Search

Background Hypothesis Animals Methods Results Conclusions Exogenous iodine interferes with the uptake of radioactive iodine (131I) by the thyroid gland. This has potential implications for the treatment of cats with hyperthyroidism that have recently undergone computed tomography (CT) with IV administration of iodinated contrast medium (ICM).To determine the time to normalize urinary iodine clearance after administration of ICM. We hypothesized that it would require 4 weeks for urinary iodine concentration (UIC) to decrease to baseline after IV administration of ICM.Ten healthy adult neutered male cats.All cats were sedated and received Iopamidol at a dose of 2 mL/kg (600 mg/kg). Urinary iodine and creatinine concentrations were measured before administration of Iopamidol and on days 1, 2, 3, 7, 10 and weeks 2 to 6 after administration. The urinary iodine‐to‐creatinine ratio (UICR) was calculated. Outcome variables were modeled using a linear mixed‐effects model.Urinary iodine concentration increased 37‐ to 884‐fold on Day 1 after ICM injection and returned to baseline during Week 2. Compared with baseline, UIC was significantly increased for Days 1 to 7 (all P < .001); UC was significantly lower for Days 1 to 10 (all P < .03); and UICR was significantly increased from Days 1 to 10 (all P < .001, except Day 10 P = .05).Urinary clearance of iodine after IV administration of ICM requires 10 days to return to baseline in healthy cats. A 2‐week interval between the iodinated contrast study and 131I treatment could be appropriate but needs to be confirmed in hyperthyroid cats. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design, Patients and Methods Results Conclusions We conducted a prospective randomized clinical trial to compare the efficacy of low‐ and high‐dose radioiodine for remnant ablation in patients with low‐risk differentiated thyroid cancer (DTC) in China. The first‐stage results showed equivalence was observed between the two groups. Here, we report recurrence and survival at 3–5 and 6–10 years and biochemical parameters.Between January 2013 and December 2014, adult patients with DTC were enroled. Patients had undergone total or near‐total thyroidectomy, with or without cervical lymph node dissection, with tumour stages T1–T3 with or without lymph node metastasis, but without distant metastasis. Patients were randomly assigned to the low‐dose (1850 MBq) or high‐dose (3700 MBq) radioiodine group. They were then followed up for 3–5 and 6–10 years. Data on biochemical abnormalities, recurrence and survival were analysed using Kolmogorov–Smirnov and χ2 tests.The data of 228 patients (mean age = 42 years; 70.6% women) were analysed, with 117 patients in the low‐dose group and 111 in the high‐dose group. There were no significant differences in biochemical abnormalities, recurrence, or survival rates at the 6–10‐year follow‐up (all p > .05). Nine patients experienced recurrence in the low‐dose group (8.7%), while eight patients experienced recurrence in the high‐dose group (8.2%). The survival rates were 100% and 98.2% in the low‐ and high‐dose groups, respectively.The long‐term effectiveness and safety of low‐dose (1850 MBq) radioiodine are the same as those of high‐dose (3700 MBq) radioiodine for thyroid remnant ablation in Chinese patients with low‐risk DTC. [ABSTRACT FROM AUTHOR]

Background: Radioactive iodine (RAI) therapy is a widely used treatment for Graves’ Hyperthyroidism (GH). However, various factors can impact the nonremission rate of GH after single RAI therapy. This study aimed to develop an online dynamic nomogram to assist physicians in providing personalized therapy for GH. Methods: Data from 454 GH patients who received RAI therapy were retrospectively reviewed and included in the present study. The univariate and multivariate analysis were conducted to investigate and identify independent influencing factors. The nomogram was developed based on the training cohort to explore non-remission rates. Finally, the reliability and accuracy of the constructed nomogram model were verified in the validation cohort via the calibration, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results: 24-hours radioactive iodine uptake (RAIU24h), effective half-life (Teff), total iodine dose (TID) and iodine dose per gram of thyroid tissue (IDPG) were independent predictors. The nomogram had a high C-index 0.922 (95% CI: 0.892–0.953), for predicting non-remission. The calibration curves demonstrated excellent consistency between the predicted and the actual probability of non-remission. ROC analysis showed that the AUC of the nomogram model and the four independent factors in the training cohort were 0.922, 0.673, 0.760, 0.761, and 0.786, respectively. The optimal cutoff value for the total nomogram scores was determined to be 155. A total score of ≥155 indicates a higher likelihood of non-remission after a single RAI therapy for GH, whereas a score below 155 suggests a greater likelihood of remission. Additionally, the DCA curve indicated that this nomogram had good clinical utility in predicting non-remission. Conclusion: An online nomogram was constructed with good predictive performance, which can be used as a practical approach to predict and assist physicians in making personalized therapy decisions for GH patients. [ABSTRACT FROM AUTHOR]

Purpose: To develop a predictive model using machine learning for levothyroxine (L-T4) dose selection in patients with differentiated thyroid cancer (DTC) after resection and radioactive iodine (RAI) therapy and to prospectively validate the accuracy of the model in two institutions. Methods: Atotal of266DTCpatientswhoreceivedRAI therapy after thyroidectomy and achieved target thyroid stimulating hormone (TSH) level were included in this retrospective study. Sixteen clinical and biochemical characteristics that could potentially influence the L-T4 dose were collected; Significant features correlated with L-T4 dose were selected usingmachine learning randomforestmethod, and a total of eight regression models were established to assess their performance in prediction of L-T4 dose after RAI therapy; The optimalmodelwas validated through a two-center prospective study (n=263). Results: Six significant clinical and biochemical features were selected, including body surface area (BSA), weight, hemoglobin (HB), height, body mass index (BMI), and age. Cross-validation showed that the support vector regression (SVR) model was with the highest accuracy (53.4%) for prediction of L-T4 dose among the established eight models. In the two-center prospective validation study, a total of 263 patients were included. The TSH targeting rate based on constructed SVR model were dramatically higher than that basedonempiricaladministration (Rate 1 (first rate):52.09%(137/263) vs 10.53% (28/266); Rate 2 (cumulative rate): 85.55% (225/263) vs 53.38% (142/266)). Furthermore, themodel significantly shortens thetime (days) toachieve targetTSHlevel (62.61 ± 58.78 vs 115.50 ± 71.40). Conclusions: The constructed SVR model can effectively predict the L-T4 dose for postoperative DTC after RAI therapy, thus shortening the time to achieve TSH target level and improving the quality of life for DTC patients. [ABSTRACT FROM AUTHOR]

Thyroglobulin (Tg) is an important tool to evaluate the persistence and recurrence risk in differentiated thyroid cancer (DTC). We aimed to evaluate the correlation between pre-radioiodine therapy stimulated Tg (pre-RAI Tg) levels and the first response to treatment evaluation, and to establish a cut-off pre-RAI Tg threshold for predicting an initial excellent response. Retrospective cohort study of DTC patients who underwent total thyroidectomy and radioiodine therapy. Response to therapy was evaluated 6 to 24 months after initial therapy, and patients were classified as: excellent response (ER); indeterminate response (IndR) and incomplete response (IncR). Total patients: 166 among which 85.5% female with mean age of 47.6 ± 13 years. The ER had a significantly lower pre-RAI Tg in comparison to IndR (p<0.001) and IncR (p<0.001), and pre-RAI Tg were different between the IndR and IncR (p=0.02). A cut-off pre-RAI Tg value at 7.55ng/ml was obtained by receiver operating characteristics curve for differentiating ER from IndR and IncR. The area under curve was 0.832 (95% CI 0.76–0.91). In multivariate analysis, ATA low-risk (RR 1.61, 95% CI 1.06–2.43, p=0.025) and Tg below 7.55ng/ml (RR 2.17, 95% CI 1.52–3.10, p<0.001) were associated with ER. After a median of 7.4-year follow-up, 124 (74.7%) patients were allocated into ER, 22 (13.2%) into IndR, and 20 (12%) into IncR. In conclusion, pre-RAI Tg predicts first evaluation of treatment response. Pre-RAI Tg cut-off was a key predictor of initial excellent response to therapy and may be an important tool in the follow-up of DTC patients. [ABSTRACT FROM AUTHOR]

Objective: The generally good prognosis of low‐ and intermediate‐risk differentiated thyroid cancer (DTC) underscored the need to identify those few patients who relapse. Design: Records of 299 low‐ or intermediate‐risk DTC patients (mean follow‐up 8.2 ± 6.2 years) were retrospectively reviewed. The sample was classified following the American Thyroid Association (ATA) dynamic risk stratification (DRS) system. Patients and Measurement: After classifying patients according to DRS at the first visit following initial therapy (FU1), structural recurrence occurred in 2/181 (1.1%), 5/81 (6.2%) and 13/26 (50.0%) with excellent, indeterminate and biochemical incomplete response to treatment, respectively. All relapses but one happened within 5 years from FU1. Univariate analysis comparing excellent, indeterminate and biochemical incomplete with structural incomplete responses at the end of the follow‐up, identified tumour size (p <.001), T status (<0.001), positive lymph nodes (N) (p <.01), multifocality (p <.004), need of additional radioactive iodine (RAI) (p <.0001) and first DRS status (p <.0003) as risk factors of recurrence. In the multivariate analysis, only RAI remained statistically significant (p <.02). Comparison between excellent and indeterminate with biochemical and structural incomplete responses, identified tumour size (p <.0004), T (p <.01), N (p <.0001), bilaterality (p <.03), first DRS status (p <.0001) and RAI (p <.001) as recurrence risk factors. T (p <.01) and first DRS (p <.0006) were confirmed in the multivariate analysis. Conclusions: Patients with DTC classified as low‐ or intermediate‐risk of recurrence with excellent response to treatment at FU1 rarely develop structural disease and this occurs almost exclusively in the first 5 years. Initial DRS status is an accurate tool for determining the risk of recurrence. [ABSTRACT FROM AUTHOR]

Aim Differentiated thyroid carcinoma (DTC) is the most prevalent endocrine malignancy, with radioactive iodine (RAI) therapy being a standard of care. However, RAI refractoriness, occurring in a subset of patients, significantly impacts survival rates. Understanding predictive factors for RAI refractoriness is crucial for optimizing patient management. Methods This retrospective study analyzed data from 90 DTC patients at Ibn Sina University Hospital, Morocco. Patients were categorized into RAI-refractory (RAIR) and non-RAIR groups based on established criteria. Statistical analyses, including univariate and multivariate logistic regression, were performed to identify predictive factors of RAI refractoriness. Results Age at the time of diagnosis ≥ 54 years, primary tumor diameter ≥ 29 mm, and distal/nodal metastasis were independent predictors of RAIR-DTC. Additionally, the oncocytic carcinoma histological subtype significantly increased the risk of refractoriness. These findings were consistent with previous studies and underscored the importance of early detection and risk stratification. Conclusion Recognition of predictive factors for RAI refractoriness, including age, tumor size, distal/nodal metastasis, and histological subtype, facilitates early identification of high-risk patients. This enables timely intervention and personalized treatment strategies, particularly relevant in resource-limited settings. Further prospective studies are warranted to validate these findings and explore additional molecular markers for improved prediction of RAI refractoriness. [ABSTRACT FROM AUTHOR]

Potassium iodide has demonstrated several therapeutic applications over time, being the choice for shielding the thyroid during radiation emergencies involving radioiodine release. Amidst the ongoing military conflict between Ukraine and Russia and the growing concern regarding the potential deployment of nuclear weapons, there has been a surge in the demand for potassium iodide across Europe. This work aimed to comprehensively review the current knowledge regarding the pharmacology, physiology, adverse effects, the protective role in reducing the risk of thyroid cancer and recommendations for potassium iodide use during radiation emergencies. Evidence on adverse effects is scarce, as potassium iodide is generally well‐tolerated. Guidelines for thyroid blocking with potassium iodide during radiation emergencies suggest that, among populations vulnerable to radioiodine exposure, the benefits of potassium iodide outweigh the risks of adverse effects. Controversial topics surrounding the utilization of potassium iodide in radiation emergencies include the prophylaxis in iodine‐deficient regions and following the detonation of dirty bombs, whether granule formulations versus tablets should be used and mental health concerns. Although the rise in demand seems to be a justified security measure, it is essential to recognize that potassium iodide protects the thyroid from radioiodine and does not impact the body's absorption of other radioactive materials or defend against external radiation exposure. [ABSTRACT FROM AUTHOR]

The frequency of thyrotoxicosis may vary between countries and some laboratory test results may be used in etiology research. This study aimed to evaluate the prevalence of thyrotoxicosis diagnoses and laboratory test results. 3246 patients with overt thyrotoxicosis were included in this study. Laboratory test results, epicrisis, thyroid ultrasonography, thyroid scintigraphy, and radioactive iodine uptake test reports of the patients were examined in the study. Thyrotoxicosis was found due to levothyroxine overdose in 58.1% of the patients. When this group was excluded, 36.1% of the patients were diagnosed with toxic multinodular goiter most frequently. TRab levels were 8.5 times higher in Graves' disease than in other diagnostic groups. Anti-TPO levels were found to be the highest in the Graves' disease and Hashitoxicosis groups compared to other diagnostic groups (p<0.001). Anti-Tg levels were found to be highest in Graves' disease, Postpartum thyroiditis, and Hashitoxicosis patients (p<0.001). The free triiodothyronine / free thyroxine ratio was significantly higher, a cut-off value of >2.94 provided a sensitivity of 66% and specificity of 64% in diagnosing Graves' disease. The causes of thyrotoxicosis show some differences between countries. Patients using levothyroxine should be informed about drug use and dose titration. The free triiodothyronine / free thyroxine ratio can be used in addition to other tests during diagnosis. [ABSTRACT FROM AUTHOR]

Background The clinical outcomes and implications of radioactive iodine therapy (RAIT) on cancer-specific survival (CSS) in World Health Organization classification of follicular thyroid carcinoma (FTC) are not well established. Material and Methods The data of eligible patients with minimally invasive FTC (mi-FTC), encapsulated angioinvasive FTC (ea-FTC), or widely invasive FTC (wi-FTC) between 2000 and 2020 were extracted from the Surveillance, Epidemiology, and End Results database. CSS, the primary outcome, was compared among the 3 subtypes of patients with FTC before and after adjusting for differences using propensity score matching (PSM). The patients with FTC in different subtypes were then divided into 2 groups: the RAIT group and the no-RAIT group. Cox proportional hazards regression analyses were applied to discover the relationships of factors associated with CSS in the each PSM cohort. Results A total of 2433 patients with mi-FTC, 216 patients with ea-FTC, and 554 patients with wi-FTC were enrolled in the original cohorts, respectively. Patients with mi-FTC or ea-FTC had similar CSS (P =.805), which was better than that of patients with wi-FTC (P <.001; P =.021). Cox proportional hazards regression analysis revealed that RAIT was not associated with improved CSS in either the mi-FTC PSM cohort (hazard ratio [HR], 1.21; 95% CI,.46-3.18; P =.705) or the wi-FTC PSM cohort (HR, 0.56; 95% CI,.35-1.08; P =.086). However, subgroup analysis demonstrated that patients with wi-FTC and N1 stage (HR, 0.44; 95% CI,.20-.99; P =.018) or M1 stage (HR, 0.25; 95% CI,.11-.53; P <.001) could gain CSS advantage from RAIT. Conclusion The RAIT can provide a CSS advantage for patients with wi-FTC who with N1-stage or M1-stage disease. [ABSTRACT FROM AUTHOR]

Background The Bethesda system classifies all fine-needle aspiration specimens into 1 of 6 categories. We speculated that cancers within each Bethesda category would have distinct clinical behavior. Methods This is a retrospective analysis of patients from a single academic medical center with a histologic diagnosis of thyroid cancer who had an initial diagnosis of Bethesda III, IV, V, or VI cytology. Results A total of 556 cases were included, with 87 cases of Bethesda III, 109 cases of IV, 120 cases of V, and 240 cases of VI. Bethesda III showed similarities with V/VI compared to IV with a predominance of papillary thyroid cancer. The interval from diagnosis to surgery was longer in Bethesda III compared to Bethesda V/VI (median 78 vs 41 days, P <.001) (Fig. 1). Yet, patients with Bethesda III had a higher probability of achieving remission (62% vs 46%, P <.03), a lower possibility of recurrence (8% vs 24%, P <.001), and a shorter interval to achieve remission (median 1218 vs 1682 days, P =.02) compared to Bethesda V/VI, which did not change after adjusting for age, sex, radioactive iodine therapy, mode of surgery, and tumor size. More than 70% of Bethesda III that later presented with recurrence had T3/T4 disease or distant metastasis. Figure 1. Time to surgery III vs V/VI. Open in new tab Download slide Conclusion Cancers with Bethesda III cytology had a less aggressive clinical phenotype with better prognosis compared to V/VI despite histological similarities. The time to remission was shorter in Bethesda III despite a longer interval between diagnosis and surgery. The initial cytological diagnosis may guide management. [ABSTRACT FROM AUTHOR]

Thyroid cancer is the most common type of endocrine cancer, and most patients have a good prognosis. However, the thyroid cancer differentiation status strongly affects patient response to conventional treatment and prognosis. Therefore, exploring the molecular mechanisms that influence the differentiation of thyroid cancer is very important for understanding the progression of this disease and improving therapeutic options. In this study, SETMAR as a key gene that affects thyroid cancer differentiation is identified. SETMAR significantly regulates the proliferation, epithelial‐mesenchymal transformation (EMT), thyroid differentiation‐related gene expression, radioactive iodine uptake, and sensitivity to MAPK inhibitor‐based redifferentiation therapies of thyroid cancer cells. Mechanistically, SETMAR methylates dimethylated H3K36 in the SMARCA2 promoter region to promote SMARCA2 transcription. SMARCA2 can bind to enhancers of the thyroid differentiation transcription factors (TTFs) PAX8, and FOXE1 to promote their expression by enhancing chromatin accessibility. Moreover, METTL3‐mediated m6A methylation of SETAMR mRNA is observed and showed that this medication can affect SETMAR expression in an IGF2BP3‐dependent manner. Finally, the METTL3‐14‐WTAP activator effectively facilitates the redifferentiation of thyroid cancer cells via the SETMAR‐SMARCA2‐TTF axis utilized. The research provides novel insights into the molecular mechanisms underlying thyroid cancer dedifferentiation and provides a new approach for therapeutically promoting redifferentiation. [ABSTRACT FROM AUTHOR]

Owing to their high porosity, open metal sites, and huge surface area, metal–organic framework (MOF) materials are commonly employed in iodine adsorption processes. Bimetallic MOFs have drawn a lot of attention since mono-metal MOFs have been unable to keep up with the demand. Bimetallic MOF materials still have drawbacks, including limited adsorption capacity, extended adsorption time, poor stability, and poor selectivity, despite their positive performance in radioactive iodine capture. It has been therefore difficult to develop adsorbents with quick iodine adsorption rates and high iodine adsorption efficiency. This study investigated the adsorption properties of a series of bimetallic MOF-74 materials (Mn–Co-MOF-74, Mn–Zn-MOF-74, and Mn–Ni-MOF-74) for radioactive iodine, as well as their design and synthesis utilizing the reflux approach. It was discovered that the adsorption performance of Mn–Ni-MOF-74 for radioiodine was superior to that of the other two bimetallic MOF-74 materials. Using the bimetallic Mn–Ni-MOF-74 as a precursor, a variety of bimetallic MOF-74 derived carbon compounds (Mn–Ni-CX) were prepared by high-temperature pyrolysis. Simultaneously, the structure of the material and the iodine adsorption characteristics have been thoroughly studied. [ABSTRACT FROM AUTHOR]

Background Patients and Methods Results Conclusion Patients with intermediate‐risk papillary thyroid carcinoma (PTC) have a favorable prognosis with standard treatment of total thyroidectomy (TT) and adjuvant radioactive iodine therapy (RAIT). However, the benefits of TT or adjuvant RAIT remain undetermined, and they are often omitted in Japan. We investigated risk factors for life‐threatening distant recurrence in patients with intermediate‐risk PTC who are optimal candidates for adjuvant RAIT.Outcomes without RAIT were retrospectively examined in 4030 intermediate‐risk conventional PTC cases underwent initial surgery from 2005 to 22 (IRB approval 20200709‐1).Lobectomy (LT) and TT was performed in 11.5% and 88.5%, respectively. Recurrent laryngeal nerve paralysis and hypoparathyroidism was less commonly observed in LT (1.3% and 0%) than TT (2.4% and 3.5 %). Fifty‐six cases (1.4%) had distant recurrence. Recurrence‐free survival rates at 10 years was 93.5%. There was no significant difference in recurrence rate between LT and TT. Age ≥55, cN1b, and tumor diameter >30 mm significantly associated with distant recurrence. There was a strong relationship between the number of positive risk factors and recurrence; the distant recurrence rate in cases of 0, 1, 2, and 3 positive factors was 0.3% (4/1203), 1.3% (25/1889), 2.7% (23/830) and 7.1% (4/52) (HR 6.46 (2.34–17.86), Log‐rank <0.001).For intermediate‐risk conventional PTC, there is no difference in prognosis even if LT was selectively conducted. However, in patients with risk factors for distant metastatic recurrence, such as age ≥55 years, cN1b, and tumor size >30 mm, adjuvant RAIT was considered eligible. [ABSTRACT FROM AUTHOR]

Purpose: This two-center study aimed to explore the main prognostic factors affecting the final disease status in children and adolescents with differentiated thyroid cancer (caDTC) following total thyroidectomy and radioiodine therapy (RAIT). Materials and Methods: All caDTC patients from two centers in the period from 2004-2022 were retrospectively included. At the last follow-up, the patients' disease status was assessed and classified as an incomplete response (IR) or as an excellent or indeterminate response (EIDR). Then, the difference in preablation stimulated thyroglobulin (ps-Tg) levels between the two groups was compared, and the threshold for predicting IR was determined using receiver operating characteristic (ROC) analysis. Moreover, univariate and multivariate analyses were conducted to identify the factors influencing the patients' ultimate disease outcomes. Results: A total of 143 patients (98 females, 45 males; median age 16 years) were recruited. After a median follow-up of 42.9 months, 80 patients (55.9%) exhibited an EIDR, whereas 63 patients (44.1%) exhibited an IR. Patients with an IR had significantly greater ps-Tg levels than did those with an EIDR (median ps-Tg 79.2 ng/mL vs. 9.3 ng/mL, p<0.001). The ROC curve showed that ps-Tg =20 ng/mL was the most accurate for predicting IR at the last follow-up. According to multivariate analysis, only ps-Tg, T stage and the therapeutic response to initial RAIT were significantly associated with IR. Conclusion: In caDTC patients, the ps-Tg level, T stage, and response to initial RAIT are critical final outcome indicators. [ABSTRACT FROM AUTHOR]

Cervical lymph node metastasis is one of the most common clinical presentations of papillary thyroid carcinoma (PTC). Occult thyroid carcinoma is described as absence of primary tumour or with presence of microcarcinoma in thyroid with cervical lymph node metastasis. Frequency of occult thyroid cancer has decreased due to developments in imaging and improved accuracy of histological examinations. 38 year old male presented to us with complaints of swelling over the left side of neck for the past 2 months. Ultrasonography was suggestive of multiple suspicious enlarged nodes in left level II, III, IV and V and fine needle aspiration cytology showed features of metastatic PTC. He was planned for total thyroidectomy with central compartment clearance and bilateral functional neck dissection. Final histopathology staging was pT0N1b. Radioactive iodine (RAI) screening showed residual functioning thyroid and later therapeutic RAI was administered. He has been on regular follow up and disease free for 1 year post treatment. Occult thyroid carcinoma is a rare diagnosis with multiple treatment plans. Few hypothesis for this entity includes tumor regression, ectopic thyroid carcinoma or missed pathological findings. [ABSTRACT FROM AUTHOR]

The VERIFY study aimed to determine the efficacy of vandetanib in patients with differentiated thyroid cancer (DTC) that is either locally advanced or metastatic and refractory to radioiodine (RAI) therapy. Specifically, VERIFY is a randomized, double-blind, multicenter phase III trial aimed to determine the efficacy and safety of vandetanib in tyrosine kinase inhibitor-naive patients with locally advanced or metastatic RAI-refractory DTC with documented progression (NCT01876784). Patients were randomized 1:1 to vandetanib or placebo. The primary endpoint was progression-free survival (PFS). Secondary endpoints included best objective response rate, overall survival (OS), safety, and tolerability. Patients continued to receive randomized treatment until disease progression or for as long as they were receiving clinical benefit unless criteria for treatment discontinuation were met. Following randomization, 117 patients received vandetanib, and 118 patients received a placebo. Median PFS was 10.0 months in the vandetanib group and 5.7 months in the placebo group (hazard ratio: 0.75; 95% CI: 0.55–1.03; P = 0.080). OS was not significantly different between treatment arms. Common Terminology Criteria for Adverse Events (CTCAE) of grade ≥3 were reported in 55.6% of patients in the vandetanib arm and 25.4% in the placebo arm. Thirty-three deaths (28.2%; one related to study treatment) occurred in the vandetanib arm compared with 16 deaths (13.6%; two related to treatment) in the placebo arm. No statistically significant improvement was observed in PFS in treatment versus placebo in patients with locally advanced or metastatic, RAI-refractory DTC. Moreover, active treatment was associated with more adverse events and more deaths than placebo, though the difference in OS was not statistically significant. [ABSTRACT FROM AUTHOR]

This Review summarizes a range of analytical techniques that can be used to detect, quantify, and/or distinguish between isotopes of iodine (e.g., long-lived 129I, short-lived 131I, stable 127I). One reason this is of interest is that understanding potential radioiodine release from nuclear processes is crucial to prevent environmental contamination and to protect human health as it can incorporate into the thyroid leading to cancer. It is also of interest for evaluating iodine retention performances of next-generation iodine off-gas capture materials and long-term waste forms for immobilizing radioiodine for disposal in geologic repositories. Depending upon the form of iodine (e.g., molecules, elemental, and ionic) and the matter state (i.e., solid, liquid, and gaseous), the available options can vary. In addition, several other key parameters vary between the methods discussed herein, including the destructive vs nondestructive nature of the measurement process (including in situ vs ex situ measurement options), the analytical data collection times, and the amount of sample required for analysis. [ABSTRACT FROM AUTHOR]

Novel Cu2O/Cu@C/SiO2 materials with low cost were conveniently synthesized using C/SiO2 derived from rice-husk as support and used for iodine gas adsorption. The iodine adsorption behaviors affected by Cu content, contact time and temperature were investigated. The adsorption capacity as high as 820 mg/g was achieved benefiting from the synergistic effect between Cu2O/Cu and C/SiO2. The results demonstrated that both Cu2O and Cu changed to CuI after iodine adsorption, indicating that the dominant adsorption mechanism was chemical reaction through formation of CuI. This work revealed that the obtained Cu2O/Cu@C/SiO2 could be included in the list of candidate iodine gas adsorbents. [ABSTRACT FROM AUTHOR]

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG-PET/CT) is a diagnostic imaging method that is based on the Warburg effect, which is the increased uptake of glucose through aerobic glycolysis in cancer cells. The diagnostic value of 18F-FDG-PET/CT for thyroid cancer is controversial. However, uptake of 18F-FDG and the corresponding maximum standardized uptake value (SUVmax) is expected to reflect the metabolic status of cancer cells. In the present study, we sought to determine the relationship between 18F-FDG uptake and tumor metabolism- associated factors. This was a single-center retrospective study. In the present study, SUVmax was compared with the expression of hexokinase 2 (HK2), glucose transporter 1 (GLUT1), vascular endothelial growth factor (VEGF), and glutaminase 1 (GLS1) in 41 patients with thyroid cancer. GLS1 expression was found to be moderately correlated with SUVmax (p < 0.001, r = 0.51), whereas HK2 and VEGF expression were weakly correlated (p = 0.011, r = 0.28, p = 0.008, r = 0.29, respectively) and GLUT1 did not correlate with SUVmax (p = 0.62, r = 0.06). Our findings suggest 18F-FDG PET/CT reflects GLS1 expression in thyroid cancer and could be used to select suitable candidates for GLS1 inhibitor treatment. [ABSTRACT FROM AUTHOR]

With so many thyroid knobs (nodules) discovered by accident, it is critical to recognize as many aberrant knobs (nodules) as possible from fine-needle aspiration (FNA) biopsies or other medical procedures while excluding those that are virtually certainly benign. Thyroid ultrasonography, on the other hand, is prone to interobserver variability and subjective translations. An effective deep learning model for segmenting and categorizing thyroid nodules in this study follows the stages below: data collection from a well-known archive, The Thyroid Digital Image Database (TDID), which comprises ultrasound pictures from 298 patients, preprocessing using anisotropic diffusion filter (ADF) for removing noise and enhancing the images, segmentation using a bilateral filter for segmenting images, feature extraction using grey level occurrence matrix (GLCM), feature selection using Multi-objective Particle Swarm with Random Forest Optimization (MbPSRA) and finally classification happens were Residual U-Net will be used. Experiment evaluation states the proposed model outperforms well than other state-of-art models. [ABSTRACT FROM AUTHOR]

Background: Oncocytic carcinoma (OCA) was recently reclassified as a distinct differentiated thyroid carcinoma (DTC). Given its rarity, OCA studies are limited. This study describes the characteristics of OCA in a 20‐year cohort. Methods: Retrospective analysis of patients with OCA at a single tertiary care hospital from 2000 to 2021. Results: Fifty‐one OCA patients (22M:29F) were identified. The mean age at diagnosis was 60.3 years; 90% presented as palpable mass; 24% had a family history of thyroid cancer. None had vocal fold paresis. On ultrasound, most tumors were solid and hypoechoic. FNA (n = 14) showed Bethesda‐4 lesions in 93%. All were treated surgically. Histologically, 63% demonstrated angioinvasion, 35% had lymphovascular invasion, and 15% had extrathyroidal extension. Radioactive iodine was used as adjunct therapy in 77%. Conclusion: OCA has distinct features that distinguish it from other DTCs, and additional focused studies will help clarify the aggressive nature, treatment options, and prognosis of the disease. [ABSTRACT FROM AUTHOR]

Thyroid cancer incidence increases worldwide annually, primarily due to factors such as ionizing radiation (IR), iodine intake, and genetics. Papillary carcinoma of the thyroid (PTC) accounts for about 80% of thyroid cancer cases. RET/PTC1 (coiled‐coil domain containing 6 [CCDC6]‐rearranged during transfection) rearrangement is a distinctive feature in over 70% of thyroid cancers who exposed to low doses of IR in Chernobyl and Hiroshima‒Nagasaki atomic bombings. This study aims to elucidate mechanism between RET/PTC1 rearrangement and IR in PTC. N‐thy‐ori‐3‐1 cells were subjected to varying doses of IR (2/1/0.5/0.2/0.1/0.05 Gy) of IR at different days, and result showed low‐dose IR‐induced RET/PTC1 rearrangement in a dose‐dependent manner. RET/PTC1 has been observed to promote PTC both in vivo and in vitro. To delineate the role of different DNA repair pathways, SCR7, RI‐1, and Olaparib were employed to inhibit non‐homologous end joining (NHEJ), homologous recombination (HR), and microhomology‐mediated end joining (MMEJ), respectively. Notably, inhibiting NHEJ enhanced HR repair efficiency and reduced IR‐induced RET/PTC1 rearrangement. Conversely, inhibiting HR increased NHEJ repair efficiency and subsequent RET/PTC1 rearrangement. The MMEJ did not show a markable role in this progress. Additionally, inhibiting DNA‐dependent protein kinase catalytic subunit (DNA‐PKcs) decreased the efficiency of NHEJ and thus reduced IR‐induced RET/PTC1 rearrangement. To conclude, the data suggest that NHEJ, rather than HR or MMEJ, is the critical cause of IR‐induced RET/PTC1 rearrangement. Targeting DNA‐PKcs to inhibit the NHEJ has emerged as a promising therapeutic strategy for addressing IR‐induced RET/PTC1 rearrangement in PTC. [ABSTRACT FROM AUTHOR]

Aims Materials and Methods Results Conclusions To investigate the impact of various clinical factors associated with Graves' disease on the success rate of radioiodine (RAI) therapy for Graves' disease within 3 years, and to determine the optimal range of iodine dosage per unit volume that yields the highest cure rate for Graves' disease within 1 year.This retrospective study included patients diagnosed with Graves' disease who underwent RAI therapy at the Second Affiliated Hospital of Anhui Medical University between October 2012 and October 2022. The cumulative success rate was analysed using the Kaplan–Meier method. Univariate and multivariate Cox proportional hazards regression models were employed to evaluate factors associated with successful treatment of Graves' disease. Outcomes were categorized as either success or failure for all patients.Overall, 1994 patients were enrolled in this study, including 594 (29.8%) male and 1399 (70.2%) female patients. The success and failure groups comprised 1645 (82.4%) and 349 patients (17.6%), respectively, after a 3‐year follow‐up period. Multivariate regression analysis demonstrated that sex, antithyroid drug (ATD) use before RAI therapy, age, thyroid receptor antibody (TRAb) levels, iodine dose, thyroid mass, and early ATD use before RAI therapy were independent influencing factors for Graves' disease cure.We found that female patients and those with TRAbs ≥31.83 IU/L and thyroid mass ≥ 73.42 g had a lower cure rate. Therefore, thyroid size, disease severity, and duration of disease should be comprehensively considered when making treatment decisions and iodine dose selection in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Pooled data analysis from three phase I/II larotrectinib clinical trials revealed that larotrectinib demonstrated rapid and durable disease control and a favorable safety profile for patients with neurotrophic-tropomyosin receptor kinase (NTRK) fusion positive thyroid carcinoma. Herein, we report the case of a patient with papillary thyroid carcinoma (PTC) and liver metastases who demonstrated a durable response to treatment with larotrectinib. Case presentation: A 50-year-old female with PTC was referred to our hospital for postoperative observation. Computed tomography (CT) scan was performed to screen for distant metastasis, since thyroglobulin concentration increased gradually, and revealed multiple distant metastases, including multiple liver metastases. Radioactive iodine was administered at a dose of 100 mCi. However, uptake was observed only in the thyroid bed, and distant metastases had no avidity. As liver metastases progressed, lenvatinib (24 mg/day) was initiated after confirmation of liver metastases by liver biopsy 9 years and 1 month after the initial referral to our hospital. Since the multiple metastases became refractory for lenvatinib, the OncoGuide™ NCC Oncopanel System was performed, and the SQSTM1–NTRK1 gene fusion was confirmed. Larotrectinib was subsequently administered at a dose of 200 mg/day. The CT before the initiation of larotrectinib showed multiple liver metastases with a maximum diameter of 48 mm. The first CT evaluation at 1 month after the initiation of larotrectinib treatment showed that the tumor volume was reduced by 28% in the RECIST 1.1 criteria. After 3 months of larotrectinib treatment, a 38% reduction in the tumor volume was achieved as the best clinical response. The only side effect was grade 1 myalgia. At 12 months after the initiation of larotrectinib treatment, none of the lesions had progressed. Conclusions: In conclusion, larotrectinib demonstrated effective antitumor activity against liver metastases of PTC, a relatively rare site of distant metastasis. Furthermore, the efficacy of larotrectinib was maintained, even though the patient had a history of multi-tyrosine kinase inhibitor treatment and a relatively infrequent fusion gene, SQSTM1–NTRK1. [ABSTRACT FROM AUTHOR]

Orthognathic surgery has a high incidence of postoperative nausea (PON) and vomiting (POV), delaying mobility initiation and postoperative recovery. Bleeding is another risk associated with this surgical procedure. We aimed to compare total intravenous anesthesia (TIVA) and volatile anesthesia in patients undergoing orthognathic surgery in terms of postoperative nausea and vomiting (PONV) incidence and hemodynamic changes. This retrospective study included 82 patients who underwent bilateral sagittal split ramus osteotomies at Saga University Hospital between April 2016 and April 2021. We compared the effects of TIVA and volatile anesthesia on PONV onset after surgery, acute postoperative hemodynamic changes (blood pressure and heart rate), and factors contributing to PONV. PON was significantly lower in the TIVA group than in the volatile anesthesia group. The total dose of fentanyl contributed to the onset of POV, while the onset of PON was associated with low volumes of fluid infusion and urine in the TIVA and volatile anesthesia groups, respectively. Furthermore, post-extubation hemodynamic change was significantly smaller in the TIVA group than in the volatile anesthesia group. Therefore, TIVA could have a reduced risk of PONV and hemodynamic changes in patients undergoing orthognathic surgery. Employing TIVA could mitigate perioperative complications and enhance patient safety. [ABSTRACT FROM AUTHOR]

Background and purpose: Thyroid papillary carcinoma (PTC) had a high possibility of recurrence after surgery, and thyroid stimulating hormone (TSH) suppression and radioactive iodine (131I) were used for postoperative therapy. This study explored the potential mechanism of lymph node metastasis (LNM) and aimed to develop differentiated treatments for PTC. Method: This study explored the risk factors of lymph node metastasis in PTC by analyzing the clinical information of 2073 cases. The Cancer Genome Atlas Thyroid Cancer (TCGA-THCA) and the Gene Expression Omnibus (GEO) databases of gene expression were analyzed to identify the interrelationships between gene expression to phenotype. Results: Analyzing clinical data, we found that male gender, younger age, larger tumor size, and extra-thyroidal extension (ETE) were risk significant risk factors for lymph node metastasis(P<0.05). Conversely, thyroid function parameters such as TSH, FT3, FT4, TSH/FT3, and TSH/FT4 didn't correlate with LNM (P>0.05), and TSH levels were observed to be higher in females(P<0.05). Gene expression analysis revealed that SLC5A5 was down-regulated in males, younger individuals, and those with lymph node metastasis, and a lower level of SLC5A5 was associated with a worse disease-free survival(P<0.05). Additionally, our examination of single-cell RNA sequencing (scRNA-seq) data indicated that SLC5A5 expression was reduced in tumors and lymph node metastasis samples, correlating positively with the expression of TSHR. Conclusion: The impact of TSH on PTC behavior remained unclear, while the capacity for absorbing 131I in dependence on SLC5A5 showed variations across different genders and ages. We conclude that postoperative treatment of PTC should take into account the differences caused by gender and age. [ABSTRACT FROM AUTHOR]

A 71-year-old woman was diagnosed with unresectable metastatic follicular thyroid carcinoma (FTC) and thyrotoxicosis. She was negative for the presence of thyroxine receptor antibody and thyroid-stimulating antibody. Whole-body scintigraphy revealed increased 99mTc-pertechnetate uptake in metastatic bone lesions but not in the thyroid nodule. Since radioactive iodine therapy was not applicable because the canalis vertebralis had been invaded, treatment with lenvatinib was initiated, along with methimazole and potassium iodide. The serum level of thyroid hormone decreased. The patient developed hypothyroidism, which continued after the methimazole was stopped, suggesting that lenvatinib suppressed the hyperthyroidism. To our best knowledge, this is the first report of a patient with functioning bone lesions of metastatic FTC in whom hyperthyroidism was controlled by lenvatinib without radioactive iodine therapy. [ABSTRACT FROM AUTHOR]

Exploring the materials that effectively capture radioactive iodine is crucial in managing nuclear waste produced from nuclear power plants. In this study, a β-ketoenamine-linked covalent organic framework (bCOF) is reported as an effective adsorbent to capture iodine from both vapor and solution. The bCOF's high porosity and heteroatom-rich skeleton offer notable iodine vapor uptake capacity of up to 2.51 g g-1 at 75 °C under ambient pressure. Furthermore, after five consecutive adsorption-desorption cycles, the bCOF demonstrates high reusability performance with significant iodine vapor capacity retention. The adsorption mechanism was also investigated using various ex situ structural characterization techniques, and these mechanistic studies revealed the existence of a strong chemical interaction between the bCOF and iodine. The bCOF also showed good iodine uptake performance of up to 512 mg g-1 in cyclohexane with high removal efficiencies. The bCOF's performance in adsorbing iodine from both vapor and solution makes it a promising material to be used as an effective adsorbent in capturing radioactive iodine emissions from nuclear power plants. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to develop and psychometrically evaluate a patient-reported outcome measure (PROM), SAlivary, LAcrimal, NaSal (SALANS), to document patients' symptoms after radioactive iodine (RAI) treatment for differentiated thyroid cancer (DTC). Methods: We generated and iteratively revised SALANS items based on expert input, focus group discussions and feedback from cognitive testing (n = 17). We administered an initial SALANS measure with 39 items to patients diagnosed with DTC in the past two years (n = 105). Exploratory factor analysis (EFA) examined the factor structure of the SALANS items. We assessed the consistency reliability and related the total and subscale scores of the final SALANS to existing PROMs to assess validity. Results: The final SALANS consisted of 33 items and six subscales (sialadenitis, taste, xerostomia, dry eyes, epiphora, and nasal) with six factors extracted by EFA. The six subscales demonstrated good internal reliability (α range = 0.87—0.92). The SALANS total score showed good convergent validity with the Xerostomia Inventory (r = 0.86) and good discriminant validity with a measure of spirituality (r = − 0.05). The mean SALANS total score was significantly higher (d = 0.5, p < 0.04) among patients who had RAI compared to those who did not have RAI. Conclusion: Preliminary evidence suggests that SALANS is a novel and reliable PROM to assess the type and frequency all symptoms experienced after RAI treatment for DTC. Future work is needed to further validate and develop the scale. [ABSTRACT FROM AUTHOR]

Background: Differentiated thyroid cancer (DTC) patients have an outstanding overall long-term survival rate, and certain subsets of DTC patients have a very high likelihood of disease recurrence. Radioactive iodine (RAI) therapy is a cornerstone in DTC management, but cancer cells can eventually develop resistance to RAI. Radioactive iodine-refractory DTC (RAIR-DTC) is a condition defined by ATA 2015 guidelines when DTC cannot concentrate RAI ab initio or loses RAI uptake ability after the initial therapy. The RAIR condition implies that RAI cannot reveal new met-astatic foci, so RAIR-DTC metabolic imaging needs new tracers. 18F-FDG PET/CT has been widely used and has demonstrated prognostic value, but 18F-FDG DTC avidity may remain low. Fibroblast activation protein inhibitors (FA-Pi)s, prostatic-specific membrane antigen (PSMA), and somatostatin receptor (SSTR) tracers have been proposed as theragnostic agents in experimental settings and Arg-Gly-Asp (RGD) peptides in the diagnostic trial field. Multi-targeted tyrosine kinase inhibitors are relatively new drugs approved in RAIR-DTC therapy. Despite the promising targeted setting, they relate to frequent adverse-event onset. Sorafenib and trametinib have been included in re-differentiation protocols aimed at re-inducing RAI accumulation in DTC cells. Results appear promising, but not excellent. Conclusions: RAIR-DTC remains a challenging nosological entity. There are still controversies on RAIR-DTC definition and post-RAI therapy evaluation, with post-therapy whole-body scan (PT-WBS) the only validated criterion of response. The recent introduction of multiple diagnostic and therapeutic agents obliges physicians to pursue a multidisciplinary approach aiming to correct drug introduction and timing choice. [ABSTRACT FROM AUTHOR]

Background: The high doses of radioiodine‐131 (131I) and, subsequently, the high radioactive burden for dog and environment warrants optimization of 131I therapy in dogs with thyroid carcinoma (TC). Hypothesis/Objectives: To evaluate the effect of a revised protocol with recombinant human thyroid stimulating hormone (rhTSH) on tumor radioactive iodine uptake (RAIU) in dogs with TC. Animals: Nine client‐owned dogs diagnosed with TC. Methods: A prospective cross‐over study in which tumor RAIU was calculated and compared at 8 hours (8h‐RAIU) and 24 hours (24h‐RAIU) after injection of radioactive iodine‐123 (123I), once with and once without rhTSH (ie, 250 μg, IM, 24 and 12 hours before 123I) in each dog. Simultaneously, serum total thyroxine (TT4) and TSH were measured at baseline (T0), and 6 (T6), 12 (T12), 24 (T24), and 48 hours (T48) after the first rhTSH administration. Results: Tumor RAIU was significantly higher at 24 hours with rhTSH compared to no rhTSH (mean difference = 8.85%, 95% CI of [1.56; 16.14]; P =.03), while this was non‐significant at 8 hours (mean difference = 4.54%, 95% CI of [0.35; 8.73]; P =.05). A significant change of serum TT4 (median difference T24 − T0 = 35.86 nmol/L, interquartile range [IQR] = 15.74 nmol/L) and TSH (median difference T24 − T0 = 1.20 ng/mL, IQR = 1.55 ng/mL) concentrations occurred after administration of rhTSH (P <.001). Conclusions and Clinical Importance: Recombinant human TSH could optimize 131I treatment in dogs with TC by increasing tumor RAIU and thus 131I treatment efficacy. [ABSTRACT FROM AUTHOR]

In the current study, a zirconium-containing anion exchange resin was synthesized as an oxidizing resin for iodide adsorption from aqueous solutions. The static adsorption capacity of the oxidizing resin was 612.86 mg/g (obtained from isotherm studies and the Langmuir model). This capacity was 31% higher than the capacity of counter parent resin for iodide adsorption. Adsorption performance of the oxidizing resin was close to maximal over a wide range of pHs (2–7), and the best results were obtained at pH = 3 (8.5% higher than the resin capacity in neutral pH). Iodide removal selectivity in the presence of three commonly encountered anions SO 4 2 - , NO 3 - and Cl - was improved. The iodide selectivity of oxidizing resin in the presence of Cl - ion was excellent. Breakthrough curves of both resins with and without encountered anions were fitted with common breakthrough curve models. The results were consistent with the results of the batch mood experiments. Pseudo-second-order kinetic was described kinetic behavior of both resins well. An iodide adsorption mechanism was proposed using the results of batch experiments and the resin characterizations (XPS and Raman spectra). The potential of oxidizing resin for iodide oxidation into iodine increased the capacity and selectivity of resin toward iodide ions. [ABSTRACT FROM AUTHOR]

As a classic theranostic radiopharmaceutical, radioiodine (131I) has been utilized in the management of differentiated thyroid cancer (DTC) for more than 8 decades, and the refinement of its clinical practice has been raised recently. This study was conducted to evaluate the efficiency of a diagnostic (Dx) 131I scan in optimizing the indication of initial radioiodine oncolytic treatment (ROT) for metastatic DTC by predicting therapeutic outcomes. A total of 100 patients (Dx positive, n=29; Dx negative, n=71) were eligible for patient-based analysis. The matching rate was 83.0% between the Dx and the post-therapeutic scans (kappa = 0.648, P <0.001). The biochemical remission rate and structural shrinkage rate induced by the initial ROT in the Dx-positive group were, respectively, greater than those in the Dx-negative group (83.3% vs. 17.4%, P <0.001; 37.9% vs. 4.2%, P <0.001). Notably, the predictive values of positive Dx scans for ROT responsiveness and negative Dx scans for ROT nonresponsiveness reached up to 89.7% and 84.5%, respectively. This Dx scan approach seems viable in characterizing the 131I-avidity of metastatic DTC and plays a pivotal role in optimizing the indication of initial ROT for metastatic DTC. • Dx scan using 74 MBq of 131I is feasible without stunning effect. • Dx scan strongly agrees with the Rx scan in assessing the 131I-avidity of metastatic DTC. • Dx scan optimizes the indication of initial ROT by predicting therapeutic outcomes. [ABSTRACT FROM AUTHOR]

Our previous study showed that elevated preoperative thyroglobulin (pre-Tg) level predicted the risk of developing radioiodine refractory in PTC patients. In the present study, we aimed to evaluate the prognostic value of pre-Tg in papillary thyroid microcarcinoma (PTMC). After a specific inclusion and exclusion criteria were applied, a total of 788 PTMCs were enrolled from Jiangyuan Hospital affiliated to Jiangsu Institute of Nuclear Medicine between Jan 2015 and Dec 2019. Among them, 107 PTMCs were treated with radioiodine therapy (RAIT) and the response to therapy was grouped as excellent response (ER), and non-excellent response (NER: indeterminate response, IDR and biochemical incomplete response, BIR). Multivariable logistic regression was used to identify predictors for the response of RAIT in PTMCs. Higher pre-Tg levels were detected in PTMCs with RAIT as compared with PTMCs without RAIT (p=0.0018). Higher levels of pre-Tg were also found in patients with repeated RAIT as compared with patients with single RAIT (p<0.0001). Furthermore, pre-Tg level was higher in PTMC with IDR (n=16) and much higher in BIR (n=9) as compared with patients with ER (n=82, p=0.0003) after RAIT. Multivariate analysis showed that pre-Tg level over 16.79 ng/ml [OR: 6.55 (2.10–20.39), p=0.001] was the only independent predictor for NER in PTMC with RAIT. We found that high level of pre-Tg predicted a poor RAIT outcome in PTMC. Our finding explores a prospective way in identifying high-risk PTMCs with poor response to RAIT. [ABSTRACT FROM AUTHOR]

False positive radioiodine uptake may pose difficulties in diagnosis and subsequent management of thyroid cancer. Combined imaging techniques, such as SPECT/CT, play a crucial role in accurately identifying the specific location of radioiodine uptake, thereby avoiding potential diagnostic error. This is particularly important in situations where unexpected uptake could lead to unnecessary treatment interventions such as surgery or radioiodine treatment. In this study, we discuss a case involving a 38-year-old female with a history of thyroid cancer and I-131 treatment. Approximately six years later, her course was complicated by left sided epiphora leading to dacryocystorhinostomy and subsequently elevation of thyroglobulin (Tg) levels prompting retreatment by radioiodine. The post-therapy whole-body scan revealed false-positive radioiodine uptake on the left side of the skull, conclusively confirmed through SPECT/CT imaging to be localized in the patient's left eye. [ABSTRACT FROM AUTHOR]

Purpose: Struma ovarii is a highly specialized teratoma consisting primarily of mature thyroid tissue. However, malignant struma ovarii coexisting with thyroid carcinoma, not to mention autoimmune disease, is uncommon. Malignant struma ovarii complicated with papillary thyroid carcinoma, Hashimoto's thyroiditis and polycystic ovarian syndrome has never been reported in literature. Patients and Methods: A 32-year-old female was admitted to our hospital due to a history of abdominal distension and menolipsis over the past half a year. Physical examination touched a 6 × 6 cm mass with a clear boundary, normal movement, and no pressing pain in the right adnexal area, Imaging revealed a cystic solid mass of 6 × 7 cm in the right ovary and the level of tumor markers including CA125, CA199, CA153, CEA, AFP were normal, but with low TSH and increased TPOAb, TGAb, TRAb. Laparoscopic right ovary tumor resection was performed, followed by comprehensive staging surgery, as well as thyroidectomy after pathologic diagnosis. The patient was diagnosed with a combination of follicular thyroid cancer from struma ovarii, papillary thyroid carcinoma and Hashimoto's thyroiditis, along with polycystic ovarian syndrome. Immunohistochemical staining showed positivity for Ag, CK-pan, CK7, PAX8 and TTF-1 in the right ovarian mass, and the left thyroid was positive for the BRAF V600E mutation. Results: The patient underwent thyroxine suppression therapy and radioactive iodine 131I therapy after operation. Serum thyroglobulin was undetectable, and no signs of recurrence or metastasis were detected in the imaging examination at the 2-year follow-up. Conclusion: Malignant struma ovarii coexisting with thyroid carcinoma is rare. No report has been identified in literature review on the rare malignant struma ovarii coexisting with thyroid carcinoma, Hashimoto's thyroiditis and polycystic ovarian syndrome. Our case can offer experience of diagnosis and treatment to some extent for such rare case. Therefore, it is essential to consider the association between ovarian tumors and the endocrine system. This case is valuable in understanding the diagnosis and management of such an unusual complicated disease. [ABSTRACT FROM AUTHOR]

Background: The normal reference values for the thyroid uptake of radioactive iodine and Tc-99m pertechnetate in euthyroid patients vary by geographical location as well as the amount of iodine intake in the diet. The present study examines the normal reference values for thyroid uptake of Tc-99m pertechnetate in the North of Iran. Methods: The participants of this study were 64 patients (all over 20 years of age) who had referred to the Nuclear Medicine Center of the Shahid Beheshti Hospital for thyroid scan over the period between March 2018 and May 2020. It is worth mentioning that relying on laboratory test results, only patients with normal thyroid function were included in this cross-sectional study. Results: The median, the 5th and 95th percentiles and thyroid uptake range of 99mTc-pertechnetate in euthyroid patients were 0.9, 0.6 to 1.8% and 0.54 - 1.80%, respectively. Conclusion: The percentage of uptake in the thyroid gland in each geographical area varies based on race and diet content, so it is necessary to determine the percentage of uptake in each specific region and even check it periodically. [ABSTRACT FROM AUTHOR]

Primary cardiac malignant tumors are extremely rare, making up about 10% of all primary cardiac tumors. Most of these tumors are primary sarcomas, with primary mesothelioma being even less common. This report details a 53-year-old male patient diagnosed with primary cardiac malignant mesothelioma. The patient had symptoms of chest pain and difficulty breathing. A CT scan showed an enlarged heart, fluid around the heart, and irregular thickening of the pericardium. Diagnosis was confirmed through a surgical biopsy, which showed the presence of malignant mesothelioma. After the procedure, the patient received appropriate cardiac support. Although stable at discharge, the patient unfortunately died three months later due to severe wheezing. There may be a potential link between exposure to radioactive iodine treatment and this outcome. This case highlights the diagnostic and treatment challenges of primary cardiac malignant tumors and reminds physicians to consider this rare disease when evaluating patients with similar symptoms. [ABSTRACT FROM AUTHOR]

Safe confinement of fission iodine isotopes for long-term radioactive waste disposal remains a formidable challenge, as conventional sorbents provide inherently weak iodine-host interactions. We report here a novel halogen bond (X-bond) directed strategy to sequester volatile iodine in hydrogen-bonded (H-bonded) frameworks with unprecedented stability. Charge-assisted H-bonded frameworks bearing open halide sites are developed, showing distinctive iodine encapsulation behaviors without compromising the crystallinity. Direct crystallographic evidence indicates the formation of X-bonds, i.e., ∣–∣⋯Cl− and ∣–∣⋯Br−, within the confined pore channels. Unusual polyhalogen anions, i.e., [I2Cl2]2− and [I2Br2]2−, sustained in H-bonded frameworks are identified for the first time. The X-bond reinforced host-guest interaction affords robust iodine trapping without leaking out even at elevated temperatures up to 180 °C. By integrating the halogen-bond chemistry with H-bonded frameworks, this study offers fresh concepts for developing effective host reservoirs to secure fission iodine isotopes from spent fuel reprocessing off-gases. [ABSTRACT FROM AUTHOR]

Background Mutations in micro-RNA (miRNA) regulators DICER1 and DGCR8 have recently been uncovered, revealing a potential novel mechanism driving thyroid tumor development. However, the true frequency of these hotspot mutations in follicular-patterned thyroid tumors (FTs) and their relation to established driver gene events remain elusive. Methods A total of 440 FTs from 2 institutions were interrogated for DICER1, DGCR8, and RAS family hotspot mutations using Sanger sequencing. Whole-exome sequencing was also performed to identify additional driver gene aberrations in DICER1/DGCR8 -mutant cases. Subsets of cases were further analyzed using miRNA expression profiling, and key dysregulated miRNAs were validated as markers of DICER1 mutations using quantitative RT-PCR analysis. The Cancer Genome Atlas (TCGA) database was also probed for DICER1 / DGCR8 mutations and miRNA dysregulation. Results Fourteen (3.2%) and 4 (1%) FTs harbored DICER1 and DGCR8 hotspot mutations, respectively, in the combined cohort, and no cases with normal tissue available were found to exhibit a constitutional variant. Two DGCR8 -mutant cases also harbored oncogenic RAS mutations. Whole-exome sequencing analysis did not identify additional driver gene events in DICER1 / DGCR8- positive cases. Comprehensive miRNA expression profiling revealed a unique pattern of dysregulated miRNAs in DICER1 / DGCR8- mutant cases compared with wild-type lesions. Moreover, DICER1 -mutant cases showed a remarkable reduction of 5′ arm miRNAs, findings corroborated in the TCGA cohort. Conclusion DICER1 and DGCR8 hotspot mutations are rare in unselected cohorts of FTs, and mutated cases exhibit a specific miRNA profile. Although DGCR8 mutations may coexist with established RAS gene alterations, FTs with DICER1 variants were devoid of other driver gene events. [ABSTRACT FROM AUTHOR]

To investigate the levels of 131I activity in thyroid of workers at the place of radioiodine therapy and their main influential factors in China, 341 workers at 38 hospitals performing radioiodine therapy procedure in five provinces were recruited to be measured in 2021. A hand-held gamma spectrometer with NaI(Tl) probe was plastered to the thyroids and thighs of the subjects during the measurement, and each measurement time was 120 s. The internal exposure dose was calculated, and the committed effective dose was estimated. In 86 (25.22%) of the 341 examined workers, 131I thyroid activity was above minimum detectable activity (MDA , 26.6 Bq). The maximum activity was 4.9 × 103 Bq. The detection results above MDA were at 22 (57.89%) different hospitals. The detectable rate for private hospitals (4.8%) was significantly lower than that for public hospitals (26.6%), P < 0.05. The detectable rate for hospitals in provincial capital cities (15.4%) was significantly lower than in nonprovincial capital cities (41.7%), P < 0.001. The detectable rate for hospitals engaged in 131I therapy for thyroid cancer (31.2%) was significantly higher than only for hyperthyroidism (10.3%), P < 0.001. A total of 32 subjects' committed effective dose might exceed 1 mSv. Results indicated the 131I activity in the thyroid of workers at the place of radioiodine varied considerably in China, and mainly related to ownership, location and therapy program of the hospitals. [ABSTRACT FROM AUTHOR]

Objectives: To determine the incidence, presentation, frequency and management of immune checkpoint inhibitors (ICI)‐related endocrinopathies in a comprehensive cancer centre in Oman, particularly with programme death 1/programme death‐ligand 1 (PD‐1/PD‐L1) inhibitors. Background: A high number of patients treated with PD‐1/PD‐L1 inhibitors for the management of solid tumours developed endocrinopathies. Methods: This is a retrospective study of patients admitted to Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) from August 2021 to December 2022. All adults diagnosed with solid cancers and have received at least one dose of ICIs were included. Patients with incomplete data were excluded from the analysis. Data regarding the ICI‐induced endocrinopathy were collected. Results: A total of 139 patients were included in the study of which 58% were females. The median age of the cohort was 56 years. The incidence of endocrine‐related adverse events was 28%. The mean time for the development of endocrine adverse events after treatment initiation was 4.1 ± 2.8 months. Of the patients who developed toxicity, 90% had hypothyroidism. Ten patients developed hyperthyroidism, two patients were diagnosed with secondary adrenal insufficiency/hypophysitis and one patient developed Type 1 diabetes mellitus (DM). Using univariable logistic regression weight and body mass index (BMI) significantly impacted the development of endocrine immune‐related adverse events (irAEs). Conclusions: This is the first study from the Sultanate of Oman to assess PD‐1/PDL‐1 ICI‐induced endocrinopathies. The most common endocrine adverse event is thyroid dysfunction, mainly hypothyroidism followed by hyperthyroidism. Hypophysitis, primary adrenal insufficiency and CIADM occur less frequently, but have a more significant effect on the patient's health. The treating physician should be aware of ICI‐induced endocrinopathies, screening and treatment. Furthermore, our study showed that patients with a higher BMI have a greater risk of developing irAES. Further studies are needed to establish the predictors of endocrine irAEs. [ABSTRACT FROM AUTHOR]

Silver-containing silica gel is a commonly used iodine waste adsorption material in post-treatment plants, and can be formed by adsorbing iodine with silver-containing silica gel, which provides a feasible method for treatment of radioactive iodine. The accurate determination of iodine content in iodine-containing silica gel samples can verify the adsorption efficiency of iodine and provide data support for the post-processing process. Silver ions and iodide ions in the iodine-containing silica gel samples form insoluble silver iodide during the dissolution process, it is difficult to quantitatively convert the iodide ions in silver iodide into soluble iodide ions, iodine elements or iodate ions. Therefore it is difficult to measures the iodine content in iodine containing silica gel samples. During the experiment, the effects of masking silver ions on iodide ions were considered. By checking the solubility product constant of the silver compound, the method of adding sulfide ions was used to generate a silver sulfide precipitate that was more difficult to dissolve than silver iodide, thus eliminating the interference of silver ion. The displaced iodide ions existed stably in alkaline solutions, and because of the high iodine content, inductively coupled plasma spectrometry (ICP-OES) was used to measure IS content. During the experiment, the effects of sodium sulfide add-on, ammonia concentration, ultrasound time, etc. on the results were investigated, and the ICP-OES method was used to measure the iodine content in the sample. Experimental results showed that the amount of sodium sulfide added was related to the silver content, excessive sulfide ions needed to be added to precipitate silver ions. Different ammonia concentrations affected the sensitivity of iodine, while the somication time had little effect on the results. The detection limit of the method was 0.52 mg/g after optimizing the experimental conditions, and two silica gel samples containing iodine and silver were measured 6 times, with an average value of 34.8 mg/g and 59.3 mg/g. The relative standard deviations were 2.7% and 2.0%, and the recovery of the spiked was 95. 0%--103%, which could meet the determination of iodine in iodine containing silica gel samples. [ABSTRACT FROM AUTHOR]

Excessive intake of iodine will do harm to human health. In recent years, high iodine groundwater has become a global concern after high arsenic and high fluorine groundwater. A deep understanding of the environmental factors affecting iodine accumulation in groundwater and the mechanism of migration and transformation is the scientific prerequisite for effective prevention and control of iodine pollution in groundwater. The paper comprehensively investigated the relevant literature on iodine pollution of groundwater and summarized the present spatial distribution and hydrochemical characteristics of iodine-enriched groundwater. Environmental factors and hydrogeological conditions affecting iodine enrichment in aquifers are systematically summarized. An in-depth analysis of the hydrologic geochemistry, physical chemistry, biogeochemistry and human impacts of iodine transport and transformation in the surface environment was conducted, the results and conclusions in the field of high iodine groundwater research are summarized comprehensively and systematically. Stable isotope can be used as a powerful tool to track the sources of hydrochemical components, biogeochemistry processes, recharge sources and flow paths of groundwater in hydrogeological systems, to provide effective research methods and means for the study of high iodine groundwater system, and deepen the understanding of the formation mechanism of high iodine groundwater, the application of isotopic technique in high iodine groundwater is also systematically summarized, which enriches the method and theory of high iodine groundwater research. This paper provides more scientific basis for the prevention and control of groundwater iodine pollution and the management of groundwater resources in water-scarce areas. [ABSTRACT FROM AUTHOR]

Copyright of Baghdad Science Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The growing incidence of differentiated thyroid cancer (DTC) have been linked to insulin resistance and metabolic syndrome. The imperative need for developing effective diagnostic imaging tools to predict the non-iodine-avid status of lung metastasis (LMs) in differentiated thyroid cancer (DTC) patients is underscored to prevent unnecessary radioactive iodine treatment (RAI). Methods: Primary cohort consisted 1962 pretreated LMs of 496 consecutive DTC patients with pretreated initially diagnosed LMs who underwent chest CT and subsequent post-treatment radioiodine SPECT. After automatic lesion segmentation by SE V-Net, SE Net deep learning was trained to predict noniodine-avid status of LMs. External validation cohort contained 123 pretreated LMs of 24 consecutive patients from other two hospitals. Stepwise validation was further performed according to the nodule's largest diameter. Results: The SE-Net deep learning network yielded area under the receiver operating characteristic curve (AUC) values of 0.879 (95% confidence interval: 0.852-0.906) and 0.713 (95% confidence interval: 0.613-0.813) for internal and external validation. With the LM diameter decreasing from =10mm to =4mm, the AUCs remained relatively stable, for smallest nodules (=4mm), the model yielded an AUC of 0.783. Decision curve analysis showed that most patients benefited using deep learning to decide radioactive I131 treatment. Conclusion: This study presents a noninvasive, less radioactive and fully automatic approach that can facilitate suitable DTC patient selection for RAI therapy of LMs. Further prospective multicenter studies with larger study cohorts and related metabolic factors should address the possibility of comprehensive clinical transformation. [ABSTRACT FROM AUTHOR]

Subcutaneous implantation is an unexpected complication of thyroid surgery. Our study aimed to analyze the clinical features and outcomes of implantation after thyroid surgery. We retrospectively searched for the patients with implants of thyroid tumor after surgery from our database prior to August 2023. The clinical and pathological data were reviewed. Six female patients with a mean age of 33.6 ± 13.3 years were enrolled in this study. There was a rare case with mucinous adenocarcinoma, three follicular thyroid carcinoma, and two papillary thyroid carcinoma. The case with primary enteric adenocarcinoma of thyroid with subcutaneous implantation was first reported. The patient with mucinous adenocarcinoma received six courses of TP regimen chemotherapy. Five cases received radioactive iodine therapy. After a mean of 69.5 months of follow-up, one case recurred in the lateral region, and no metastasis or recurrence happened in the other five cases. Although the implantation after thyroid surgery is uncommon, the cases serve as a reminder to take greater care to avoid implantation. [ABSTRACT FROM AUTHOR]

Background: Aurora kinase A (AURKA) and tumor-infiltrating lymphocytes (TILs) are both known to play an essential role in tumorigenesis. However, the expression and prognostic value of the AURKA and TILs in medullary thyroid carcinoma (MTC) have not yet been investigated. Patients and methods: Surgical specimens and clinical data of 137 patients diagnosed with MTC were collected. AURKA expression and TILs infiltration were quantified by immunohistochemistry and hematoxylin-eosin staining. Subsequently, the prognostic value of AURKA expression and TIL infiltration in MTC was evaluated. Results: AURKA was highly expressed in patients with multifocal tumor, cervical lymph node metastasis, and an advanced TNM stage, indicating a high probability of recurrence. AURKA further exhibited a positive correlation with TILs (R = 0.44, P < 0.001). High expression of AURKA combined with a low numbers of TILs (AURKAhigh/TILslow) was identified as an independent prognostic factor for biochemical recurrence (odds ratio: 4.57, 95% confidence interval: 1.54--14.66, P < 0.01) and recurrence-free survival (hazard ratio: 3.64, 95% confidence interval: 1.52--8.71, P < 0.001). The combination of AURKA and TILs apparently improves the prognostic value for biochemical recurrence (area under the curve: 0.751) and structural recurrence (area under the curve: 0.836) of MTC. Notably, AURKAhigh/TILslow demonstrated a high value for prediction of distant or unresectable locoregional recurrence, with an overall accuracy of 86.9%. Conclusion: AURKAhigh is associated with the MTC malignancy. The combination of AURKAhigh/TILslow was identified as novel independent prognostic marker in MTC, predicting incurable disease recurrence with high accuracy. [ABSTRACT FROM AUTHOR]

Background: Telomere length is associated with cancer risk and cancer aggressiveness. Radioactive iodine (RAI) therapy for thyroid cancer has raised concerns for second primary malignancy (SPM) in patients with high cumulative doses. The association between RAI dose and peripheral blood leukocyte telomere length was examined. Methods: A total of 425 patients were included who underwent total thyroidectomy and were followed up for at least 1 year with or without RAI treatment. The relative telomere length (RTL) of the patients was assessed via a quantitative polymerase chain reaction amplification method. RAI doses were divided into five groups on the basis of cumulative dose, and a comparison was made among these groups. Results: The number of patients with RAI treatment was 287 (67.5%), and the cumulative RAI dose was 3.33 GBq (range, 1.11–131.35 GBq). The mean RTL was significantly shorter in the highest RAI group (>22.2 GBq) compared to both the no‐RAI and lower dose groups. The association between RAI dose and RTL was positive in the lower RAI group (1.1–3.7 GBq) and negative in the highest RAI group in both univariate and multivariate analyses. We observed 59 (13.9%) SPMs and 20 (4.7%) mortalities, and RTL did not show a significant risk effect for all‐cause, thyroid cancer–specific, or SPM‐specific mortality. Conclusions: In patients with thyroid cancer who underwent total thyroidectomy, peripheral blood leukocyte telomere length exhibited a significant association with cumulative RAI dose higher than 22.2 GBq. These results suggest the possibility of telomere length shortening in patients who undergo high‐dose RAI treatment. By assessing relative telomere length, an association between the cumulative dose of radioactive iodine and the shortening of telomeres was observed. [ABSTRACT FROM AUTHOR]