RT Journal Article SR Electronic T1 Comparison of Empiric Versus Whole-Body/-Blood Clearance Dosimetry–Based Approach to Radioactive Iodine Treatment in Patients with Metastases from Differentiated Thyroid Cancer JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 717 OP 722 DO 10.2967/jnumed.116.179606 VO 58 IS 5 A1 Deandreis, Désirée A1 Rubino, Carole A1 Tala, Hernan A1 Leboulleux, Sophie A1 Terroir, Marie A1 Baudin, Eric A1 Larson, Steve A1 Fagin, James A. A1 Schlumberger, Martin A1 Tuttle, R. Michael YR 2017 UL http://jnm.snmjournals.org/content/58/5/717.abstract AB The optimal management of radioactive iodine (RAI) treatment in patients with metastatic thyroid cancer (TC) is still a matter of debate. Methods: We retrospectively analyzed 352 patients with RAI-avid metastatic well-differentiated TC treated with 131I by an empiric fixed activity of 3.7 GBq at Gustave Roussy (GR, n = 231) or by personalized activity (2.7–18.6 GBq) based on whole-body/-blood clearance (WB/BC) dosimetry at Memorial Sloan Kettering Cancer Center (MSKCC, n = 121). The primary endpoint was to compare overall survival (OS) in the 2 groups of patients by log-rank test. Results: Patients received a median cumulative activity of 14.8 GBq at GR and 24.2 GBq at MSKCC (P < 0.0001). The median follow-up after the diagnosis of metastases was 7.2 y (0.4−31 y). Five-year OS was 86.8% and 78.8% for patients treated at GR and at MSKCC, respectively (P < 0.01). However, there was no statistical difference in OS after correction for sex, age at the diagnosis of distant metastases, metastases site, and metastases extension between the 2 centers (P = 0.16). OS at 5 y was 96% and 96% for patients younger than 40 y with micrometastases, 70% and 65% for patients older than 40 y with macrometastases or multiple metastases, and 92% and 87% for younger patients with macrometastases or older patients with micrometastases treated at GR and MSKCC, respectively (P = not significant). Conclusion: Routine use of WB/BC dosimetry without lesional dosimetry provided no OS advantage when compared with empiric fixed RAI activity in the management of thyroid cancer patients with RAI-avid distant metastases.