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226 results on '"Tulchinsky, Mark"'

5. Assessing potential impact of 2015 American Thyroid Association guidelines on community standard practice for I-131 treatment of low-risk differentiated thyroid cancer: case study of Jordan

Author

Juweid, Malik E., Rabadi, Nidal J., Tulchinsky, Mark, Aloqaily, Mohammed, Al-Momani, Ahmad, Arabiat, Majd, Abu Ain, Gassem, Al Hawari, Hussam, Al-Momani, Munther, Mismar, Ayman, Abulaban, Amr, Taha, Ibrahim, Alhouri, Abdullah, Zayed, Ayman, Albsoul, Nader, and Al-Abbadi, Mousa A.

Published
2021
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22. SNMMI Procedure Standard/EANM Practice Guideline for Nuclear Medicine Evaluation and Therapy of Differentiated Thyroid Cancer: Abbreviated Version

Author

Avram, Anca M, Giovanella, Luca, Greenspan, Bennett, Lawson, Susan A, Luster, Markus, Nostrand, Douglas Van, Peacock, Justin G, Petranović Ovčariček, Petra, Silberstein, Edward, Tulchinsky, Mark, Verburg, Frederik A, Vrachimis, Alexis, and Radiology & Nuclear Medicine

Subjects
differentiated thyroid cancer, guideline, SDG 3 - Good Health and Well-being
Abstract

Differentiated thyroid cancers (DTC) are slow- growing tumors with very low disease-specific mortality rates for local−regional disease (5-y survival: 99.9% for localized disease, 98.3% for regional metastatic disease). However, distant metastatic disease is associated with significantly worse prognosis (5-y survival: 54.9%) (1). Standard-of-care management for DTC includes risk-adapted surgery, postoperative 131I therapy, and thyroid hormone therapy. In uncommon cases of radioiodine-refractory tumors, additional therapy may include reoperative surgical intervention, external radiotherapy, and interventional radiology for treatment of locoregional metastases and multikinase or tyrosine kinase inhibitors for treatment of distant metastatic disease.

Published
2022

35. The role of Tg kinetics in predicting 2-[18F]-FDG PET/CT results and overall survival in patients affected by differentiated thyroid carcinoma with detectable Tg and negative 131I-scan.

Author

Albano, Domenico, Tulchinsky, Mark, Dondi, Francesco, Mazzoletti, Angelica, Bertagna, Francesco, and Giubbini, Raffaele

Abstract

Purpose: The aim of this study was to assess the potential role of thyroglobulin (Tg) kinetics in predicting 2-[18F]-FDG-PET/CT results and overall survival (OS) in patients affected by differentiated thyroid carcinoma (DTC) and suspected recurrence. Methods: On hundred and thirty-nine patients were retrospectively included. All patients underwent 2-[18F]-FDG-PET/CT due to detectable Tg levels and negative [131I] whole-body scan. The last two consecutive serum Tg measurements before PET/CT were used for Tg-doubling time (TgDT) and Tg-velocity (Tg-vel) calculation. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff points for Tg, TgDT and Tg-vel for predicting PET/CT results. Results: One hundred and fifteen (83%) patients had positive PET/CT for DTC recurrence, while the remaining 24 (17%) negative. Stimulated Tg before PET and Tg-vel were significantly higher in patients with a positive PET/CT scan than negative scan (average Tg 190 vs 14 ng/mL, p = 0.006; average Tg-vel 4.2 vs 1.7 ng/mL/y, p < 0.001). Instead, TgDT was significantly shorter in positive scan (average TgDT 1.4 vs 4.4 years, p < 0.001). ROC curve analysis revealed the best Tg, TgDT and Tg-vel cutoff of 18 ng/mL,1.36 years and 1.95 ng/mL/y. In patients with Tg<18 ng/mL, the PET/CT detection rate was significantly lower in patients with low Tg-vel (p = 0.018) and with long TgDT (p = 0.001). ATA class risk, PET/CT results and Tg before PET were confirmed to be independent prognostic variables for OS. Conclusions: Tg kinetics may help to predict 2-[18F]-FDG-PET/CT results in DTC patients with negative [131I]WBS and detectable Tg, especially in case of low-moderate Tg. [ABSTRACT FROM AUTHOR]

Published
2021
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39. Contemporary considerations in adjuvant radioiodine treatment of adults with differentiated thyroid cancer.

Author

Juweid, Malik E., Tulchinsky, Mark, Mismar, Ayman, Momani, Munther, Zayed, Ayman A., Al Hawari, Hussam, Albsoul, Nader, and Mottaghy, Felix M.

Subjects
CLINICAL trials, ADULTS, THYROID gland, THYROID cancer
Abstract

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy with a growing incidence worldwide. The initial conventional management is surgery, followed by consideration of 131I treatment that includes three options. These are termed remnant ablation (targeting benign thyroid remnant), adjuvant (targeting presumed microscopic DTC) and known disease (targeting macroscopic DTC) treatments. Some experts mostly rely on clinicopathologic assessment for recurrence risk to select patients for the 131I treatment. Others, in addition, apply radioiodine imaging to guide their treatment planning, termed theranostics (aka theragnostics or radiotheragnostics). In patients with low‐risk DTC, remnant ablation rather than adjuvant treatment is generally recommended and, in this setting, the ATA recommends a low 131I activity. 131I adjuvant treatment is universally recommended in patients with high‐risk DTC (a primary tumor of any size with gross extrathyroidal extension) and is generally recommended in intermediate‐risk DTC (primary tumor >4 cm in diameter, locoregional metastases, microscopic extrathyroidal extension, aggressive histology or vascular invasion). The optimal amount of 131I activity for adjuvant treatment is controversial, but experts reached a consensus that the 131I activity should be greater than that for remnant ablation. The main obstacles to establishing timely evidence through randomized clinical trials for 131I therapy include years‐to‐decades delay in recurrence and low disease‐specific mortality. This mini‐review is intended to update oncologists on the most recent clinical, pathologic, laboratory and imaging variables, as well as on the current 131I therapy‐related definitions and management paradigms, which should optimally equip them for individualized patient guidance and treatment. [ABSTRACT FROM AUTHOR]

Published
2020
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