Source:http://linkedlifedata.com/resource/pubmed/id/17761397
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
8
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pubmed:dateCreated |
2007-9-17
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pubmed:abstractText |
In the present study we investigated the role of radio-guided surgery with Iodine-131 (I-131) in a group of 31 patients with differentiated thyroid cancer (DTC) and loco-regional recurrent disease. The principal inclusion criterion for I-131 radio-guided surgery in our protocol was the presence of an I-131 positive loco-regional disease relapse after previous total thyroidectomy and at least 2 ineffective conventional I-131 treatments. The protocol we used consisted of the following steps. Day 0: all patients were hospitalized and received a therapeutic 3.7 GBq (100 mCi) dose of I-131 after thyroid hormone therapy withdrawal in condition of overt hypothyroidism (serum TSH levels>30 microUI/ml). Day 3: a whole body scan following the therapeutic I-131 dose (TxWBS) administration was acquired. Day 5: neck surgery was performed through a wide bilateral neck exploration using a 15-mm collimated gamma probe, measuring the absolute intra-operative counts and calculating the lesion to background (L/B) ratio. Day 7: post-surgery TxWBS was performed using the remaining radioactivity to evaluate the completeness of tumoral lesions extirpation. The final histologic examination showed the presence of 184 metastatic foci; among them, 98 (53.2%) were evident by both TxWBS and gamma probe evaluation, 76 (41.3%) were demonstrated only by gamma probe, and 10 (5.4%) were negative by both TxWBS and gamma probe evaluation. During follow-up (8 months to 4.9 years, mean 2.8 years), DxWBS, serum Tg levels off l-T4, and US showed absence of loco-regional disease in 25 patients (80.6%) while 6 patients had persistent disease. In conclusion, this protocol allowed us to identify neoplastic foci with high sensitivity and specificity, enabling us to remove loco-regional I-131 disease recurrences resistant to previous conventional I-131 therapies. Furthermore, the gamma probe allowed detection of some additional tumoral foci in sclerotic areas or located behind vascular structures that were not visualized at the pre-surgery TxWBS evaluation.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Sep
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pubmed:issn |
0753-3322
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
61
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
477-81
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pubmed:meshHeading |
pubmed-meshheading:17761397-Adult,
pubmed-meshheading:17761397-Aged,
pubmed-meshheading:17761397-Female,
pubmed-meshheading:17761397-Humans,
pubmed-meshheading:17761397-Iodine Radioisotopes,
pubmed-meshheading:17761397-Lymphatic Metastasis,
pubmed-meshheading:17761397-Male,
pubmed-meshheading:17761397-Middle Aged,
pubmed-meshheading:17761397-Neoplasm Recurrence, Local,
pubmed-meshheading:17761397-Radiopharmaceuticals,
pubmed-meshheading:17761397-Sensitivity and Specificity,
pubmed-meshheading:17761397-Surgery, Computer-Assisted,
pubmed-meshheading:17761397-Thyroid Neoplasms,
pubmed-meshheading:17761397-Thyroidectomy,
pubmed-meshheading:17761397-Treatment Outcome
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pubmed:year |
2007
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pubmed:articleTitle |
Iodine-131 radio-guided surgery in differentiated thyroid cancer: outcome on 31 patients and review of the literature.
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pubmed:affiliation |
Nuclear Medicine Service, PET Unit, 'S. Maria della Misericordia' Hospital, Istituto Oncologico Veneto (IOV)-IRCCS, Viale Tre Martiri, 140, 45100 Rovigo, Italy. domenico.rubello@libero.it
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pubmed:publicationType |
Journal Article,
Comparative Study
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