The Role of Pretherapy Quantitative Imaging and Dosimetry in Radioiodine Therapy for Advanced Thyroid Cancer.

Autor:	Taprogge J; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom; jan.taprogge@icr.ac.uk.; Institute of Cancer Research, London, United Kingdom., Abreu C; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.; Institute of Cancer Research, London, United Kingdom., Yusuf S; Department of Nuclear Medicine and PET/CT, Royal Marsden NHSFT, Sutton, United Kingdom., Ainsworth G; Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom., Phillip RH; Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom., Gear JI; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.; Institute of Cancer Research, London, United Kingdom., Gregory R; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.; Institute of Cancer Research, London, United Kingdom., Leek F; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.; Institute of Cancer Research, London, United Kingdom., Murray I; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.; Institute of Cancer Research, London, United Kingdom., Coulson AB; Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom., Brown SR; Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom., Du Y; Department of Nuclear Medicine and PET/CT, Royal Marsden NHSFT, Sutton, United Kingdom., Newbold K; Thyroid Unit, Royal Marsden NHSFT, Sutton, United Kingdom; and., Wadsley J; Department of Oncology, Weston Park Hospital, Sheffield, United Kingdom., Flux GD; Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.; Institute of Cancer Research, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2023 Jul; Vol. 64 (7), pp. 1125-1130. Date of Electronic Publication: 2023 Apr 28.
DOI:	10.2967/jnumed.122.264913
Abstrakt:	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. (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze:	MEDLINE
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