The almost all patients with hyperthyroidism problems treated with nuclear medicine cure his ailment. So says the Head of the Nuclear Medicine Service Saint John’s HospitalJose Verdu, which indicates that it deals with radiopharmaceuticals thyroid disease in people who do not respond to other pharmacological treatments and? present symptoms such as goiter, tachycardia or excessive sweating.
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The treatment consists of giving them a radiopharmaceutical, 131INa, which has been used for many years and which its therapeutic effects are well known. The majority of patients are operated on an outpatient basis, that is, they are given the capsule of this radiopharmaceutical and following assessing that its radiation level does not exceed certain limits they go home. A small percentage “must be admitted, not because of its side effects, but because of the radiation protection of the people around them and the environment”, explains the head of Nuclear Medicine.
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This service has celebrated the XXVI Conference of the Nuclear Medicine and Molecular Imaging Society of Valencia and Murcia held at the Severo Ochoa de la Miguel Hernandez University. Around 80 experts attended, including nuclear doctors, radioactive facility operators and diagnostic imaging technicians, who have shared knowledge on diagnostic techniques by scintigraphic (SPECT) and molecular (PET) imaging, the use of equipment, the use of radiopharmaceuticals, the radioguided surgery or the newest treatments such as the use of new radiopharmaceuticals to address tumors such as neuroendocrine.
In this sense, Health highlights the collaboration and coordination between the eight hospital centers that have a nuclear medicine service in the Community, This allows for better patient care.
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As explained by the head of the Nuclear Medicine Service of the Hospital de Sant Joan, “the regional public hospitals We collaborate when referring patients who need treatment if the service is not available in a certain hospital. Just as patients from the entire province of Alicante come here to treat ailments such asthyroid cancer, hyperthyroidism or pheochromocytomas, we can also refer a patient to La Fefor example, when it is indicated a treatment with 177Lutetium-Dotatate”, which is a new radiopharmaceutical.
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The Sant Joan Hospital in Alicante treated in 2022 a 165 patients from the entire province due to hyperthyroidism and only 17 were admitted until their radiation levels dropped. 10% of patients required hospitalization following being treated for hyperthyroidism. The urine of the people who receive the radiopharmaceutical must be collected and disposed of following a safety protocol, so as not to contaminate the environment with radiation.
State-of-the-art equipment
Before administering the pill, the patient is summoned to the Nuclear Medicine Service to explain what the treatment consists of and sign an informed consent. Then a thyroid scintigraphy with state-of-the-art equipment of the center, proves that “it helps us nuclear doctors to calculate the dose to be administereddepending on their weight and other variables that the scintigraphy gives us”, explains Verdú.
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Once the drug is taken, three months later, he is scheduled for a clinical check-up once more., the last step that includes an analysis and that “since the covid pandemic we have carried out by telephone to avoid users having to travel”. These 165 patients have greatly improved their quality of life since then, curing their hyperthyroidism, “although around 50% and depending on the type of hyperthyroidism they had developed, they may present hypothyroidism post treatment, but this is a much more benign ailment that responds very well to drug treatment and with much fewer side effects”, adds the doctor.
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With regard to high-tech equipment in the health system, Dr. José Verdú has stated that “nuclear medicine is experiencing a sweet moment, since, with state-of-the-art equipment donated by Amancio Ortega, those acquired by the hospital itself, and those that are arriving from the INVEAT funds of the European Union, we have state-of-the-art technology in public health to care for our patients”.
“Nuclear medicine is experiencing a sweet moment. With the state-of-the-art equipment donated by Amancio Ortega, those purchased by the hospital, and those that come from EU funds, we have state-of-the-art technology in public health”
Doctor Jose Verdu. Head of the Nuclear Medicine Service of the Hospital de Sant Joan
As an example of this renovation of the technology park, in the Hospital de Sant Joan, a reference center for public healthcare in the province of Alicante to care for all patients in the field of nuclear medicine, there are two SPECT-CT gamma cameras (latest generation hybrid equipment that allows simultaneous scintigraphy and CT scans) and a PET-CT.
One of the latest advances in nuclear medicine is the incorporation of new radiopharmaceuticals for metabolic treatments. The invited presentation, given by doctors Pilar Bello and Stefan Prado, from Hospital La Fe, dealt with one of these treatments in patients with neuroendocrine tumors using the radiopharmaceutical 177 Lutecium-equipped.
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In this sense, doctor Verdú has explained that “although they are not as aggressive as others, neuroendocrine tumors can secrete hormones and cause syndromes due to this hormonal hypersecretion, with side effects such as gastroduodenal ulcers, or carcinoid syndrome that can cause facial redness or diarrhea.
“Right now these treatments are only applied in La Fe, but with one more doctor joining our service we might provide it at the Hospital de San Juan and thus provide service to the entire province of Alicante”
Jose Verdu. Head of the Nuclear Medicine Service of the Hospital de Sant Joan
In the future, the indications for the use of this new radiopharmaceutical will be extended, as explained by the head of Nuclear Medicine, to the treatment of other types of tumors such as paragangliomas, pheocomocytomas, or cancers radioiodine resistant thyroid.
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Another radiopharmaceutical that has appeared recently is 177lutetium-PSMA “with a therapeutic indication in more frequent tumors such as the metastatic prostate”, indicates Verdú.
On behalf of the Hospital de Sant Joan, Dr. Olga Rosas has intervened, who has commented on a case that exemplifies the usefulness of positron emission tomography (PET) in the diagnosis of autoimmune encephalitis.
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The manager of the Alicante-Sant Joan Health department, Beatriz Massa, wanted to highlight “the strategic importance of Saint John’s Hospital in the approach and treatment of those processes that require nuclear medicine in the province of Alicante”.
The vice president of theSociety of Nuclear and Molecular Medicine of Valencia and Murcia, María del Carmen Redal, and a nuclear doctor at the Hospital Clìnic de Valencia, has pointed out that “today is an important day for all of us since we can share professional concerns strengthen interpersonal relationships and see how each service shows us its science”.
