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Treatment of Recurrent/Metastatic Thyroid Cancer with Radioactive Iodine

  • Naykky Singh Ospina
  • M. Regina CastroEmail author
Chapter

Abstract

Radioactive iodine treatment is indicated in patients with differentiated thyroid cancer for remnant ablation and treatment of micrometastases, for recurrent local disease not amenable to surgery, and for treatment of distant metastases. The diagnosis of recurrent or distant metastatic disease in patients with differentiated thyroid cancer is based on the measurement of thyroglobulin levels and evaluation of a neck ultrasound, with further imaging reserved for patients with abnormal results. The preparation of patients who are to receive RAI treatment is based on a strategy of depleting the body iodine stores (by following a low iodine diet) and by increasing serum TSH levels (with thyroid hormone withdrawal or using recombinant human TSH). The dose of RAI to be used may be determined by dosimetry or by following an empiric treatment regimen. The use of RAI is associated with specific side effects and treatment burden that should be clearly discussed with patients.

Keywords

Thyroid cancer Radioactive iodine Thyroid hormone withdrawal Recombinant TSH Thyroglobulin 

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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Division of Endocrinology, Diabetes, Metabolism, and Nutrition and Department of Internal MedicineMayo ClinicRochesterUSA
  2. 2.Knowledge and Evaluation Research Unit, Division of EndocrinologyMayo ClinicRochesterUSA

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