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Thyroid Cancer pp 225–235Cite as

Stunning by 131I Scanning: Untoward Effect of 131I Thyroid Imaging Prior to Radioablation Therapy

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Abstract

Thyroid stunning is a temporary suppression of iodine-trapping function of the thyrocytes and thyroid cancer cells as a result of the radiation given off by the scanning (or first) dose of 131I. The stunned cells may not be able to take up the ensuing therapeutic 131I to the degree of their original unaffected capacity. This may lead to an incomplete ablation of the thyroid remnant or metastatic lesion. Stunning is radiation dose dependent, i.e., the higher the radiation dose absorbed by the target tissue, the greater the stunning effect. The use of 123I in lieu of 131I for diagnostic scanning avoids stunning, due to the 100-fold lower absorbed radiation dose. When 123I is not available or otherwise practical, other possible measures to reduce stunning include reducing the diagnostic 131I dose, decreasing the time between the dose and scan, and shortening the interval between scanning and 131I treatment.

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Acknowledgments

The authors are grateful to Drs. Richard Schnute, Christine Park, and Trudy Lionel for reviewing this article and rendering helpful suggestions and to Dr. S. Bae of Koshin University, Korea, for providing images for Figs. 16.2 and 16.4.

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Authors and Affiliations

  1. Department of Radiology, Indiana University Hospital, Indianapolis, IN, USA

    Hee-Myung Park MD

  2. Department of Nuclear Medicine, Department of Pathology, Seton Medical Center, 1900 Sullivan Avenue, Daly City, CA, 94015, USA

    Stephen K. Gerard MD, PhD

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  1. Hee-Myung Park MD
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Correspondence to Stephen K. Gerard MD, PhD .

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Editors and Affiliations

  1. Department of Medicine, MedStar Washington Hospital Center Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

  2. Nuclear Medicine Research MedStar Research Institute and Washington Hospital Center, Georgetown University School of Medicine Washington Hospital Center, Washington, DC, USA

    Douglas Van Nostrand

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Park, HM., Gerard, S.K. (2016). Stunning by 131I Scanning: Untoward Effect of 131I Thyroid Imaging Prior to Radioablation Therapy. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3314-3_16

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  • DOI: https://doi.org/10.1007/978-1-4939-3314-3_16

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