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proLékaře.cz / Journals / Nuclear Medicine / 2018 - 2

Evaluation of the effectiveness of radioiodine ablation for differentiated thyroid carcinoma at low-risk patients

Czech version

Authors: Vladimír Dedek 1,2;  Hana Materová 1,3
Authors‘ workplace: Klinika nukleární medicíny, FN Ostrava, ČR 1;  Ústav zobrazovacích metod, 3 Katedra biomedicínských oborů, Lékařská fakulta, Ostravská univerzita v Ostravě, ČR 2
Published in: NuklMed 2018;7:22-31
Category: Original Article

Overview

Introduction:
Postoperative radioiodine (RJ) ablation (TERJ) with a preferred use of low dose can be indicated also at low-risk patients with a differentiated thyroid carcinoma (DTC) according to current guidelines.

Aim:
Assessment of TERJ effectivity used in low-risk patients with DTC after applying of 1.1 GBq of 131I.

Material:
61 pts (53 females) with a DTC after declared total thyroidectomy due to a papillary or papillary-follicular cancer (60 pts) and follicular cancer (1 pt). Classification according to the tumor volume was as follows: T1a 45 pts, T1b 10 pts, and T2 6 pts.

Methods:
Pts were admitted to our department at hypothyroidism; neck scintigraphy with the detection of residual thyroid tissue after surgery was assessed. Initial level of thyroglobulin (Tg) ranges from < 0.1 to 9.0 µg/l. Blood content of antibody against Tg (anti-Tg) was increased in 18 cases (0.9–333 U/ml). Radioiodine ablation dose of 1.1 GBq was applied in all pts. Rehospitalization again at hypothyroidism was performed 6 months later; whole-body scan was done after a diagnostic dose of 110 MBq 131I. Negative scintigraphy at the region of the neck together with a low level of Tg below 2 µg/l or decline of anti-Tg in pts with a low Tg <0.1 µg/l was considered as an effective TERJ.

Results:
Negative follow-up scintigraphy with no detectable thyroid tissue was present in 52/61 pts. The second criterion, i.e. level of Tg below 2 µg/l or decline of anti-Tg was present in all these pts; the therapeutic effectivity of TERJ was thus 85.2 %. TERJ was not effective in 9/61 pts (14.8 %).

Conclusion:
According to our experience, the efficacy of TERJ after applying of 1.1 GBq of 131I (85.2 %) is comparable to the literature and also to our previous results with a group of 131 pts after applying of 3.7 GBq of 131I form the years 2007 to 2012, when the therapeutic effectivity was 80 %.

Key Words:
low-risk differentiated thyroid carcinoma, radioiodine ablation, whole-body scintigraphy, level of thyroglobulin

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Nuclear medicine Radiodiagnostics Radiotherapy
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