Dosimetry and thyroid cancer: the individual dosage of radioiodine

Abstract

Adjuvant therapy of differentiated thyroid cancer with radioactive iodine ( 131 I) is a standard procedure for the ablation of remnant thyroid tissue following surgery and for the treatment of iodine-avid metastases. Presently, there are two dosimetric concepts for the treatment of thyroid cancer using radioiodine: a) the bone marrow dose limited approach and b) lesion-based dosimetry. Both concepts and their clinical applications are described. In addition, the use of 124 I as a diagnostic and dosimetric agent is discussed. Treatment of children and adolescents with radioiodine requires special precautions; individualized approaches in this setting are reviewed. The limitations of treatments aiming at high absorbed doses are addressed as well as the doses to normal organs. Finally, new concepts for further elaborating the potential of thyroid cancer treatment using 131 I are introduced.

The role of 18F-fluorodeoxyglucose positron emission tomography in differentiated thyroid cancer before surgery

“…PET using new radiopharmaceuticals has not yet been fully evaluated. The clinical advantage of PET using 124 I is the generation of information regarding lesional dosimetry for 131 I treatment (Lassmann et al 2010). …”

The Environmental Dose Measurements of High Dose Iodine-131 Treated Thyroid Cancer Patients during Hospitalization Period

“…There is a broad range of the conventional fixed activities of 131 I recommended to be administered [4,5]. Normally, the activity is limited for safety reasons to around 7.4 GBq [6]. A summary on the use of fixed activities for the treatment of DTC can be found in a review articles [7][8][9].…”

The “reset button” revisited: why high activity 131I therapy of advanced differentiated thyroid cancer after dosimetry is advantageous for patients

“…For advanced DTC several 131 I activity selection strategies are available [7][8][9][10][11]. The most commonly used approach is empirical activity selection, in which the physician chooses an activity based on convention, experience and patient-related parameters.…”