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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Nuclear Medicine 2023
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.
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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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