Transarterial radioembolization with Iodine-131-Lipiodol for hepatic metastases from gastrointestinal malignancies - Experience in tertiary care oncology center in India.

CONTEXT: Unresectable colorectal hepatic metastases can be treated with radioembolization. AIMS: The aim of this study is to analyze the response and survival benefits of transarterial radioembolization (TARE) with Iodine-131 (131I) Lipiodol for hepatic metastases from gastrointestinal malignancies. SETTINGS AND DESIGN: Retrospective study of 20 patients with pathologically proven hepatic metastases from primary gastrointestinal malignancies referred for palliative therapy with TARE. SUBJECTS AND METHODS: At baseline, standard laboratory and imaging data were recorded. All patients fulfilling the inclusion/exclusion criteria underwent TARE with 131I Lipiodol. Post procedure, the patients were reviewed after 1 month with follow-up positron emission tomography-computed tomography and tumor marker levels to evaluate treatment response with continued follow-up till December 2016 and overall survival calculated. STATISTICAL ANALYSIS USED: Data were analyzed using a statistical analysis package (Social sciences, version 15.0 for Windows; SSPS Inc.). Survival data were plotted using Kaplan-Meier survival curves. RESULTS: At the end of follow-up period, 15 of 20 patients were alive. The mean and median survival was 38.88 ± 5.0 months (95% confidence interval [CI], 29.03-48.74 months, P = 0.17) and 49.3 ± 12.4 months (95% CI, 25.0-73.7 months, P = 0.17), respectively. 66 months survival was 75%. Response evaluation in 10 patients showed partial response in 3 (30%), stable disease in 2 (20%) and progressive disease in 5 (50%) patients. All patients with partial response showed a reduction in serum tumor marker levels. CONCLUSIONS: TARE with 131I-Lipiodol is highly effective with a significant survival benefit in refractory cases of hepatic metastases from gastrointestinal malignancies.

Demographic data of thyroiditis from a south Indian city.

BACKGROUND: Thyroiditis involves thyroid gland inflammation due to a wide variety of causes. The common varieties are subacute, silent and postpartum thyroiditis. AIMS AND OBJECTIVES: To retrospectively collect demographic data of thyroiditis from Bangalore over the past 5 years. MATERIALS AND METHODS: Data were collected from three major nuclear medicine centers in Bangalore of the patients who came for technetium (Tc) 99m pertechnetate scan of the thyroid. The diagnosis was based on the Tc 99 scan evidence of thyroiditis in these patients and biochemical evidence of thyrotoxicosis. RESULTS: The total number of cases recorded were 2513. The females were more commonly affected compared with males with sex distribution of 1698 females and 815 females (2:1). The mean age of females was 32.5 ± 11.3 years whereas the mean age of males was 37.2 ± 12.4 years. The highest numbers of cases were recorded in the months of June and August. CONCLUSIONS: The females developed thyroiditis frequently and at an earlier age when compared with males. This data could give us an insight into the demographic pattern of thyroiditis in our country and may help in planning future preventive strategies.

(177)Lu-DOTATATE therapy in patients with neuroendocrine tumours: 5 years' experience from a tertiary cancer care centre in India.

PURPOSE: The choice of an appropriate treatment option in patients with inoperable or metastatic neuroendocrine tumours (NETs) is limited, and approximately 50 % of patients have advanced NET at diagnosis, and 65 % die within 5 years. Treatment with (177)Lu-DOTATATE ((177)Lu-[DOTA(0),Tyr(3)] octreotate) is a promising new option in the treatment of metastatic NETs. METHODS: Patients with metastatic NET who underwent (177)Lu-DOTATATE during the period 2009 to 2013 were included in this retrospective study. Follow-up imaging studies including a (68)Ga-DOTANOC PET/CT scan and a posttherapy (177)Lu-DOTATATE scan were compared with baseline imaging to determine response to treatment. Progression-free survival (PFS) was calculated using the Kaplan-Meier method and Cox regression analysis was also done. RESULTS: Ten patients (25 %) had a minimal response, 13 (32.5 %) had a partial response and 9 (22.5 %) had stable disease. Progressive disease was seen in 8 patients (20 %), including 6 patients who died during or after the treatment period. The estimated mean PFS in those who received one or two cycles of (177)Lu-DOTATATE was 8.3 months (95 % CI 6.2 to 10.3 months) compared to an estimated mean PFS of 45.6 months (95 % CI 40.9 to 50.2 months) in those who received more than two cycles of (177)Lu-DOTATATE (log-rank Mantel-Cox Χ (2) = 8.01, p = 0.005). CONCLUSION: Our study showed that treatment with (177)Lu-DOTATATE should be considered in the management of NETs, considering the limited success of alternative treatment modalities. Treatment response and PFS is determined primarily by the dose delivered and best results are obtained when more than two cycles of (177)Lu-DOTATATE are given, with careful monitoring for possible side effects.

PET/CT guidance for percutaneous fine needle aspiration cytology/biopsy.

PET/CT, used as a guiding tool, can improve the accuracy of percutaneous fine needle aspiration cytology (FNAC)/biopsy due to its ability to incorporate both physiological and anatomical information.