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Iwanaga H, Fujita N, Abe S, Naganawa S, Kato K. Correlation between the thyroid computed tomography value and thyroid function in hyperthyroidism: a retrospective study. Ann Nucl Med 2024:10.1007/s12149-024-01938-0. [PMID: 38787504 DOI: 10.1007/s12149-024-01938-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Radioiodine (I-131) therapy for hyperthyroidism is a well-established and safe treatment option. This study aimed to investigate the relationship between the computed tomography (CT) value and the function and volume of the thyroid gland by identifying the factors that induce changes in the CT value of patients with hyperthyroidism. METHODS This retrospective study evaluated 38 patients with Graves' disease and 10 patients with Plummer disease. To obtain the mean CT value and volume of the thyroid gland, the entire thyroid gland was set as the region of interest. A test dose of 3.7 MBq I-131 was administered before initiating I-131 therapy, and the radioiodine uptake (RIU) rate was assessed after 3, 24, 96, and 168 h. An approximate curve was plotted based on the RIU values obtained, and the effective half-life (EHL) was calculated. The correlation between the mean CT value and the volume of the thyroid gland, 24-h RIU, EHL, and the free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and TSH receptor antibody (TRAb) levels was evaluated. RESULTS The CT value exhibited a significant positive correlation with EHL in patients with Graves' disease (r = 0.62, p < 0.0001) as well as patients with Plummer disease (r = 0.74, p < 0.05). However, it did not display any correlation with the remaining parameters. CONCLUSION The CT value is significantly correlated with EHL, suggesting that it reflects thyroid function and is mainly related to the factors associated with iodine discharge.
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Affiliation(s)
- Haruna Iwanaga
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, Japan
- Department of Radiological and Medical Laboratory Sciences, Department of Integrated Health Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, Japan
| | - Shinji Abe
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, Japan
| | - Shinji Naganawa
- Functional Medical Imaging, Biomedical Imaging Sciences, Division of Advanced Information Health Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsuhiko Kato
- , 1-20, Daikominami 1‑Chome, Higashi-Ku, Nagoya, 461-8673, Japan.
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Happel C, Bockisch B, Leonhäuser B, Sabet A, Grünwald F, Groener D. The influence of thionamides on intra-thyroidal uptake of 131I during radioiodine-131 treatment of Graves' disease. Sci Rep 2023; 13:21190. [PMID: 38040820 PMCID: PMC10692093 DOI: 10.1038/s41598-023-47228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/10/2023] [Indexed: 12/03/2023] Open
Abstract
Graves' disease is one of the most common causes of hyperthyroidism. Guideline recommendations advocate the intake of thionamides for at least 1 year. If hyperthyroidism persists, subsequent radioiodine-131 treatment (RIT) is a therapeutic option. Thionamides are known to influence intra-thyroidal bio-kinetics of iodine and should therefore be discontinued at least 3 days prior to RIT if possible. However, the required therapeutic activity has to be calculated individually by pre-therapeutic measurement of the uptake prior to RIT [radioiodine-131 uptake test (RIUT)] in Germany according to national guidelines. Therefore, the aim of this study was to quantify the influence of thionamides on intra-therapeutic uptake. A cohort of 829 patients with Graves' disease undergoing RIUT and RIT was analysed. Patients were subdivided into three groups. Group A: patients with carbimazole medication (n = 312), group B: patients with methimazole medication (n = 252) and group C: patients without thionamides (n = 265). Group A and B were further subdivided depending on the reduction of dosage of thionamides. In order to analyse the influence of thionamides, the variance of the determined individual extrapolated maximum intra-thyroidal uptake (EMU) between RIUT and RIT within the single groups and within the subgroups was statistically evaluated. When administering an equal dose of thionamides or no thionamides in RIUT and RIT (groups A1, B1 and C) no significant differences were detected when comparing EMU in RIT to EMU in RIUT (p > 0.05). In the subgroups A2-A4 (reduced dosage of carbimazole prior to RIT) EMU was significantly increased in RIT compared to RIUT [21% for a reduction of 0 to < 10 mg/d (A2), 39% for a reduction of 10-15 mg/d (A3) and 80% for a reduction of > 15 mg/d (A4)]. In the subgroups B2-B4 (reduced dosage of methimazole prior to RIT) EMU was as well significantly increased in RIT compared to RIUT [26% for a reduction of 0 to < 10 mg/d (B2), 36% for a reduction of 10-15 mg/d (B3) and 59% for a reduction of > 15 mg/d (B4)]. A significant dose-dependent increase of EMU in RIT compared to EMU in RIUT in patients discontinuing or reducing thionamides was detected. Therefore, thionamides should be discontinued at least 2 days prior to RIUT in order to achieve the designated target dose more precisely and to minimize radiation exposure of organs at risk.
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Affiliation(s)
- Christian Happel
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany.
| | - Benjamin Bockisch
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - Britta Leonhäuser
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - Amir Sabet
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - Frank Grünwald
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - Daniel Groener
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
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Happel C, Kranert WT, Bockisch B, Sabet A, Grünwald F, Groener D. The influence of thyroid hormone medication on intra-therapeutic half-life of 131I during radioiodine therapy of solitary toxic thyroid nodules. Sci Rep 2022; 12:13925. [PMID: 35978004 PMCID: PMC9385611 DOI: 10.1038/s41598-022-18170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
Despite a significantly improved dietary iodine supply, solitary toxic thyroid nodules (STN) are still a common clinical problem in former iodine deficient areas. Radioiodine treatment (RIT) is a well-established therapeutic option with few side effects and high success rates. As radioiodine biokinetics are individual for every patient, the necessary activity has to be calculated individually by a pre-therapeutic measurement of the intra-therapeutic effective half-life (EHL) in a radioiodine uptake test (RIUT). A suppressive medication with triiodothyronine (T3) or tetraiodothyronine (T4) is often needed to suppress uptake in normal thyroid tissue. Therefore, the aim of this study was to quantify the possible influence of this medication on intra-therapeutic radioiodine biokinetics. A cohort of 928 patients with STN undergoing RIUT and RIT was analysed. Patients were subdivided into 3 groups. Group T3: medication with T3 (n = 274), group T4: medication with T4 (n = 184) and group NM: no additional medication (n = 470). The T3 and T4 subgroups were further subdivided depending on the dose of thyroid hormone medication. In order to analyse the influence of thyroid hormone medication on individual intra-thyroidal biokinetics, the variance of the determined individual EHL between RIUT and RIT within the single groups and within the subgroups was investigated. EHL was significantly decreased between RIUT and RIT in the T3 and T4 subgroups (EHL: T3: 5.9 ± 1.1 d in RIUT and 3.3 ± 1.4 d in RIT (− 43%) (p < 0.05); T4: 5.9 ± 1.2 d in RIUT and 3.4 ± 1.5 d in RIT (− 42%) (p < 0.05). The decrease of EHL did not differ statistically between T3 or T4. However, both showed a highly significant difference compared to the NM group (p < < 0.05). A further subgroup analysis showed a significant dependence of the decrease in EHL related to the dose of thyroid hormone medication of 35–58% (T3) and 15–67% (T4) (p < 0.05). A significantly reduced EHL compared to RIUT in patients receiving thyroid hormone medication was detected. Moreover, a significant correlation between the dose of thyroid hormone medication (T3 or T4) and the decrease of EHL was found. Therefore, an adaption of the calculated activity should be considered in RIUT to obtain the required radiation dose in RIT of patients suffering from STN.
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Affiliation(s)
- Christian Happel
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany.
| | - Wolfgang Tilman Kranert
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Benjamin Bockisch
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Amir Sabet
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Frank Grünwald
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany
| | - Daniel Groener
- Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany
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Zuhayra M, Helm A, Ranjan J, Jüptner M, Zhao Y, Marx M, Assam I, Alfteimi A, Lützen U. A simple, reliable and accurate approach for assessing [ 131I]-capsule activity leading to significant reduction of radiation exposure of medical staff during radioiodine therapy. Phys Med 2022; 96:157-165. [PMID: 35306454 DOI: 10.1016/j.ejmp.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE According to German law, the [131I]-capsule activity has to be checked in the context of radioiodine therapy (RIT) immediately before application. The measurement leads to significant radiation exposure of the medical personnel, especially of their hands. We aimed to establish a method for estimating [131I]-capsule activity by measuring the dose rate (DR) at contact of the delivered lead closed container carrying the [131I]-capsules and to evaluate radiation exposure in comparison to conventional [131I]-capsule measurement using a dose calibrator. METHODS DR on the surface of the closed lead container was measured at two locations and correlated linearly with the [131I]-capsule activity measured in a dose calibrator to create calibrating curves. The hand and whole body (effective) doses were determined with official dose meters during validation of our method in clinical practice. RESULTS The determination coefficients (R2) of linear calibration curves were greater than 0.9974. The total relative uncertainty for estimating [131I]-capsule activity with our method was <±7.5% which is lower than the uncertainty of the nominal activity and quite close to the threshold limit for the maximum allowed uncertainty of ± 5% for measuring activity in radioactive drugs. The reduction of the hand dose caused by our method was 97% compared with the conventional measurements of the [131I]-capsules in a dose calibrator. CONCLUSION Measuring DR on the surface of the closed lead containers enables the [131I]-capsules activity to be estimated simply, reliably and with sufficient accuracy leading to significant reduction of the radiation exposure for the medical staff.
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Affiliation(s)
- Maaz Zuhayra
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Alexander Helm
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Joshua Ranjan
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Michael Jüptner
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Yi Zhao
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Marlies Marx
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Isong Assam
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Ammar Alfteimi
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
| | - Ulf Lützen
- Department of Nuclear Medicine, Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Karl Lennert Cancer Center North, Feld-Str. 21, D-24105, Germany.
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Duan H, Iagaru A, Aparici CM. Radiotheranostics - Precision Medicine in Nuclear Medicine and Molecular Imaging. Nanotheranostics 2022; 6:103-117. [PMID: 34976584 PMCID: PMC8671964 DOI: 10.7150/ntno.64141] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
'See what you treat and treat what you see, at a molecular level', could be the motto of theranostics. The concept implies diagnosis (imaging) and treatment of cells (usually cancer) using the same molecule, thus guaranteeing a targeted cytotoxic approach of the imaged tumor cells while sparing healthy tissues. As the brilliant late Sam Gambhir would say, the imaging agent acts like a 'molecular spy' and reveals where the tumoral cells are located and the extent of disease burden (diagnosis). For treatment, the same 'molecular spy' docks to the same tumor cells, this time delivering cytotoxic doses of radiation (treatment). This duality represents the concept of a 'theranostic pair', which follows the scope and fundamental principles of targeted precision and personalized medicine. Although the term theranostic was noted in medical literature in the early 2000s, the principle is not at all new to nuclear medicine. The first example of theranostic dates back to 1941 when Dr. Saul Hertz first applied radioiodine for radionuclide treatment of thyroid cells in patients with hyperthyroidism. Ever since, theranostics has been an integral element of nuclear medicine and molecular imaging. The more we understand tumor biology and molecular pathology of carcinogenesis, including specific mutations and receptor expression profiles, the more specific these 'molecular spies' can be developed for diagnostic molecular imaging and subsequent radionuclide targeted therapy (radiotheranostics). The appropriate selection of the diagnostic and therapeutic radionuclide for the 'theranostic pair' is critical and takes into account not only the type of cytotoxic radiation emission, but also the linear energy transfer (LET), and the physical half-lives. Advances in radiochemistry and radiopharmacy with new radiolabeling techniques and chelators are revolutionizing the field. The landscape of cytotoxic systemic radionuclide treatments has dramatically expanded through the past decades thanks to all these advancements. This article discusses present and promising future theranostic applications for various types of diseases such as thyroid disorders, neuroendocrine tumors (NET), pediatric malignancies, and prostate cancer (PC), and provides an outlook for future perspectives.
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Affiliation(s)
- Heying Duan
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA, USA
| | - Andrei Iagaru
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA, USA
| | - Carina Mari Aparici
- Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA, USA
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Advances in Functional Imaging of Differentiated Thyroid Cancer. Cancers (Basel) 2021; 13:cancers13194748. [PMID: 34638232 PMCID: PMC8507556 DOI: 10.3390/cancers13194748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 12/25/2022] Open
Abstract
Simple Summary Since the 1940s, radioactive iodine has been used for functional imaging and for treating patients with differentiated thyroid cancer (DTC). During this long-lasting experience, the use of iodine isotopes evolved, especially during the last years due to improved knowledge of thyroid cancer biology and improved performances of imaging tools. The present review summarizes recent advances in the field of functional imaging and theragnostic approach of DTC. Abstract The present review provides a description of recent advances in the field of functional imaging that takes advantage of the functional characteristics of thyroid neoplastic cells (such as radioiodine uptake and FDG uptake) and theragnostic approach of differentiated thyroid cancer (DTC). Physical and biological characteristics of available radiopharmaceuticals and their use with state-of-the-art technologies for diagnosis, treatment, and follow-up of DTC patients are depicted. Radioactive iodine is used mostly with a therapeutic intent, while PET/CT with 18F-FDG emerges as a useful tool in the diagnostic management and complements the use of radioactive iodine. Beyond 18F-FDG PET/CT, other tracers including 124I, 18F-TFB and 68Ga-PSMA, and new methods such as PET/MR, might offer new opportunities in selecting patients with DTC for specific imaging modalities or treatments.
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Happel C, Kranert WT, Gröner D, Baumgarten J, Halstenberg J, Bockisch B, Sabet A, Grünwald F. Focus on radioiodine-131 biokinetics: the influence of methylprednisolone on intratherapeutic effective half-life of 131I during radioiodine therapy of Graves' disease. Endocrine 2021; 73:125-130. [PMID: 33439464 PMCID: PMC8211592 DOI: 10.1007/s12020-020-02593-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022]
Abstract
AIM Radioiodine therapy (RIT) may trigger the development of Graves' ophthalmopathy (GO) or exacerbate pre-existing subclinical GO. Therefore, glucocorticoid administration is recommended for patients with pre-existing GO. Aim of this study was to analyze the influence of glucocorticoid therapy with methylprednisolone on intratherapeutic effective half-life (EHL) of radioiodine-131 in patients with Graves' disease (GD) as recent studies showed an effect for prednisolone. METHODS In a retrospective study, 264 patients with GD who underwent RIT without any additional antithyroid medication were evaluated. Intrathyroidal EHL was determined pre- and intratherapeutically. Patients with co-existing GO (n = 43) received methylprednisolone according to a fixed scheme starting 1 day prior to RIT, patients without GO (n = 221) did not receive any protective glucocorticoid medication. The ratios of EHL during RIT and during radioiodine uptake test (RIUT) were compared. RESULTS Patients receiving methylprednisolone showed a slight decrease of the mean EHL from 5.63 d (RIUT) to 5.39 d (RIT) (p > 0.05). A comparable result was obtained in patients without glucocorticoids (5.71 d (RIUT) to 5.47 d (RIT); p > 0.05). The ratios of the EHL between RIT and RIUT failed to show a significant difference between the two groups. EHL is therefore not significantly influenced by an additional protective treatment with methylprednisolone. CONCLUSIONS In the present study a decreased intrathyroidal EHL under glucocorticoid medication with methylprednisolone could not be detected. Therefore, co-medication with methylprednisolone in patients with GO may be preferred to avoid an intratherapeutic decrease of EHL by accompanying protective glucocorticoides.
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Affiliation(s)
- C Happel
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany.
| | - W T Kranert
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - D Gröner
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - J Baumgarten
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - J Halstenberg
- Department of Anesthesiology, Alice-Hospital, Darmstadt, Germany
| | - B Bockisch
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - A Sabet
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
| | - F Grünwald
- Department of Nuclear Medicine, Goethe University Frankfurt, University Hospital, Theodor Stern Kai 7, D-60590, Frankfurt/Main, Germany
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Fahey FH, Grant FD. Celebrating eighty years of radionuclide therapy and the work of Saul Hertz. J Appl Clin Med Phys 2021; 22:4-10. [PMID: 33533204 PMCID: PMC7856499 DOI: 10.1002/acm2.13175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/01/2021] [Accepted: 05/01/2021] [Indexed: 11/11/2022] Open
Abstract
March 2021 will mark the eightieth anniversary of targeted radionuclide therapy, recognizing the first use of radioactive iodine to treat thyroid disease by Dr. Saul Hertz on March 31, 1941. The breakthrough of Dr. Hertz and collaborator physicist Arthur Roberts was made possible by rapid developments in the fields of physics and medicine in the early twentieth century. Although diseases of the thyroid gland had been described for centuries, the role of iodine in thyroid physiology had been elucidated only in the prior few decades. After the discovery of radioactivity by Henri Becquerel in 1897, rapid advancements in the field, including artificial production of radioactive isotopes, were made in the subsequent decades. Finally, the diagnostic and therapeutic use of radioactive iodine was based on the tracer principal that was developed by George de Hevesy. In the context of these advancements, Hertz was able to conceive the potential of using of radioactive iodine to treat thyroid diseases. Working with Dr. Roberts, he obtained the experimental data and implemented it in the clinical setting. Radioiodine therapy continues to be a mainstay of therapy for hyperthyroidism and thyroid cancer. However, Hertz struggled to gain recognition for his accomplishments and to continue his work and, with his early death in 1950, his contributions have often been overlooked until recently. The work of Hertz and others provided a foundation for the introduction of other radionuclide therapies and for the development of the concept of theranostics.
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Affiliation(s)
- Frederic H Fahey
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frederick D Grant
- Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Weber WA, Czernin J, Anderson CJ, Badawi RD, Barthel H, Bengel F, Bodei L, Buvat I, DiCarli M, Graham MM, Grimm J, Herrmann K, Kostakoglu L, Lewis JS, Mankoff DA, Peterson TE, Schelbert H, Schöder H, Siegel BA, Strauss HW. The Future of Nuclear Medicine, Molecular Imaging, and Theranostics. J Nucl Med 2021; 61:263S-272S. [PMID: 33293447 DOI: 10.2967/jnumed.120.254532] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 12/20/2022] Open
Affiliation(s)
| | | | | | | | | | - Frank Bengel
- Medizinische Hochschule Hannover, Hannover, Germany
| | - Lisa Bodei
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Irène Buvat
- Institut Curie, Université PSL, Inserm, Orsay, France
| | | | | | - Jan Grimm
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | | | | | - Jason S Lewis
- Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | | | - Todd E Peterson
- Vanderbilt University Medical Center, Nashville, Tennessee; and
| | | | - Heiko Schöder
- Memorial Sloan Kettering Cancer Center, New York, New York
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Yafout M, Ousaid A, Khayati Y, El Otmani IS. Gold nanoparticles as a drug delivery system for standard chemotherapeutics: A new lead for targeted pharmacological cancer treatments. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2020.e00685] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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11
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Happel C, Kranert WT, Gröner D, Bockisch B, Sabet A, Vardarli I, Görges R, Herrmann K, Grünwald F. Correction for hyperfunctioning radiation-induced stunning (CHRIS) in benign thyroid diseases. Endocrine 2020; 69:466-473. [PMID: 32173798 DOI: 10.1007/s12020-020-02258-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/03/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Radioiodine-131 treatment has been a well-established therapy for benign thyroid diseases for more than 75 years. However, the physiological reasons of the so-called stunning phenomenon, defined as a reduced radioiodine uptake after previous diagnostic radioiodine administration, are still discussed controversially. In a recent study, a significant dependence of thyroid stunning on the pre-therapeutically administered radiation dose could be demonstrated in patients with goiter and multifocal autonomous nodules. A release of thyroid hormones to the blood due to radiation-induced destruction of thyroid follicles leading to a temporarily reduced cell metabolism was postulated as possible reason for this indication-specific stunning effect. Therefore, the aim of this study was to develop dose-dependent correction factors to account for stunning and thereby improve precision of radioiodine treatment in these indications. METHODS A retrospective analysis of 313 patients (135 with goiter and 178 with multifocal autonomous nodules), who underwent radioiodine uptake testing and radioiodine treatment, was performed. The previously determined indication-specific values for stunning of 8.2% per Gray in patients with multifocal autonomous nodules and 21% per Gray in patients with goiter were used to modify the Marinelli equation by the calculation of correction factors for hyperfunctioning radiation-induced stunning (CHRIS). Subsequently, the calculation of the required activity of radioiodine-131 to obtain an intra-therapeutic target dose of 150 Gy was re-evaluated in all patients. Furthermore, a calculation of the hypothetically received target dose by using the CHRIS-calculated values was performed and compared with the received target doses. RESULTS After integrating the previously obtained results for stunning, CHRIS-modified Marinelli equations could be developed for goiter and multifocal autonomous nodules. For patients with goiter, the mean value of administered doses calculated with CHRIS was 149 Gy and did not differ from the calculation with the conventional Marinelli equation of 152 Gy with statistical significance (p = 0.60). However, the statistical comparison revealed a highly significant improvement (p < 0.000001) of the fluctuation range of the results received with CHRIS. Similar results were obtained in the subgroup of patients with multifocal autonomous nodules. The mean value of the administered dose calculated with the conventional Marinelli equation was 131 Gy and therefore significantly below the CHRIS-calculated radiation dose of 150 Gy (p < 0.05). Again, the fluctuation range of the CHRIS-calculated radiation dose in the target volume was significantly improved compared with the conventional Marinelli equation (p < 0.000001). CONCLUSIONS With the presented CHRIS equation it is possible to calculate a required individual stunning-independent radioiodine activity for the first time by only using data from the radioiodine uptake testing. The results of this study deepen our understanding of thyroid stunning in benign thyroid diseases and improve precision of dosimetry in radioiodine-131 therapy of goiter and multifocal autonomous nodules.
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Affiliation(s)
- C Happel
- Department of Nuclear Medicine, University Hospital, Goethe University, Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany.
| | - W T Kranert
- Department of Nuclear Medicine, University Hospital, Goethe University, Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany
| | - D Gröner
- Department of Nuclear Medicine, University Hospital, Goethe University, Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany
| | - B Bockisch
- Department of Nuclear Medicine, University Hospital, Goethe University, Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany
| | - A Sabet
- Department of Nuclear Medicine, University Hospital, Goethe University, Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany
| | - I Vardarli
- Department of Medicine I, Klinikum Vest GmbH, Knappschaftskrankenhaus Recklinghausen, Academic Teaching Hospital, Ruhr-University Bochum, Recklinghausen, Dorstener Str. 151, D-45657, Recklinghausen, Germany
| | - R Görges
- Department of Nuclear Medicine, University Hospital, Essen, Hufelandstraße 55, D-45147, Essen, Germany
| | - K Herrmann
- Department of Nuclear Medicine, University Hospital, Essen, Hufelandstraße 55, D-45147, Essen, Germany
| | - F Grünwald
- Department of Nuclear Medicine, University Hospital, Goethe University, Frankfurt, Theodor Stern Kai 7, D-60590, Frankfurt, Germany
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Fujita N, Koshiba Y, Abe S, Kato K. Investigation of post-therapeutic image-based thyroid dosimetry using quantitative SPECT/CT, iodine biokinetics, and the MIRD's voxel S values in Graves' disease. EJNMMI Phys 2020; 7:6. [PMID: 31993828 PMCID: PMC6987275 DOI: 10.1186/s40658-020-0274-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/16/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Before radioiodine therapy for Graves' disease, the estimated thyroid-absorbed dose is calculated based on various clinical parameters. However, the actual accumulation of iodine in the thyroid during radioiodine therapy is not determined. We validated the feasibility of post-therapeutic image-based thyroid dosimetry through quantitative single-photon emission computed tomography (SPECT) imaging and thyroid biokinetics and expanding the Medical Internal Radiation Dose Committee's (MIRD) voxel dosimetry guidelines. METHODS Forty-three patients with Graves' disease who underwent radioiodine therapy were chosen as subjects for this retrospective analysis. We acquired patients' SPECT images 24 h after oral administration. SPECT images were quantified using system volume sensitivity to calculate time-integrated activity coefficients on a voxel basis. Absorbed dose was obtained by convolving MIRD guideline voxel S values with time-integrated activity coefficients. To determine accuracy, we compared the results obtained using the post-therapeutic image-based absorbed-dose method (D̅image,PVC) with absorbed doses calculated using the method described by the European Association of Nuclear Medicine (pre-therapeutic method; DEANM). RESULTS Using image-based dosimetry as post-therapeutic dosimetry, we visualized the local accumulation and absorbed dose distribution of iodine in the thyroid. Furthermore, we determined a strong correlation (Pearson's correlation coefficient = 0.89) between both dosimetries, using the regression equation: D̅image,PVC = 0.94 × DEANM + 1.35. CONCLUSION Post-therapeutic image-based doses absorbed in the thyroid resembled those of pre-therapeutic EANM method-based absorbed doses. Additionally, the post-therapeutic image-based method had the advantage of visualizing thyroid iodine distribution, thus determining local dose distributions at the time of treatment. From these points, we propose that post-therapeutic image-based dosimetry could provide an alternative to standard pre-therapeutic dosimetry to evaluate dose response.
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Affiliation(s)
- Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan.,Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, 461-8673, Japan
| | - Yumiko Koshiba
- Department of Radiological Technology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Shinji Abe
- Department of Radiological Technology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Katsuhiko Kato
- Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, 461-8673, Japan.
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Falzone L, Salomone S, Libra M. Evolution of Cancer Pharmacological Treatments at the Turn of the Third Millennium. Front Pharmacol 2018; 9:1300. [PMID: 30483135 PMCID: PMC6243123 DOI: 10.3389/fphar.2018.01300] [Citation(s) in RCA: 473] [Impact Index Per Article: 78.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 12/11/2022] Open
Abstract
The medical history of cancer began millennia ago. Historical findings of patients with cancer date back to ancient Egyptian and Greek civilizations, where this disease was predominantly treated with radical surgery and cautery that were often ineffective, leading to the death of patients. Over the centuries, important discoveries allowed to identify the biological and pathological features of tumors, without however contributing to the development of effective therapeutic approaches until the end of the 1800s, when the discovery of X-rays and their use for the treatment of tumors provided the first modern therapeutic approach in medical oncology. However, a real breakthrough took place after the Second World War, with the discovery of cytotoxic antitumor drugs and the birth of chemotherapy for the treatment of various hematological and solid tumors. Starting from this epochal turning point, there has been an exponential growth of studies concerning the use of new drugs for cancer treatment. The second fundamental breakthrough in the field of oncology and pharmacology took place at the beginning of the '80s, thanks to molecular and cellular biology studies that allowed the development of specific drugs for some molecular targets involved in neoplastic processes, giving rise to targeted therapy. Both chemotherapy and target therapy have significantly improved the survival and quality of life of cancer patients inducing sometimes complete tumor remission. Subsequently, at the turn of the third millennium, thanks to genetic engineering studies, there was a further advancement of clinical oncology and pharmacology with the introduction of monoclonal antibodies and immune checkpoint inhibitors for the treatment of advanced or metastatic tumors, for which no effective treatment was available before. Today, cancer research is always aimed at the study and development of new therapeutic approaches for cancer treatment. Currently, several researchers are focused on the development of cell therapies, anti-tumor vaccines, and new biotechnological drugs that have already shown promising results in preclinical studies, therefore, in the near future, we will certainly assist to a new revolution in the field of medical oncology.
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Affiliation(s)
- Luca Falzone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Salvatore Salomone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Research Center for Prevention, Diagnosis and Treatment of Cancer (PreDiCT), University of Catania, Catania, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Research Center for Prevention, Diagnosis and Treatment of Cancer (PreDiCT), University of Catania, Catania, Italy
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Rosenthal MS, Angelos P, Schweppe RE. Research ethics dilemmas in thyroid disease. Curr Opin Endocrinol Diabetes Obes 2018; 25:335-340. [PMID: 30095478 DOI: 10.1097/med.0000000000000429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Since research ethics dilemmas frequently fall outside the purview of the Institutional Review Board (IRB), we present three unique recent research ethics cases in thyroidology that demonstrate research ethics dilemmas. RECENT FINDINGS The cases presented raise questions surrounding epistemic/scientific integrity, publication ethics, and professional, and personal integrity. SUMMARY Research ethics dilemmas that fall outside the purview of the IRB are appropriate for a Research Ethics Consultation, a common service in many large academic medical centers.
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Affiliation(s)
- M Sara Rosenthal
- Program for Bioethics, Departments of Internal Medicine, Pediatrics and Behavioral Science, University of Kentucky, Lexington, Kentucky
| | - Peter Angelos
- Department of Surgery, University of Chicago and MacLean Center for Clinical Medical Ethics, Chicago, Illinois
| | - Rebecca E Schweppe
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Cancer Center, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
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Kelsey MP, Haines SF, Keating FR. The Treatment of Exophthalmic Goiter with Radioiodine. Postgrad Med 2017; 6:263-73. [DOI: 10.1080/00325481.1949.11945618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Alotaibi H, Tuzlakoğlu-Öztürk M, Tazebay UH. The Thyroid Na+/I- Symporter: Molecular Characterization and Genomic Regulation. Mol Imaging Radionucl Ther 2017; 26:92-101. [PMID: 28117294 PMCID: PMC5283716 DOI: 10.4274/2017.26.suppl.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Iodide (I-) is an essential constituent of the thyroid hormones triiodothyronine (T3) and thyroxine (T4), and the iodide concentrating mechanism of the thyroid gland is essential for the synthesis of these hormones. In addition, differential uptake of iodine isotopes (radioiodine) is a key modality for the diagnosis and therapy of thyroid cancer. The sodium dependent iodide transport activity of the thyroid gland is mainly attributed to the functional expression of the Na+/I- Symporter (NIS) localized at the basolateral membrane of thyrocytes. In this paper, we review and summarize current data on molecular characterization, on structure and function of NIS protein, as well as on the transcriptional regulation of NIS encoding gene in the thyroid gland. We also propose that a better and more precise understanding of NIS gene regulation at the molecular level in both healthy and malignant thyroid cells may lead to the identification of small molecule candidates. These could then be translated into clinical practice for better induction and more effective modulation of radioiodine uptake in dedifferentiated thyroid cancer cells and in their distant metastatic lesions.
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Affiliation(s)
| | | | - Uygar Halis Tazebay
- Gebze Technical University, Department of Molecular Biology and Genetics, Kocaeli, Turkey, Phone: +90 262 605 25 22, E-mail:
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Lützen U, Zhao Y, Marx M, Imme T, Assam I, Siebert FA, Culman J, Zuhayra M. Effective method of measuring the radioactivity of [ 131I]-capsule prior to radioiodine therapy with significant reduction of the radiation exposure to the medical staff. J Appl Clin Med Phys 2016; 17:59-72. [PMID: 27455475 PMCID: PMC5690049 DOI: 10.1120/jacmp.v17i4.5942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 02/21/2016] [Accepted: 02/16/2016] [Indexed: 11/23/2022] Open
Abstract
Radiation Protection in Radiology, Nuclear Medicine and Radio Oncology is of the utmost importance. Radioiodine therapy is a frequently used and effective method for the treatment of thyroid disease. Prior to each therapy the radioactivity of the [131I]-capsule must be determined to prevent misadministration. This leads to a significant radiation exposure to the staff. We describe an alternative method, allowing a considerable reduction of the radiation exposure. Two [131I]-capsules (A01 = 2818.5; A02 = 7355.0 MBq) were measured multiple times in their own delivery lead containers - that is to say, [131I]-capsules remain inside the containers during the measurements (shielded measurement) using a dose calibrator and a well-type and a thyroid uptake probe. The results of the shielded measurements were correlated linearly with the [131I]-capsules radioactivity to create calibration curves for the used devices. Additional radioactivity measurements of 50 [131I]-capsules of different radioactivities were done to validate the shielded measuring method. The personal skin dose rate (HP(0.07)) was determined using calibrated thermo luminescent dosimeters. The determination coefficients for the calibration curves were R2 > 0.9980 for all devices. The relative uncertainty of the shielded measurement was < 6.8%. At a distance of 10 cm from the unshielded capsule the HP(0.07) was 46.18 μSv/(GBq•s), and on the surface of the lead container containing the [131I]-capsule the HP(0.07) was 2.99 and 0.27 μSv/(GBq•s) for the two used container sizes. The calculated reduction of the effective dose by using the shielded measuring method was, depending on the used container size, 74.0% and 97.4%, compared to the measurement of the unshielded [131I]-capsule using a dose calibrator. The measured reduction of the effective radiation dose in the practice was 56.6% and 94.9 for size I and size II containers. The shielded [131I]-capsule measurement reduces the radiation exposure to the staff significantly and offers the same accuracy of the unshielded measurement in the same amount of time. In order to maintain the consistency of the measuring method, monthly tests have to be done by measuring a [131I]-capsule with known radioactivity.
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Affiliation(s)
- Ulf Lützen
- Molecular Diagnostic Imaging and Therapy, University Hospital of Schleswig-Holstein (UKSH), Campus Kiel.
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Rudqvist N, Schüler E, Parris TZ, Langen B, Helou K, Forssell-Aronsson E. Dose-specific transcriptional responses in thyroid tissue in mice after (131)I administration. Nucl Med Biol 2014; 42:263-8. [PMID: 25496975 DOI: 10.1016/j.nucmedbio.2014.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/14/2014] [Accepted: 11/19/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION In the present investigation, microarray analysis was used to monitor transcriptional activity in thyroids in mice 24 h after (131)I exposure. The aims of this study were to 1) assess the transcriptional patterns associated with (131)I exposure in normal mouse thyroid tissue and 2) propose biomarkers for (131)I exposure of the thyroid. METHODS Adult BALB/c nude mice were i.v. injected with 13, 130 or 260 kBq of (131)I and killed 24h after injection (absorbed dose to thyroid: 0.85, 8.5, or 17 Gy). Mock-treated mice were used as controls. Total RNA was extracted from thyroids and processed using the Illumina platform. RESULTS In total, 497, 546, and 90 transcripts were regulated (fold change ≥1.5) in the thyroid after 0.85, 8.5, and 17 Gy, respectively. These were involved in several biological functions, e.g. oxygen access, inflammation and immune response, and apoptosis/anti-apoptosis. Approximately 50% of the involved transcripts at each absorbed dose level were dose-specific, and 18 transcripts were commonly detected at all absorbed dose levels. The Agpat9, Plau, Prf1, and S100a8 gene expression displayed a monotone decrease in regulation with absorbed dose, and further studies need to be performed to evaluate if they may be useful as dose-related biomarkers for 131I exposure. CONCLUSION Distinct and substantial differences in gene expression and affected biological functions were detected at the different absorbed dose levels. The transcriptional profiles were specific for the different absorbed dose levels. We propose that the Agpat9, Plau, Prf1, and S100a8 genes might be novel potential absorbed dose-related biomarkers to (131)I exposure of thyroid. ADVANCES IN KNOWLEDGE During the recent years, genomic techniques have been developed; however, they have not been fully utilized in nuclear medicine and radiation biology. We have used RNA microarrays to investigate genome-wide transcriptional regulations in thyroid tissue in mice after low, intermediate, and high absorbed doses from (131)I exposure in vivo. Using this approach, we have identified novel biological responses and potential absorbed dose-related biomarkers to (131)I exposure. Our research shows the importance of embracing technological advances and multi-disciplinary collaboration in order to apply them in radiation therapy, nuclear medicine, and radiation biology. IMPLICATIONS ON PATIENT CARE This work may contribute with new knowledge of potential normal tissue effects or complications that may occur after exposure to ionizing radiation in diagnostic and therapeutic nuclear medicine, and due to radioactive fallout or accident with radionuclide spread.
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Affiliation(s)
- Nils Rudqvist
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Emil Schüler
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Toshima Z Parris
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Britta Langen
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Khalil Helou
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Eva Forssell-Aronsson
- Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden; Department of Medical Physics and Medical Bioengineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Affiliation(s)
- Gilbert H Daniels
- Department of Medicine, Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
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Hertz BE, Schuller KE. Saul Hertz, MD (1905-1950): a pioneer in the use of radioactive iodine. Endocr Pract 2010; 16:713-5. [PMID: 20350908 DOI: 10.4158/ep10065.co] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hingorani M, Spitzweg C, Vassaux G, Newbold K, Melcher A, Pandha H, Vile R, Harrington K. The biology of the sodium iodide symporter and its potential for targeted gene delivery. Curr Cancer Drug Targets 2010; 10:242-67. [PMID: 20201784 DOI: 10.2174/156800910791054194] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Accepted: 02/16/2010] [Indexed: 12/12/2022]
Abstract
The sodium iodide symporter (NIS) is responsible for thyroidal, salivary, gastric, intestinal and mammary iodide uptake. It was first cloned from the rat in 1996 and shortly thereafter from human and mouse tissue. In the intervening years, we have learned a great deal about the biology of NIS. Detailed knowledge of its genomic structure, transcriptional and post-transcriptional regulation and pharmacological modulation has underpinned the selection of NIS as an exciting approach for targeted gene delivery. A number of in vitro and in vivo studies have demonstrated the potential of using NIS gene therapy as a means of delivering highly conformal radiation doses selectively to tumours. This strategy is particularly attractive because it can be used with both diagnostic (99mTc, 125I, 124I)) and therapeutic (131I, 186Re, 188Re, 211At) radioisotopes and it lends itself to incorporation with standard treatment modalities, such as radiotherapy or chemoradiotherapy. In this article, we review the biology of NIS and discuss its development for gene therapy.
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Affiliation(s)
- Mohan Hingorani
- The Institute of Cancer Research, 237 Fulham Road, London SW36JB, UK
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SKANSE B. Radioactive iodine; its use in studying the urinary excretion of iodine by humans in various states of thyroid function; a preliminary report. ACTA ACUST UNITED AC 2007; 131:251-68. [PMID: 18098987 DOI: 10.1111/j.0954-6820.1948.tb03426.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Moore FD, Sweeny DN, Cope O, Rawson RW, Means JH. The Use of Thiouracil in the Preparation of Patients With Hyperthyroidism for Thyroidectomy. Ann Surg 2007; 120:152-69. [PMID: 17858480 PMCID: PMC1617967 DOI: 10.1097/00000658-194408000-00003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- W M McConahey
- Division of Medicine, Mayo Clinic, Rochester, Minnesota
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Williams RH, Jaffe H, Bernstein B. COMPARISONS OF THE DISTRIBUTION OF RADIOACTIVE IODINE IN SERUM AND URINE IN DIFFERENT LEVELS OF THYROID FUNCTION. J Clin Invest 2006; 28:1222-7. [PMID: 16695794 PMCID: PMC439679 DOI: 10.1172/jci102156] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- R H Williams
- Thorndike Memorial Laboratory, Second and Fourth Medical Services [Harvard], Boston City Hospital, Boston, Massachusetts
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Hertz S, Roberts A. RADIOACTIVE IODINE AS AN INDICATOR IN THYROID PHYSIOLOGY. V. THE USE OF RADIOACTIVE IODINE IN THE DIFFERENTIAL DIAGNOSIS OF TWO TYPES OF GRAVES' DISEASE. J Clin Invest 2006; 21:31-2. [PMID: 16694888 PMCID: PMC435114 DOI: 10.1172/jci101276] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- S Hertz
- Thyroid Clinic, Massachusetts General Hospital, Boston
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Keating FR, Power MH, Berkson J, Haines SF. THE URINARY EXCRETION OF RADIOIODINE IN VARIOUS THYROID STATES. J Clin Invest 2006; 26:1138-51. [PMID: 16695515 PMCID: PMC439459 DOI: 10.1172/jci101906] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- F R Keating
- Division of Medicine, Mayo Clinic, Rochester, Minnesota
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RABEN MS, ASTWOOD EB. The use of radioiodine in physiological and clinical studies on the thyroid gland. J Clin Invest 2004; 28:1347-66. [PMID: 15407497 PMCID: PMC439692 DOI: 10.1172/jci102201] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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RAWSON RW. The use of radioactive iodine in studying the pathologic physiology of thyroid disease. J Clin Invest 2004; 28:1330-46, illust. [PMID: 15395281 PMCID: PMC439691 DOI: 10.1172/jci102200] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
When asked, in 1936 by J. Howard Means, Chief of Medicine at Massachusetts General Hospital, whether radioiodine could be produced for thyroid studies, Karl T. Compton, President of the Massachusetts Institute of Technology, referred the question to Robley Evans of the physics department. In response, Evans formed a team from the fields of physics and medicine that produced 128I for animal studies and, subsequently on a cyclotron dedicated to medical purposes, 130I for human uptake measurements and the treatment of hyperthyroidism. Much of what we have learned about iodine kinetics and the radioiodine therapy of Graves's disease stems from these early seminal reports. The cooperation between physicists and physicians that made their accomplishments possible stands as a model example for interdisciplinary collaboration.
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Affiliation(s)
- S J Adelstein
- Daniel C. Tosteson University Professor, Harvard Medical School, 220 Longwood Avenue-Goldenson 242, Boston, MA 02115, USA
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Abstract
Little was known about iodine metabolism in the mid-1930s, but when Saul Hertz and his chief, J. Howard Means, at the Massachusetts General Hospital (MGH) realized in 1936 that radioiodine could be made and used as a tracer, they arranged with physicists Robley Evans and Arthur Roberts at the Massachusetts Institute of Technology (MIT) to make the short-lived 128I and study its physiology in rabbits. By 1938, they showed that the rabbit's thyroid gland rapidly took up 128I, especially when there was only a little non-radioactive iodine present. There was, however, no hope of using 128I as a treatment because of its brief half-life (25 minutes). In 1939, Joseph Hamilton and Mayo Soley, working with Ernest Lawrence's cyclotron in Berkeley, California, were able to make several radioiodines; one was 130I (12-hour half-life) and another 131I (8-day half-life). They were the first to give these radioiodines to humans to study iodine physiology. The MGH-MIT group also built a cyclotron and by 1940 had generated these two new radioiodines. One of the goals of both groups was the treatment of hyperthyroidism. Hertz and Roberts were the first to do so on March 31, 1941; Hamilton and John Lawrence, Ernest's brother, began on October 12, 1941. By 1942, the United States was actively fighting in World War II. That year both Boston and Berkeley groups have preliminary data on the treatment of hyperthyroidism in Atlantic City; both showed that it was effective and went on to treat more patients. In Berkeley the therapy was viewed cautiously, and, in many case, the physicists were mainly occupied with work for the Manhattan District. In Boston Hertz used the therapy as often as he could, emphasizing the use of 130I, until he joined the U.S. Navy in 1943. Earle Chapman, a clinician on the voluntary staff of the MGH, took over Hertz's practice in 1943; their later differences over the precise treatment and who was in charge led to their falling out. After Hertz's release from the Navy he was not permitted to return to the MGH and became quite bitter; Chapman stayed on at the MGH. After the war was over, both had acquired a sufficient number of patients--there was then no such thing as a controlled trial--and wrote up the results for publication. Each wrote a different physicist, Hertz with Roberts and Chapman with Evans. When Hertz learned that Chapman's paper was being considered by the Journal of the American Medical Associations, he quickly sent his manuscript to JAMA as well. Although the editor of JAMA was puzzled by two papers on the same topic from the same institution, both papers appeared in the same issue of JAMA on May 11, 1964, and announced the new therapy was effective treatment for hyperthyroidism.
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Affiliation(s)
- C T Sawin
- Medical Service, Boston Veterans Affairs Medical Center, Massachusetts, USA
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Ansell G, Rotblat J. Radioactive iodine as a diagnostic aid for intrathoracic goitre. 1948. Br J Radiol 1995; 68:H121-7. [PMID: 7627475 DOI: 10.1259/0007-1285-68-810-h121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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GHADIMI H, SASS-KORTSAK A. Evaluation of the radioactive rose-bengal test for the differential diagnosis of obstructive jaundice in infants. N Engl J Med 1961; 265:351-8. [PMID: 13704886 DOI: 10.1056/nejm196108242650801] [Citation(s) in RCA: 42] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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GOLDBERG IJ, FITZSIMONS EA. The Thyroidal Accumulation of Radioiodine as a Clinical Test for Hyperthyroidism. Br J Radiol 1958; 31:428-32. [PMID: 13560749 DOI: 10.1259/0007-1285-31-368-428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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BELCASTRO PF, CHRISTIAN JE, DeKAY HG. The effect of x-irradiation on intestinal absorption and thyroid uptake of the iodide ion using I-131. JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION. AMERICAN PHARMACEUTICAL ASSOCIATION 1952; 41:174-7. [PMID: 14938246 DOI: 10.1002/jps.3030410403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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Radioactive Isotopes in Clinical Diagnosis. ACTA ACUST UNITED AC 1951. [DOI: 10.1016/b978-1-4831-9925-2.50011-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Technical Exhibition—Sixth International Congress of Radiology. Br J Radiol 1950. [DOI: 10.1259/0007-1285-23-270-354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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PERRY WF, GEMMELL JP. The use of radioactive iodine in the diagnosis of hyper- and hypo-thyroidism. CANADIAN MEDICAL ASSOCIATION JOURNAL 1950; 62:484-90. [PMID: 15411635 PMCID: PMC1821363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Membership Subscriptions. Br J Radiol 1949. [DOI: 10.1259/0007-1285-22-264-705-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Wilson CW. ReviewLaboratory and Workshop Notes. A selection reprinted from the Journal of Scientific Instruments, compiled and edited by LangRuth, Ph.D., A.Inst.P. (Ed. Arnold & Co., 1949, 272 pp. + xii. 21s. net.). Br J Radiol 1949. [DOI: 10.1259/0007-1285-22-264-705-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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SOISALO P. Blood iodine and thyroid function; a study of 254 cases. ACTA MEDICA SCANDINAVICA 1949; 133:186-209. [PMID: 18129776 DOI: 10.1111/j.0954-6820.1949.tb09350.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Rawson RW, Skanse BN, Marinelli LD, Fluharty RG. Radioactive iodine.Its use in studying certain functions of normal and neoplastic thyroid tissues. Cancer 1949; 2:279-92. [DOI: 10.1002/1097-0142(194903)2:2<279::aid-cncr2820020207>3.0.co;2-t] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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