Image-Based Diagnostics and Radiometabolic Therapy of Differentiated Thyroid Cancer 2.0

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 8585

Special Issue Editors


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Guest Editor
Nuclear Medicine Unit, Department of Medicine, Surgery and Farmacy, Università degli Studi di Sassari, Sassari, Italy
Interests: nuclear medicine; image-based diagnostics; SPECT; SPECT/CT; PET/CT; molecular breast imaging; oncology (breast cancer, lung cancer, thyroid cancer, neuroendocrine tumors, prostate cancer); radiomics; neurodegenerative disorders; radiometabolic therapy
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Guest Editor
Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Roma, Italy
Interests: nuclear medicine; imaging; integrated imaging; high resolution scintigraphic detectors; heart failure; radionuclide therapy; dosimetry; target alpha therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Well-differentiated thyroid cancer (DTC), which includes papillary carcinoma and follicular carcinoma, represents the vast majority of all thyroid cancers and the most frequent endocrine malignancy. The incidence of DTC is increasing worldwide due to the widespread use of thyroid ultrasound (US), but mortality is stable over the years as more cancers are diagnosed at a very early stage.

FNAC, in association with neck US, represents the method of choice for the pre-surgical diagnosis and loco-regional staging of DTC.

After surgery, neck US and 131I-Whole-Body scan, the latter preferably integrated with SPECT/CT, in combination with the serum assay of basal/stimulated Thyroglobulin (TG) and Ab-TG, are currently the diagnostic tools of preference.

18FDG-PET adds important prognostic information and is especially indicated in the presence of elevated serum levels of TG and a negative radioiodine scan.

Further diagnostic tools, such as computed tomography and MRI, may be considered in selected cases. Moreover, novel diagnostic techniques (e.g., 18FDG-PET/MRI) and radiotracers (e.g., Tetrafluoroborate) are ongoing in this field.

DTC is usually characterized by a favorable prognosis and maintains the ability to concentrate iodine, thus making the radiometabolic treatment with 131Iodine (RAI) the most effective therapy after surgery. However, recurrent DTC may become poorly differentiated over time and lose the ability to concentrate iodine. Alternative therapies (e.g., molecular targeted therapy) should be considered in RAI refractory disease.

In this Special Issue, we encourage researchers to submit original papers, review articles, brief communications, or comments on current image-based diagnostics and radiometabolic therapy of DTC. Papers focused on novel diagnostic and therapeutic tools, radiomics, and personalized medicine are also welcome.

Prof. Dr. Angela Spanu
Prof. Dr. Giuseppe De Vincentis
Guest Editors

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Keywords

  • differentiated thyroid cancer
  • neck ultrasound
  • diagnostic radioiodine scan
  • 131I-SPECT/CT
  • FDG-PET/CT
  • computed tomography
  • MRI
  • PET/MRI
  • tetrafluoroborate
  • 131I-iodine therapy
  • dosimetry
  • theranostics
  • thyroglobulin
  • radiomics
  • personalized medicine

Published Papers (4 papers)

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Review

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24 pages, 400 KiB  
Review
Personalized Dosimetry in the Context of Radioiodine Therapy for Differentiated Thyroid Cancer
by Massimiliano Pacilio, Miriam Conte, Viviana Frantellizzi, Maria Silvia De Feo, Antonio Rosario Pisani, Andrea Marongiu, Susanna Nuvoli, Giuseppe Rubini, Angela Spanu and Giuseppe De Vincentis
Diagnostics 2022, 12(7), 1763; https://doi.org/10.3390/diagnostics12071763 - 21 Jul 2022
Cited by 8 | Viewed by 2192
Abstract
The most frequent thyroid cancer is Differentiated Thyroid Cancer (DTC) representing more than 95% of cases. A suitable choice for the treatment of DTC is the systemic administration of 131-sodium or potassium iodide. It is an effective tool used for the irradiation of [...] Read more.
The most frequent thyroid cancer is Differentiated Thyroid Cancer (DTC) representing more than 95% of cases. A suitable choice for the treatment of DTC is the systemic administration of 131-sodium or potassium iodide. It is an effective tool used for the irradiation of thyroid remnants, microscopic DTC, other nonresectable or incompletely resectable DTC, or all the cited purposes. Dosimetry represents a valid tool that permits a tailored therapy to be obtained, sparing healthy tissue and so minimizing potential damages to at-risk organs. Absorbed dose represents a reliable indicator of biological response due to its correlation to tissue irradiation effects. The present paper aims to focus attention on iodine therapy for DTC treatment and has developed due to the urgent need for standardization in procedures, since no unique approaches are available. This review aims to summarize new proposals for a dosimetry-based therapy and so explore new alternatives that could provide the possibility to achieve more tailored therapies, minimizing the possible side effects of radioiodine therapy for Differentiated Thyroid Cancer. Full article

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8 pages, 3671 KiB  
Case Report
Parapharyngeal Metastasis of Papillary Carcinoma of Thyroid Gland: A Case Report and a Review of the Literature
by Massimo Campagnoli, Davide Masnaghetti, Maria Silvia Rosa, Edoardo Paganelli, Massimiliano Garzaro and Paolo Aluffi Valletti
Diagnostics 2023, 13(8), 1426; https://doi.org/10.3390/diagnostics13081426 - 15 Apr 2023
Cited by 2 | Viewed by 1659
Abstract
Papillary carcinoma is the most frequently encountered differentiated thyroid carcinoma. Usually, metastasis occurs along lymphatic pathways in the central compartment and along the jugular chain. Nevertheless, lymph node metastasis in the parapharyngeal space (PS) is a rare but possible event. In fact, a [...] Read more.
Papillary carcinoma is the most frequently encountered differentiated thyroid carcinoma. Usually, metastasis occurs along lymphatic pathways in the central compartment and along the jugular chain. Nevertheless, lymph node metastasis in the parapharyngeal space (PS) is a rare but possible event. In fact, a lymphatic pathway has been identified that connects the upper pole of the thyroid and the PS. We describe the case of a 45-year-old man with a two-month history of a right neck mass. He underwent a complete diagnostic path that highlighted the presence of a parapharyngeal mass associated with the presence of a thyroid nodule suspected to be malignant. The patient underwent surgery (thyroidectomy and removal of the PS mass that was found to be a metastatic node of papillary thyroid carcinoma). The aim of this case is to underline the importance of detecting these kinds of lesions. Nodal metastasis in PS from thyroid cancer is a rare occurrence that is not easily detectable by a clinical examination until the metastasis reaches a considerable dimension. Computed tomography (CT) and magnetic resonance imaging (MRI) permit early identification, but unfortunately, these are not usually employed as a first-level imaging technique in patients with thyroid cancer. The treatment of choice is surgery with a transcervical approach that allows for better control of the disease and of the anatomical structures. Non-surgical treatments are usually reserved for patients with advanced disease, with satisfactory results. Full article
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3 pages, 532 KiB  
Interesting Images
Delayed Presentation of Functioning Metastasis in a Patient with Follicular Thyroid Carcinoma
by Maria Inês Alexandre, Sara Donato, Helena Vilar and Valeriano Leite
Diagnostics 2023, 13(2), 281; https://doi.org/10.3390/diagnostics13020281 - 12 Jan 2023
Cited by 1 | Viewed by 1181
Abstract
Functioning metastases from differentiated thyroid carcinoma are rare and present a great therapeutic challenge. Here, we present an unusual case of a patient with metastatic thyroid carcinoma who developed a hyperthyroid state a few years after the diagnosis due to functioning metastases. Radioiodine [...] Read more.
Functioning metastases from differentiated thyroid carcinoma are rare and present a great therapeutic challenge. Here, we present an unusual case of a patient with metastatic thyroid carcinoma who developed a hyperthyroid state a few years after the diagnosis due to functioning metastases. Radioiodine treatment was effective in controlling the hyperthyroidism; however, it had no effect on tumor burden. By sharing our experience with this case, we hope to raise awareness for this rare condition and the ways to manage it. Full article
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18 pages, 3085 KiB  
Systematic Review
Radiomic Detection of Malignancy within Thyroid Nodules Using Ultrasonography—A Systematic Review and Meta-Analysis
by Eoin F. Cleere, Matthew G. Davey, Shane O’Neill, Mel Corbett, John P O’Donnell, Sean Hacking, Ivan J. Keogh, Aoife J. Lowery and Michael J. Kerin
Diagnostics 2022, 12(4), 794; https://doi.org/10.3390/diagnostics12040794 - 24 Mar 2022
Cited by 11 | Viewed by 2880
Abstract
Background: Despite investigation, 95% of thyroid nodules are ultimately benign. Radiomics is a field that uses radiological features to inform individualized patient care. We aimed to evaluate the diagnostic utility of radiomics in classifying undetermined thyroid nodules into benign and malignant using ultrasonography [...] Read more.
Background: Despite investigation, 95% of thyroid nodules are ultimately benign. Radiomics is a field that uses radiological features to inform individualized patient care. We aimed to evaluate the diagnostic utility of radiomics in classifying undetermined thyroid nodules into benign and malignant using ultrasonography (US). Methods: A diagnostic test accuracy systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Sensitivity, specificity, and area under curve (AUC) delineating benign and malignant lesions were recorded. Results: Seventy-five studies including 26,373 patients and 46,175 thyroid nodules met inclusion criteria. Males accounted for 24.6% of patients, while 75.4% of patients were female. Radiomics provided a pooled sensitivity of 0.87 (95% CI: 0.86–0.87) and a pooled specificity of 0.84 (95% CI: 0.84–0.85) for characterizing benign and malignant lesions. Using convolutional neural network (CNN) methods, pooled sensitivity was 0.85 (95% CI: 0.84–0.86) and pooled specificity was 0.82 (95% CI: 0.82–0.83); significantly lower than studies using non-CNN: sensitivity 0.90 (95% CI: 0.89–0.90) and specificity 0.88 (95% CI: 0.87–0.89) (p < 0.05). The diagnostic ability of radiologists and radiomics were comparable for both sensitivity (OR 0.98) and specificity (OR 0.95). Conclusions: Radiomic analysis using US provides a reproducible, reliable evaluation of undetermined thyroid nodules when compared to current best practice. Full article
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