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Endocrinology to Extend Current Knowledge About the Optimal Ablative Dose of I-131

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Endocrinology to Extend Current Knowledge About the Optimal Ablative Dose of I-131 [Downloaded free from http://www.wjnm.org on Tuesday, October 9, 2018, IP: 203.10.55.11] POSTER PRESENTATIONS - SATURDAY Endocrinology to extend current knowledge about the optimal ablative dose of I-131. Methods: In our cohort, 160 adult patients (129 females, 31 males; mean age 46±14 years, range P001 18-89 years) diagnosed with histologically confirmed Discordant Thyroglobulin and Diagnostic papillary or follicular thyroid cancer, were randomized 131I Whole-Body Scan in Differentiated in prospective, phase III, open-label, single-center study, Thyroid Carcinoma: The Clinical Value of during 2000-2004, to receive either 1.1 GBq or 3.7 GBq Nuclear Medicine of I-131 after thyroidectomy. At randomization, patients were stratified according to the histologically verified 1 1 Emily Mia C Acayan* , R Ogbac cervical lymph node status, and were prepared for 1 St. Luke’s Medical Center, Quezon City, Philippines ablation using thyroid hormone withdrawal. No uptake Background/Aims: The overall 10-year survival rate for in the whole body scan with I-131 and thyroglobulin middle-age adults with differentiated thyroid cancer concentration <1 ng/mL at 4-8 months after treatment declines to 40% in the presence of distant metastasis. was considered successful ablation. Results: Median A 34 year old female patient, diagnosed with follicular follow-up time was 13.02 years (mean 11.03±4.80 years; thyroid cancer, having had completion thyroidectomy range 0.33-17.13 years). Altogether 81 patients received and multiple radioiodine therapies, and appearing to 1.1GBq, ablation was successful in 45 (56%) after one be disease-free for six years, presented with elevated administration of I-131 and 36 (44%) needed one or more thyroglobulin but negative diagnostic 131I whole body administrations to replete the ablation. Of these, 4 (8.9%) scan. Methods: 18F-FDG positron emission tomography and 5 (14%) patients were later relapsing respectively. showed probable locoregional nodal metastases. Of the 79 patients treated with 3.7 GBq 45 (57%) had Empiric therapy with 5550 MBq 131I was given for successful ablation after one administration and 34 ablation. Results: Post-radioiodine therapy whole (43%) needed several treatments. Of these, 2 (4.4%) and body scan with single-photon emission computed 9 (26.5%) patients were relapsing respectively. Of these tomography/computed tomography done two days 79 participants, three died from thyroid cancer during after oral administration revealed multiple osseous the median follow-up of 13 years. Activity groups did not metastases with no lesions in locoregional nodes. differ in the proportion of patients relapsing (p=0.951). Conclusion: During follow-up of median 13 years 1.1 Conclusion: This case discusses the most common GBq is as effective as 3.7 GBq for ablation of the thyroid tools used in monitoring thyroid cancer recurrence remnant. and metastasis. Emphasis is given on the clinical utility of thyroglobulin, the advantage of optimal thyroid stimulating hormone level prior to diagnostic P003 tests, the role of empiric 131I therapy, and the value of The Evaluation of Protective and Mitigating post-radioiodine therapy whole body scan with single- Effects of Vitamin C against Side Effects photon emission computed tomography/computed Induced by Radioiodine Therapy tomography. Mehrosadat Alavi*1, E Jafari2, M Haghani1 1Ionizing and Non-Ionizing Radiation Protection P002 Research Center, Shiraz University of Medical 13-Year Outcomes after Low versus High Sciences, Shiraz, 2Department of Medical Physics, Activity of Radioiodine to Ablate the Islamic Republic of Iran Thyroid after Thyroidectomy for Cancer: A Background/Aims: The goal of this study, in addition Prospective Randomized Study to confirming that ionizing radiation in differentiated Veera Ahtiainen*1, L Vaalavirta1, M Tenhunen1, thyroid cancer (DTC) patients ablated with radioiodine H Mäenpää1 causes stress oxidative, was to evaluate protective and 1Cancer Center, Helsinki University Hospital, mitigative effect of vitamin C on this phenomenon. Helsinki, Finland Methods: 58 DTC patients for radioactive iodine therapy (RAIT) by 5550 Mbq Iodine-131 were divided Background/Aims: The optimal activity of radioiodine into four groups. Group one (control group) were 16 (131I) in papillary and follicular thyroid cancer following patients who underwent RAIT, routinely. Groups 2, 3 thyroidectomy remains unknown in long term follow-up. and 4 received 1500 mg vitamin C daily 2 days after, Some, shorter follow-up studies suggest that activities 1.1 2 days before to 2 days after and 2 days before RAIT, GBq and 3.7 GBq are considered equally effective. We respectively. Serum oxidative stress markers including evaluated the long term outcomes of primary ablation malondialdehyde (MDA), glutathione (GSH), catalase © 2018 World Journal of Nuclear Medicine | Published by Wolters Kluwer - Medknow 49 [Downloaded free from http://www.wjnm.org on Tuesday, October 9, 2018, IP: 203.10.55.11] Abstracts (CAT), and superoxide dismutase (SOD) were measured extrathyroidal extension (p=0.030), radioiodine (RAI) immediately before and 2 days after RAIT. Results: A refractory persistent disease (p=0.0393) until end of significant increase in MDA after RAIT was observed follow-up (p=0.017). Patients with co-existing mutations in all groups (p<0.05). The concentrations of MDA were were significantly associated with poorer outcome. significantly higher in the control group compared Kaplan-Meier graph depicts the association of wild- to the intervention groups (p<0.05). A significant type versus various mutations with event-free-survival. decrease in the control group (p=0.049) and increase Conclusion: Patients with co-existing BRAFV600E and in group 4 (p=0.026) were observed in GSH level after TERT mutations showed the worst clinicopathologic RAIT (p<0.05). Mean variation of GSH was significant outcomes. The detection of these mutations paves path between control group with groups 3 (p=0.008) and for the early treatment of RAI refractory disease patients 4 (p=0.003). The results indicate that activity of SOD with alternate therapeutic options. remained unchanged in all groups (p>0.05). A significant increase was observed in CAT activity after RAIT in all P005 groups (p<0.05), which was higher in control group Evaluation of Recurrent Thyroid Carcinoma than intervention groups. In groups 3 (p=0.043) and 4 (p=0.05), this increase in CAT activity was significantly by High-Resolution Ultrasonography 131 lower than the control group. Conclusion: RAIT causes Where I Whole-Body Scan Is Negative serum oxidative stress, which can be ameliorated by and Normal Thyroglobulin Level using vitamin C as an antioxidant. These results indicate Shankar Biswas*1, F Haque1, F Rahman1, M Islam1, that radioprotective effect of vitamin C is preferable to S Hossain1 its mitigative effect. 1Department of Nuclear Medicine and Ultrasound, Institute of Nuclear Medicine and Allied Sciences, P004 Bangladesh Atomic Energy Commission, Dhaka, Prevalence of Genetic Duet and its Bangladesh Influence on the Prognosis of Differentiated Background/Aims: Total thyroidectomy followed Papillary Thyroid Carcinoma Patients by radioiodine therapy (RIT) and life long hormone replacement is the routine protocol of differentiated C S Bal*1, S Ballal1, S Shakya1, S Mathur2 Departments of 1Nuclear Medicine and 2Pathology, thyroid cancer management. During follow up usually AIIMS, New Delhi, India we consider serum thyroglobulin (Tg) and whole body scan (WBS) with 131I. This study was designed to unravel Background/Aims: The primary objective of the study the impact of ultrasonography in patients with recurrent was to investigate the prevalence of BRAFV600E thyroid cancer where WBS was negative and normal and TERT promoter mutations in papillary thyroid Tg level. Methods: We enrolled ten patients (age 36±13 cancer and secondary objective was their correlation years; 9 female) who were attended to Institute of Nuclear with various clinicopathologic features in the Indian Medicine & Allied Sciences (INMAS), Dhaka for routine population. Methods: A retrospective study of 160 follow up. All patients were sent for further management pathologically proven papillary thyroid cancer patients after total thyroidectomy. Thyroid scan with 99mTc and including 105 women and 55 men with a median age other relevant laboratory tests were performed initially. of 35 years (range 13–77 years) was conducted in the RIT was given according to our institutional protocol. Department of Nuclear Medicine, AIIMS, New Delhi, During follow up at certain intervals WBS with 4 mCi India. The study period was from the year 2008 to 2016 131I and Tg level were evaluated. Along with these, neck with a mean follow-up of 32.7 months (12-101 months). palpation and high resolution ultrasound were done Univariate and multivariate analysis was performed routinely for specific features of metastasis (i.e loss of hilar to determine the association of BRAFV600E and TERT fat, rounded shape & micro calcification). Results: All promoter with clinicopathologic features. Prognostic of them had differentiated papillary thyroid carcinoma. factors affecting the event-free survival were analysed Two patients needed revision surgery for removing by Kaplan-Meier curves. Results: The prevalence of residual tissue. Lymphovascular invasion was present BRAFV600E mutation was in 33% (53/160) and TERT in 4 patients and substantially they needed radical neck mutation in 17.5% (28/160) of patients. Both mutations
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