranostic power, to optimize patient-specific (individualized) treatment decisions. Molecular imaging with varying radioisotopes of iodine (i.e., 131I, 123I, 124I) is an indispensable component of dynamic and theragnostic risk stratification of differentiated carcinoma (DTC) while [18F]F-fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) helps in addressing disease aggressiveness, detects distant metastases, and risk-stratifies patients with radioiodine-refractory DTC, poorly differentiated and anaplastic thyroid cancers. For medullary thyroid cancer (MTC), a neuroendocrine tumor derived from thyroid C-cells, [18F]F-dihydroxyphenylalanine (6-[18F]FDOPA) PET/CT and/or [18F]FDG PET/CT can be used dependent on serum markers levels and kinetics. In addition to radioiodine therapy for DTC, some theragnostic approaches are promising for metastatic MTC as well. Moreover, new redifferentiation strategies are now available to restore uptake in radioiodine-refractory DTC while new theragnostic approaches showed promising preliminary results for advanced and aggressive forms of follicular-cell derived thyroid cancers (i.e., peptide receptor radiotherapy). In order to help clinicians put the role of molecular imaging into perspective, the appropriate role and emerging opportunities for molecular imaging and theragnostics in thyroid cancer are discussed in our present review.

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Diagnostic 123I Whole Body Scan Prior to Ablation of Thyroid Remnant in Patients With Papillary Thyroid Cancer

Abstract: Our study suggests a significant role of the pre-therapy I WBS in PTC patients referred for I ablation post-thyroidectomy. The actual I dose that was administered based on the I WBS differed from the dose recommended in the absence of the I WBS in 49% of the cases.

Cited by 16 publications

References 19 publications

A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer

A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the European Thyroid Association, the Society of Nuclear Medicine and Molecular Imaging on Current Diagnostic and Theranostic Approaches in the Management of Thyroid Cancer

Preablation Diagnostic Whole‐Body Scan vs Empiric Radioactive Iodine Ablation in Differentiated Thyroid Cancer: Cost‐effectiveness Analysis

Molecular Imaging and Theragnostics of Thyroid Cancers

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