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The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer
Radioactive iodine is well established as a successful treatment for differentiated thyroid cancer (DTC), although around 15% of patients have local recurrence or develop distant metastases and may become refractory to radioactive iodine (RAI). A personalized approach to treatment, based on the abso...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Society of Nuclear Medicine
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315692/ https://www.ncbi.nlm.nih.gov/pubmed/37116914 http://dx.doi.org/10.2967/jnumed.122.264913 |
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author | Taprogge, Jan Abreu, Carla Yusuf, Siraj Ainsworth, Gemma Phillip, Rachel H. Gear, Jonathan I. Gregory, Rebecca Leek, Francesca Murray, Iain Coulson, Amy B. Brown, Sarah R. Du, Yong Newbold, Kate Wadsley, Jonathan Flux, Glenn D. |
author_facet | Taprogge, Jan Abreu, Carla Yusuf, Siraj Ainsworth, Gemma Phillip, Rachel H. Gear, Jonathan I. Gregory, Rebecca Leek, Francesca Murray, Iain Coulson, Amy B. Brown, Sarah R. Du, Yong Newbold, Kate Wadsley, Jonathan Flux, Glenn D. |
author_sort | Taprogge, Jan |
collection | PubMed |
description | Radioactive iodine is well established as a successful treatment for differentiated thyroid cancer (DTC), although around 15% of patients have local recurrence or develop distant metastases and may become refractory to radioactive iodine (RAI). A personalized approach to treatment, based on the absorbed radiation doses delivered and using treatments to enhance RAI uptake, has not yet been developed. Methods: We performed a multicenter clinical trial to investigate the role of selumetinib, which modulates the expression of the sodium iodide symporter, and hence iodine uptake, in the treatment of RAI-refractory DTC. The iodine uptake before and after selumetinib was quantified to assess the effect of selumetinib. The range of absorbed doses delivered to metastatic disease was calculated from pre- and posttherapy imaging, and the predictive accuracy of a theranostic approach to enable personalized treatment planning was investigated. Results: Significant inter- and intrapatient variability was observed with respect to the uptake of RAI and the effect of selumetinib. The absorbed doses delivered to metastatic lesions ranged from less than 1 Gy to 1,170 Gy. A strong positive correlation was found between the absorbed doses predicted from pretherapy imaging and those measured after therapy (r = 0.93, P < 0.001). Conclusion: The variation in outcomes from RAI therapy of DTC may be explained, among other factors, by the range of absorbed doses delivered. The ability to assess the effect of treatments that modulate RAI uptake, and to estimate the absorbed doses at therapy, introduces the potential for patient stratification using a theranostic approach. Patient-specific absorbed dose planning might be the key to more successful treatment of advanced DTC. |
format | Online Article Text |
id | pubmed-10315692 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Society of Nuclear Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-103156922023-07-04 The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer Taprogge, Jan Abreu, Carla Yusuf, Siraj Ainsworth, Gemma Phillip, Rachel H. Gear, Jonathan I. Gregory, Rebecca Leek, Francesca Murray, Iain Coulson, Amy B. Brown, Sarah R. Du, Yong Newbold, Kate Wadsley, Jonathan Flux, Glenn D. J Nucl Med Clinical Investigation Radioactive iodine is well established as a successful treatment for differentiated thyroid cancer (DTC), although around 15% of patients have local recurrence or develop distant metastases and may become refractory to radioactive iodine (RAI). A personalized approach to treatment, based on the absorbed radiation doses delivered and using treatments to enhance RAI uptake, has not yet been developed. Methods: We performed a multicenter clinical trial to investigate the role of selumetinib, which modulates the expression of the sodium iodide symporter, and hence iodine uptake, in the treatment of RAI-refractory DTC. The iodine uptake before and after selumetinib was quantified to assess the effect of selumetinib. The range of absorbed doses delivered to metastatic disease was calculated from pre- and posttherapy imaging, and the predictive accuracy of a theranostic approach to enable personalized treatment planning was investigated. Results: Significant inter- and intrapatient variability was observed with respect to the uptake of RAI and the effect of selumetinib. The absorbed doses delivered to metastatic lesions ranged from less than 1 Gy to 1,170 Gy. A strong positive correlation was found between the absorbed doses predicted from pretherapy imaging and those measured after therapy (r = 0.93, P < 0.001). Conclusion: The variation in outcomes from RAI therapy of DTC may be explained, among other factors, by the range of absorbed doses delivered. The ability to assess the effect of treatments that modulate RAI uptake, and to estimate the absorbed doses at therapy, introduces the potential for patient stratification using a theranostic approach. Patient-specific absorbed dose planning might be the key to more successful treatment of advanced DTC. Society of Nuclear Medicine 2023-07 /pmc/articles/PMC10315692/ /pubmed/37116914 http://dx.doi.org/10.2967/jnumed.122.264913 Text en © 2023 by the Society of Nuclear Medicine and Molecular Imaging. https://creativecommons.org/licenses/by/4.0/Immediate Open Access: Creative Commons Attribution 4.0 International License (CC BY) allows users to share and adapt with attribution, excluding materials credited to previous publications. License: https://creativecommons.org/licenses/by/4.0/. Details: http://jnm.snmjournals.org/site/misc/permission.xhtml. |
spellingShingle | Clinical Investigation Taprogge, Jan Abreu, Carla Yusuf, Siraj Ainsworth, Gemma Phillip, Rachel H. Gear, Jonathan I. Gregory, Rebecca Leek, Francesca Murray, Iain Coulson, Amy B. Brown, Sarah R. Du, Yong Newbold, Kate Wadsley, Jonathan Flux, Glenn D. The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer |
title | The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer |
title_full | The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer |
title_fullStr | The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer |
title_full_unstemmed | The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer |
title_short | The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer |
title_sort | role of pretherapy quantitative imaging and dosimetry in radioiodine therapy for advanced thyroid cancer |
topic | Clinical Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315692/ https://www.ncbi.nlm.nih.gov/pubmed/37116914 http://dx.doi.org/10.2967/jnumed.122.264913 |
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