Home > Journals > The Quarterly Journal of Nuclear Medicine and Molecular Imaging > Past Issues > Articles online first > The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2018 Mar 08

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Cite this article as

 

 

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2018 Mar 08

DOI: 10.23736/S1824-4785.18.03029-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Radioiodine ablation in thyroid cancer patients: renal function and external radiation dose rate at discharge according to patient preparation

Yeon-Hee HAN 1, Hwan-Jeong JEONG 1, Myung-Hee SOHN 1, Sun Y. LEE 2, Seok T. LIM 1

1 Department of Nuclear Medicine, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, Republic of Korea; 2 Department of Radiation Oncology, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk, Republic of Korea


PDF


BACKGROUND: An elevated thyroid stimulating hormone (TSH) level is essential for the uptake of radioiodine into thyroid remnants and residual thyroid cancer in patients undergoing high-dose radioiodine therapy (HD-RIT). Recently, the use of recombinant human thyroid stimulating hormone (rh- TSH) has increased in preference over the conventional method of thyroid hormone withdrawal (THW). However, the clinical influences of the two methods, aside from the therapeutic effects, have not been widely evaluated. The aim of this work was to investigate the influences of the two methods, particularly on the renal function and external radiation dose rate (EDR) from patients undergoing HD-RIT.
METHODS: From February 2012 to November 2016, 667 patients (M:F=138:529, mean age: 47.7 ± 11.8 years), who underwent first HD-RIT (120, 150, or 180 mCi, 1 mCi = 37 MBq) for ablation of remnant thyroid tissue or residual thyroid cancer, were enrolled. Patients who were proven to have distant metastasis to lung or bone were excluded. Low- to high-risk patients based on 2015 American thyroid association management guidelines who underwent first HD-RIT in our department were included. The period from total thyroidectomy to HD-RIT was limited within 12 months. The following parameters were collected and evaluated: age, gender, histology type and TNM stage of thyroid cancer, glomerular filtration rate on the admission day for total thyroidectomy (baseline GFR), GFR on the day of HD-RIT (follow-up GFR), thyroglobulin (Tg) and thyroid stimulating hormone (TSH) levels on the day of HD-RIT, and EDR on the discharge day after HD-RIT.
RESULTS: There were 386 patients using the THW method and 281 patients choosing the rh-TSH method. The baseline GFR of the THW group (106±16 mL/min/1.73 m2) and that of the rh-TSH group (104±17 mL/min/1.73 m2) were within normal limits and there was no significant difference. However, follow- up GFR of the THW group (84±17 mL/min/1.73 m2) was much lower than that of the rh-TSH group (104±16 mL/min/1.73 m2) (P=0.000). In the THW group, the follow-up GFR decreased significantly (P=0.000), yet the follow-up GFR of the rh-TSH group was not statistically different when compared with its baseline GFR (P=0.142). EDRs were lower in all rh-TSH subgroups compared to those of THW subgroups with statistical significance. Tg and TSH levels were not different between the two groups, excluding a few small-sized subgroups analyses.
CONCLUSIONS: In this retrospective analysis of renal function and EDR, the use of rh-TSH appears to help maintain renal function and finally decrease EDR in contrast to the THW method when undergoing HD-RIT.


KEY WORDS: Thyroid cancer - Iodine radioisotope - Thyroid hormone - Thyrotropin

top of page