Guidelines on radioiodine therapy for differentiated thyroid carcinoma

2005 ◽  
Vol 44 (06) ◽  
pp. 229-237 ◽  
Author(s):  
M. K. Pixberg ◽  
U. Dörr ◽  
M. Dietlein ◽  
H. Schlemmer ◽  
J. Grimm ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
External Beam Radiotherapy ◽  
German Society ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
131I Activity ◽  
Treatment Data ◽  
The Impact

SummaryAim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing Multicenter Study Differentiated Thyroid Carcinoma (MSDS) were analyzed. Patients, methods: Patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pN0/1/x M0/x (UICC, 5th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4–6 weeks), in 33% and 84% with regard to 131I activity for RIT (1-3 vs. 1-4 GBq; ± 10%), and in 16% and 60% with regard to 131I activity for WBS (15319-300 vs. 15319-400 MBq; ± 10%). Conclusions: The 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes.

Evaluation of Parotid Salivary Gland Echo Texture by Ultrasound Examinations and Correlation With Whole‐Body Scintigraphy After Radioiodine Therapy in Patients With Differentiated Thyroid Carcinoma

2020 ◽  
Vol 39 (9) ◽  
pp. 1811-1818
Author(s):  
Graziele Aparecida Simões Lima ◽  
Rossana Verónica Mendoza López ◽  
Ricardo Miguel Costa Freitas ◽  
Jose Willegaignon ◽  
Marcelo Tatit Sapienza ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Parotid Salivary Gland

scholarly journals Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

2009 ◽  
Vol 53 (7) ◽  
pp. 874-879 ◽  
Author(s):  
Maria Eduarda Mello ◽  
Rodrigo C. Flamini ◽  
Rossana Corbo ◽  
Marcelo Mamede
Keyword(s):  
Thyroid Carcinoma ◽  
False Positive ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Radioiodine Uptake

The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy.

scholarly journals Survival and Therapeutic Modalities in Patients with Bone Metastases of Differentiated Thyroid Carcinomas

2001 ◽  
Vol 86 (4) ◽  
pp. 1568-1573 ◽  
Author(s):  
Marie-Odile Bernier ◽  
Laurence Leenhardt ◽  
Catherine Hoang ◽  
Andre Aurengo ◽  
Jean-Yves Mary ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Radioiodine Therapy ◽  
Survival Rates ◽  
Young Patients ◽  
Differentiated Thyroid Carcinoma ◽  
Prognostic Features ◽  
Therapeutic Modalities ◽  
Age Range ◽  
The Impact

Data for patients with bone metastases (BMs) of differentiated thyroid carcinoma (DTC) were retrospectively studied to identify factors associated with survival. We especially studied the impact of therapies. Among the 1977 patients followed for DTC in our department from 1958 to 1999, 109 (77 females and 32 males; age range, 20–87 yr) presented BMs. All patients except 1 underwent total thyroidectomy, followed by radioiodine therapy (≥3.7 gigabecquerels) in 95 cases. Survival rates at 5 and 10 yr were 41% and 15%, respectively. Univariate analyses indicated that a young age at BM discovery (P < 0.005) and the discovery of BM as a revealing symptom of DTC (P < 0.05) were features significantly associated with improved survival as well as radioiodine therapy (P < 10−4) and BM complete surgery (P < 0.02). Using multivariate analysis, the detection of BMs as a revealing symptom of thyroid carcinoma (P < 0.0005), the absence of metastasis appearance in other organs than bones during the follow-up (P < 0.03), the cumulative dose of radioiodine therapy (P < 0.0001), and complete BM surgery in young patients (P < 0.04) appeared as independent prognostic features associated with an improved survival.

scholarly journals Thyroid hormone deficiency and postmenopausal status independently increase serum osteoprotegerin concentrations in women

2007 ◽  
Vol 156 (5) ◽  
pp. 539-545 ◽  
Author(s):  
José I Botella-Carretero ◽  
Francisco Alvarez-Blasco ◽  
José Luis San Millán ◽  
Héctor F Escobar-Morreale
Keyword(s):  
Thyroid Carcinoma ◽  
Analysis Of Variance ◽  
Repeated Measures ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Control Group ◽  
Creatinine Ratio ◽  
Postmenopausal Status ◽  
Acute Hypothyroidism ◽  
The Impact

Objective: To study the impact of thyroxine (T4) withdrawal on serum osteoprotegerin concentrations in women, using a healthy euthyroid control group matched for age and postmenopausal status as reference. Subjects and design: Nineteen women with differentiated thyroid carcinoma were studied the last day on T4 suppressive treatment, 4–7 days after withdrawal and the day before whole body scanning. Eighteen women matched for age and postmenopausal status served as controls. Serum thyroid hormones, urinary bone markers and serum osteoprotegerin concentrations were measured. Statistical methods included repeated measures analysis of variance and one-way analysis of variance. Results: Patients progressed from subclinical or mild hyperthyroidism at baseline to normal free T4 and triiodothyronine levels 4–7 days later, ending in overt hypothyroidism before scanning. Serum osteoprotegerin increased, and urinary deoxypyridolines/creatinine and pyridolines/creatinine ratios decreased, with acute hypothyroidism (P = 0.026, P = 0.003, and P < 0.001 respectively). Urinary deoxypyridolines/creatinine ratio, pyridolines/creatinine ratio, and serum osteocalcin during hypothyroidism were lower compared with those of healthy controls (P = 0.023, P = 0.019, and P = 0.011 respectively). Serum osteoprotegerin concentrations were higher in postmenopausal patients when compared with premenopausal ones, irrespective of the changes in thyroid function (P = 0.001). Conclusion: Serum osteoprotegerin concentrations increase following acute hypothyroidism after T4 withdrawal in women with differentiated thyroid carcinoma, and also with postmenopausal status.

Differentiated thyroid carcinoma: Incremental diagnostic value of 131I SPECT/CT over planar whole body scan after radioiodine therapy

Endocrine ◽  
2016 ◽  
Vol 56 (3) ◽  
pp. 551-559 ◽  
Author(s):  
Valentina Zilioli ◽  
Alessia Peli ◽  
Maria Beatrice Panarotto ◽  
Giancarlo Magri ◽  
Ahmed Alkraisheh ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
Diagnostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan

scholarly journals Radioiodine in Differentiated Thyroid Carcinoma: Do We Need Diagnostic Pre-Ablation Iodine-123 Scintigraphy to Optimize Treatment?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 553
Author(s):  
Elizabeth de Koster ◽  
Taban Sulaiman ◽  
Jaap Hamming ◽  
Abbey Schepers ◽  
Marieke Snel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Treatment Success ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Thyroid Remnant ◽  
Node Metastasis ◽  
Unsuccessful Treatment

Changing insights regarding radioiodine (I-131) administration in differentiated thyroid carcinoma (DTC) stir up discussions on the utility of pre-ablation diagnostic scintigraphy (DxWBS). Our retrospective study qualitatively and semi-quantitatively assessed posttherapy I-131 whole-body scintigraphy (TxWBS) data for thyroid remnant size and metastasis. Findings were associated with initial treatment success after nine months, as well as clinical, histopathological, and surgical parameters. Possible management changes were addressed. A thyroid remnant was reported in 89 of 97 (92%) patients, suspicion of lymph node metastasis in 26 (27%) and distant metastasis in 6 (6%). Surgery with oncological intent and surgery by two dedicated thyroid surgeons were independently associated with a smaller remnant. Surgery at a community hospital, aggressive tumor histopathology, histopathological lymph node metastasis (pN1) and suspicion of new lymph node metastasis on TxWBS were independently associated with an unsuccessful treatment. Thyroid remnant size was unrelated to treatment success. All 13 pN1 patients with suspected in situ lymph node metastases on TxWBS had an unsuccessful treatment, opposite 19/31 (61%) pN1 patients without (p = 0.009). Pre-ablative knowledge of these TxWBS findings had likely influenced management in 48 (50%) patients. Additional pre-ablative diagnostics could optimize patient-tailored I-131 administration. DxWBS should be considered, especially in patients with pN1 stage or suspected in situ lymph node metastasis. Dependent on local surgical expertise, DxWBS is not recommended to evaluate thyroid remnant size.

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