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Review ArticleContinuing Education

Radioiodine Therapy for Thyroid Cancer in the Era of Risk Stratification and Alternative Targeted Therapies

Daniel A. Pryma and Susan J. Mandel
Journal of Nuclear Medicine September 2014, 55 (9) 1485-1491; DOI: https://doi.org/10.2967/jnumed.113.131508
Daniel A. Pryma
1Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and
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Susan J. Mandel
2Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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    FIGURE 1.

    A 54-y-old man presented with papillary thyroid cancer metastatic to lungs and lymph nodes. (A) After surgery, dosimetrically derived therapy was done, and anterior posttherapy scan is shown. Multiple subsequent treatments were given for residual disease. (B) Representative anterior posttherapy scan showing residual disease in lungs. (C) Anterior image from final diagnostic scan showing no remaining visible disease. In total, this patient received more than 74 GBq across multiple dosimetric treatments and achieved years of progression-free survival while maintaining acceptable hematologic and lung function.

  • FIGURE 2.
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    FIGURE 2.

    Various signaling pathways in cancers that are amenable to targeted therapies. Sorafenib has inhibitory effects on multiple pathways. EGFR = endothelial growth factor receptor; HIF-1 = hypoxia-inducible factor-1; HIF-2 = hypoxia-inducible factor-2; PDGF = platelet-derived growth factor; SF = sorafenib; TFGα = tumor growth factor α; VEGF = vascular endothelial growth factor; VHL = von Hippel Lindau. (Reprinted with permission of (54).)

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Journal of Nuclear Medicine: 55 (9)
Journal of Nuclear Medicine
Vol. 55, Issue 9
September 1, 2014
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Radioiodine Therapy for Thyroid Cancer in the Era of Risk Stratification and Alternative Targeted Therapies
Daniel A. Pryma, Susan J. Mandel
Journal of Nuclear Medicine Sep 2014, 55 (9) 1485-1491; DOI: 10.2967/jnumed.113.131508

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Radioiodine Therapy for Thyroid Cancer in the Era of Risk Stratification and Alternative Targeted Therapies
Daniel A. Pryma, Susan J. Mandel
Journal of Nuclear Medicine Sep 2014, 55 (9) 1485-1491; DOI: 10.2967/jnumed.113.131508
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  • Article
    • Abstract
    • THYROID CANCER PATHOPHYSIOLOGY, RADIOBIOLOGY, AND DEMOGRAPHICS
    • CURRENT UTILIZATION OF RADIOACTIVE IODINE THERAPY
    • PATIENT SELECTION
    • DOSE SELECTION
    • IODINE-REFRACTORY DISEASE
    • OPTIONS FOR IODINE-REFRACTORY DISEASE
    • CONCLUSION
    • Acknowledgments
    • Footnotes
    • REFERENCES
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Keywords

  • thyroid cancer
  • radioiodine therapy
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