HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Supplemental Data Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hänscheid, H. Articles by Reiners, C. Search for Related Content PubMed PubMed Citation Articles by Hänscheid, H. Articles by Reiners, C.

Iodine Biokinetics and Dosimetry in Radioiodine Therapy of Thyroid Cancer: Procedures and Results of a Prospective International Controlled Study of Ablation After rhTSH or Hormone Withdrawal

¹ Klinik und Poliklinik für Nuklearmedizin, Universität Würzburg, Würzburg, Germany; ² Department of Radiology, University of Cinncinati, Cinncinati, Ohio; ³ Section of Endocrinology, Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy; ⁴ Section of Endocrinology, Department of Internal Medicine, Endocrinology and Metabolism, University of Siena, Siena, Italy; ⁵ Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland; ⁶ Division of Nuclear Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; ⁷ Service de Medicine Nucleaire et de Cancerologie Endocrinienne, Institut Gustave Roussy, Villejuif, France; ⁸ Department of Nuclear Medicine, London Health Sciences Centre, London, Ontario, Canada; ⁹ Divisions of Endocrinology and Nuclear Medicine, Departments of Internal Medicine and Radiology, The Ohio State University, Columbus, Ohio; ¹⁰ Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas M.D. Anderson Cancer Center, Houston, Texas; ¹¹ Division of Endocrinology, Department of Medicine, University of Colorado Health Sciences Center, Aurora, Colorado; and ¹² Department of Nuclear Medicine, Centre Rene Huguenin, Saint Cloud, France

Correspondence: For correspondence or reprints contact: Heribert Hänscheid, PhD, Klinik und Poliklinik für Nuklearmedizin, Universität Würzburg, Josef-Schneider-Strasse 2, D-97080 Würzburg, Germany. E-mail: haenscheid{at}nuklearmedizin.uni-wuerzburg.de

Technical aspects and results of the dosimetric assessments of postoperative radioiodine ablation in the framework of an international, prospective, controlled, randomized, comparative study of the effectiveness of ablation therapy with 3.7 GBq ¹³¹I in differentiated thyroid cancer after stimulation with recombinant human TSH (rhTSH) or by thyroid hormone withdrawal (THW) are presented. Methods: Sixty-three patients were randomized after thyroidectomy to either the THW or the rhTSH group. Scintigraphic neck images were acquired starting 48 h after radioiodine administration to assess biokinetics in the thyroid remnant. The activity in blood samples was quantified and data from whole-body probe measurements and scintigraphic whole-body scans were combined to deduce retention curves in blood and whole body, respectively. The absorbed dose to the blood was calculated using a modified approach based on the formalism of the MIRD Committee of the Society of Nuclear Medicine. Results: The effective half-time in the remnant thyroid tissue was significantly longer after rhTSH than THW (67.6 ± 48.8 vs. 48.0 ± 52.6 h, respectively; P = 0.01), whereas the observed differences of the mean 48-h ¹³¹I uptakes (0.5% ± 0.7% vs. 0.9% ± 1.0% after THW; P = 0.1) and residence times (0.9 ± 1.3 vs. 1.4 ± 1.5 h after THW; P = 0.1) between the rhTSH and THW groups were not statistically significant. The specific absorbed dose to the blood was significantly (P <0.0001) lower after administration of rhTSH (mean, 0.109 ± 0.028 mGy/MBq; maximum, 0.18 mGy/MBq) than after THW (mean, 0.167 ± 0.061 mGy/MBq; maximum, 0.35 mGy/MBq), indicating that higher activities of radioiodine might be safely administered after exogenous stimulation with rhTSH. Conclusion: Indication of an influence of the residence time of radioiodine in the blood on the fractional uptake into thyroid remnant was found. A novel regimen is proposed in which therapeutic activities to be administered are determined from the individual specific blood dose.

Key Words: differentiated thyroid cancer • radioiodine therapy • rhTSH • blood dose • dosimetry

Related articles in JNM:

This Month in JNM

JNM 2006 47: 9a-10a. [Full Text]  

This article has been cited by other articles:

				H. Remy, I. Borget, S. Leboulleux, N. Guilabert, F. Lavielle, J. Garsi, C. Bournaud, S. Gupta, M. Schlumberger, and M. Ricard 131I Effective Half-Life and Dosimetry in Thyroid Cancer Patients J. Nucl. Med., September 1, 2008; 49(9): 1445 - 1450. [Abstract] [Full Text] [PDF]

				I. D. Hay, I. R. McDougall, and J. C. Sisson Perspective: The Case Against Radioiodine Remnant Ablation in Patients with Well-Differentiated Thyroid Carcinoma J. Nucl. Med., August 1, 2008; 49(8): 1395 - 1397. [Abstract] [Full Text] [PDF]

				R. T. Kloos Approach to the Patient with a Positive Serum Thyroglobulin and a Negative Radioiodine Scan after Initial Therapy for Differentiated Thyroid Cancer J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 1519 - 1525. [Abstract] [Full Text] [PDF]

				A. Serna, M. Alcaraz, J. L. Navarro, C. Acevedo, V. Vicente, and M. Canteras Biological dosimetry and Bayesian analysis of chromosomal damage in thyroid cancer patients Radiat Prot Dosimetry, May 1, 2008; 129(4): 372 - 380. [Abstract] [Full Text] [PDF]

				T. Pilli, E. Brianzoni, F. Capoccetti, M. G. Castagna, S. Fattori, A. Poggiu, G. Rossi, F. Ferretti, E. Guarino, L. Burroni, et al. A Comparison of 1850 (50 mCi) and 3700 MBq (100 mCi) 131-Iodine Administered Doses for Recombinant Thyrotropin-Stimulated Postoperative Thyroid Remnant Ablation in Differentiated Thyroid Cancer J. Clin. Endocrinol. Metab., September 1, 2007; 92(9): 3542 - 3546. [Abstract] [Full Text] [PDF]

				M. Lassmann and H. Hanscheid Spatial Dose Mapping for Individualizing Radioiodine Treatment J. Nucl. Med., January 1, 2007; 48(1): 2 - 4. [Full Text] [PDF]

				G. Sgouros, H. Song, P. W. Ladenson, and R. L. Wahl Lung Toxicity in Radioiodine Therapy of Thyroid Carcinoma: Development of a Dose-Rate Method and Dosimetric Implications of the 80-mCi Rule J. Nucl. Med., December 1, 2006; 47(12): 1977 - 1984. [Abstract] [Full Text] [PDF]

				P Mernagh, S Campbell, M Dietlein, M Luster, E Mazzaferri, and A R Weston Cost-effectiveness of using recombinant human TSH prior to radioiodine ablation for thyroid cancer, compared with treating patients in a hypothyroid state: the German perspective Eur. J. Endocrinol., September 1, 2006; 155(3): 405 - 414. [Abstract] [Full Text] [PDF]