The biodistribution of radioiodine on posttherapy iodine-131 scans in thyroid cancer patients with chronic renal failure

Abstract

Patients with chronic renal failure exhibited significant salivary gland, oral, nasal, and gastric activity 1 week after radioiodine administration. The linear pattern of oral activity unresponsive to rinsing and persistence of gastric activity for 1 week might suggest adsorption of radioiodine to mucosal cells. Salivary gland dysfunction and the risk of second primary malignancy in iodine-concentrating organs appear as important indications for radioiodine dose reduction in this patient group.

Safe use of radiopharmaceuticals in patients with chronic kidney disease: a systematic review

“…The other study-performed in 10 patients, with four patients on CAPD and six patients on HD starting after 24 h-based their advice on higher and more persistent salivary gland, nasal, oral, and gastrointestinal uptake of [ 131 I]sodium iodine in this group of patients. In this study, six patients experienced persistent xerostomia and one patient a transient epistaxis (Aktaş et al 2008).…”

“…After a full-text screening we excluded another 31 studies for various reasons: they gave no relevant information on dosing or aspects related to dosing ( n = 18), they addressed only the radiation safety of staff ( n = 5), described renal imaging ( n = 5), or were review ( n = 3). A total of 34 studies remained for inclusion in this systematic review (Akers et al 2016 ; Aktaş et al 2008 ; Alevizaki et al 2006 ; Bhat et al 2017 ; Courbon et al 1997 , 2006 ; Culpepper et al 1992 ; Daumerie et al 1996 ; Demko et al 1998 ; Driedger et al 2006 ; El-Zeftawy et al 2017 ; Fofi et al 2013 ; Holst et al 2005 ; Howard and Glasser 1981 ; Jiménez et al 2001 ; Kaptein et al 2000 ; Kode et al 2017 ; Laffon et al 2008 ; Magné et al 2002 ; McKay and Malaroda 2019 ; McKillop et al 1985 ; Mello et al 1994 ; Minamimoto et al 2007 ; Miyasaka et al 1997 ; Morrish et al 1990 ; Pahlka and Sonnad 2006 ; Sinsakul and Ali 2004 ; Tobes et al 1989 ; Toriihara et al 2015 ; Toubert et al 2001 ; Vermandel et al 2020 ; Wang et al 2003 ; Willegaignon et al 2010 ; Yeyin et al 2016 ). The selection process is illustrated in a PRISMA flow diagram (Fig.…”

“…Two studies recommended a lower therapeutic dose in patients with CKD stage 5 but did not quantify the optimal dose (Aktaş et al 2008 ; Pahlka and Sonnad 2006 ). One of these studies based this recommended dose on a theoretical pharmacokinetic model that included both CAPD and HD with several regimes starting after 24 h or 48 h (Pahlka and Sonnad 2006 ).…”

“…Although the findings for therapeutic radiopharmaceuticals were limited, some studies indicated that dose adjustments in patients with CKD are important, and that altered biodistribution does affect therapeutic response and the risk of toxicity for non-target organs. A non-optimised dose in patients with CKD may lead to inadequate treatment (Aktaş et al 2008 ), increased radiation exposure (El-Zeftawy et al 2017 ), or an increased risk of adverse effects (for example, bone marrow toxicity, xerostomia, epistaxis, sialadenitis, or xerostomia from treatment with [ 131 I]sodium iodine) (Aktaş et al 2008 ; Alevizaki et al 2006 ; Holst et al 2005 ; Vermandel et al 2020 ).…”

“…In this case-control study, the standard uptake values (SUV)-normalised by body weight, as the control subjects had a greater body weight-in the gluteal muscles, subcutaneous fat, spleen, and right atrium were higher in patients on HD than in control subjects. The increased This study used a dose based on the 24-h radioiodine uptake and the weight of the gland (Demko et al 1998) Timing of dialysis should be consistent for both 24-h uptake study and treatment, and the most reasonable time for dialysis is 24 h after administration (Demko et al 1998) This study used a dose of approximately one-third of the dose based on the 24-h radioiodine uptake and the weight of the gland (Miyasaka et al 1997 Reconsider alternate treatment (Aktaş et al 2008) The dialysis frequency and the time interval between dose administration and dialysis can both be used effectively (Pahlka and Sonnad 2006) Lower therapeutic doses are recommended. The patient has to be administered around 75% of normal dose (Fofi et al 2013;Vermandel et al 2020) Daily HD until a safe value of radioactivity for discharge was reached (Fofi et al 2013) For metastatic patients pretherapeutic dosimetry studies are recommended (Vermandel et al 2020) Lower therapeutic doses are recommended.…”