Low-Activity 124I-PET/Low-Dose CT Versus 131I Probe Measurements in Pretherapy Assessment of Radioiodine Uptake in Benign Thyroid Diseases

Published on Feb 25, 2014in The Journal of Clinical Endocrinology and Metabolism5.958
· DOI :10.1210/JC.2013-4390
Julian G. Westphal2
Estimated H-index: 2
,
Thomas Winkens10
Estimated H-index: 10
+ 1 AuthorsMartin Freesmeyer15
Estimated H-index: 15
Sources
Abstract
Context: Radioiodine therapy of benign thyroid diseases requires pretherapy assessment of radioactive iodine uptake (RAIU) for reliable therapy planning. Objective: Our objective was to assess RAIU by low-activity 124I-positron emission tomography/low-dose computed tomography (124I-PET/CT) in comparison with standard 131I probe measurements. Design/Setting: This prospective comparative study was conducted at the Jena University Hospital, Jena, Germany, in a referral center setting. Patients: A total of 79 patients with benign thyroid diseases were screened, 40 of whom met the inclusion criteria (stable TSH, free T3 and free T4 levels; no thyroid-specific medication, no iodine contamination) and 24 of whom agreed to participate by signing an informed consent. Interventions: All patients received the standard 131I scintillation probe uptake test 30 hours after administration of 3 MBq 131I. Seven days later, all patients were subjected to 124I-PET/CT uptake measurement 30 hours after administration of 1 MBq ...
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References32
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#1Andreas M. DarrH-Index: 2
#2Thomas OpfermannH-Index: 12
Last. Martin FreesmeyerH-Index: 15
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Purpose of the ReportThe standard thyroid functional imaging method, 99mTc-pertechnetate (99mTc-PT) planar scintigraphy, has technical drawbacks decreasing its sensitivity in detecting nodules or anatomical pathology. 124I-PET, lacking these disadvantages and allowing simultaneous CT, may have great
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A 52-year-old woman presented with apparent carcinoid syndrome. Gallium 68 (Ga)-DOTATOC positron emission tomography (PET)/computed tomography (CT) found a 2.5-cm somatostatin receptor (SR)positive nodule in the left thyroid lobe. Basal serum calcitonin was 5184 ng/L, TSH was 0.63 mU/L, and free T4 was 16.98 pmol/L, so medullary thyroid cancer was suspected. Ultrasonography (Figure 1, A and B), F-fluorodeoxyglucose (FDG) PET/CT, and iodine 124 (I) PET/ CT, performed to allocate thyroid nodules t...
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#1Heribert Hänscheid (University of Würzburg)H-Index: 24
#2Cristina Canzi (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 8
Last. Michael Lassmann (University of Würzburg)H-Index: 53
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The EANM Dosimetry Committee Series “Standard Operational Procedures for Pre-Therapeutic Dosimetry” (SOP) provides advice to scientists and clinicians on how to perform patient-specific absorbed dose assessments. This particular SOP describes how to tailor the therapeutic activity to be administered for radioiodine therapy of benign thyroid diseases such as Graves’ disease or hyperthyroidism. Pretherapeutic dosimetry is based on the assessment of the individual 131I kinetics in the target tissue...
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#2Abass Alavi (HUP: Hospital of the University of Pennsylvania)H-Index: 133
Last. Alan D. Waxman (Cedars-Sinai Medical Center)H-Index: 31
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1UC Health University Hospital, Cincinnati, Ohio; 2Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; 3Beaumont Health System, Royal Oak, Michigan; 4Guy’s Hospital, London, United Kingdom; 5Columbia University Medical Center, New York, New York; 6Cincinnati Children’s Medical Center, Cincinnati, Ohio; 7New York–Presbyterian/Weill Cornell Medical Center, New York, New York; 8University of Southern California, Los Angeles, California; 9University of California at Los Angeles, ...
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124I-PET/CT has a high clinical potential in patients with differentiated thyroid cancer (DTC). Two aspects deserve special mention: staging of recurrent or residual disease and pretherapy dosimetry. Used in combination 124I-PET and CT allows foci of highly specific 124I uptake to be localized with a low radiation dose, which is specifically important in pretherapy diagnostics. In addition in the combination of FDG-PET and CT non-iodine-avid lesions may be detected and may be discriminated from ...
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: Iodine-131-labelled agents are successfully used in cancer treatment. In the pretherapy dosimetry approach, positron emission tomography/computed tomography (PET/CT) using (124)I provides a modality to estimate absorbed dose to tumours and can be considered as the preferred imaging method for this purpose in (131)I radiopharmaceutical therapies. For accurate dosimetry, serial measurements of activity concentrations (ACs) over an appropriate time period are necessary. Consequently, accurate AC ...
#1Jennifer J. Shin (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 22
#2Hermes C. Grillo (Harvard University)H-Index: 93
Last. Gregory W. Randolph (Harvard University)H-Index: 60
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Objectives/Hypothesis: Our overarching objective is to provide a comprehensive analysis of goiter data in two paired articles. This first article focuses on the preoperative evaluation. The following null hypotheses have been tested: 1) there is no correlation between goiter size and preoperative symptoms, 2) there is no correlation between preoperative neck imaging abnormalities and preoperative symptoms, and 3) there are no predictors for goiter recurrence. Sudy Design: A retrospective review ...
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#1Michael Lassmann (University of Würzburg)H-Index: 53
#2Carlo ChiesaH-Index: 32
Last. Manuel Bardiès (French Institute of Health and Medical Research)H-Index: 32
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Many recent publications in nuclear medicine contain data on dosimetric findings for existing and new diagnostic and therapeutic agents. In many of these articles, however, a description of the methodology applied for dosimetry is lacking or important details are omitted. The intention of the EANM Dosimetry Committee is to guide the reader through a series of suggestions for reporting dosimetric approaches. The authors are aware of the large amount of data required to report the way a given clin...
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#1Robert F. Hobbs (Johns Hopkins University)H-Index: 60
#2Richard L. WahlH-Index: 84
Last. George Sgouros (Johns Hopkins University)H-Index: 75
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Since the 1990s, patient-specific 3-dimensional (3D)-imaging–based dosimetry has been an area of interest and ongoing development (1). To the extent that this dosimetry technique has been applied to patient studies, all applications have been retrospective. In this work, prospective or real-time implementation of an imaging-based Monte Carlo calculation using the 3D-RD dosimetry package (2) is illustrated for the radioiodine treatment of a pediatric thyroid cancer patient. Implementation of a 3D...
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Purpose Quantitative 124I PET imaging is challenging as 124I has a complex decay scheme. In this study the performance of a Philips Gemini dual GS PET/CT system was optimized and assessed for 124I.
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Last. Michael C. Kreissl (Otto-von-Guericke University Magdeburg)H-Index: 6
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Both, ultrasonography but also radionuclide imaging using [99mTc]Pertechnetate or radioactive iodine isotopes are essential tools used during the diagnostic workup of hyperthyroidism with or without structural alterations of the thyroid. Colour duplex sonography and ultrasound elastography may add important information in order to find the cause of the hormone excess. During the last years, also hybrid imaging using SPECT/-(CT) or PET-based methods, such as [124]Iodine-PET/CT or [124]Iodine-PET/...
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#1Martin FreesmeyerH-Index: 15
#2Thomas WinkensH-Index: 10
Last. Philipp SeifertH-Index: 8
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In conventional thyroid diagnostics, the topographical correlation between thyroid nodules (TN) depicted on ultrasound (US) in axial or sagittal orientation and coronally displayed scintigraphy images can be challenging. Sensor-navigated I-124-PET/US fusion imaging has been introduced as a problem-solving tool for ambiguous cases. The purpose of this study was to investigate the results of multiple unexperienced medical students (MS) versus multiple nuclear medicine physicians (MD) regarding the...
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Aim To investigate the value of I-124 positron emission tomography (PET) / ultrasound (US) fusion imaging in comparison to conventional diagnostics (CD) of Thyroid nodules (TN) by multiple observers. Methods Digital patient case files (PCF) of patients that received CD and I-124-PET/US in clinical routine were prepared containing cine-loops of the examinations. All physicians with nuclear medicine specialty from Germany, Austria, and Switzerland were invited to participate. 106 acquired observer...
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Abstract The purpose of this study is to investigate I-124 positron emission tomography (PET)/ultrasound (US) fusion imaging for function assessment of thyroid nodules. In 70 patients, 201 lesions were examined with conventional diagnostics (CD) (thyroid US, laboratory findings and Tc-99m pertechnetate scintigraphy), Tc-99m pertechnetate single photon emission computed tomography (SPECT) and I-124 PET/computed tomography (CT). Subsequently, US fusion imaging (SPECT/US and PET/US) was performed b...
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#1Martin FreesmeyerH-Index: 15
#2Anja Sophie GablerH-Index: 1
Last. Thomas WinkensH-Index: 10
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PURPOSE: This study aimed at investigating the performance of late I PET/CT for radioiodine uptake (RAIU) measurement at 336 hours after administration in patients with benign thyroid diseases requiring radioiodine therapy. Special attention was paid to the comparability of I uptake (I-RAIU) to the clinical standard (I-RAIU, probe measurement). Considering cost aspects, we sought to establish an economically reasonable examination protocol based on scan duration and administered activity. METHOD...
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#1Falk GühneH-Index: 5
#2Christian KühnelH-Index: 5
Last. Martin FreesmeyerH-Index: 15
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Purpose 124I-PET/CT can be used for pre-therapeutic assessment of radioactive iodine uptake in benign thyroid disorders, however systematic comparisons with intra-therapeutic uptake are still lacking for these disorders. The goals of this study were to compare 124I RAIU and conventional 131I RAIU tests with each other; to compare both tests with intra-therapeutic uptake (reference); and to verify the time course of radioactive iodine uptake at three time points (30, 102, and 336 h [14 days] post...
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#1Anja Sophie Gabler (FSU: University of Jena)H-Index: 1
#2Christian Kühnel (FSU: University of Jena)H-Index: 5
Last. Martin Freesmeyer (FSU: University of Jena)H-Index: 15
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This study aimed to assess a hypothetical minimum administered activity of (124)I required to achieve comparability between pretherapeutic radioiodine uptake (RAIU) measurements by (124)I PET/CT and by (131)I RAIU probe, the clinical standard. In addition, the impact of different reconstruction algorithms on (124)I RAIU and the evaluation of pixel noise as a parameter for image quality were investigated.Different scan durations were simulated by different reconstruction intervals of 600-s list-m...
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Background Benign thyroid diseases are widely common in western societies. However, the volumetry of the thyroid gland, especially when enlarged or abnormally formed, proves to be a challenge in clinical routine. The aim of this study was to develop a simple and rapid threshold-based isocontour extraction method for thyroid volumetry from 124I-PET/CT data in patients scheduled for radioactive iodine therapy.
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#1Daniel A. Pryma (UPenn: University of Pennsylvania)H-Index: 27
#2Susan J. Mandel (UPenn: University of Pennsylvania)H-Index: 55
Differentiated thyroid cancers are typically iodine-avid and can be effectively treated with radioiodine. In most patients, radioiodine treatment is done for ablation of residual tissue, and in these cases the focus should be on using the minimum effective dose. Adjuvant therapy can be done to reduce the risk of recurrence, but optimal patient selection and dose are unclear. Patients with advanced disease benefit most from treatment with the maximum-tolerated dose. Recent research has focused on...
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