| 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. | |
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MedLine Citation:
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PMID: 16595499 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Technical aspects and results of the dosimetric assessments of postoperative radioiodine ablation in the framework of an international, prospective, controlled, randomized, comparative study of the effectiveness of ablation therapy with 3.7 GBq (131)I in differentiated thyroid cancer after stimulation with recombinant human TSH (rhTSH) or by thyroid hormone withdrawal (THW) are presented. METHODS: Sixty-three patients were randomized after thyroidectomy to either the THW or the rhTSH group. Scintigraphic neck images were acquired starting 48 h after radioiodine administration to assess biokinetics in the thyroid remnant. The activity in blood samples was quantified and data from whole-body probe measurements and scintigraphic whole-body scans were combined to deduce retention curves in blood and whole body, respectively. The absorbed dose to the blood was calculated using a modified approach based on the formalism of the MIRD Committee of the Society of Nuclear Medicine. RESULTS: The effective half-time in the remnant thyroid tissue was significantly longer after rhTSH than THW (67.6 +/- 48.8 vs. 48.0 +/- 52.6 h, respectively; P = 0.01), whereas the observed differences of the mean 48-h (131)I uptakes (0.5% +/- 0.7% vs. 0.9% +/- 1.0% after THW; P = 0.1) and residence times (0.9 +/- 1.3 vs. 1.4 +/- 1.5 h after THW; P = 0.1) between the rhTSH and THW groups were not statistically significant. The specific absorbed dose to the blood was significantly (P <0.0001) lower after administration of rhTSH (mean, 0.109 +/- 0.028 mGy/MBq; maximum, 0.18 mGy/MBq) than after THW (mean, 0.167 +/- 0.061 mGy/MBq; maximum, 0.35 mGy/MBq), indicating that higher activities of radioiodine might be safely administered after exogenous stimulation with rhTSH. CONCLUSION: Indication of an influence of the residence time of radioiodine in the blood on the fractional uptake into thyroid remnant was found. A novel regimen is proposed in which therapeutic activities to be administered are determined from the individual specific blood dose. |
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Authors:
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Heribert Hänscheid; Michael Lassmann; Markus Luster; Stephen R Thomas; Furio Pacini; Claudia Ceccarelli; Paul W Ladenson; Richard L Wahl; Martin Schlumberger; Marcel Ricard; Al Driedger; Richard T Kloos; Steven I Sherman; Bryan R Haugen; Vincent Carriere; Carine Corone; Christoph Reiners |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 47 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-04-05 Completed Date: 2006-06-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 648-54 Citation Subset: IM |
Affiliation:
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Klinik und Poliklinik für Nuklearmedizin, Universität Würzburg, D-97080 Würzburg, Germany. haenscheid@nuklearmedizin.uni-wuerzburg.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Humans International Cooperation Iodine Radioisotopes / pharmacokinetics*, therapeutic use Prospective Studies Radiotherapy Dosage Recombinant Proteins / therapeutic use Thyroid Gland / drug effects, pathology, radiation effects* Thyroid Neoplasms / drug therapy, metabolism*, radiotherapy* Thyroidectomy Thyrotropin / therapeutic use* Thyroxine / administration & dosage, therapeutic use* Whole-Body Counting |
| Chemical | |
Reg. No./Substance:
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0/Iodine Radioisotopes; 0/Recombinant Proteins; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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