Radioiodine Therapy of Thyroid Cancer Dosimetry
Radioactive iodine therapy has been established in the management of patients with metastatic thyroid cancer therapy. The optimal activity to be administered has been under discussion since its first use. The activity can be determined using two approaches, empiric and dosimetry based. Administering an empirical activity is low cost and easy, and the rate and severity of side effects are well known and accepted. However, it can lead to undertreat or overtreat patients, due to the different specific characteristics of the iodine kinetics in each patient.
Therefore, an individual dosimetry-based approach is advisable to determine the correct activity to be administered in order to be effective and, at the same time, to limit severe side effects.
Here a simple method to perform individual dosimetry is proposed, based on the Committee on Medical Internal Radiation Dose schema. It can be applied both to perspective and peri-therapy dosimetry, depending on the goal and the available resources; since it improves awareness in taking a decision in patient’s management, it represents a powerful instrument to support clinical strategies aimed at improving safety and efficacy of treatments.
KeywordsThyroid cancer Radioactive iodine therapy Individual dosimetry Treatment optimization Perspective dosimetry Peri-therapy dosimetry
- 3.Benua RS, Cicale NR, Sonemberg M, Rawson RW. The relation of radioiodine dosimetry to results and complications in the treatment of metastatic thyroid cancer. Am J Roentgenol Radium Therapy, Nucl Med. 1962;87:171–82.Google Scholar
- 4.Benua RS, Leeper RD. A method and rationale for treating metastatic thyroid carcinoma with the largest safe dose of I-131. In: Medeiros-Neto G, Gaitan E, editors. Frontiers in thyroidology, vol. 2. New York: Plenum Medical Book; 1986. p. 1317–21.Google Scholar
- 5.Hurley JR, Becker DV. The use of radioiodine in the management of thyroid cancer. In: Freeman LM, Weissmann HS, editors. Nuclear medicine annual. New York: Raven Press; 1983. p. 329.Google Scholar
- 12.International Commission on Radiological Protection Publication 70. Basic anatomical & physiological data for use in radiological protection – the skeleton. In: Ann. Annals of the ICRP, vol 25(2). Oxford:Pergamon Press; 1995.Google Scholar
- 19.Heinsched H, et al. Iodine biokinetics and dosimetry in radioiodine therapy of thyroid cancer: procedures and results of a prospective international controlled study of ablation after rhTSH or hormone withdrawal. J Nucl Med. 2006;47:648–54.Google Scholar
- 23.Fard-Esfahani A, Emami-Ardekani A, Fallahi B, Fard-Esfahani P, Beikia D, Hassanzadeh-Rada A, Eftekharia M. Adverse effects of radioactive iodine-131 treatment for differentiated thyroid carcinoma. Nucl Med Commun. 2014;35:811–7.Google Scholar
- 24.Bolch WE, Bouchet LG, Robertson JS, Wessels BW, Siegel JA, Howell RW, Erdi AK, Aydogan B, Costes S, Watson EE. MIRD pamphlet no. 17: the dosimetry of nonuniform activity distributions—radionuclide S values at the voxel level. J Nucl Med. 1999;40:118–368.Google Scholar
- 26.Pettinato C, Monari F, Nanni C, Allegri V, Marcatili S, Civollani S, Cima S, Spezi E, Mazzarotto R, Fanti S. Usefulness of 124I PET/CT imaging to predict absorbed doses in patients affected by metastatic thyroid cancer and treated with 131I. Q J Nucl Med Mol Imaging. 2012;56:509–14.PubMedGoogle Scholar