Development of a pediatric differentiated thyroid carcinoma registry within the EuRRECa project: rationale and protocol.

Background: Although differentiated thyroid carcinoma (DTC) is the most frequent endocrine pediatric cancer, it is rare in childhood and adolescence. While tumor persistence and recurrence are not uncommon, mortality remains extremely low. Complications of treatment are however reported in up to 48% of the survivors. Due to the rarity of the disease, current treatment guidelines are predominantly based on the results of small observational retrospective studies and extrapolations from results in adult patients. In order to develop more personalized treatment and follow-up strategies (aiming to reduce complication rates), there is an unmet need for uniform international prospective data collection and clinical trials. Methods and analysis: The European pediatric thyroid carcinoma registry aims to collect clinical data for all patients ≤18 years of age with a confirmed diagnosis of DTC who have been diagnosed, assessed, or treated at a participating site. This registry will be a component of the wider European Registries for Rare Endocrine Conditions project which has close links to Endo-ERN, the European Reference Network for Rare Endocrine Conditions. A multidisciplinary expert working group was formed to develop a minimal dataset comprising information regarding demographic data, diagnosis, treatment, and outcome. We constructed an umbrella-type registry, with a detailed basic dataset. In the future, this may provide the opportunity for research teams to integrate clinical research questions. Ethics and dissemination: Written informed consent will be obtained from all participants and/or their parents/guardians. Summaries and descriptive analyses of the registry will be disseminated via conference presentations and peer-reviewed publications.

PET/TC en endocrinología nuclear. Resultados de la encuesta difundida por las distintas redes sociales de la SEMNIM en España / PET/CT in nuclear endocrinology: Results of the survey diffused through different social networks of the SEMNIM in Spain

Objetivo Desde el Grupo de Trabajo de Endocrinología de la SEMNIM, se planteó la necesidad de conocer el uso actual de la tecnología PET/TC aplicada en el campo de la endocrinología. El objetivo de la encuesta era obtener una fotografía instantánea del uso de la PET/TC en endocrinología nuclear, con el fin de conocer si está siendo adecuadamente utilizada y detectar posibles necesidades. Material y métodos Durante el primer trimestre del 2022, se analizaron los datos obtenidos de una encuesta que se difundió a través de distintas redes sociales a lo largo de la segunda mitad del 2021. Se recogieron datos sobre el uso de las distintas técnicas PET/TC en el carcinoma diferenciado de tiroides, el carcinoma medular de tiroides, los tumores neuroendocrinos y el hiperparatiroidismo. Resultados Un total de 15 centros respondieron la encuesta. El 79% de los hospitales utilizan la 18F-FDG PET/TC en el diagnóstico y/o seguimiento del carcinoma diferenciado de tiroides (media de exploraciones anuales: 36,9; rango 10-100). El 85% utilizan la 18F-DOPA PET/TC para el estudio de recidiva bioquímica de carcinoma medular de tiroides (media estudios anuales: 7,8; rango 2-20). El 77% utilizan la 18F-DOPA PET/TC para el estudio de los tumores neuroendocrinos: el 77% utilizan la 18F-DOPA PET/TC (media de 10 exploraciones anuales; rango 2-30) y el 69% utilizan el 68Ga-DOTA-SA (media de 24,7 exploraciones anuales; rango 2-127). El 79% utilizan la 18F-colina PET/TC para el estudio del hiperparatiroidismo (media de 30,1 exploraciones anuales; rango 10-120). Conclusiones El uso de la técnica PET/TC en endocrinología aún no está generalizado, sin embargo, vimos que las indicaciones en las cuales se utiliza son, en general, las reportadas en los distintos consensos (AU)

Aim To know the current use of the PET/CT technology applied in the field of endocrinology, the Endocrinology Working Group of SEMNIM proposed conducting a survey. The objective was to obtain a snapshot of the use of PET/CT in nuclear endocrinology, to know if it is being used properly and detect possible needs. Material and methods During the first quarter of 2022, we analyzed the data obtained from a survey that was distributed through different social networks throughout the second half of 2021. The survey asked for the use of the different PET/CT techniques available in Spain in different endocrinological pathologies like differentiated thyroid carcinoma, medullary thyroid carcinoma, neuroendocrine tumors and hyperparathyroidism. Results A total of 15 centers responded to the survey. A percentage of 79 of hospitals used 18F-FDG PET/CT in the diagnosis and/or follow-up of differentiated thyroid carcinoma (mean annual studies: 36.9; range 10–100); 85% used 18F-DOPA PET/CT for the study of biochemical recurrence of medullary thyroid carcinoma (mean annual studies: 7.8; range 2–20); 77% used 18F-DOPA PET/CT for the study of neuroendocrine tumors: 77% used 18F-DOPA PET/CT (mean of 10 scans per year; range 2–30) and 69% used 68Ga-DOTA-SA (mean of 24.7 studies per year; range 2–127); 79% used 18F-choline PET/CT for the study of hyperparathyroidism (mean of 30.1 annual studies; range 10–120). Conclusions We detected that the use of the PET/CT technique in endocrinology is not yet widespread, however, we saw that the indications in which it is used are, in general, those reported in the different consensus (AU)

PET/CT in nuclear endocrinology: Results of the survey diffused through different social networks of the SEMNIM in Spain.

AIM: To know the current use of the PET/CT technology applied in the field of endocrinology, the Endocrinology Working Group of SEMNIM proposed conducting a survey. The objective was to obtain a snapshot of the use of PET/CT in nuclear endocrinology, to know if it is being used properly and detect possible needs. MATERIAL AND METHODS: During the first quarter of 2022, we analyzed the data obtained from a survey that was distributed through different social networks throughout the second half of 2021. The survey asked for the use of the different PET/CT techniques available in Spain in different endocrinological pathologies like differentiated thyroid carcinoma, medullary thyroid carcinoma, neuroendocrine tumors and hyperparathyroidism. RESULTS: A total of 15 centers responded to the survey. A percentage of 79 of hospitals used 18F-FDG PET/CT in the diagnosis and/or follow-up of differentiated thyroid carcinoma (mean annual studies: 36.9; range 10-100); 85% used 18F-DOPA PET/CT for the study of biochemical recurrence of medullary thyroid carcinoma (mean annual studies: 7.8; range 2-20); 77% used 18F-DOPA PET/CT for the study of neuroendocrine tumors: 77% used 18F-DOPA PET/CT (mean of 10 scans per year; range 2-30) and 69% used 68Ga-DOTA-SA (mean of 24.7 studies per year; range 2-127); 79% used 18F-choline PET/CT for the study of hyperparathyroidism (mean of 30.1 annual studies; range 10-120). CONCLUSIONS: We detected that the use of the PET/CT technique in endocrinology is not yet widespread, however, we saw that the indications in which it is used are, in general, those reported in the different consensus.

Gated-SPECT de reposo tras inyección intradolor de 99mTc-MIBI en paciente sin antecedentes de cardiopatía isquémica / Rest gated-SPECT myocardial perfusion post 99mTc-MIBI injection in a patient with acute chest pain and with no medical history of ischemic heart disease

El estudio gated-SPECT de perfusión miocárdica es una técnica utilizada e indicada para la valoración de los pacientes con un diagnóstico no claro de cardiopatía isquémica. El estudio gated-SPECT de reposo precoz en fase aguda tiene una alta sensibilidad y alto valor predictivo negativo para descartar enfermedad coronaria. Presentamos el caso de una paciente ingresada para el estudio de dolor torácico, a la que se le realizó un estudio de perfusión miocárdica de esfuerzo-reposo, cuyo resultado podría haber sido equívoco debido al estado clínico de la paciente durante la inyección del radiofármaco (AU)

Gated-SPECT myocardial perfusion imaging is a widely used technique indicated for assessment of patients with no clear diagnosis of ischemic heart disease. Early rest gated-SPECT myocardial perfusion study in patients with acute chest pain has high sensitivity and high negative predictive value for ruling out coronary disease. We report a case of a patient admitted for the study of her chest pain. She underwent a myocardial perfusion stress-rest whose interpretation could have been equivocal due to the clinical status of the patient during the injection of the radiotracer (AU)

[Rest gated-SPECT myocardial perfusion post (99m)Tc-MIBI injection in a patient with acute chest pain and with no medical history of ischemic heart disease]. / Gated-SPECT de reposo tras inyección intradolor de (99m)Tc-MIBI en paciente sin antecedentes de cardiopatía isquémica.

Gated-SPECT myocardial perfusion imaging is a widely used technique indicated for assessment of patients with no clear diagnosis of ischemic heart disease. Early rest gated-SPECT myocardial perfusion study in patients with acute chest pain has high sensitivity and high negative predictive value for ruling out coronary disease. We report a case of a patient admitted for the study of her chest pain. She underwent a myocardial perfusion stress-rest whose interpretation could have been equivocal due to the clinical status of the patient during the injection of the radiotracer.

El SPECT con 201Talio en la detección de recidiva del carcinoma de laringe / 201Thalium SPECT in the detection of recurrent laryngeal carcinoma

Objetivo. Evaluar el rendimiento del SPECT con 201Talio en la detección de la recidiva local y/o diseminación ganglionar regional del carcinoma faringolaríngeo. Material y métodos. Se estudiaron 29 pacientes con el diagnóstico de carcinoma faringolaríngeo (media: 60,9 años), tratados con cirugía, quimioterapia y radioterapia. Entre 3 a 6 meses después de finalizar el tratamiento, a todos se les practicó un estudio planar y SPECT una hora después de la administración de 148 MBq de 201Talio. La captación se valoró en 4 grados (0 no captante-3 muy intenso) y se constató la presencia o no de ganglios captantes. El resultado gammagráfico se correlacionó con el seguimiento clínico y radiológico a largo plazo (media: 2,50 años). Se valoraron como positivos de recurrencia, los estudios con captación centrocervical focal de grado 2-3 o la presencia de adenopatías captantes. Resultados. Se obtuvieron 9 verdaderos positivos, 14 verdaderos negativos, tres falsos positivos y tres falsos negativos. La sensibilidad fue del 75%, la especificidad del 82,4%, el valor predictivo positivo del 75% y el valor predictivo negativo del 82,4%. De los tres falsos positivos, dos correspondieron a captaciones en el lecho quirúrgico y uno a captación atribuida a ganglios laterocervicales. Los tres falsos negativos presentaron captaciones de grado 1, correspondiendo dos de ellos a metástasis pulmonares sin evidencia de recidiva local. Conclusión. El uso del SPECT con 201Talio en la evaluación pronóstica del paciente con carcinoma de laringe tratado muestra unos resultados muy aceptables para la detección de recidiva local y/o diseminación ganglionar regional(AU)

Objective. To evaluate the diagnostic yield of 201Thallium SPECT in the detection of local and/or regional lymph node dissemination of pharyngolaryngeal carcinoma. Material and methods. 29 patients who had been diagnosed with pharyngolaryngeal carcinoma were studied (mean age: 60.9 years). These patients had been treated by surgery, chemotherapy and radiotherapy. At between 3 to 6 month after finishing the treatment, all of them underwent a planar and SPECT study at one hour after the administration of 148 MBq of 201Thallium. Uptake was scored on four grades: from 0 (no uptake) to 3 (very intense uptake). The presence or non-presence of lymph nodes with uptake was also evaluated. All the results on the scintigraphy were correlated with long term clinical and radiological follow-up (mean: 2.5 years). The studies were classified as positive for recurrence when the uptake was 2-3 and/or with presence of lymph nodes with uptake. Results. We obtained 9 true positive, 14 true negative, 3 false positive and 3 false negative results. Sensitivity was 75%, specificity was 82.4%, positive predictive value was 75% and negative predictive value was 82.4%. Two out of three false positives corresponded to the surgical bed uptake and one was attributed to the laterocervical lymph nodes. The three false negatives had grade 1 uptakes, two of them corresponding to pulmonary metastasis without evidence of local recurrence. Conclusions. The use of 201Thallium SPECT in the prognostic evaluation in patients with a treated laryngeal carcinoma shows very acceptable results in the detection of local recurrence and/or regional lymph node dissemination(AU)

[201Thalium SPECT in the detection of recurrent laryngeal carcinoma]. / El SPECT con (201)Talio en la detección de recidiva del carcinoma de laringe.

OBJECTIVE: To evaluate the diagnostic yield of (201)Thallium SPECT in the detection of local and/or regional lymph node dissemination of pharyngolaryngeal carcinoma. MATERIAL AND METHODS: 29 patients who had been diagnosed with pharyngolaryngeal carcinoma were studied (mean age: 60.9 years). These patients had been treated by surgery, chemotherapy and radiotherapy. At between 3 to 6 month after finishing the treatment, all of them underwent a planar and SPECT study at one hour after the administration of 148 MBq of (201)Thallium. Uptake was scored on four grades: from 0 (no uptake) to 3 (very intense uptake). The presence or non-presence of lymph nodes with uptake was also evaluated. All the results on the scintigraphy were correlated with long term clinical and radiological follow-up (mean: 2.5 years). The studies were classified as positive for recurrence when the uptake was 2-3 and/or with presence of lymph nodes with uptake. RESULTS: We obtained 9 true positive, 14 true negative, 3 false positive and 3 false negative results. Sensitivity was 75%, specificity was 82.4%, positive predictive value was 75% and negative predictive value was 82.4%. Two out of three false positives corresponded to the surgical bed uptake and one was attributed to the laterocervical lymph nodes. The three false negatives had grade 1 uptakes, two of them corresponding to pulmonary metastasis without evidence of local recurrence. CONCLUSIONS: The use of (201)Thallium SPECT in the prognostic evaluation in patients with a treated laryngeal carcinoma shows very acceptable results in the detection of local recurrence and/or regional lymph node dissemination.

Inflamación granulomatosa por reacción de cuerpo extraño en estudio de PET/TAC con FDG en un paciente con recidiva tumoral de carcinoma colorrectal / Foreign body granulomatous inflammation in PET/CT scan study with FDG in a patient withtumor recurrence of colorectoral carcinoma

No disponible

[Comparison of administration of rhTSH with withdrawal of thyroid hormone. Follow-up of patients with differentiated thyroid carcinoma]. / Estudio comparativo entre la utilización de TSH recombinante y la estimulación endógena con TSH. Valoración en el seguimiento de los pacientes con carcinoma diferenciado de tiroides.

UNLABELLED: Recombinant human thyrotropin (rhTSH) has been introduced recently in follow up of differentiated thyroid cancer (DTC) patients, as an alternative of thyroid hormone withdrawal. The aim of this retrospective study is to compare recombinant human thyrotropin versus endogenous stimulation. MATERIAL AND METHODS: Thirty-three patients with DTC with previous thyroidectomy and thyroid ablation were selected. All patients underwent whole-body radioiodine scanning and third day serum thyroglobulin (TG) measurement by two techniques, the first one after conventional thyroid hormone withdrawal (TSHe, TGe), and the second one after rhTSH stimulation (TSHr, TGr). Measurement of TG was performed on the third day due to the infrastructure. We only included patients with stable disease, without therapeutic interventions between two consecutive controls in an interval inferior to one year. Two qualitative categories were defined for TG (positive TG > 2 ng/ml or negative TG<2 ng/ml) and whole-body radioiodine scan (positive or negative). RESULTS: TSHe: 62.9 +/- 55.48; TSHr: 113.16 +/- 50.6; (p: ns); TGe: 62.5 +/- 115.7; TGr: 54.6 +/- 111.1; (p: 0.044). Quantitative data analysis showed significant differences between two techniques. Qualitative data analysis showed no significant differences in clinical setting based in TG and radioiodine scan. CONCLUSIONS: Administration of rhTSH produces a significantly higher increase of TSH than thyroid hormone withdrawal and lower increase in TG levels. There were no significant differences in the stage of disease (TG and whole-body radioiodine scan).

Estudio comparativo entre la utilización de TSH recombinante y la estimulación endógena con TSH. Valoración en el seguimiento de los pacientes con carcinoma diferenciado de tiroides / Comparison of administration of rhTSH with withdrawal of thyroid hormone. Follow-up of patients with differentiated thyroid carcinoma

En el seguimiento habitual de los pacientes con cáncer diferenciado (CDT) se ha introducido recientemente el uso de la hormona tirotropa (TSH) humana recombinante (rhTSH) como alternativa a la retirada del tratamiento supresivo hormonal. El objetivo de este estudio retrospectivo es comparar el resultado de la administración de rhTSH con respecto a la estimulación con TSH endógena en el seguimiento del CDT. Material y métodos. Hemos seleccionado 33 pacientes con CDT a los que se había practicado previamente una tiroidectomía total y la ablación de restos tiroideos con 131I. Todos los pacientes tenían un control previo de rastreo con yodo y tiroglobulina (TG) sérica con suspensión del tratamiento hormonal (TSHe, TGe) y un nuevo control con rhTSH (TSHr, TGr). La determinación de la TG se realizó el tercer día por motivos de infraestructura. Se incluyeron sólo los pacientes sin cambios clínicos ni actuaciones terapéuticas entre los dos controles realizados con un intervalo máximo de un año. Se definieron dos categorías para la TG (positiva si TG > 2 ng/ml y negativa si TG < 2ng/ml) y para el rastreo (positivo o negativo). Resultados. Los valores analíticos obtenidos para cada control fueron los siguientes: TSHe: 62,9 ± 55,48 U/ml; TSHr: 113,16 ± 50,6 U/ml; (p: ns); TGe: 62,5 ± 115,7 mg/ml; TGr: 54,6 ± 111,1 mg/ml; (p: 0,044). La valoración cualitativa de los resultados obtenidos (prueba positiva o negativa) en ambos controles no mostró diferencias significativas ni en el resultado de la TG ni en rastreo con yodo. Conclusiones. El incremento de la TSH con previa administración de rhTSH es significativamente mayor que el incremento mediante estimulación endógena, mientras que las cifras de TG son globalmente menores. No se aprecian diferencias en la valoración de la presencia o ausencia de la enfermedad mediante TG y rastreo con yodo

Recombinant human thyrotropin (rhTSH) has been introduced recently in follow up of differentiated thyroid cancer (DTC) patients, as an alternative of thyroid hormone withdrawal. The aim of this retrospective study is to compare recombinant human thyrotropin versus endogenous stimulation. Material and methods. Thirty-three patients with DTC with previous thyroidectomy and thyroid ablation were selected. All patients underwent whole-body radioiodine scanning and third day serum thyroglobulin (TG) measurement by two techniques, the first one after conventional thyroid hormone withdrawal (TSHe, TGe), and the second one after rhTSH stimulation (TSHr, TGr). Measurement of TG was performed on the third day due to the infrastructure. We only included patients with stable disease, without therapeutic interventions between two consecutive controls in an interval inferior to one year. Two qualitative categories were defined for TG (positive TG > 2ng/ml or negative TG < 2ng/ml) and whole-body radioiodine scan (positive or negative). Results. TSHe: 62.9 ± 55.48; TSHr: 113.16 ± 50.6; (p: ns); TGe: 62.5 ± 115.7; TGr: 54.6 ± 111.1; (p: 0.044). Quantitative data analysis showed significant differences between two techniques. Qualitative data analysis showed no significant differences in clinical setting based in TG and radioiodine scan. Conclusions. Administration of rhTSH produces a significantly higher increase of TSH than thyroid hormone withdrawal and lower increase in TG levels. There were no significant differences in the stage of disease (TG and whole-body radioiodine scan)