Reduction of Salivary Gland Damage During Radioiodine Therapy for Differentiated Thyroid Cancers

Influence of Radioiodine Therapy on Oral Health and Salivary Production in Patients With Differentiated Thyroid Carcinoma

OBJECTIVE

To evaluate the characteristics related to oral health and salivary production in patients with differentiated thyroid carcinoma (DTC) after radioiodine therapy (RIT).

METHODS

Cross-sectional study, which included patients with DTC after ablative and/or adjuvant RIT. Patients underwent assessment of oral health conditions, subjective assessment of xerostomia, and measurement of salivary flow. Salivary glands were assessed by cervical ultrasound at the time of clinical evaluation.

RESULTS

Sixty-seven DTC patients were included. Oral health was found very good or good in 60% of patients, 84% had no dental plaque or a slight amount, and 53% had normal-looking gums. There was a negative correlation between the salivary flow with activity of RIT ablative, number of RITs received, and total activity of radioiodine administered until oral assessment. Reduction in parotid gland volume on ultrasound was associated with greater number of times receiving RIT, longer time between RIT and patient assessment, greater 131I activity administered.

CONCLUSION

Good or very good oral health was observed in 60% of patients with DTC after RIT, 15% reported hyposalivation, and 13%, frequent xerostomia. Higher number and higher total activity of radioiodine administered, as well as reduction in the volume and heterogeneous texture of parotid gland on ultrasound were predictive factors of lower salivary flow.

68Ga-DOTA-FAPI-04 PET/CT imaging in radioiodine-refractory differentiated thyroid cancer (RR-DTC) patients

OBJECTIVE

This study aimed to assess the potential of ⁶⁸Ga-DOTA-FAPI-04 PET/CT for the detection of the radioiodine-refractory differentiated thyroid cancer (RR-DTC) lesions.

METHODS

We analyzed the ⁶⁸Ga-DOTA-FAPI-04 PET/CT imaging data of 24 RR-DTC patients (7 men and 17 women; 49.6 ± 10.5 year). Clinical data were collected including history, last post-therapeutic radioiodine whole body scan, contemporary CT, thyroglobulin, and antithyroglobulin. Target lesions were selected and measured by the RECIST 1.1. The mean growth rates of the target lesions in the past 6 months were recorded. Tumor uptake of lesions were quantified by SUVmax and the tumor-to-background ratios. The correlation between SUVmax and target lesion growth rate and thyroglobulin was analyzed.

RESULTS

On patient-based analysis, positive metastases were detected in 87.5% (21/24) patients. Except for the lymph node (LN) metastasis of 3 patients (patient 6, 12 and 17#) and the lung metastasis of another 3 patients (patient 9, 13 and 21#), most of the lesions were positive on ⁶⁸Ga-DOTA-FAPI-04 PET/CT images, including LN metastasis and distant metastasis such as lung, bone and pleura. There were altogether 33 target lesions including 30 lung metastases and 3 LN metastases with the mean SUVmax and the growth rate were 4.25 and 6.51%, respectively. SUVmax was statistically associated with the growth rates of the target lesions (p = 0.047). No statistically significant correlation was found between the SUVmax and the serum thyroglobulin levels (p = 0.139).

CONCLUSIONS

⁶⁸Ga-DOTA-FAPI-04 PET/CT has a promising detection rate for RR-DTC metastasis. The FAPI uptake of the tumor may provide a potential therapeutic target for RR-DTC.

TRIAL REGISTRY

NIH Clinical Trials.gov (NCT04499365).

KSNM60 in Nuclear Endocrinology: from the Beginning to the Future

Nuclear endocrinology is the main ignitor for founding the Korean Society of Nuclear Medicine (KSNM) in the early 1960s by outstanding pioneering medical doctors. Management of thyroid diseases required nuclear medicine technology in the early days of the KSNM and was rapidly developed by advancements in nuclear medicine technology. Nuclear thyroidology remains one of the main clinical applications in nuclear medicine worldwide. Nuclear medicine technology provides essential information for diagnosing and assessing diseases of the parathyroid glands, pituitary gland, and neuroendocrine tumors (NETs). In addition, therapeutic nuclear medicine is essential for managing nonresectable NETs. Nuclear endocrinology remains a major section in clinical nuclear medicine, and members of the KSNM have contributed to progressing better management of benign and malignant endocrine diseases. This review summarizes the historical activities and milestone contributions to nuclear endocrinology made by the members of the KSNM over the past 60 years to congratulate the KSNM on its 60-year anniversary.