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The article discusses a study on the role of pharmacists in monitoring of thyroid cancer patients enrolled in the Thyroid Cancer Monitoring Service (TCMS). The study showed that the 152 thyroid stimulating hormone (TSH) results obtained from the 54 patients under TCMS and 311 TSH from the 55 patients receiving usual care met the prescribed goal as driven by the physician's notes. It also showed that pharmacists have the capability to take care of patients in thyroid cancer monitoring facility.

Recombinant human TSH (rhTSH) is used to increase radioiodine uptake during imaging of thyroid cancer, obviating the need to render the patient hypothyroid. We assessed the reproducibility of radioiodine uptake, serum thyrotropin (TSH), and stimulated serum thyroglobulin (Tg) levels after rhTSH administration. A retrospective review was performed of patients at Stanford who underwent whole-body 131I scanning for surveillance of thyroid cancer twice after thyroidectomy and 131I ablation, with rhTSH prior to each scan. Forty-eight hour radioiodine uptake, peak serum TSH, and stimulated serum Tg levels for each study were recorded. Paired t tests and correlation analysis were used to assess interexamination repeatability. Twenty-three patients underwent two scintiscans with rhTSH, for a total of 46 exams. There was no significant difference between percent uptake at 48 h in the paired exams ( p=0.40). Serum TSH level was measured in 45 of 46 exams; TSH exceeded 50 mIU/l in all cases, and there was no significant difference between paired TSH levels ( p=0.93). All patients had stimulated serum Tg levels measured, with no significant difference between paired Tg levels ( p=0.40); after excluding one patient whose Tg changed from 15.8 ng/ml to undetectable between scans without interval treatment, the p value rose to 0.95. There was a strong correlation among paired uptake values ( r=0.85, p<0.0001), peak serum TSH ( r=0.69, p=0.0003), and stimulated Tg levels ( r=0.81, p<0.0001). No discordant scan interpretations were reported. Forty-eight hour radioiodine uptake, peak serum TSH, and stimulated serum Tg levels after administration of rhTSH are repeatable between studies, demonstrating reproducibility of diagnostic results without rendering patients hypothyroid. [ABSTRACT FROM AUTHOR]

18 F-fluorodeoxyglucose (FDG) PET/CT is widely used for oncologic imaging. This study aimed to evaluate, using data simulation, if reduction of injected FDG dose or PET acquisition time could be technically feasible when utilizing a sensitive commercial PET/CT imaging system, without sacrificing image quality, image-based staging accuracy, or standardized uptake value (SUV) accuracy. De-identified, standard of care oncologic FDG PET/CT datasets from 83 adults with lymphoma, lung carcinoma or breast carcinoma were retrospectively analyzed. All images had been acquired using clinical standard dose and acquisition time on a single PET/CT system. The list mode datasets were retrospectively software reprocessed to achieve undersampling of counts, thus simulating the effect of shorter PET acquisition time or lower injected FDG dose. The simulated reduced-count images were reviewed and compared with full-count images to assess and compare qualitative (subjective image quality, stage stability) and semi-quantitative (image noise, SUVmax stability, signal-to-noise and contrast-to-noise ratios within index lesions driving cancer stage) parameters. While simulated reduced-count images had measurably greater noise, there appeared to be no significant loss of image-based staging accuracy nor SUVmax reproducibility down to simulated FDG dose of 0.05 mCi/kg at continuous bed motion rate of 1.1 mm/sec. This retrospective simulation study suggests that a modest reduction of either injected FDG dose or emission scan time might be feasible in this limited oncologic population scanned on a single PET/CT system. Verification of these results with prospectively acquired images using actual low injected FDG activity and/or short imaging time is recommended., Competing Interests: None., (AJNMMI Copyright © 2021.)