HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Hindié, E. Articles by Toubert, M.-E. Search for Related Content PubMed PubMed Citation Articles by Hindié, E. Articles by Toubert, M.-E.

¹ Department of Nuclear Medicine, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Avenue Claude Vellefaux, 75475 Paris Cedex 10, France
² Imagerie Moléculaire Diagnostique et Ciblage Thé rapeutique, B2T, IUH, Université Paris 7, Hôpital Saint-Louis, 75475 Paris Cedex 10, France
³ DSV/I²BM/SHFJ/LIME, Commissariat à l’Energie Atomique, 91000 Orsay, France
⁴ Departments of Nuclear Medicine and
⁵ Endocrinology, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 75012 Paris, France
⁶ Department of Endocrine Surgery, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, 75475 Paris Cedex 10, France

(Correspondence should be addressed to E Hindié; Email: elif.hindie{at}sls.aphp.fr)

Bone is the second most frequent target of distant metastases in patients with differentiated thyroid cancer, and such forms carry a very poor prognosis. The impact of ¹³¹I therapy in this setting is controversial. We describe the diagnostic circumstances and outcome of patients with bone metastases recently managed in two institutions. Among 921 consecutive thyroid cancer patients who had total thyroidectomy and ¹³¹I ablation between January 2000 and December 2004 and who were subsequently monitored, bone metastases had been diagnosed in 16 patients. In three cases, the bone metastases were non-functioning (negative ¹³¹I uptake) . These patients were treated with surgery and radiotherapy but progressed rapidly. The other 13 patients had functioning (positive ¹³¹I uptake) bone metastases. In five of them, thyroid cancer was revealed by signs of distant involvement (bone pain, n = 4; dyspnea, n = 1). The bone metastases progressed in these five patients, despite local therapy and multiple courses of ¹³¹I. The bone metastases in the remaining eight patients were discovered on the post-surgery ¹³¹I therapy scan. Complementary radiological studies were negative except in one patient in whom one of the metastases (a 5 mm lesion of the right humerus) was visible on magnetic resonance imaging (MRI). Six of these patients showed a good response to ¹³¹I therapy, with ¹³¹I uptake and Tg levels becoming undetectable or showing a sharp fall. One patient refused ¹³¹I therapy; bone metastases became visible on MRI within 1 year and the Tg level rose tenfold. The disease progressed in one patient despite ¹³¹I therapy. Post-surgical ¹³¹I ablation can contribute to early detection of bone metastases at a time when the Tg level may be only moderately elevated, when other radiological studies are negative, and when the disease is potentially curable by ¹³¹I therapy.

This article has been cited by other articles:

				C. Champion, P. Zanotti-Fregonara, and E. Hindie Reply: 131I Radiation Dose Distribution in Metastases of Thyroid Carcinoma J. Nucl. Med., May 1, 2009; 50(5): 834 - 834. [Full Text] [PDF]

				P. Zanotti-Fregonara, D. Rubello, and E. Hindie Bone Metastases of Differentiated Thyroid Cancer: The Importance of Early Diagnosis and 131I Therapy on Prognosis J. Nucl. Med., November 1, 2008; 49(11): 1902 - 1903. [Full Text] [PDF]

				M M Muresan, P Olivier, J Leclere, F Sirveaux, L Brunaud, M Klein, R Zarnegar, and G Weryha Bone metastases from differentiated thyroid carcinoma Endocr. Relat. Cancer, March 1, 2008; 15(1): 37 - 49. [Abstract] [Full Text] [PDF]