TITLE

Radioactive Body Burden Measurements in 131Iodine Therapy for Differentiated Thyroid Cancer: Effect of Recombinant Thyroid Stimulating Hormone in Whole Body 131Iodine Clearance

AUTHOR(S)
Ravichandran, Ramamoorthy; Al Saadi, Amal; Al Balushi, Naima
PUB. DATE
January 2014
SOURCE
World Journal of Nuclear Medicine;Jan2014, Vol. 13 Issue 1, p56
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Protocols in the management of differentiated thyroid cancer, recommend adequate thyroid stimulating hormone (TSH) stimulation for radioactive 131I administrations, both for imaging and subsequent ablations. Commonly followed method is to achieve this by endogenous TSH stimulation by withdrawal of thyroxine. Numerous studies worldwide have reported comparable results with recombinant human thyroid stimulating hormone (rhTSH) intervention as conventional thyroxine hormone withdrawal. Radiation safety applications call for the need to understand radioactive 131I (RA131I) clearance pattern to estimate whole body doses when this new methodology is used in our institution. A study of radiation body burden estimation was undertaken in two groups of patients treated with RA131I; (a) one group of patients having thyroxine medication suspended for 5 weeks prior to therapy and (b) in the other group retaining thyroxine support with two rhTSH injections prior to therapy with RA131I. Sequential exposure rates at 1 m in the air were measured in these patients using a digital auto-ranging beta gamma survey instrument calibrated for measurement of exposure rates. The mean measured exposure rates at 1 m in µSv/h immediately after administration and at 24 h intervals until 3 days are used for calculating of effective ² time of clearance of administered activity in both groups of patients, 81 patients in conventionally treated group (stop thyroxine) and 22 patients with rhTSH administration. The 131I activities ranged from 2.6 to 7.9 GBq. The mean administered 131I activities were 4.24 ± 0.95 GBq (n = 81) in "stop hormone" group and 5.11 ± 1.40 GBq (n = 22) in rhTSH group. The fall of radioactive body burden showed two clearance patterns within observed 72 h. Calculated T²eff values were 16.45 h (stop hormone group) 12.35 h (rhTSH group) for elapsed period of 48 h. Beyond 48 h post administration, clearance of RA131I takes place with T²eff > 20 h in both groups. Neck and stomach exposure rate measurements showed reduced uptakes in the neck for rhTSH patients compared with "stop thyroxine" group and results are comparable with other studies. Whole body clearance is faster for patients with rhTSH injection, resulting in less whole body absorbed doses, and dose to blood. These patients clear circulatory radioactivity faster, enabling them to be discharged sooner, thus reduce costs of the hospitalization. Reduction in background whole body count rate may improve the residual thyroid images in whole body scan. rhTSH provides TSH stimulation without withdrawal of thyroid hormone and hence can help patients to take up therapy without hormone deficient problems in the withdrawn period prior to RA131I therapy. This also will help in reducing the restriction time periods for patients to mix up with the general population and children.
ACCESSION #
97536796

 

Related Articles

  • Associations between Gene Expression Variations and Ovarian Cancer Risk Alleles Identified from Genome Wide Association Studies. Hua Zhao; Jie Shen; Wang, Dan; Gregory, Steven; Medico, Leonardo; Qiang Hu; Li Yan; Kunle Odunsi; Shashikant Lele; Song Liu // PLoS ONE;Nov2012, Vol. 7 Issue 11, Special section p1 

    Functional genetic variations play important roles in shaping phenotypic differences among individuals through affecting gene expression, and thus, very likely to influence disease susceptibility, such as cancer susceptibility. One critical question in this era of post-genome wide association...

  • Prognostic Implications of Radioiodine Avidity and Serum Thyroglobulin in Differentiated Thyroid Carcinoma with Distant Metastasis. Kim, Hye Jeong; Lee, Ji In; Kim, Na Kyung; Min, Yong-Ki; Kim, Sun Wook; Chung, Jae Hoon // World Journal of Surgery;Dec2013, Vol. 37 Issue 12, p2845 

    Background: Although differentiated thyroid carcinoma (DTC) rarely develops distant metastases, the present study was performed to evaluate factors that affect the survival of patients with DTC who present with distant metastasis. Methods: Among 4,989 patients who underwent thyroid surgery for...

  • Recombinant Human Thyroid Stimulating Hormone versus Thyroid Hormone Withdrawal for Radioactive Iodine Treatment of Differentiated Thyroid Cancer with Nodal Metastatic Disease. Wolfson, Robert M.; Rachinsky, Irina; Morrison, Deric; Driedger, Al; Spaic, Tamara; Van Uum, Stan H. M. // Journal of Oncology;2/19/2016, p1 

    Introduction. Recombinant human thyroid stimulating hormone (rhTSH) is approved for preparation of thyroid remnant ablation with radioactive iodine (RAI) in low risk patients with well differentiated thyroid cancer (DTC). We studied the safety and efficacy of rhTSH preparation for RAI treatment...

  • Weight Changes in Patients with Differentiated Thyroid Carcinoma during Postoperative Long-Term Follow-up under Thyroid Stimulating Hormone Suppression. Seo Young Sohn; Ji Young Joung; Yoon Young Cho; Sun Mi Park; Sang Man Jin; Jae Hoon Chung; Sun Wook Kim // Endocrinology & Metabolism;Sep2015, Vol. 30 Issue 3, p343 

    Background: There are limited data about whether patients who receive initial treatment for differentiated thyroid cancer (DTC) gain or lose weight during long-term follow-up under thyroid stimulating hormone (TSH) suppression. This study was aimed to evaluate whether DTC patients under TSH...

  • INVESTIGATION OF THYROID NODULES IN THE FEMALE POPULATION IN CYPRUS AND IN ROMANIA. PICIU, ANDRA; ANDRIANOU, XANTHI D.; IRIMIE, ALEXANDRU; BĂLĂCESCU, OVIDIU; ZIRA, CHRISTINA; BĂRBUŞ, ELENA; PEŞTEAN, CLAUDIU; ARISTEIDOU, KYRIAKOS; THEOFANOUS, THALIA; AGATHOKLEOUS, MARGERITA; PICIU, DOINA; MAKRIS, KONSTANTINOS C. // Clujul Medical;2015, Vol. 88 Issue 4, p494 

    Background and aims. The most common thyroid disorders, with an increasing detection worldwide, are the thyroid nodules and thyroiditis, which leads to an increase of thyroid cancer incidence. In two different countries with a different exposure to risk factors for thyroid cancer, such as Cyprus...

  • 99mTc-Labeled-rhTSH Analogue (TR1401) for Imaging Poorly Differentiated Metastatic Thyroid Cancer. Galli, Filippo; Manni, Isabella; Piaggio, Giulia; Balogh, Lajos; Weintraub, Bruce D.; Szkudlinski, Mariusz W.; Fremont, Valerie; Dierckx, Rudi A.J.O.; Signore, Alberto // Thyroid;Aug2014, Vol. 24 Issue 8, p1297 

    Background: Differentiated thyroid carcinomas originating from thyroid follicular cells are frequent tumors of the thyroid with relatively good prognosis due to improved surgical techniques and follow-up procedures. Poorly differentiated thyroid cancers, which lose iodine uptake ability, in most...

  • Thyrotropin-α.  // Reactions Weekly;Apr2015, Vol. 1545 Issue 1, p233 

    The article discusses a study published in the October 2013 issue of the "European Journal of Nuclear Medicine and Molecular Imaging" that presented a case report of a follicular thyroid cancer patient who experienced pain following administration of thyrotropin-alpha.

  • Histone Deacetylase Inhibition Affects Sodium Iodide Symporter Expression and Induces 131I Cytotoxicity in Anaplastic Thyroid Cancer Cells. Pugliese, Mariateresa; Fortunati, Nicoletta; Germano, Antonina; Asioli, Sofia; Marano, Francesca; Palestini, Nicola; Frairia, Roberto; Boccuzzi, Giuseppe; Catalano, Maria Graziella // Thyroid;Jul2013, Vol. 23 Issue 7, p838 

    Background: Anaplastic thyroid cancers (ATCs) represent only 1%-2% of all thyroid tumors, but they account for up to 50% of the mortality. Treatment of differentiated thyroid carcinomas is well standardized and the use of radioiodine represents an essential step; in contrast, there is no...

  • Early post-treatment FDG PET predicts survival after Y microsphere radioembolization in liver-dominant metastatic colorectal cancer. Sabet, Amir; Meyer, Carsten; Aouf, Anas; Sabet, Amin; Ghamari, Shahab; Pieper, Claus; Mayer, Karin; Biersack, Hans-Jürgen; Ezziddin, Samer // European Journal of Nuclear Medicine & Molecular Imaging;Mar2015, Vol. 42 Issue 3, p370 

    Purpose: The aim of this study was to evaluate the predictive value of early metabolic response 4 weeks post-treatment using F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in patients with unresectable hepatic metastases of colorectal cancer (CRC) undergoing radioembolization...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics