| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Médecine Nucléaire, Centre Paul Papin, Cedex, France
Correspondence: For correspondence or reprints contact: Jean-Pierre Muratet, MD, Centre Paul Papin, Médecine Nucláire, 2, rue Moll, 49033 Angers Cedex 01 , France.
ABSTRACT
The therapeutic outcome after 131I first ablative treatment in patients operated on for nonmedullary differentiated thyroid carcinoma was compared after both the currently used scanning dose of 111 MBq 131I and a scanning dose of 37 MBq 131I. Methods: Two-hundred twenty-nine consecutive patients with no known metastases were retrospectively studied. They were divided in two populations according to the scanning dose (127 patients with 111 MBq and 102 patients with 37 MBq). All patients received 111 or 37 MBq 131I for diagnostic purposes and 3.7 GBq 131I for ablative therapy 9 days later. To assess the efficacy of the treatment, all patients were studied with 131I and with thyroglobulin plasma assays 6-17 mo later. Results: Successful outcome was significantly more frequent after a scanning dose of 37 MBq 131I than after a scanning dose of 111 MBq (76% versus 50%, p < 0.001). The treatment efficacy was particularly enhanced after 37 MBq in patients with associated lymphocytic thyroiditis. Conclusion: In patients with no known metastases, our data suggest that the impairment of the treatment efficacy observed aftera scanning dose of 111 MBq 131I is related to a stunning effect on the thyroid remnants. The threshold amount above which this effect begins to occur in thyroid remnants could be between 37 and 111 MBq 131I. Consequently, a scanning dose of only 37 MBq 131I could be recommended before first ablative treatment. The absence of metastatic patients in our study prevents any conclusion about the possible stunning of the neoplastic tissue. Nevertheless, we must suspect such an effect and try to avoid it, especially during follow-up after first radioiodine therapy. For instance, one may consider postponing radioiodine treatment several weeks or even months after scanning dose administration or using only thyroglobulin measurement for patients who are likely to receive a subsequent radioiodine treatment.
Key Words: iodine-131 treatment • thyroid cancer • scanning dose • stunning effect
This article has been cited by other articles:
|
|
 |
|
  R. B T Verkooijen, F. A Verburg, J. W van Isselt, C. J M Lips, J. W Smit, and M. P M Stokkel The success rate of I-131 ablation in differentiated thyroid cancer: comparison of uptake-related and fixed-dose strategies Eur. J. Endocrinol., September 1, 2008; 159(3): 301 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. P. Donahue, N. P. Shah, S. L. Lee, and M. E. Oates Initial Staging of Differentiated Thyroid Carcinoma: Continued Utility of Posttherapy 131I Whole-Body Scintigraphy Radiology, March 1, 2008; 246(3): 887 - 894. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. B. Silberstein Comparison of Outcomes After 123I Versus 131I Preablation Imaging Before Radioiodine Ablation in Differentiated Thyroid Carcinoma J. Nucl. Med., July 1, 2007; 48(7): 1043 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K. Gerard and H.-M. Park Stunning Effect J. Nucl. Med., February 1, 2007; 48(2): 328 - 329. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Hackshaw, C. Harmer, U. Mallick, M. Haq, and J. A. Franklyn 131I Activity for Remnant Ablation in Patients with Differentiated Thyroid Cancer: A Systematic Review J. Clin. Endocrinol. Metab., January 1, 2007; 92(1): 28 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Sisson, A. M. Avram, S. A. Lawson, P. G. Gauger, and G. M. Doherty The So-Called Stunning of Thyroid Tissue J. Nucl. Med., September 1, 2006; 47(9): 1406 - 1412. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B Jarzab, D Handkiewicz-Junak, and J Wloch Juvenile differentiated thyroid carcinoma and the role of radioiodine in its treatment: a qualitative review Endocr. Relat. Cancer, December 1, 2005; 12(4): 773 - 803. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A F Leger, M Pellan, F Dagousset, A Chevalier, I Keller, and J Clerc A case of stunning of lung and bone metastases of papillary thyroid cancer after a therapeutic dose (3.7 GBq) of 131I and review of the literature: implications for sequential treatments Br. J. Radiol., May 1, 2005; 78(929): 428 - 432. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K. Gerard and H. Q. Dam Stunning with 131I Diagnostic Whole-Body Imaging of Patients with Thyroid Cancer * Dr Dam responds: Radiology, March 1, 2005; 234(3): 972 - 974. [Full Text] [PDF]
|
|
|
|
|
|
F. A Verburg, B. de Keizer, C. J M Lips, P. M J Zelissen, and J. M H de Klerk Prognostic significance of successful ablation with radioiodine of differentiated thyroid cancer patients Eur. J. Endocrinol., January 1, 2005; 152(1): 33 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Q. Dam, S. M. Kim, H. C. Lin, and C. M. Intenzo 131I Therapeutic Efficacy Is Not Influenced by Stunning after Diagnostic Whole-Body Scanning Radiology, August 1, 2004; 232(2): 527 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Lassmann, M. Luster, H. Hanscheid, and C. Reiners Impact of 131I Diagnostic Activities on the Biokinetics of Thyroid Remnants J. Nucl. Med., April 1, 2004; 45(4): 619 - 625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Sisson, B. L. Shulkin, and S. Lawson Increasing Efficacy and Safety of Treatments of Patients with Well-Differentiated Thyroid Carcinoma by Measuring Body Retentions of 131I J. Nucl. Med., June 1, 2003; 44(6): 898 - 903. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. L. Parthasarathy and E. S. Crawford Treatment of Thyroid Carcinoma: Emphasis on High-Dose 131I Outpatient Therapy J. Nucl. Med. Technol., December 1, 2002; 30(4): 165 - 171. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Robbins, S. M. Larson, N. Sinha, A. Shaha, C. Divgi, K. S. Pentlow, R. Ghossein, and R. M. Tuttle A Retrospective Review of the Effectiveness of Recombinant Human TSH as a Preparation for Radioiodine Thyroid Remnant Ablation J. Nucl. Med., November 1, 2002; 43(11): 1482 - 1488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Postgard, J. Himmelman, U. Lindencrona, N. Bhogal, D. Wiberg, G. Berg, S. Jansson, E. Nystrom, E. Forssell-Aronsson, and M. Nilsson Stunning of Iodide Transport by 131I Irradiation in Cultured Thyroid Epithelial Cells J. Nucl. Med., June 1, 2002; 43(6): 828 - 834. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Brenner Is Thyroid Stunning a Real Phenomenon or Just Fiction? J. Nucl. Med., June 1, 2002; 43(6): 835 - 836. [Full Text] [PDF]
|
|
|
|
|
|
A. S. Alzahrani, S. Bakheet, M. Al Mandil, A. Al-Hajjaj, A. Almahfouz, and A. Al Haj 123I Isotope as a Diagnostic Agent in the Follow-Up of Patients with Differentiated Thyroid Cancer: Comparison with Post 131I Therapy Whole Body Scanning J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5294 - 5300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. F. Morris, A. D. Waxman, and G. D. Braunstein The Nonimpact of Thyroid Stunning: Remnant Ablation Rates in 131I-Scanned and Nonscanned Individuals J. Clin. Endocrinol. Metab., August 1, 2001; 86(8): 3507 - 3511. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Diehl, F. Grunwald, and H. W.D. Yeung Stunning After Tracer Dosimetry J. Nucl. Med., July 1, 2001; 42(7): 1129 - 1129. [Full Text] [PDF]
|
|
|
|
|
|
E. L. Mazzaferri and R. T. Kloos Current Approaches to Primary Therapy for Papillary and Follicular Thyroid Cancer J. Clin. Endocrinol. Metab., April 1, 2001; 86(4): 1447 - 1463. [Full Text]
|
|
|
|
|
|
M T. Bajen, S. Mane, A. Munoz, and J. Ramon Garcia Effect of a Diagnostic Dose of 185 MBq 131I on Postsurgical Thyroid Remnants J. Nucl. Med., December 1, 2000; 41(12): 2038 - 2042. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
