Research
Presently On-going Research Studies
Research Title: Comparison of 131I and 124I in the evaluation of lesions secondary to differentiated thyroid cancer after thyroid hormone withdrawal
Researchers/Investigators: Van Nostrand D, Atkins F, Kulkarni K, Khorjekar G, Schneider M.
Overview: This is a continuous of three different studies evaluating the ability of 131I and 124I in the detection of lesions secondary to differentiated thyroid cancer after the patient has been prepared with thyroid hormone withdrawal.
Research Title: Comparison of 131I and 124I in the evaluation of lesions secondary to differentiated thyroid cancer after injection of recombinant human thyroid stimulating hormone.
Researchers/Investigators: Van Nostrand D, Atkins F, Kulkarni K, Khorjekar G, Schneider M.
Overview: This is a continuous of three different studies evaluating the ability of 131I and 124I in the detection of lesions secondary to differentiated thyroid cancer after the patient has been prepared with injections with recombinant human thyroid stimulating hormone.
Research Title: Comparison of 131I and 124I in the evaluation of lesions secondary to differentiated thyroid cancer after thyroid hormone withdrawal and injection of recombinant human thyroid stimulating hormone.
Researchers/Investigators: Van Nostrand D, Atkins F, Kulkarni K, Khorjekar G, Schneider M.
Overview: This is a continuous of three different studies evaluating the ability of 131I and 124I in the detection of lesions secondary to differentiated thyroid cancer after the patient has been prepared with both thyroid hormone withdrawal and injections with recombinant human thyroid stimulating hormone.
Research Title: 124I Lesion Dosimetry in Comparison to Clinical Outcomes
Researchers/Investigators: Van Nostrand D, Atkins F, Srinivasan S, Sgouros G.
Overview: This study is evaluated the estimated radiation exposure to various lesions of differentiated thyroid cancer to administered 131I using the new Sgouros' 3DRD software to the outcomes from the administered 131I.
Research Title: Validation of Bi-exponential Equation for Determination of Maximum Tolerated Prescribed Activity of 131I by the %48 Hour Whole Body Retention
Researchers/Investigators: Atkins F, Van Nostrand D, Burman K, Wartofsky L.
Overview: Dr. Atkins has determined a Bi-exponential Equation to be used with the % 48 hour whole body retention measurement in patients with differentiated thyroid cancer. This study is a subsequent on-going study to validate the utility of the bi-exponential equation.
Research Title: Comparison of Utility of Bi-exponential Equation for Determination of Maximum Tolerated Prescribed Activity of 131I by the %48 Hour Whole Body Retention in Patients Prepared with Thyroid Hormone withdrawal vs Recombinant Human TSH Injections.
Researchers/Investigators: Atkins F, Van Nostrand D, Burman K, Wartofsky L.
Overview: Dr. Atkins has determined a Bi-exponential Equation to be used with the % 48 hour whole body retention measurement in patients with differentiated thyroid cancer. This study is a subsequent on-going study to validate the utility of the bi-exponential equation.
Project Title: Translation of the English book entitled "Thyroid Cancer: A Guide for Patients into Chinese
Translators: Haixia Guan, MD, Dalian China, and Zuyue Wang, M.D. Washington Hospital Center
Overview: This is a translation from English to Chinese Mandarin of the successful book for patients regarding thyroid cancer
Research Title: In-vitro Evaluation of Amifostine's Effects on Differentiated Thyroid Cancer
Researchers/Investigators: Vasko V, Van Nostrand D, Klubo-Gwiezdzinska J, Burman K , Wartofsky L.
Overview: Amifostine has been shown to protect the salivary glands from 131I radiation therapy for differentiated thyroid cancer. However, no good study is available evaluating whether or not the amifostine also protects the thyroid cancer from the radiation effects of 131I therapy. The purpose of this study is to evaluate in-vitro whether or not the amifostine also protects the thyroid cancer from the radiation effects of 131I.
Research Title: Characterization of Salivary Gland Side Effects: The Washington Hospital Center Experience.
Researchers/Investigators: Kharazi P, Van Nostrand D, Khorjekar G, Schneider M, Burman K, Wartofsky L.
Overview: This is a survey of patients treated at Washington Hospital Center for salivary gland side effects after 131I therapy.
Research Title: Pulmonary Fibrosis in Patients with Pulmonary Metastases from Differentiated Thyroid Cancer and Treated with 131I: The Washington Hospital Experience
Researchers/Investigators: Van Nostrand D, Schneider, Burman K, Wartofsky L.
Overview: This is a retrospective study evaluating the frequency and severity of pulmonary fibrosis in patient with pulmonary metastases from differentiated thyroid carcinoma treated with dosimetrically determined doses of 131I at Washington Hospital Center.
Research Title: Response of Absolute Neutrophil and Platelet Count in Patients with Differentiated Thyroid Cancer Treated with 131I: The Washington Hospital Experience
Researchers/Investigators: Van Nostrand D, Schneider, Burman K, Wartofsky L.
Overview: This is a retrospective study evaluating the frequency and severity of decrease in baseline absolute neutrophil and platelet count in patients treated with dosimetrically determined doses of 131I at Washington Hospital Center.
Recently Completed Research Projects and/or Submissions to Meetings and Journals.
Research Title: Retrospective Study of the Utility of 18F Sodium Fluoride PET Bone Scans in Patients with Differentiated Thyroid Cancer. Submitted to 2012 Annual Society of Nuclear Medicine J Nucl Med. (abstract) 2012.
Researchers/Investigators: Schneider M, Van Nostrand D, Khorjekar G, Burman K, Wartofsky L.
Overview: This study is evaluating the utility of 18F sodium fluoride PET-CT bone scans in the alteration of the management of patients with differentiated thyroid cancer. 18F sodium fluoride PET-CT bone scans are superior to the standard bone scans performed with 99mTc MDP.
Research Title: Predicting Positive Post-131I-Therapy Scans in Patients who have Thyroid Cancer and Negative Pre-Radioiodine Therapy Scans. Submitted to 2012 Annual Society of Nuclear Medicine J Nucl Med. (abstract) 2012.
Researchers/Investigators: Hall JP, Van Nostrand D, Kharazi P, Mete M, Moreau S, Acio E, Wartofsky L.
Overview: In patients with negative diagnostic radioiodine scans, it is problematic regarding whether or not a patient should be treated with another therapy of 131I. Two parameters, the maximum tolerated activity from dosimetry and thyroglobulin levels are evaluated to see if they can help predict which patients who have a negative diagnostic radioiodine scan will have a positive post-therapy scan after a therapy with 131I.
Research Title: So, How Low is the Radiation Exposure from Airport Security Screening Devices? An educational exhibit. Submitted to 2012 Annual Society of Nuclear Medicine J Nucl Med. (abstract) 2012.
Researchers/Investigators: Schneider MT, Mohapatra S, Atkins F, Khorjekar G, Van Nostrand D.
Overview: Although this is not an issue of Nuclear Medicine, reduction of medical use and other use of radiation is a concern to Nuclear Medicine physicians and the patients whom we treat. This exhibit reports on the radiation exposure from Airport Security screening devices.
Research Title: Characterization of Salivary Gland Side Effects Up to 7 Days After 131I Therapy: Updated Report of the Thyroid Cancer Survivors' Association, Inc. (ThyCa) National Survey. Submitted to 2012 Annual Society of Nuclear Medicine J Nucl Med. (abstract) 2012.
Researchers/Investigators: Hall J, Kharazi P, Van Nostrand D, Khorjekar G, Brennan M, McIver B , Mete M., Bloom G.
Overview: This is an update of our large national Thyroid Cancer Survivors' Association survey regarding multiple characterizations of salivary gland side effects occurring within the first 7 days after 131I therapy.
Research Title: Selecting prescribed activity of 131I therapy for pediatric patients: An educational exhibit. Submitted to 2012 Annual Society of Nuclear Medicine meeting. J Nucl Med. (abstract) 2012.
Researchers/Investigators: Glister O, Kulkarni K, Van Nostrand D.
Overview: The selection of the prescribed activity of 131I for therapy for thyroid cancer in pediatric patients is problematic and very controversial. This educational exhibit reviews the literature on selection of prescribed activity of 131I for pediatric patients.
Research Title: Brain metastases secondary to differentiated thyroid cancer: an educational exhibit. Submitted to 2012 Annual Society of Nuclear Medicine J Nucl Med. (abstract) 2012.
Researchers/Investigators: Hall JP, Van Nostrand D, Schneider M, Burman K.
Overview: Although brain metastases secondary to differentiated thyroid cancer is infrequent, the management of such is very important to the patient. This exhibit reviews the literature with emphasis on the apparent improved survival of the patient with surgical rather than 131I therapy.
Research Title: Does a negative diagnostic 131I planar scan AND 124I PET scan in patients with elevated Tg exclude 131I uptake on 131I post- therapy scan? Updated Results. Submitted to 2012 Annual Society of Nuclear Medicine meeting. J Nucl Med. (abstract) 2012.
Researchers/Investigators: Khorjekar G , Van Nostrand D, Moreau S, Burman K, Chennupati SP, Bandaru VV, Wartofsky L.
Overview: In patients with negative diagnostic radioiodine scans performed with either 131I or 123I, it is problematic regarding whether or not a patient should be treated with another therapy of 131I. This study evaluated whether or not an 124I PET-CT predicts whether or not the post-therapy 131I scans will show functioning metastases.
Research Title: 18F Fluoro-deoxyglucose PET and Thyroid Nodules: An educational exhibit. Submitted to 2012 Annual Society of Nuclear Medicine meeting. J Nucl Med. (abstract) 2012.
Researchers/Investigators: Garcia C, Schneider M, Van Nostrand D, Burman K, Wartofsky L.
Overview: This exhibit reviews the literature and discusses the management of incidentally detected FDG uptake on PET scan in a thyroid nodule.
Research Title: Comparison of PET Images Obtained with PET-CT vs PET-MR: A Pilot Study. Submitted to 2012 Annual Society of Nuclear Medicine meeting. J Nucl Med. (abstract) 2012. (Performed at the National Institute of Health in association with one of our residents)
Researchers/Investigators: Millo C, Khorjekar GR, Maass-Moreno R, Neumann R, Bluemke D.
Overview: PET-MR has recently become available, and the National Institute of Health is one of the first facilities to obtain this state of the art equipment. These authors have performed a preliminary study evaluating the comparable quality of PET scans performed on a PET-CT to the images obtained on a PET-MR in the same patients.
Research Title: Evaluation of the anxiety and depression in patients prior to PET-CT. Submitted to 2012 Annual Society of Nuclear Medicine meeting. J Nucl Med. (abstract) 2012. (Turkey)
Researchers/Investigators: Elboga U, Elboga G, Çelen YC, Van Nostrand D.
Overview: This study was performed by a team of physicians at Gazientep University in Turkey along with the participation of one of our staff. This study evaluated the level of anxiety and depression patients with thyroid cancer prior to their PET-CT scan.
Past Research Projects
Research Title: The Comparison of I-124 and I-131 Radiopharmacokinetics
Researchers/Investigators: Dr. Douglas Van Nostrand, Dr. Frank Atkins, Shari Moreau, Kenneth Burman, Leonard Wartofsky.
Overview: This is a research study evaluating the new positron emitting radioiodine isotope, I-124, for the evaluation of patients with thyroid cancer. This radioisotope has multiple potential advantageous over the standard radioiodine isotopes of I-131 and I-123. I-124 holds the promise for (1) superior images obtained with a PET-CT scanner, (2) tomographic images, which are cross sectional images, (3) images that can be fused (co-registered) with CT or MRI images, and (4) quantitation that is superior to I-123 and I-131.
Research Title: The Evaluation of "Over" and "Under" Treatment of Thyroid Cancer with Empirically-Determined Dosages
Researchers/Investigators: Dr. Kanchan Kulkarni, Dr. Douglas Van Nostrand, Dr. Atkins FB, Dr. Aiken MJ, Dr. Burman K, Dr. Wartofsky L.
Overview: This study evaluates how frequently empiric dosages of I-131 potentially "over" and "under" treat patients with well-differentiated thyroid carcinoma.
Research Title: The Evaluation of "Over" and "Under" Treatment of Empiric Dosages in Patients with Pulmonary Metastases from Well-Differentiated Thyroid Carcinoma
Researchers/Investigators: Dr. Giuseppe Esposito, Dr. Douglas Van Nostrand, Dr. Frank Atkins.
Overview: This study evaluates how frequently empiric dosages of I-131 potentially "over" and "under" treat patients with well-differentiated thyroid carcinoma who have metastasis to the lungs.
Research Title: The Utility of the Percent 48-hour Whole Body Retention in the Selection of Radioiodine Dosages for the Treatment of Patients with Well-Differentiated Thyroid Carcinoma
Researchers/Investigators: Dr. Douglas Van Nostrand, Dr. Frank Atkins, Shari Moreau, Dr. Marta Aiken, Dr. Kenneth Burman, Dr. Leonard Wartofsky.
Overview: This study evaluates the use of a single whole body measurement rather than measurements before each day for 5 days or longer for "dosimetry" to select a higher or lower dosage of I-131 relative to empiric dosages for the treatment of metastatic well-differentiated thyroid carcinoma.
Research Title: The Utility of Pre-Ablation Scans
Researchers/Investigators: Dr. Douglas Van Nostrand, Dr. Marta Aiken, Dr. Frank Atkins, Shari Moreau, Dr. Carlos Garcia, Dr. Giuseppe Esposito, Dr. Elmo Acio, Dr. Kenneth Burman, Dr. Leonard Wartofsky.
Overview: This study is the evaluation of the utility of the radioiodine scan prior to radioiodine ablation in patient who have had a recent diagnosis of thyroid cancer and a recent thyroidectomy.
Research Title: The Utility of Fusion of PET with MRI in the Evaluation of Patient with Suspect Recurrent Well-Differentiated Thyroid Carcinoma in the Neck
Researchers/Investigators: Laura Ann Seiboth, Dr. Elmo Acio, Dr. Douglas Van Nostrand, Dr. Kenneth Burman, Dr. Leonard Wartofsky.
Overview: PET scans performed with radiolabeled glucose and MRI scans have been shown to be useful in the evaluation of recurrence in the neck region of well-differentiated thyroid carcinoma. With new software, the MRI and glucose-PET images can be fused, and the objective of this study is to evaluate whether the interpretation of the fused glucose-PET and MRI images improves the correct localization of uptake on the PET scan to the patient anatomy. This may potentially help the patient in several ways such as helping to better determine which lymph node on MRI should be considered for fine needle aspiration or biopsy or demonstrating that the PET glucose uptake is located in muscle or brown fat.
Research Title: The Utility of Pinhole Images vs Parallel Collimator Images vs Whole Body Images in the Evaluation of Functioning Thyroid Tissue in the Thyroid Bed and Neck
Researchers/Investigators: Dr. Marta Aiken, Dr. Douglas Van Nostrand
Overview: Imaging for thyroid cancer in nuclear medicine can be performed with many different approaches. One factor that may affect the quality of imaging is the type of collimator and scanning technique. This study evaluates three approaches for imaging: (1) whole body imaging with a parallel collimator, (2) "spot-imaging" with parallel hole collimator, and (3) "spot-imaging" with a pinhole collimator. Further information is available in the patient book entitled Thyroid Cancer: A Patient's Guide, D Van Nostrand, Gary Bloom, Leonard Wartofsky, Eds, Keystone Press, Baltimore 2004 (English and Spanish) and in the medical textbook entitled Thyroid Cancer: A Comprehensive Guide to Clinical Management. L Wartofsky, D Van Nostrand, Eds, Humana Press, Toyota, New Jersey, January 2006
Research Title: The Radio-pharmacokinetics of Radioiodine in the Salivary Gland Pre- and Post- Sialagogue
Researchers/Investigators: Dr. Atkins Dr. Van Nostrand
Overview: This study is evaluating the likelihood and frequency of a "rebound" of I-131 uptake in the salivary gland after the administration of sialagogue (i.e. lemon juice).
Research Title: Evaluation of methods for the Modification of 18FDG Uptake in Brown Fat on PET scans.
Researchers/Investigators: Dr. Carlos Garcia, Dr. Douglas Van Nostrand
Overview: This is the evaluation of methods for the modification of glucose uptake in brown fat on PET scans in the neck area, which may obscure the identification of abnormal uptake of radiolabeled glucose in that area in patients with well-differentiated thyroid cancer.
Publications
Van Nostrand D. Sialoadenitis secondary to 131I therapy for well-differentiated thyroid cancer. Oral Diseases, 2011;17:154-161.
George Sgouros1, Robert F. Hobbs1, Francis B. Atkins2, Douglas Van Nostrand2, Paul W. Ladenson3, Richard L. Wahl1. 3-D Radiobiological Dosimetry (3D-RD) with I-124 PET for I-131 therapy of Thyroid Cancer. 1The Russell H. Morgan Dept. of Radiology, Division of Nuclear Medicine, 3Department of Endocrinology Johns Hopkins University, School of Medicine, Baltimore MD, 2The Washington Hospital Center, Division of Nuclear Medicine, Washington DC. Submitted for publication European Journal of Nuclear Medicine.
Joanna Klubo-Gwiezdzinska K, Burman KD, Van Nostrand D, Wartofsky L. Does an undetectable rhTSH-stimulated Tg level 12 months after initial treatment of thyroid cancer indicate remission? Clinical Endocrinology (2011) 74, 111–117.
Joanna Klubo-Gwiezdzinska, Kenneth D. Burman, Douglas Van Nostrand, and Leonard Wartofsky. Levothyroxine Treatment in Pregnancy: Indications, Efficacy, and Therapeutic Regimen. Journal of Thyroid Research 2011, Article ID 843591, 12 pages.
Klubo-Gwiezdzinska J, Van Nostrand D, Atkins F, Burman K, Jonklaas J, Mete M, Wartofsky L. Efficacy of Dosimetric Versus Empiric Prescribed Activity of 131I for Therapy of Differentiated Thyroid Cancer. J Clin Endocrinol Metab 2011;96(10):3217-3225.
Klubo-Gwiezdzinska J, Van Nostrand D, Efficacy of Dosimetric Versus Empiric Prescribed Activity of 131I for Therapy of Differentiated Thyroid Cancer Thyroid. 2011, 96:3217-3225.
Van Nostrand D, Khorjekar GR, O'Neil J, Moreau S, Atkins F, Kharazi P, Mete M, Chennupati S, Burman K, Wartofsky L. Recombinant human thyroid stimulating hormone versus thyroid hormone withdrawal in the identification of metastasis in differentiated thyroid cancer with 131I planar whole body and 124I PET. J Nucl Med 2012;TBD.
Klubo-Gwiezdzinska J, Burman KD, Van Nostrand D, et al. Radioiodine treatment of metastatic thyroid cancer: relative efficacy and side effect profile of preparation by thyroid hormone withdrawal versus recombinant human thyrotropin. Thyroid 2012;22:in press.