Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3)

2007 ◽  
Vol 46 (05) ◽  
pp. 213-219 ◽  
Author(s):  
J. Dressler ◽  
W. Eschner ◽  
F. Grünwald ◽  
M. Lassmann ◽  
B. Leisner ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
131I Therapy ◽  
131I Ablation ◽  
Procedure Guidelines ◽  
Lower Blood ◽  
Higher Sensitivity

SummaryThe procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for 131I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative 131I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC ≤1 cm 131I ablation may be helpful in an individual constellation. Preparation for 131I ablation requires low iodine diet for two weeks and TSHstimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lower blood activity) and the advantages of endogenous TSHstimulation (necessary for 131I-therapy in patients with metastases, higher sensitivity of 131I whole-body scan) are discussed. In most centers standard activities are used for 131I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of 131I should not exceed 1–10 MBq, alternative tracers are 123I or 124I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene.

Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 2)

2004 ◽  
Vol 43 (04) ◽  
pp. 115-120 ◽  
Author(s):  
J. Dressler ◽  
J. Farahati ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Tnm Classification ◽  
Whole Body ◽  
Procedure Guidelines ◽  
Special Cases ◽  
Deutsche Gesellschaft Für Chirurgie ◽  
Thyroglobulin Concentration

SummaryThe procedure guidelines for radioiodine therapy (RIT) of differentiated thyroid cancer (version 2) are the counterpart to the procedure guidelines for 131I whole-body scintigraphy (version 2) and specify the interdisciplinary guidelines for thyroid cancer of the Deutsche Krebs-gesellschaft and the Deutsche Gesellschaft für Chirurgie concerning the nuclear medicine part. Compared with version 1 facultative options for RIT can be chosen in special cases: ablative RIT for papillary microcarcinoma ≤1 cm, ablative RIT for mixed forms of anaplastic and differentiated thyroid cancer, and RIT in patients with a measurable or increasing thyroglobulin concentration but without detectable metastases by imaging. The description of the pretherapeutic dosimetry now includes the isotopes 123I and 124I as well as a broader range of the activity of 131I. Activities of 2-5 GBq 131I are recommended for the first ablative RIT. If high accumulative activities of 131I are expected, men who have not yet finished their family planning should be advised to the option of sperm cryoconservation. An interdisciplinary consensus is necessary whether the new TNM-classification (UICC, 6th edition, 2002) will lead to modified recommendations for surgical or nuclear medicine therapy, especially for the surgical completeness and for the ablative RIT of pT1 papillary cancer.

Procedure guideline for radioiodine therapy and 131iodine whole-body scintigraphy in paediatric patients with differentiated thyroid cancer

2007 ◽  
Vol 46 (05) ◽  
pp. 224-231 ◽  
Author(s):  
M. Dietlein ◽  
M. Biermann ◽  
M. Frühwald ◽  
T. Linden ◽  
P. Bucsky ◽  
...  
Keyword(s):  
Body Weight ◽  
Thyroid Cancer ◽  
Thyroid Hormones ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Whole Body ◽  
Paediatric Patients ◽  
Procedure Guidelines ◽  
Radioiodine Ablation ◽  
Node Metastases

SummaryThe procedure guideline for radioiodine (131I) therapy and 131I whole-body scintigraphy of differentiated thyroid cancer in paediatric patients is the counterpart to the procedure guidelines (version 3) for adult patients and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Characteristics of thyroid cancer in children are the higher aggressiveness of papillary thyroid cancer, the higher frequency of extrathyroidal extension and of disseminated pulmonary metastases as well as the high risk of local recurrences. Radioiodine therapy is generally recommended in children, the 131I activity depends on the children's body weight. Radioiodine ablation in children with small papillary cancer (≤1 cm) should be considered. TSH stimulation is reached two weeks (children) or three weeks (adolescents) after withdrawal of thyroid hormones. Anti-emetic drugs are highly recommended. CT of the chest and examination of pulmonary function are clearly indicated if there is any suspicion on metastases. 3–6 months after 131I ablation, the 131I whole-body scintigraphy is highly recommended as lymph node metastases are frequently detected in paediatric patients. Follow-up care should be arranged in shorter intervals than in adults to test the compliance and to adapt dosage of thyroid hormones to the children's body weight. Reference values of fT3 are higher in children than in adults. Evidence is insufficient to describe in which constellation the TSH may be kept within the low normal level. Therefore, TSH suppression is generally recommended.

scholarly journals Pulmonary metastases in differentiated thyroid cancer: efficacy of radioiodine therapy and prognostic factors

2015 ◽  
Vol 173 (3) ◽  
pp. 399-408 ◽  
Author(s):  
Hong-Jun Song ◽  
Zhong-Ling Qiu ◽  
Chen-Tian Shen ◽  
Wei-Jun Wei ◽  
Quan-Yong Luo
Keyword(s):  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Whole Body ◽  
Metastatic Node ◽  
Serum Thyroglobulin

ContextData from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed.ObjectiveTo assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC.MethodsA total of 372 patients with pulmonary metastasis from DTC treated with131I entered the study. According to the results of131I whole-body scan (WBS), pulmonary metastases were classified as131I-avid and non-131I-avid. For patients with131I-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic131I-WBS. Overall survival was calculated by the Kaplan–Meier method. Factors predictive of the outcome were determined by multivariate analyses.ResultsAmong patients demonstrating131I-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after131I therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of131I-avid and non-131I-avid.ConclusionThis study indicated that, most131I-avid pulmonary metastases from DTC can obtain partial or complete remission after131I therapy. Younger patients (<40 years old) with only pulmonary metastases and small (‘fine miliaric’ or micronodular) metastases appear to have relative favorite outcomes. Patients who do not respond to131I treatment have a worse prognosis.

scholarly journals Does Radioiodine Therapy in Patients with Differentiated Thyroid Cancer Increase the Frequency of Another Malignant Neoplasm?

ISRN Oncology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Renata Midori Hirosawa ◽  
Monica Marivo ◽  
Juliana de Moura Leite Luengo ◽  
Jose Vicente Tagliarini ◽  
Emanuel Cellice Castilho ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Clinical Laboratory ◽  
Malignant Neoplasm ◽  
Differentiated Thyroid Carcinoma ◽  
Cancer Type ◽  
Primary Malignancy ◽  
The Moment

Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not (131I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before 131I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before 131I therapy and of 69.4 ± 11.4 years for the group after it (P=0.02). Of the 148 patients treated with 131I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P<0.05). Conclusion. The frequency of another neoplasia found after 131I was similar to that found before 131I.

scholarly journals The significance of clinic-diagnostic factors in the course of estimation of side exposure of differentiated thyroid cancer patients after radioiodine therapy

2021 ◽  
Vol 30 (2) ◽  
pp. 101-112
Author(s):  
I.K. Khvostunov ◽  
◽  
V.V. Krylov ◽  
A.A. Rodichev ◽  
N.N. Shepel ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Chromosomal Aberrations ◽  
Radionuclide Therapy ◽  
Time Course ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Individual Characteristics ◽  
Internal Exposure ◽  
Whole Body

The radioiodine therapy is the most well-known branch of radionuclide therapy. The therapy composed of thyroidectomy and iodine-131 radiopharmaceutical is the “gold standard” for treat-ment of differentiated thyroid cancer patients (DTC). Given metastases in lymph nodes such therapy is absolutely exclusive treatment mode. At the same time, despite the targeted effect of radioiodine on pathological foci a side internal exposure of healthy organs and tissues is noted in the course of radioiodine therapy. Therefore, a reliable assessment of the side exposure is nec-essary taking into account the individual characteristics of patients considering that the side dose varies significantly from patient to patient. For this reason, the identification of significance of personal clinic-diagnostic factors determined the side whole body exposure is the vital and im-portant task. In this aspect, the cytogenetic examination of DTC patients by means of the analysis of chromosomal aberrations in peripheral blood lymphocytes is the goal of essential importance. The certain types of chromosomal aberrations are specific radiation markers that unequivocally indicate radiation exposure. Using the frequency of radiation markers the side absorbed dose can be reliably estimated. In the present work, the statistical analysis of the significance of vari-ous clinic-diagnostic factors in relation to the induction of radiation markers in the blood lympho-cytes was performed. For that end the results of the cytogenetic examination of the group com-prised of 38 DTC patients have been used. The examined patients underwent a course of radio-iodine therapy in the department of radionuclide therapy of the A.F. Tsyb MRRC, Obninsk. The slide preparation and cytogenetic analysis were carried out in the laboratory of radiation cytoge-netic of the same Center. The performed analysis of the correlation matrix with respect to the dependence of the increased frequency of stable and unstable markers resulted from a one-time course of radioiodine therapy showed no meaningfulness at the level R>0.3 for all the studied factors. For the absolute value of the frequency of radiation markers, both before and after radioiodine therapy, the meaningful relationship was found at the level R>0.7 for unsta-ble and at the level R>0.8 for stable markers with a total administered activity of radioiodine dur-ing all the previous courses of radioiodine therapy.

scholarly journals Management of papillary and follicular (differentiated) thyroid carcinoma - an update

1970 ◽  
Vol 16 (2) ◽  
pp. 126-130
Author(s):  
Md Abdul Mobin Choudhury ◽  
Md Abdul Alim Shaikh
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Endemic Goiter ◽  
Follicular Carcinoma ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Cancers ◽  
Surgical Options ◽  
Definitive Management

Thyroid cancers are quite rare, accounting for only 1.5% of all cancers in adults and 3% of all cancers in children. Differentiated thyroid cancer comprises 95% of all thyroid cancers. Of all thyroid cancers 74-80% of cases are papillary cancers. Incidences of follicular carcinoma are higher in regions where incidence of endemic goiter is high. Surgery is the definitive management of thyroid cancer. There is agreement that patients with large, locally aggressive or metastatic differentiated thyroid cancer require total thyroidectomy but there is continuing disagreement on the most appropriate operation for 'low risk' differentiated thyroid cancer. Adjuvant treatments are thyroid hormone suppression and radioiodine therapy rather than chemotherapy and radiotherapy. Prognosis is generally excellent and is influenced by factors related to the patient, the disease and the therapy. This article reviews the basis of surgical treatment of differentiated thyroid cancer and assesses the evidences supporting the surgical options. Key words: Papillary Carcinoma; Follicular Carcinoma; Hemithyroidectomy; Total Thyroidectomy DOI: 10.3329/bjo.v16i2.6848Bangladesh J Otorhinolaryngol 2010; 16(2): 126-130

Diagnostic Whole-Body Scanning Before Radioiodine Therapy for Pulmonary Metastases of Differentiated Thyroid Cancer

2008 ◽  
Vol 33 (12) ◽  
pp. 845-851 ◽  
Author(s):  
Yasushi Tachi ◽  
Shingo Iwano ◽  
Katsuhiko Kato ◽  
Masanori Tadokoro ◽  
Shinji Naganawa
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Pulmonary Metastases ◽  
Whole Body ◽  
Body Scanning

scholarly journals Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1740
Author(s):  
Michele Klain ◽  
Carmela Nappi ◽  
Marina De Risi ◽  
Leandra Piscopo ◽  
Fabio Volpe ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Half Life ◽  
Differentiated Thyroid Cancer ◽  
Multivariable Analysis ◽  
Whole Body ◽  
131I Therapy ◽  
Retention Data ◽  
Remnant Ablation ◽  
131I Treatment ◽  
Body Retention

Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insights regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients’ clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable among patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I.

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