Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality

Radioiodine-avid Bone Metastases From Differentiated Thyroid Cancer Without Structural Abnormality, a Singular Entity With Heterogeneous Outcomes.

Bone radioiodine (RAI) uptake without structural abnormality in thyroid cancer (TC) patients may be related to false positive or to microscopic foci of metastatic tissue. In such cases, outcome is reported to be excellent.

Indeed, Robenshtok et al. reported a serie of patients with RAI-avid bone metastases of TC without structural abnormality on imaging studies who have more favorable long-term prognosis than those harbouring structurally visible bone metastases and do not undergo skeletal-related complications.

The investigators report the case of Mrs D., who had been operated for a pathologic tumor stage 3: pT3(m) poorly differentiated TC at the age of 43. The first post-therapeutic whole body scan revealed 3 foci of bone uptake (right clavicle, L2, L3). The elevated level of thyroglobulin (157ng/mL) favoured the hypothesis of bone metastases despite the absence of any structural lesion on CT and MRI. She received 7 courses of radioiodine therapy. The right clavicle RAI uptake persisted, and subsequent CT disclosed an osteolytic lesion which was treated by radiofrequency and external beam radiation. Twenty-five years after the diagnosis, she has a persistent morphological disease with a 30x8mm progressive lesion on the right clavicle, for which surgery is planned.

The aim of the present study is to describe the natural history and evolution of radioiodine avid bone metastases from thyroid cancer without structural abnormalities and to identify prognosis factors.

Study Overview

• Status: Unknown
• Conditions: Bone Metastases; Thyroid Cancer
• Intervention / Treatment: Other: Administrative data; Other: Clinical data; Other: Histological data; Other: Imaging data; Other: Biological data; Other: Further treatment

• Study Type: Observational
• Enrollment (Anticipated): 30

Contacts and Locations

• Study Contact: Name: Claire BOURNAUD, MD; Phone Number: +33 4 72 35 69 99; Email: claire.bournaud-salinas@chu-lyon.fr
• Study Contact Backup: Name: Claire MARX; Email: claire.marx@chu-lyon.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients who received total thyroidectomy in a context of differentiated thyroid cancer showing at post-therapy scintigraphy at least one radioiodine bone uptake without structural correlation on high-resolution imaging

Description

Inclusion Criteria:

• Differentiated thyroid cancer
• Ablation therapy with post dose scintigraphy
• At least one radioiodine bone uptake without structural correlation on high-resolution imaging

Exclusion Criteria:

• A single radio iodine bone uptake with structural correlation on imaging
• Diagnosis of bone metastasis after a skeletal related event including spinal cord compression, pathological fracture, need for external beam radiation, surgery to bone, or development of hypercalcemia of malignancy
• Follow up less than 6 months
• Missing data in medical record

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of complete remission of thyroid cancer	Disappearance of pathologic radio iodine uptake, including bone uptake, on post-therapy scintigraphy; No structural evidence of disease on high-resolution imaging; Suppressed serum Tg < 0.6 ng/mL, no detectable TgAb (thyroglobulin antibody)	1 month

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon

Study record dates

Study Major Dates

• Study Start (Anticipated): November 1, 2019
• Primary Completion (Anticipated): December 1, 2019
• Study Completion (Anticipated): December 1, 2019

Study Registration Dates

• First Submitted: October 22, 2019
• First Submitted That Met QC Criteria: October 25, 2019
• First Posted (Actual): October 28, 2019

Study Record Updates

• Last Update Posted (Actual): October 28, 2019
• Last Update Submitted That Met QC Criteria: October 25, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Keywords: Radioiodine Bone Metastases; Thyroid Cancer
• Additional Relevant MeSH Terms: Pathologic Processes; Neoplasms; Neoplasms by Site; Endocrine System Diseases; Hematologic Diseases; Endocrine Gland Neoplasms; Musculoskeletal Diseases; Head and Neck Neoplasms; Neoplastic Processes; Bone Diseases; Neoplasm Metastasis; Thyroid Diseases; Bone Neoplasms; Bone Marrow Diseases; Thyroid Neoplasms
• Other Study ID Numbers: 69HCL19_1919

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No