SNMMI/EANM practice guideline vs. ETA Consensus Statement: differences and similarities in approaching differentiated thyroid cancer management—the EANM perspective

Ovčariček, Petra Petranović; Kreißl, Michael C.; Campennì, Alfredo; Keizer, Bart de; Murat, Tuncel; Vrachimis, Alexis; Deandreis, Désirèe; Giovanella, Luca

doi:10.1007/s00259-022-05935-1

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…The fact that even patients with a low risk can show persistent disease, even if they are few, should be kept in mind. This is an important aspect to consider in everyday clinical practice and should be carefully taken into account, especially with regard to the currently discussed indication for radioiodine therapy [ 15 , 16 ]. A recent German position paper by nuclear medicine physicians and endocrine surgeons, written by Schmidt et al, summarizes areas of disagreement based on a literature review in comparison with the ATA [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The ATA and the ETA are cautious about RAI in low-risk patients and see the indication for it only in individual exceptional cases. However, individual countries such as Germany and associations such as the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) see a possible advantage for low-risk patients [ 16 ]. Additionally, many patients (12–50%, according to Perros et al [ 17 ]) show lymph node metastases, even in pT1a tumors.…”

Section: Discussionmentioning

confidence: 99%

“…As such, the percentage of Nx-operated patients is high, especially in Germany, which is an iodine-deficient country (in our study, 40/121 (33%) patients received Nx thyroidectomy, which does not allow for any statement about possibly present lymph node metastases). Radioiodine therapy can be an adjuvant approach in these supposedly low-risk patients [ 16 ]. Accounting for the well-known high incidence of lymph node metastases, adjuvant therapy, as opposed to remnant ablation, is therefore traditionally pursued in Germany.…”

Section: Discussionmentioning

confidence: 99%

“…Accounting for the well-known high incidence of lymph node metastases, adjuvant therapy, as opposed to remnant ablation, is therefore traditionally pursued in Germany. This is why patients usually receive activities that are considered to be therapeutically appropriate [ 15 , 16 , 18 ]. Tuttle et al emphasize in their joint statement by the ATA, EANM, SNMMI and ETA that a clear distinction should be made between a remnant ablation and an adjuvant therapy concept, specifically that the latter is heavily influenced by local conditions [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a current analysis of the ESTIMABL2-trial patients with low-risk thyroid cancer after thyroidectomy, a follow-up strategy that did not involve the use of radioiodine (1.1 GBq) was non-inferior to an ablation strategy with radioiodine, regarding the occurrence of functional, structural, and biologic events at 3 years’ follow-up [ 21 ]. The main criticisms of this study, as stated by specialists such as those from the group of Tuncel et al, are the low activity of 1.1 GBq (which induces remnant ablation, no adjuvant therapy [ 16 ]), the study population (pT1a/b, N0/x) covering only a part of the low-risk group, and the short follow-up period, which, according to the work of Sawka et al, should be at least 10 years [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Application of the American Thyroid Association Risk Assessment in Patients with Differentiated Thyroid Carcinoma in a German Population

et al. 2023

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Background: The American Thyroid Association (ATA) uses criteria to assess the risk for persistent disease in differentiated thyroid carcinoma (DTC) after radioiodine therapy (RAI). There are no data available showing that this classification can be adopted unadjusted by Germany. Aim: The aim of our study is to investigate whether the ATA classification can be applied to a German population for short-term prognosis. Furthermore, we investigated the influence of an age cutoff value. Methods: We retrospectively analyzed 121 patients who were referred to our tertiary referral center. Patients were classified into risk categories, and the therapy response was determined according to ATA. Results: A total of 73/83 (88%) ATA low-risk patients and 12/19 (63%) intermediate-risk patients showed an excellent response; 2/19 (11%) high-risk patients had a biochemical, and 6 (31%) had a structural incomplete response. Of all 39 patients ≥55 years, 84% had an excellent response. Using a cut off of 50 years, 50/62 (81%) of the older patients showed an excellent response. Conclusion: The ATA risk classification is able to estimate the response to RAI therapy in a German population. A shift from 55 to 50 years as an age cutoff value does not result in any relevant change in the treatment response.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Application of the American Thyroid Association Risk Assessment in Patients with Differentiated Thyroid Carcinoma in a German Population

et al. 2023

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Biomarkers and Molecular Imaging in Postoperative DTC Management

Albano

Dondi

Bellini

et al. 2023

Integrated Diagnostics and Theranostics of Thyroid Diseases

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The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine [iodine-131 (131I)] therapy, individualized thyroid hormone therapy, and follow-up for detection of patients with recurrent or persistent disease.Recently, several international associations like ATA, EANM, and SNMMI developed specific guidelines for the management of these patients. They shared that an individualized risk-adapted approach should be suggested considering the main clinical, epidemiological, and histopathological features. The postoperative management of DTC is a challenge because several biomarkers and molecular imaging tools are available. The choice of execution and the timing of neck ultrasound, serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin, the 131I/123I diagnostic whole-body scans integrated by single photon emission computed tomography/computed tomography (SPECT/CT) if indicated, and 18F-fluorodeoxyglucose ([18F]-FDG) positron emission tomography/CT (PET/CT) is directly related to the patients’ characteristics. In this chapter, we summarize the role of the main biomarker and molecular imaging examinations in the management of DTC patients in postoperative setting.

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Metastases to the pituitary gland: insights from the German pituitary tumor registry

Haberbosch,

Schmid,

Hubertus

et al. 2023

Pituitary

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Metastatic involvement of the pituitary gland is a rare but clinically significant phenomenon, that often poses diagnostic and therapeutic challenges. The aim of this study was to provide a comprehensive analysis of the origin of pituitary metastases using data from the German Pituitary Tumor Registry, one of the globally largest collections of pituitary pathology specimens. Here, we report data from a retrospective analysis of patients with metastases to the pituitary registered between 1990 and 2022. Out of 17,896 pituitary cases in the registry during this period, a total of 96 metastases to the pituitary gland were identified, accounting for 0.5% of all pituitary tumors in the registry. The mean age of the patients was 64 years. Breast cancer was identified as the primary tumor in 25% of total cases (n = 24/96) and in 50% of female patients. The second most prevalent primary tumor was lung cancer (18.75%, n = 18/96), followed by renal cell carcinoma (14.58%, n = 14/96). In comparison to current meta-analyses, this cohort shows a higher prevalence of metastases originating from the kidney. Furthermore, in contrast to the existing literature, no case of primary thyroid tumor was identified. Our study highlights the importance of pituitary metastases as a differential diagnosis in patients presenting with pituitary tumors.

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SNMMI/EANM practice guideline vs. ETA Consensus Statement: differences and similarities in approaching differentiated thyroid cancer management—the EANM perspective

Cited by 10 publications

References 20 publications

Application of the American Thyroid Association Risk Assessment in Patients with Differentiated Thyroid Carcinoma in a German Population

Application of the American Thyroid Association Risk Assessment in Patients with Differentiated Thyroid Carcinoma in a German Population

Biomarkers and Molecular Imaging in Postoperative DTC Management

Metastases to the pituitary gland: insights from the German pituitary tumor registry

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