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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) US-guided percutaneous ablation of thyroid nodules with 177LU-MAA (LUTMA) - Feas...
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Vol. 43. Issue 4.
(July - August 2024)
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Vol. 43. Issue 4.
(July - August 2024)
Original Article
US-guided percutaneous ablation of thyroid nodules with 177LU-MAA (LUTMA) - Feasibility study
Ablación percutánea guiada por US de nódulos tiroides con 177LUMAA (LUTMA) - estudio de viabilidad
Sait Sagerb, Elife Akguna,
Corresponding author
elifekaymak@hotmail.com

Corresponding author.
, Mohammad Abuqbeitahc, Azizullah Nazarib, Nami Yeyinb, Emre Karayelb, Huseyin Pehlivanoglub, Aslan Aygunb, Haluk Burcak Saymanb
a Department of Nuclear Medicine, University of Health Sciences Turkey, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
b Department of Nuclear Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
c Palestine Polytechnic University, Collage of Medicine and Health Sciences, Medical Imaging and Nuclear Medicine Department, Palestine
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Table 1. Pre-ablative and follow-up volumes of nodules, the injected LUTMA activity, and the expected absorbed dose to nodules.
Abstract
Purpose

The main purpose is to evaluate the safety, and efficacy of 177Lutetium labeled macroaggregated albumin (LUTMA) ablation of thyroid nodules.

Materials and methods

Patients with confirmed benign nodules who were not candidate or did not accept surgery were enrolled. Under ultrasonography (USG) guidance, LUTMA which was produced in our department, was administered into the nodules. Nodule volumes were assessed via USG before the injection and at 1-week, 1-month, and 3-months post-treatment. We calculated the volume reduction rates (VRRs) for these intervals. To detect extranodular activity leakage, patients underwent SPECT/CT imaging at one hour, 24 h, and one week post-injection.

Results

Fifteen patients (male: 12, female: 3) with benign thyroid nodules were eligible to join this study. These nodules were categorized as cystic (n = 9), solid (n = 3), or mixed (n = 3). Median nodules volume was 6.59 ml (range: 0.56–55 ml). Predicted absorbed dosee to the nodules varied between 10–1036 Gy. The VRRs at 3 months was 85% for all nodule types with gradual increases over time: 0%–92%, 20%–97%, and 28%–98% at 1 week, 1 month, and 3-months, respectively. The median VRR of cystic nodules was 89% (range: 81%–98%) at 3-months. It is significantly higher than solid ones (P = .009). None of the patients experienced adverse reactions or discomfort during the injection or follow-up.

Conclusion

LUTMA treatment significantly reduces the volume of benign thyroid nodules, offering relief from disease-associated symptoms and cosmetic concerns. It emerges as a promising alternative to surgical and other local treatments for benign thyroid nodule ablation.

Clinical signification

LUTMA is a novel theranostic radiopharmaceutical which is promising in local ablative treatment of benign thyroid nodules.

Keywords:
177Lu
MAA
Thyroid
Nodule
Ablation
Resumen
Propósito

El objetivo principal es evaluar la seguridad y eficacia de la ablación de los nódulos tiroideos con albúmina macroagregada marcada con lutecio (LUTMA).

Materiales y métodos

Se inscribieron pacientes con nódulos benignos confirmados que no eran candidatos o no aceptaron la cirugía. Bajo guía de ecografía (USG), se administró en los nódulos LUTMA, que se produjo en nuestro departamento. Los volúmenes de los nódulos se evaluaron mediante ecografía antes de la inyección y 1 semana, 1 mes y 3 meses después del tratamiento. Calculamos las tasas de reducción de volumen (VRR) para estos intervalos. Para detectar fugas de actividad extranodular, los pacientes se sometieron a imágenes SPECT/CT una hora, 24 horas y una semana después de la inyección.

Resultados

Quince pacientes (hombres: 12, mujeres: 3) con nódulos tiroideos benignos fueron elegibles para participar en este estudio. Estos nódulos se clasificaron como quísticos (n = 9), sólidos (n = 3) o mixtos (n = 3). El volumen medio de los nódulos fue de 6,59 ml (rango: 0,56–55 ml). La dosis absorbida prevista en los nódulos varió entre 10 y 1036 Gy. La VRR a los 3 meses fue del 85% para todos los tipos de nódulos con aumentos graduales a lo largo del tiempo: 0%–92%, 20%–97% y 28%–98% a la 1 semana, 1 mes y 3 meses, respectivamente. La mediana del VRR de los nódulos quísticos fue del 89% (rango: 81%–98%) a los 3 meses. Es significativamente mayor que los sólidos (P = ,009). Ninguno de los pacientes experimentó reacciones adversas o molestias durante la inyección o el seguimiento.

Conclusión

El tratamiento con LUTMA reduce significativamente el volumen de los nódulos tiroideos benignos, ofreciendo alivio de los síntomas asociados a la enfermedad y de los problemas estéticos. Surge como una alternativa prometedora a los tratamientos quirúrgicos y otros tratamientos locales para la ablación del nódulo tiroideo benigno.

Significado clínico

LUTMA es un nuevo radiofármaco teranóstico prometedor en el tratamiento ablativo local de los nódulos tiroideos benignos.

Palabras clave:
177Lu
MAA
Tiroides
Nódulo
Ablación

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