title: Grouping of Metastatic Thyroid Carcinoma by Molecular Imaging Features to Allow for Individualized Treatment, with Emphasis on the TENIS Syndrome.
abstract: The process of radioiodine ((131)I) refractoriness, dedifferentiation, and development of thyroglobulin elevation and negative iodine scintigraphy (TENIS) syndrome in metastatic differentiated thyroid carcinoma (DTC) could be viewed as a disease continuum rather than a single event or an all-or-none phenomenon. In this report, the important role of molecular functional imaging in systematically exploring the disease biology and course of metastatic DTC is presented. Making this role the base, this report proposes a novel clinical classification for TENIS syndrome using molecular functional imaging. Such an endeavor, in our view, would aid in classification into subgroups and development of an individualized treatment strategy for patients with metastatic DTC. Case illustrations are presented that substantiate this viewpoint, including the value of combined assessment in selected cases and the requirement of a multipronged treatment approach for certain case scenarios. In addition to multiple other considerations, we believe that molecular functional imaging-based characterization of metastatic lesions could evolve as an important determinant for defining the optimal treatment strategy in patients with metastatic DTC, making the clinical management more rational and scientific.
authors: Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Parel, Bombay, India drsanb@yahoo.com.
authors: Sandip
authors: S
authors: Basu
authors: Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Parel, Bombay, India.
authors: Rahul Vithalrao
authors: RV
authors: Parghane
mesh_terms: D001692:Biological Transport; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D057285:Precision Medicine; D013954:Thyroglobulin / Q000378:metabolism*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D019788:Fluorodeoxyglucose F18; D013954:Thyroglobulin
keywords: 18F-FDG PET/CT; 68Ga-DOTATATE; TENIS; differentiated thyroid carcinoma; radioiodine scan; thyroglobulin