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Radioiodine Scan Index: A Simplified, Quantitative Treatment Response Parameter for Metastatic Thyroid Carcinoma

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Abstract

Purpose

We aimed to develop and validate a simplified, novel quantification method for radioiodine whole-body scans (WBSs) as a predictor for the treatment response in differentiated thyroid carcinoma (DTC) patients with distant metastasis.

Methods

We retrospectively reviewed serial WBSs after radioiodine treatment from 2008 to 2011 in patients with metastatic DTC. For standardization of TSH simulation, only a subset of patients whose TSH level was fully enhanced (TSH > 80 mU/l) was enrolled. The radioiodine scan index (RSI) was calculated by the ratio of tumor-to-brain uptake. We compared correlations between the RSI and TSH-stimulated serum thyroglobulin (TSH_s_Tg) level and between the RSI and Tg reduction rate of consecutive radioiodine treatments.

Results

A total of 30 rounds of radioiodine treatment for 15 patients were eligible. Tumor histology was 11 papillary and 4 follicular subtypes. The TSH_s_Tg level was mean 980 ng/ml (range, 0.5–11,244). The Tg reduction rate after treatment was a mean of −7 % (range, −90 %–210 %). Mean RSI was 3.02 (range, 0.40–10.97). RSI was positively correlated with the TSH_s_Tg level (R2 = 0.3084, p = 0.001) and negatively correlated with the Tg reduction rate (R2 = 0.2993, p = 0.037). The regression equation to predict treatment response was as follows: Tg reduction rate = −14.581 × RSI + 51.183.

Conclusions

Use of the radioiodine scan index derived from conventional WBS is feasible to reflect the serum Tg level in patients with metastatic DTC, and it may be useful for predicting the biologic treatment response after radioiodine treatment.

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Disclosure

Conflict of interest

Jong-Ryool Oh, Byeong-Cheol Ahn, Shin Young Jeong, Sang-Woo Lee and Jaetae Lee declare that they have no conflict of interest.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study. Additional informed consent was obtained from all patients for which identifying information is included in this article.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, 50, Samduk 2-ga, Jung gu, Daegu, Republic of Korea, 700-721

    Jong-Ryool Oh, Byeong-Cheol Ahn, Shin Young Jeong, Sang-Woo Lee & Jaetae Lee

  2. Department of Nuclear Medicine, Raphael Hospital, 303, Jungang-daero, Jung-gu, Daegu, Republic of Korea, 700-803

    Jong-Ryool Oh

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  1. Jong-Ryool Oh
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Correspondence to Byeong-Cheol Ahn.

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Oh, JR., Ahn, BC., Jeong, S.Y. et al. Radioiodine Scan Index: A Simplified, Quantitative Treatment Response Parameter for Metastatic Thyroid Carcinoma. Nucl Med Mol Imaging 49, 174–181 (2015). https://doi.org/10.1007/s13139-015-0335-3

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  • DOI: https://doi.org/10.1007/s13139-015-0335-3

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