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Guidelines for radioiodine therapy of differentiated thyroid cancer

  • M. Luster
  • S. E. Clarke
  • M. Dietlein
  • M. Lassmann
  • P. Lind
  • W. J. G. Oyen
  • J. Tennvall
  • E. Bombardieri
Guidelines

Abstract

Introduction

The purpose of the present guidelines on the radioiodine therapy (RAIT) of differentiated thyroid cancer (DTC) formulated by the European Association of Nuclear Medicine (EANM) Therapy Committee is to provide advice to nuclear medicine clinicians and other members of the DTC-treating community on how to ablate thyroid remnant or treat inoperable advanced DTC or both employing large 131-iodine (131I) activities.

Discussion

For this purpose, recommendations have been formulated based on recent literature and expert opinion regarding the rationale, indications and contraindications for these procedures, as well as the radioiodine activities and the administration and patient preparation techniques to be used. Recommendations also are provided on pre-RAIT history and examinations, patient counselling and precautions that should be associated with 131I iodine ablation and treatment. Furthermore, potential side effects of radioiodine therapy and alternate or additional treatments to this modality are reviewed. Appendices furnish information on dosimetry and post-therapy scintigraphy.

Keywords

Radioiodine therapy Thyroid remnant ablation Radioiodine treatment Guidelines 

Abbreviations

beta-hCG

beta human chorionic gonadotropin

Bq

Becquerel

Ci

Curie

CT

computed tomography

DTC

differentiated thyroid carcinoma

dxWBS

diagnostic whole-body scan

EANM

European Association of Nuclear Medicine

Gy

Gray

123I

123-iodine

124I

124-iodine

131I

131-sodium or potassium iodide

LT3

triiodothyronine

LT4

levothyroxine

NIS

sodium iodine symporter

PET

positron emission tomography

QOL

quality-of-life

rhTSH

recombinant human thyroid-stimulating hormone

RAIT

radioiodine therapy

ROI

region of interest

rxWBS

post-therapy whole-body scan

SPECT

single photon emission computed tomography

Tg

serum thyroglobulin

THW

thyroid hormone withdrawal or withholding

TSH

thyroid-stimulating hormone

US

ultrasonography

WBS

whole-body scan

XRT

external beam radiotherapy

Notes

Acknowledgments

The authors thank Professor Furio Pacini of the University of Siena and Robert J. Marlowe for their critical reviews of the manuscript. Development of this paper was supported by a grant from Genzyme Europe B.V.

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Copyright information

© EANM 2008

Authors and Affiliations

  • M. Luster
    • 1
  • S. E. Clarke
    • 2
  • M. Dietlein
    • 3
  • M. Lassmann
    • 1
  • P. Lind
    • 4
  • W. J. G. Oyen
    • 5
  • J. Tennvall
    • 6
  • E. Bombardieri
    • 7
  1. 1.Department of Nuclear MedicineUniversity of WürzburgWürzburgGermany
  2. 2.Guys and St. Thomas HospitalLondonUK
  3. 3.Department of Nuclear MedicineUniversity of CologneCologneGermany
  4. 4.Department of Nuclear Medicine and EndocrinologyPositron Emission Tomography/Computed Tomography CentreKlagenfurtAustria
  5. 5.Radboud University Nijmegen Medical CentreNijmegenThe Netherlands
  6. 6.Department of OncologyLund University HospitalLundSweden
  7. 7.National Cancer Institute FoundationMilanItaly

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