Recommendations for post-surgical thyroid ablation in differentiated thyroid cancer: a 2015 position statement of the Italian Society of Endocrinology.

Unlabelled: Post-surgical ablation of thyroid remnant with radioactive iodine (RAI) in differentiated thyroid cancer (DTC) is aimed to destroy any thyroid remnant in the thyroid bed (remnant ablation) and any microscopic foci of cancer cells eventually present within the thyroid remnant (adjuvant therapy). The present text is an attempt to offer practice guidelines for the indication of thyroid ablation and the preparation of DTC patients considering the latest achievement in the field and the changing epidemiology of DTC observed in the last 10 years.

Methodology: The executive committee of the Italian Society of Endocrinology appointed a task force of thyroid cancer expert including Nuclear Medicine Physicians and Endocrinologists to provide a consensus on the post-surgical ablation in thyroid cancer patients.

Post-surgical thyroid ablation with low or high radioiodine activities results in similar outcomes in intermediate risk differentiated thyroid cancer patients.

Background: In differentiated thyroid cancer (DTC) patients at intermediate risk of recurrences, no evidences are provided regarding the optimal radioactive iodine (RAI) activity to be administered for post-surgical thyroid ablation.

Methods: This study aimed to evaluate the impact of RAI activities on the outcome of 225 DTC patients classified as intermediate risk, treated with low (1110-1850  MBq) or high RAI activities (≥3700  MBq).

Results: Six to 18 months after ablation, remission was observed in 60.

18-fluorine fluorodeoxyglucose positron emission tomography with computerized tomography versus computerized tomography alone for the management of solitary lung nodules with diameters inferior to 1.5 cm.

Objective: Aim of the study was to establish a noninvasive method for the preoperative characterisation of a pulmonary nodule when biopsy of the small mass is impossible.

Methods: From 1 January 2006 to 31 December 2008, we observed 124 asymptomatic patients with a noncalcified single lung nodule highlighted by computerised tomography (CT) of the thorax. Patients were divided into 2 groups: Group A consisted of 57 patients with lesion diameters between 0.

The effectiveness of 124I PET/CT in patients with differentiated thyroid cancer.

Aim: Several studies consider 124I PET useful in the evaluation of differentiated thyroid cancer (DTC). The aim of this work was to evaluate the usefulness of 124I positron emission tomography (PET)/computed tomography (CT) for: 1) pretherapeutic staging; 2) optimizing the administering activity in case of remnants ablation; 3) individualizing a complex dosimetry case by case especially in plurimetastatic patients.

Methods: A total of 69 patients were studied in our department between September 2007 and June 2008: 17 male and 52 female, aged 17-83 (mean age 46.

Lack of association between urinary iodine excretion and successful thyroid ablation in thyroid cancer patients.

Background: Low-iodine diet is prescribed before (131)I administration in patients with differentiated thyroid cancer, although no study has properly quantified its clinical benefit.

Objective: Our study aimed to evaluate the association between urinary iodine excretion (UIE) and (131)I ablation by correlating UIE with the rate of successful ablation.

Patients: We retrospectively studied 201 differentiated thyroid cancer patients who had received (131)I therapy and posttherapy whole-body scan (WBS) for remnant ablation after either thyroid hormone withdrawal (THW group, n = 125) or recombinant human TSH (rhTSH group, n = 76).

Technetium-99m sestamibi scintigraphy is sensitive and specific for the staging and the follow-up of patients with multiple myeloma: a multicentre study on 397 scans.

We evaluated the additional benefit of Technetium(99)-sestamibi (99mTc-MIBI) scanning in comparison with standard X-ray techniques for multiple myeloma patients either at diagnosis or during follow-up. Between February 2001 and January 2005, 397 whole body scans were acquired. On 229 scans performed at diagnosis, 146 (64%) were positive and 81 cases have discordant X-ray results.

The role of lymphoscintigraphy in rectal laparoscopic surgery: can the sentinel node concept be applied to rectal carcinoma?

Background: Lymphadenectomy for rectal cancer, whether by open surgery or laparoscopy, is still a controversial subject. If we consider that approximately 20% of patients have nodal obturator metastases, then we must concede that extended lymphadenectomy is useless in the other 80% of patients. We set out to determine whether lymphoscintigraphy could show the lymphatic drainage from the cancer toward the obturator lymph nodes and thus help us to select the patients who would benefit by their removal.

[Sentinel lymph node identification in the staging of cutaneous melanoma. Blue dye vs. radioguided localization].

Background: The purpose of this study is to emphasize the usefulness of combined intraoperative gamma-detecting-probe (C-Trak) and blue dye guided research of sentinel nodes (SN) in the treatment of cutaneous melanoma.

Methods: At the Department of General Surgery of Macerata Hospital, after informed consent, 22 consecutive patients (10 males and 12 females) with mean age 53 years (20-78 years) affected by histologically proved cutaneous malignant melanoma in stage I (TC, ultrasonography and bone scintigraphy) were studied by dynamic lymphoscintigraphy with 10.8-22.

[Sentinel lymph nodes in skin melanoma].

Background: Early node dissection offers increased survival in patients with node metastases only. The study of sentinel node (SN) using blue dye and radiolocalization permits to identify patients who could undergo lymphadenectomy.

Methods: At Department of Surgery of Macerata General Hospital 22 patients with melanoma of trunk or limbs at I and II stage were submitted to SN biopsy.

[Competitive sports activity in subjects undergoing the surgical correction of an ostium-secundum type of interatrial defect: the experience of 9 cases].

Patients who have undergone surgical repair of congenital heart diseases are usually not allowed to participate in competitive sports. In the present study we report our long-term experience with 9 male athletes aged 17 to 23 years who participate in competitive sports after undergoing surgical repair of ostium secundum atrial septal defect at a median age of 9 years; six of them play football and three of them volleyball. Competitive sport activities began 1 to 5 years after surgical repair.

[Instrumental diagnosis of the post-phlebitic syndrome of the lower limbs].

A series of patients with post-phlebitic syndrome (PPS) of the lower extremities is described with emphasis on the value of combined doppler echography and phleboscintiscans for diagnostic purposes. On this basis, PPS is classified into 5 stages. A personal treatment protocol validated by a two-year follow-up is also proposed.