tailieunhanh - Nuclear Medicine Communications

The classical therapeutic approach to patients with differentiated thyroid cancer (DTC) is based on total or near-total thyroidectomy, followed by 131I treatment and thyroid-stimulating hormone suppressive therapy. This approach allows complete cure in many patients, especially when the tumour is diagnosed at an early stage; it also allows long-term survival in patients with locoregional recurrences or distant metastases if they can be treated with 131I. In contrast, when metastatic DTC deposits lose their ability to trap 131I (non-functioning metastases), a worse prognosis is expected. Nevertheless, in patients with locoregional non-functioning recurrences, an early diagnosis and prompt surgical extirpation can lead to a favourable prognosis | .Nuclear Medicine Communications Editorial Radio-guided surgery of differentiated thyroid cancer using 131 or 99mTc-Sestamibi Domenico Rubelloa Massimo Salvatorib Maria Rosa Pelizzoc Lucia Rampina Stefano Fantid Michele Gregianine and Giuliano Marianif The classical therapeutic approach to patients with differentiated thyroid cancer DTC is based on total or near-total thyroidectomy followed by 131I treatment and thyroid-stimulating hormone suppressive therapy. This approach allows complete cure in many patients especially when the tumour is diagnosed at an early stage it also allows long-term survival in patients with locoregional recurrences or distant metastases if they can be treated with 131I. In contrast when metastatic DTC deposits lose their ability to trap 131I non-functioning metastases a worse prognosis is expected. Nevertheless in patients with locoregional non-functioning recurrences an early diagnosis and prompt surgical extirpation can lead to a favourable prognosis. In these cases radical surgery is needed. This can be achieved with radio-guided surgery using a hand-held gamma probe and a tumour-seeking radiotracer to detect intraoperatively the smallest metastatic lesions. In this paper we discuss the two principal techniques proposed in the literature for radio-guided surgery of non-functioning DTC metastatic recurrences the first using high doses of 131I and the second using low doses of 99mTc-Sestamibi. Nucl Med Commun 27 1-4 @ 2006 Lippincott Williams Wilkins. Nuclear Medicine Communications 2006 27 1-4 Keywords differentiated thyroid cancer 131I radio-guided surgery 99mTc-Sestamibi aNuclear Medicine Service - PET Unit S. Maria della Misericordia Hospital Rovigo bNuclear Medicine Service Policlinico Gemelli Sacro Cuore Roma University Rome cDepartment of Surgery Padova University Padova dNuclear Medicine Service - PET Unit Policlinico S. Orsola-Malpighi Bologna eNuclear Medicine Service PET Unit Umberto I Hospital Mestre VE and fRegional Centre

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