REVIEW  RAI THERAPY IN ADVANCED DIFFERENTIATED THYROID CANCER: FOCUS ON DOSIMETRY Free access

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 September;63(3):258-66

DOI: 10.23736/S1824-4785.19.03211-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Major limits of dosimetrically determined activities in advanced differentiated thyroid carcinoma

Monica FINESSI ✉, Virginia LIBERINI, Désirée DEANDREIS

Division of Nuclear Medicine, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy

The 2013/59 EURATOM directive defines all nuclear medicine applications for therapeutic purpose as a form of radiotherapy and underlines the need of both justification and optimization of these procedures, including radioactive iodine therapy (RAIT) with [131I] for metastatic differentiated thyroid cancer (DTC). In metastatic DTC, optimal activity to be administered to achieve the best response rate with limited toxicity is still a matter of debate and international guidelines do not provide univocal recommendations on the preferable use of empiric versus a dosimetry-based approach in these patients. The purpose of this literature review is to describe the possible limits of dosimetry in RAIT planning according to methodological aspects, tumoral heterogeneity and to report clinical data on the impact on patients’ outcome of different approaches. Due to the lack of standardized dosimetry protocols and clinical data assessing the superiority of a dosimetry-based vs an empiric approach in these patients, there is a need of standardisation and prospective, properly conducted studies to validate and to assess the best approach.

KEY WORDS: Radiometry; Thyroid neoplasms; Lymphatic metastasis