Skip to main content
SpringerLink
Log in

Treatment of Recurrent/Metastatic Thyroid Cancer with Radioactive Iodine

  • Chapter
  • First Online:
Management of Thyroid Nodules and Differentiated Thyroid Cancer

  • 1426 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317–22. doi:10.1001/jamaoto.2014.1.

    Article  PubMed  Google Scholar 

  2. Pellegriti G, Frasca F, Regalbuto C, Squatrito S, Vigneri R. Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol. 2013;2013:965212. doi:10.1155/2013/965212.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lepoutre-Lussey C, Deandreis D, Leboulleux S, Schlumberger M. Postoperative radioactive iodine administration for differentiated thyroid cancer patients. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):363–71. doi:10.1097/MED.0000000000000100.

    Article  CAS  PubMed  Google Scholar 

  4. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133. doi:10.1089/thy.2015.0020.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Carvalho DP, Ferreira AC. The importance of sodium/iodide symporter (NIS) for thyroid cancer management. Arq Bras Endocrinol Metabol. 2007;51(5):672–82.

    Article  PubMed  Google Scholar 

  6. Haymart MR, Banerjee M, Stewart AK, Koenig RJ, Birkmeyer JD, Griggs JJ. Use of radioactive iodine for thyroid cancer. JAMA. 2011;306(7):721–8. doi:10.1001/jama.2011.1139.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214. doi:10.1089/thy.2009.0110.

    Article  PubMed  Google Scholar 

  8. Mazzaferri EL, Kloos RT. Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86(4):1447–63. doi:10.1210/jcem.86.4.7407.

    Article  CAS  PubMed  Google Scholar 

  9. Scheffel RS, Zanella AB, Antunes D, Dora JM, Maia AL. Low recurrence rates in a cohort of differentiated thyroid carcinoma patients: a referral center experience. Thyroid. 2015;25(8):883–9. doi:10.1089/thy.2015.0077.

    Article  PubMed  Google Scholar 

  10. Suh YJ, Kwon H, Kim SJ, Choi JY, Lee KE, Park YJ, Park do J, Youn YK. Factors affecting the locoregional recurrence of conventional papillary thyroid carcinoma after surgery: a retrospective analysis of 3381 patients. Ann Surg Oncol. 2015;22(11):3543–9. doi:10.1245/s10434-015-4448-9.

    Article  PubMed  Google Scholar 

  11. Giovanella L, Clark PM, Chiovato L, Duntas L, Elisei R, Feldt-Rasmussen U, Leenhardt L, Luster M, Schalin-Jantti C, Schott M, Seregni E, Rimmele H, Smit J, Verburg FA. DIAGNOSIS OF ENDOCRINE DISEASE Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer: a clinical position paper. Eur J Endocrinol. 2014;171(2):R33–46. doi:10.1530/Eje-14-0148.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Jonklaas J. Role of radioactive iodine for adjuvant therapy and treatment of metastases. J Natl Compr Canc Netw. 2007;5(6):631–40.

    CAS  PubMed  Google Scholar 

  13. Schlumberger M, Baudin E. Serum thyroglobulin determination in the follow-up of patients with differentiated thyroid carcinoma. Eur J Endocrinol. 1998;138(3):249–52.

    Article  CAS  PubMed  Google Scholar 

  14. Giovanella L, Ceriani L, Suriano S, Ghelfo A, Maffioli M. Thyroglobulin measurement before rhTSH-aided 131I ablation in detecting metastases from differentiated thyroid carcinoma. Clin Endocrinol (Oxf). 2008;69(4):659–63. doi:10.1111/j.1365-2265.2008.03244.x.

    Article  CAS  Google Scholar 

  15. Toubeau M, Touzery C, Arveux P, Chaplain G, Vaillant G, Berriolo A, Riedinger JM, Boichot C, Cochet A, Brunotte F. Predictive value for disease progression of serum thyroglobulin levels measured in the postoperative period and after (131)I ablation therapy in patients with differentiated thyroid cancer. J Nucl Med. 2004;45(6):988–94.

    CAS  PubMed  Google Scholar 

  16. Aygun N. Imaging of recurrent thyroid cancer. Otolaryngol Clin North Am. 2008;41(6):1095–106. doi:10.1016/j.otc.2008.05.003. viii.

    Article  PubMed  Google Scholar 

  17. Westbury C, Vini L, Fisher C, Harmer C. Recurrent differentiated thyroid cancer without elevation of serum thyroglobulin. Thyroid. 2000;10(2):171–6.

    Article  CAS  PubMed  Google Scholar 

  18. do Rosario PWS, Borges MAR, Fagundes TA, Franco ACHM, Purisch S. Is stimulation of thyroglobulin (Tg) useful in low-risk patients with thyroid carcinoma and undetectable Tg on thyroxin and negative neck ultrasound? Clin Endocrinol (Oxf). 2005;62(2):121–5. doi:10.1111/j.1365-2265.2005.00212.x.

    Article  CAS  Google Scholar 

  19. Persoon AC, Jager PL, Sluiter WJ, Plukker JT, Wolffenbuttel BH, Links TP. A sensitive Tg assay or rhTSH stimulated Tg: what’s the best in the long-term follow-up of patients with differentiated thyroid carcinoma? PLoS One. 2007;2(8):e816. doi:10.1371/journal.pone.0000816.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Rosario PW, Furtado Mde S, Mineiro Filho AF, Lacerda RX, Calsolari MR. Value of diagnostic radioiodine whole-body scanning after initial therapy in patients with differentiated thyroid cancer at intermediate and high risk for recurrence. Thyroid. 2012;22(11):1165–9. doi:10.1089/thy.2012.0026.

    Article  CAS  PubMed  Google Scholar 

  21. de Meer SG, Vriens MR, Zelissen PM, Borel Rinkes IH, de Keizer B. The role of routine diagnostic radioiodine whole-body scintigraphy in patients with high-risk differentiated thyroid cancer. J Nucl Med. 2011;52(1):56–9. doi:10.2967/jnumed.110.080697.

    Article  PubMed  Google Scholar 

  22. Hoang JK, Sosa JA, Nguyen XV, Galvin PL, Oldan JD. Imaging thyroid disease: updates, imaging approach, and management pearls. Radiol Clin North Am. 2015;53(1):145–61. doi:10.1016/j.rcl.2014.09.002.

    Article  PubMed  Google Scholar 

  23. Al-Qahtani KH, Al Asiri M, Tunio MA, Aljohani NJ, Bayoumi Y, Munir I, AlAyoubi A. Nasolacrimal duct obstruction following radioactive iodine 131 therapy in differentiated thyroid cancers: review of 19 cases. Clin Ophthalmol. 2014;8:2479–84. doi:10.2147/OPTH.S71708.

    PubMed  PubMed Central  Google Scholar 

  24. Kucuk ON, Gultekin SS, Aras G, Ibis E. Radioiodine whole-body scans, thyroglobulin levels, 99mTc-MIBI scans and computed tomography: results in patients with lung metastases from differentiated thyroid cancer. Nucl Med Commun. 2006;27(3):261–6.

    Article  PubMed  Google Scholar 

  25. Piekarski JD, Schlumberger M, Leclere J, Couanet D, Masselot J, Parmentier C. Chest computed tomography (CT) in patients with micronodular lung metastases of differentiated thyroid carcinoma. Int J Radiat Oncol Biol Phys. 1985;11(5):1023–7.

    Article  CAS  PubMed  Google Scholar 

  26. Lal G, Fairchild T, Howe JR, Weigel RJ, Sugg SL, Menda Y. PET-CT scans in recurrent or persistent differentiated thyroid cancer: is there added utility beyond conventional imaging? Surgery. 2010;148(6):1082–9. doi:10.1016/j.surg.2010.09.015; discussion 1089–1090.

    Article  PubMed  Google Scholar 

  27. Leboulleux S, Schroeder PR, Schlumberger M, Ladenson PW. The role of PET in follow-up of patients treated for differentiated epithelial thyroid cancers. Nat Clin Pract Endocrinol Metab. 2007;3(2):112–21. doi:10.1038/ncpendmet0402.

    Article  PubMed  Google Scholar 

  28. Grant CS. Recurrence of papillary thyroid cancer after optimized surgery. Gland Surg. 2015;4(1):52–62. doi:10.3978/j.issn.2227-684X.2014.12.06.

    PubMed  PubMed Central  Google Scholar 

  29. Lewis BD, Hay ID, Charboneau JW, McIver B, Reading CC, Goellner JR. Percutaneous ethanol injection for treatment of cervical lymph node metastases in patients with papillary thyroid carcinoma. AJR Am J Roentgenol. 2002;178(3):699–704. doi:10.2214/ajr.178.3.1780699.

    Article  CAS  PubMed  Google Scholar 

  30. Lim CY, Yun JS, Lee J, Nam KH, Chung WY, Park CS. Percutaneous ethanol injection therapy for locally recurrent papillary thyroid carcinoma. Thyroid. 2007;17(4):347–50. doi:10.1089/thy.2006.0251.

    Article  CAS  PubMed  Google Scholar 

  31. Magarey MJ, Freeman JL. Recurrent well-differentiated thyroid carcinoma. Oral Oncol. 2013;49(7):689–94. doi:10.1016/j.oraloncology.2013.03.434.

    Article  PubMed  Google Scholar 

  32. Ito Y, Kudo T, Kobayashi K, Miya A, Ichihara K, Miyauchi A. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5,768 patients with average 10-year follow-up. World J Surg. 2012;36(6):1274–8. doi:10.1007/s00268-012-1423-5.

    Article  PubMed  Google Scholar 

  33. Patron V, Hitier M, Bedfert C, Le Clech G, Jegoux F. Occult lymph node metastases increase locoregional recurrence in differentiated thyroid carcinoma. Ann Otol Rhinol Laryngol. 2012;121(5):283–90.

    Article  PubMed  Google Scholar 

  34. Ilgan S, Karacalioglu AO, Pabuscu Y, Atac GK, Arslan N, Ozturk E, Gunalp B, Ozguven MA. Iodine-131 treatment and high-resolution CT: results in patients with lung metastases from differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2004;31(6):825–30. doi:10.1007/s00259-004-1460-x.

    Article  CAS  PubMed  Google Scholar 

  35. Samaan NA, Schultz PN, Haynie TP, Ordonez NG. Pulmonary metastasis of differentiated thyroid carcinoma: treatment results in 101 patients. J Clin Endocrinol Metab. 1985;60(2):376–80. doi:10.1210/jcem-60-2-376.

    Article  CAS  PubMed  Google Scholar 

  36. Durante C, Haddy N, Baudin E, Leboulleux S, Hartl D, Travagli JP, Caillou B, Ricard M, Lumbroso JD, De Vathaire F, Schlumberger M. Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. J Clin Endocrinol Metab. 2006;91(8):2892–9. doi:10.1210/jc.2005-2838.

    Article  CAS  PubMed  Google Scholar 

  37. Sawka AM, Ibrahim-Zada I, Galacgac P, Tsang RW, Brierley JD, Ezzat S, Goldstein DP. Dietary iodine restriction in preparation for radioactive iodine treatment or scanning in well-differentiated thyroid cancer: a systematic review. Thyroid. 2010;20(10):1129–38. doi:10.1089/thy.2010.0055.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Padovani RP, Maciel RM, Kasamatsu TS, Freitas BC, Marone MM, Camacho CP, Biscolla RP. Assessment of the effect of two distinct restricted iodine diet durations on urinary iodine levels (collected over 24 h or as a single-spot urinary sample) and Na(+)/I(−) symporter expression. Eur Thyroid J. 2015;4(2):99–105. doi:10.1159/000433426.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Jury HPT, Castagna MG, Fioravanti C, Cipri C, Brianzoni E, Pacini F. Lack of association between urinary iodine excretion and successful thyroid ablation in thyroid cancer patients. J Clin Endocr Metab. 2010;95(1):230–7. doi:10.1210/jc.2009-1624.

    Article  CAS  Google Scholar 

  40. Schlumberger M, Lacroix L, Russo D, Filetti S, Bidart JM. Defects in iodide metabolism in thyroid cancer and implications for the follow-up and treatment of patients. Nat Clin Pract Endocrinol Metab. 2007;3(3):260–9. doi:10.1038/ncpendmet0449.

    Article  CAS  PubMed  Google Scholar 

  41. Leboeuf R, Perron P, Carpentier AC, Verreault J, Langlois MF. L-T3 preparation for whole-body scintigraphy: a randomized-controlled trial. Clin Endocrinol (Oxf). 2007;67(6):839–44. doi:10.1111/j.1365-2265.2007.02972.x.

    Article  CAS  Google Scholar 

  42. Lim DJ, Kim WB, Kim BH, Kim TY, Jo YS, Kang HC, Park YJ, Yi KH, Shong M, Kim IJ, Park do J, Kim SW, Chung JH, Lee J, Koong SS, Shong YK. Differences in physicians’ and patients’ perception of acute hypothyroid symptoms induced by thyroid hormone withdrawal in thyroid cancer patients: a multicenter survey in Korea. Eur Thyroid J. 2015;4(1):48–54. doi:10.1159/000371512.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Marturano I, Russo M, Spadaro A, Latina A, Malandrino P, Regalbuto C. Comparison of conventional L-thyroxine withdrawal and moderate hypothyroidism in preparation for whole-body 131-I scan and thyroglobulin testing. J Endocrinol Invest. 2015;38(9):1017–22. doi:10.1007/s40618-015-0318-3.

    Article  CAS  PubMed  Google Scholar 

  44. Luster M, Lassmann M, Haenscheid H, Michalowski U, Incerti C, Reiners C. Use of recombinant human thyrotropin before radioiodine therapy in patients with advanced differentiated thyroid carcinoma. J Clin Endocr Metab. 2000;85(10):3640–5. doi:10.1210/jc.85.10.3640.

    Article  CAS  PubMed  Google Scholar 

  45. Robbins RJ, Driedger A, Magner J. Recombinant human thyrotropin-assisted radioiodine therapy for patients with metastatic thyroid cancer who could not elevate endogenous thyrotropin or be withdrawn from thyroxine. Thyroid. 2006;16(11):1121–30. doi:10.1089/thy.2006.16.1121.

    Article  CAS  PubMed  Google Scholar 

  46. Luster M, Lippi F, Jarzab B, Perros P, Lassmann M, Reiners C, Pacini F. rhTSH-aided radioiodine ablation and treatment of differentiated thyroid carcinoma: a comprehensive review. Endocr Relat Cancer. 2005;12(1):49–64. doi:10.1677/erc.1.00830.

    Article  CAS  PubMed  Google Scholar 

  47. Tuttle RM, Lopez N, Leboeuf R, Minkowitz SM, Grewal R, Brokhin M, Omry G, Larson S. Radioactive iodine administered for thyroid remnant ablation following recombinant human thyroid stimulating hormone preparation also has an important adjuvant therapy function. Thyroid. 2010;20(3):257–63. doi:10.1089/thy.2009.0401.

    Article  CAS  PubMed  Google Scholar 

  48. Klubo-Gwiezdzinska J, Burman KD, Van Nostrand D, Mete M, Jonklaas J, Wartofsky L. Radioiodine treatment of metastatic thyroid cancer: relative efficacy and side effect profile of preparation by thyroid hormone withdrawal versus recombinant human thyrotropin. Thyroid. 2012;22(3):310–7. doi:10.1089/thy.2011.0235.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Tala H, Robbins R, Fagin JA, Larson SM, Tuttle RM. Five-year survival is similar in thyroid cancer patients with distant metastases prepared for radioactive iodine therapy with either thyroid hormone withdrawal or recombinant human TSH. J Clin Endocrinol Metab. 2011;96(7):2105–11. doi:10.1210/jc.2011-0305.

    Article  CAS  PubMed  Google Scholar 

  50. Tuttle RM, Leboeuf R, Robbins RJ, Qualey R, Pentlow K, Larson SM, Chan CY. Empiric radioactive iodine dosing regimens frequently exceed maximum tolerated activity levels in elderly patients with thyroid cancer. J Nucl Med. 2006;47(10):1587–91.

    PubMed  Google Scholar 

  51. Kulkarni K, Van Nostrand D, Atkins F, Aiken M, Burman K, Wartofsky L. The relative frequency in which empiric dosages of radioiodine would potentially overtreat or undertreat patients who have metastatic well-differentiated thyroid cancer. Thyroid. 2006;16(10):1019–23. doi:10.1089/thy.2006.16.1019.

    Article  CAS  PubMed  Google Scholar 

  52. Chao M. Management of differentiated thyroid cancer with rising thyroglobulin and negative diagnostic radioiodine whole body scan. Clin Oncol (R Coll Radiol). 2010;22(6):438–47. doi:10.1016/j.clon.2010.05.005.

    Article  CAS  Google Scholar 

  53. Pacini F, Agate L, Elisei R, Capezzone M, Ceccarelli C, Lippi F, Molinaro E, Pinchera A. Outcome of differentiated thyroid cancer with detectable serum Tg and negative diagnostic (131)I whole body scan: comparison of patients treated with high (131)I activities versus untreated patients. J Clin Endocrinol Metab. 2001;86(9):4092–7. doi:10.1210/jcem.86.9.7831.

    Article  CAS  PubMed  Google Scholar 

  54. Sherman SI, Tielens ET, Sostre S, Wharam Jr MD, Ladenson PW. Clinical utility of posttreatment radioiodine scans in the management of patients with thyroid carcinoma. J Clin Endocrinol Metab. 1994;78(3):629–34. doi:10.1210/jcem.78.3.8126134.

    CAS  PubMed  Google Scholar 

  55. Alzahrani AS, Bakheet S, Al Mandil M, Al-Hajjaj A, Almahfouz A, Al Haj A. 123I isotope as a diagnostic agent in the follow-up of patients with differentiated thyroid cancer: comparison with post 131I therapy whole body scanning. J Clin Endocrinol Metab. 2001;86(11):5294–300. doi:10.1210/jcem.86.11.8030.

    Article  CAS  PubMed  Google Scholar 

  56. Fard-Esfahani A, Emami-Ardekani A, Fallahi B, Fard-Esfahani P, Beiki D, Hassanzadeh-Rad A, Eftekhari M. Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma. Nucl Med Commun. 2014;35(8):808–17. doi:10.1097/MNM.0000000000000132.

    CAS  PubMed  Google Scholar 

  57. Van Nostrand D, Neutze J, Atkins F. Side effects of “rational dose” iodine-131 therapy for metastatic well-differentiated thyroid carcinoma. J Nucl Med. 1986;27(10):1519–27.

    PubMed  Google Scholar 

  58. Kim J-h, Yoo WS, Park YJ, Park DJ, Yun TJ, Choi SH, Sohn C-H, Lee KE, Sung M-W, Youn Y-K, Kim KH, Cho BY. Efficacy and safety of radiofrequency ablation for treatment of locally recurrent thyroid cancers smaller than 2 cm. Radiology 2015;276(3):909–18. doi:http://dx.doi.org/10.1148/radiol.15140079.

  59. Sawka AM, Thabane L, Parlea L, Ibrahim-Zada I, Tsang RW, Brierley JD, Straus S, Ezzat S, Goldstein DP. Second primary malignancy risk after radioactive iodine treatment for thyroid cancer: a systematic review and meta-analysis. Thyroid. 2009;19(5):451–7. doi:10.1089/thy.2008.0392.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition and Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Naykky Singh Ospina MD & M. Regina Castro MD

  2. Knowledge and Evaluation Research Unit, Division of Endocrinology, Mayo Clinic, Rochester, MN, USA

    Naykky Singh Ospina MD

Authors
  1. Naykky Singh Ospina MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Regina Castro MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Regina Castro MD .

Editor information

Editors and Affiliations

  1. Endocrine Surgery, Department of Surgery, Duke University Medical Center Duke Cancer Institute, Durham, North Carolina, USA

    Sanziana A. Roman

  2. Department of Surgery, Duke University Medical Center Duke Cancer Institute, Durham, North Carolina, USA

    Julie Ann Sosa

  3. Division of Surgical Oncology and Endocrine Surgery, Vanderbilt Endocrine Surgery Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA

    Carmen C. Solórzano

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Singh Ospina, N., Castro, M.R. (2017). Treatment of Recurrent/Metastatic Thyroid Cancer with Radioactive Iodine. In: Roman, S., Sosa, J., Solórzano, C. (eds) Management of Thyroid Nodules and Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-43618-0_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43618-0_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43616-6

  • Online ISBN: 978-3-319-43618-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation