1.Lesion-Wise Comparison of Pre-Therapy and Post-Therapy Effective Half-Life of Iodine-131 in Pediatric and Young Adult Patients with Differentiated Thyroid Cancer Undergoing Radioiodine Therapy
Praveen KUMAR ; Chandrasekhar BAL ; Nishikant Avinash DAMLE ; Sanjana BALLAL ; S N DWIVEDI ; Sandeep AGARWALA
Korean Journal of Nuclear Medicine 2019;53(3):199-207
PURPOSE:
The effective half-life of radioiodine is an important parameter for dosimetry in differentiated thyroid cancer patients, particularly in children. We determined the pre-therapy and post-therapy effective half-life in different types of lesions, i.e., remnant, node, or lung metastases.
METHODS:
Of 84 patients recruited, 27 were < 18 years (group 1) and the remaining 57 were between 18 and 21 years (group 2). A total of 114 studies were conducted and 253 lesions were analyzed. Serial whole-body scans were acquired at 24, 48, and ≥ 72 h after administration of iodine-131. Region of interests was drawn over lesions to determine counts in the lesion. Time versus counts graphs were plotted and mono-exponentially fitted to determine effective half-life.
RESULTS:
The post-therapy effective half-life was found to be lesser than pre-therapy effective half-life in all types of lesions and in all groups. Median effective half-life was found maximum in intact lobe, minimum in the lung, and intermediate in remnant and nodes. In the assessment of all lesions together, pre- and post-therapy median and interquartile range (IQR) effective half-life were 59.8 (37–112) h and 48.6 (35.2–70.8) h (p < 0.0001) in group 1, 73.9 (46.2–112.7) h and 60 (57.4–85.9) h (p < 0.0001) in group 2, and 68.6 (41.53–112.36) h and 54.7 (36–80.6) h (p < 0.0001) in combined group, respectively. Importantly, the pre- and post-therapy median effective half-life serially dropped after each successive cycles of iodine-131.
CONCLUSIONS
There was a significant difference in pre-therapy and post-therapy effective half-life in all types of lesions. These results may have implications in calculating the correct therapeutic dose in children and in young adults.
2.Lesion-Wise Comparison of Pre-Therapy and Post-Therapy Effective Half-Life of Iodine-131 in Pediatric and Young Adult Patients with Differentiated Thyroid Cancer Undergoing Radioiodine Therapy
Praveen KUMAR ; Chandrasekhar BAL ; Nishikant Avinash DAMLE ; Sanjana BALLAL ; S N DWIVEDI ; Sandeep AGARWALA
Korean Journal of Nuclear Medicine 2019;53(3):199-207
PURPOSE: The effective half-life of radioiodine is an important parameter for dosimetry in differentiated thyroid cancer patients, particularly in children. We determined the pre-therapy and post-therapy effective half-life in different types of lesions, i.e., remnant, node, or lung metastases.METHODS: Of 84 patients recruited, 27 were < 18 years (group 1) and the remaining 57 were between 18 and 21 years (group 2). A total of 114 studies were conducted and 253 lesions were analyzed. Serial whole-body scans were acquired at 24, 48, and ≥ 72 h after administration of iodine-131. Region of interests was drawn over lesions to determine counts in the lesion. Time versus counts graphs were plotted and mono-exponentially fitted to determine effective half-life.RESULTS: The post-therapy effective half-life was found to be lesser than pre-therapy effective half-life in all types of lesions and in all groups. Median effective half-life was found maximum in intact lobe, minimum in the lung, and intermediate in remnant and nodes. In the assessment of all lesions together, pre- and post-therapy median and interquartile range (IQR) effective half-life were 59.8 (37–112) h and 48.6 (35.2–70.8) h (p < 0.0001) in group 1, 73.9 (46.2–112.7) h and 60 (57.4–85.9) h (p < 0.0001) in group 2, and 68.6 (41.53–112.36) h and 54.7 (36–80.6) h (p < 0.0001) in combined group, respectively. Importantly, the pre- and post-therapy median effective half-life serially dropped after each successive cycles of iodine-131.CONCLUSIONS: There was a significant difference in pre-therapy and post-therapy effective half-life in all types of lesions. These results may have implications in calculating the correct therapeutic dose in children and in young adults.
Child
;
Half-Life
;
Humans
;
Lung
;
Neoplasm Metastasis
;
Thyroid Gland
;
Thyroid Neoplasms
;
Young Adult
3.Incidental Detection of Parathyroid Adenoma on Somatostatin Receptor PET/CT and Incremental Role of ¹â¸F-Fluorocholine PET/CT in MEN1 Syndrome
Saurabh ARORA ; Nishikant Avinash DAMLE ; Averilicia PASSAH ; Madhav Prasad YADAV ; Sanjana BALLAL ; Vivek AGGARWAL ; Yashdeep GUPTA ; Praveen KUMAR ; Madhavi TRIPATHI ; Chandrasekhar BAL
Korean Journal of Nuclear Medicine 2018;52(3):238-242
Multiple endocrine neoplasia type 1 (MEN1) syndrome is characterized by combined occurrence of tumors of endocrine glands including the parathyroid, the pancreatic islet cells, and the anterior pituitary gland. Parathyroid involvement is the most common manifestation and usually the first clinical involvement inMEN1 syndrome, followed by gastroentero-pancreatic neuroendocrine tumors (NETs). Here we present a case where the patient initially presented with metastatic gastric NET and a single parathyroid adenoma was detected incidentally on â¶â¸Ga-DOTANOC PET/CT done as part of post ¹â·â·Lu-DOTATATE therapy (PRRT) follow-up. Further ¹â¸F-fluorocholine PET/CT showed four adenomas for which the patient subsequently underwent subtotal parathyroidectomy.
4.Incidental Detection of Parathyroid Adenoma on Somatostatin Receptor PET/CT and Incremental Role of ¹⁸F-Fluorocholine PET/CT in MEN1 Syndrome
Saurabh ARORA ; Nishikant Avinash DAMLE ; Averilicia PASSAH ; Madhav Prasad YADAV ; Sanjana BALLAL ; Vivek AGGARWAL ; Yashdeep GUPTA ; Praveen KUMAR ; Madhavi TRIPATHI ; Chandrasekhar BAL
Korean Journal of Nuclear Medicine 2018;52(3):238-242
Multiple endocrine neoplasia type 1 (MEN1) syndrome is characterized by combined occurrence of tumors of endocrine glands including the parathyroid, the pancreatic islet cells, and the anterior pituitary gland. Parathyroid involvement is the most common manifestation and usually the first clinical involvement inMEN1 syndrome, followed by gastroentero-pancreatic neuroendocrine tumors (NETs). Here we present a case where the patient initially presented with metastatic gastric NET and a single parathyroid adenoma was detected incidentally on ⁶⁸Ga-DOTANOC PET/CT done as part of post ¹⁷⁷Lu-DOTATATE therapy (PRRT) follow-up. Further ¹⁸F-fluorocholine PET/CT showed four adenomas for which the patient subsequently underwent subtotal parathyroidectomy.
Adenoma
;
Endocrine Glands
;
Follow-Up Studies
;
Gastrinoma
;
Humans
;
Hyperparathyroidism
;
Islets of Langerhans
;
Multiple Endocrine Neoplasia Type 1
;
Neuroendocrine Tumors
;
Parathyroid Neoplasms
;
Parathyroidectomy
;
Pituitary Gland, Anterior
;
Positron-Emission Tomography and Computed Tomography
;
Receptors, Somatostatin
;
Somatostatin