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

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Thyroid Cancer

Abstract

Thyroid stunning is a radiobiological phenomenon. It may be defined as 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 tissue-absorbed radiation dose from the scanning is often sufficient to cause hypofunction but usually not enough to destroy the target cells. The stunned cells may not be able to take up the ensuing therapeutic radioiodine-131 to the degree of their original unaffected capacity. It may lead to an incomplete ablation of the thyroid remnant or metastatic lesion. Stunning is radiation dose-dependent, i.e., the higher the radiation-absorbed dose to the target tissue, the greater the stunning effect. Stunning is a matter of quantity, not quality, and certainly is not an “all or none” phenomenon; there is a spectrum of severity. When severe, there is often a visually apparent reduction in uptake of the therapy dose of 131I in the target lesion when the diagnostic and posttherapy scans are compared. When mild, it may be noticeable only when the thyroid iodide uptake function is measured. However, the visual evidence of decreased radioiodine uptake caused by stunning could be confounded by one or more uncontrolled differences in technical and/or physiologic constraints between the diagnostic and posttreatment scans.

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Author information

Authors and Affiliations

  1. Indiana University, Indianapolis

    Hee-Myung Park MD (Professor Emeritus of Radiology, Professor of Nuclear Medicine)

  2. Kwandong University, Korea

    Hee-Myung Park MD (Professor Emeritus of Radiology, Professor of Nuclear Medicine)

  3. Nuclear Medicine, Seton Medical Center, Daly City, CA

    Stephen K. Gerard MD, PhD (Chief)

Authors
  1. Hee-Myung Park MD
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  2. Stephen K. Gerard MD, PhD
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Editors and Affiliations

  1. Washington Hospital Center, Washington, DC

    Leonard Wartofsky MD, MPH, MACP  & Douglas Van Nostrand MD, FACP, FACNP  & 

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© 2006 Humana Press Inc., Totowa, NJ

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Park, HM., Gerard, S.K. (2006). Stunning: Untoward Effect of 131I Thyroid Imaging Prior to Radioablation Therapy. In: Wartofsky, L., Van Nostrand, D. (eds) Thyroid Cancer. Humana Press. https://doi.org/10.1007/978-1-59259-995-0_36

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  • DOI: https://doi.org/10.1007/978-1-59259-995-0_36

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-462-3

  • Online ISBN: 978-1-59259-995-0

  • eBook Packages: MedicineMedicine (R0)

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