• Title/Summary/Keyword: Iodine-131

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Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

  • Zaman, Maseeh Uz;Fatima, Nosheen;Padhy, Ajit Kumar;Zaman, Unaiza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6209-6213
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    • 2013
  • Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of non-randomized trials and evolving trends fueled by recently published randomized studies.

Iodine-131 S values for use in organ dose estimation of Korean patients in radioiodine therapy

  • Yeom, Yeon Soo;Shin, Bangho;Choi, Chansoo;Han, Haegin;Kim, Chan Hyeong
    • Nuclear Engineering and Technology
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    • v.54 no.2
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    • pp.689-700
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    • 2022
  • In the present study, iodine-131 S values (rT ← thyroid) were calculated for 30 target organs and tissues using the most recently developed Korean reference computational phantoms. The calculated S values were then compared with those of the International Commission on Radiological Protection (ICRP) reference computational phantoms to investigate the dosimetric impact of the Korean S values against those of the ICRP reference phantoms. The results showed significant differences in the S values due to the different anatomical/morphological characteristics between the Korean and ICRP reference phantoms. Most target organs/tissues showed that the S values of the Korean reference phantoms are lower than those of the ICRP reference phantoms, by up to about 4 times (male spleen and female thymus). Exceptionally, three target organs/tissues (gonads, thyroid, and extrathoracic region) showed that the S values of the Korean reference phantoms are greater, by 1.5-3.7 times. We expect that the S values calculated in the present study will be beneficially used to estimate organ/tissue doses of Korean patients under radioiodine therapy.

Acute Myelogenous Leukemia Developed after Radioactive Iodine Therapy and Palliative Radiation Therapy in Metastatic Papillary Thyroid Cancer (갑상선 유두암환자에서 방사성 옥소 치료와 고식적 방사선 치료 후 발생한 급성 골수성 백혈병)

  • Ko, Tae-Young;Kwag, Jae-Sik;Oh, Kyung-Suk;Lee, Seung-Bai;Chung, Byung-Sun;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.5
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    • pp.436-442
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    • 1998
  • Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.

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Comparison of the Measured Radiation Dose-rate by the Ionization Chamber and GM(Geiger-Müller) Counter After Radioactive Iodine Therapy in Differentiated Thyroid Cancer Patients (분화성 갑상선암환자의 방사성 요오드 치료시 전리함과 Geiger-Muller계수관에서 방사선량률 측정값 비교)

  • Park, Kwang-hun;Kim, Kgu-hwan
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.565-570
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    • 2016
  • Radioactive iodine($^{131}I$) treatment reduces recurrence and increases survival in patients with differentiated thyroid cancer. However, it is important in terms of radiation safety management to measure the radiation dose rate generated from the patient because the radiation emitted from the patient may cause the exposure. Research methods, it measured radiation dose-rate according to the elapsed time from 1 m from the upper abdomen of the patient by intake of radioactive iodine. Directly comparing the changes over time, high dose rate sensitivity and efficiency is statistically significant, and higher chamber than GM counter(p<0.05). Low dose rate sensitivity and efficiency in the chamber had lower levels than gm counter, but not statistically significant(p>0.05). In this study confirmed the characteristics of calibrated ionization chamber and GM counter according to the radiation intensity during high-dose radioactive iodine therapy by measuring the accurate and rapid radiation dose rate to the patient explains, discharged patients will be reduced to worry about radiation hazard of family and others person.

The Analysis of radioactivity Concentration in drainage when using a radioactive Iodine (방사성옥소 사용 시 배수 중 방사능농도 분석)

  • Lee, Kyung-Jae;Sul, Jin-Hyung;Park, Young-Jae;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.28-34
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    • 2018
  • Purpose With regard to the use of radioiodine in domestic medical institution, the case of exceeding the allowance of nuclear safety Act about radioactive concentration in drainage was found. Through understanding the cause of exceeding case and analyzing radioactive concentration in drainage, evaluating the relationship of the public waters in surroundings and usefulness. Materials and Methods From November 1, 2014 to April 30th, 2015, the research is aiming at domestic twenty hospitals for six months. By using a HPGe gamma-ray spectrometer(Canberra DSA-1000) and GENIE-2000 Analysis software for comparative analysis, measuring a radioactive concentration of radioiodine in drainage. Consequently, we confirm the excess of radioactive concentration of radioiodine in seven medical institutions. Results Conducting a survey of twenty hospitals and average radioactive concentration of radioiodine in drainage appears $42,100Bq/m^3$. The features of domestic hospitals where show a high radioactive concentration are a number of medical treatment patient when using radioactive iodine and the absence of private rest room. During I-131 whole body scan, the pretreatment procedure of urinating is considered emission of residual Iodine. In public waters, the cause of exceeding detect on radioactive concentration in drainage suppose a diagnostic radioactive iodine. Conclusion We confirm the importance of enhanced education, providing a safety control instructions and installing a private rest rooms for patients who injected a low capacity radioiodine. Also, constructing institutional and legal management system is considered about the Emission management standard in drainage.

Percutaneous Intranodular Injection Therapy of Radioactive Iodine-131 in Treatment of Benign Thyroid Nodules: A Preliminary Study (방사선 요오드-131의 국소주입에 의한 양성 갑상선 결절의 치료)

  • Ha Il-Joo;Lim Dong-Pyo;Yoon Jung-Han;JaeGal Young-Jong;Boom Hee-Seoung
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.174-178
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    • 2001
  • Background and Objective: Percutaneous ethanol injection therapy has been used in the treatment of the benign thyroid diseases. Although the reported side-effects of the therapy was mild and transient, some side-effects including local or radiating pain are troublesome to the patients. Radioactive iodine-131($Ra-^{131}I$) also has been effectively and safely used for management of the benign thyroid diseases. So we developed the percutaneous intranodular injection therapy of $Ra-^{131}I$ as an alternative of percutaneous ethanol injection therapy. Materials and Methods: From December 1998 to October 1999, we treated 29 outpatients (25 women and 4 men, mean age: $47{\pm}12$ years). Inclusion criteria were follows; age >30 years, cytologically benign, with normal thyroid function, cold nodule on thyroid scintigram, solid or mixed natured nodules in sonographical evaluation. Nodular volume was estimated by sonography according to the ellipsoid formula. $Ra-^{131}I$(0.1mCi/ml) was administered in a single dose injection. Follow-up studies every 3 months consisted of full history, thyroid function test, and sonography. We determined the therapeutic response is effective if the volume reduction of the nodule occurred above 30%. Results: After at least 3 months follow-up, 11 patients showed effective response, 12 patients showed minimal or unchanged response and 6 patients showed progression. Although side-effects such as injection pain, febrile reaction, and hormonal changes were absent, an infectious complication in injection site was developed from 1 case. Conclusion: Although we need a more prolonged follow-up to evaluate the delayed sequelae, we can suggest that percutaneous intranodular injection therapy of $Ra-^{131}I$ may be an attractive non-surgical treatment in selected cases of benign thyroid nodules.

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Management of Recurrent Thyroid Carcinoma with Negative Diagnostic Radioiodine Whole-Body Scan (진단적 방사성옥소 전신스캔이 음성인 갑상선 재발암의 진료)

  • Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.117-124
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    • 2001
  • Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

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Removal of radioactive methyliodide from the gas stream with a composite sorbent based on polyurethane foam

  • Obruchikov, Alexander V.;Magomedbekov, Eldar P.;Merkushkin, Aleksei O.
    • Nuclear Engineering and Technology
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    • v.52 no.5
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    • pp.1093-1097
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    • 2020
  • A composite iodine sorbent was obtained in the form of porous polymer matrix with activated carbon particles impregnated with triethylenediamine deposited on its surface. A comparative assessment of the radioactive methyliodide capturing efficiency by the composite sorbent and a sample of industrial charcoal sorbent was conducted. It was shown that under the selected testing conditions, the hydraulic resistance of the composite sorbent is lower, and the sorption capacity is higher than that of the industrial charcoal sorbent. A method for comparing the effectiveness of iodine sorbents, based on the calculation of the ratio of the sorption capacity index to the minimum capacity index, needed for the required purification degree was proposed.

Korean-specific iodine S values for use in internal dosimetry

  • Tae-Eun Kwon;Yoonsun Chung;Choonsik Lee
    • Nuclear Engineering and Technology
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    • v.55 no.12
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    • pp.4659-4663
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    • 2023
  • The use of iodine S values derived using the International Commission Radiological Protection (ICRP) phantoms may introduce significant bias in internal dosimetry for Koreans due to anatomical variability. In the current study, we produced an extensive dataset of Korean S values for selected five iodine radioisotopes (I-125, I-129, I131, I-133, and I-134) for use in radiation protection. To calculate S values, we implemented Monte Carlo simulations using the Mesh-type Reference Korean Phantoms (MRKPs), developed in a high-quality/fidelity mesh format. Noticeable differences were observed in S value comparisons between the Korean and ICRP reference phantoms with ratios (Korean/ICRP) widely ranging from 0.16 to 6.2. The majority of S value ratios were lower than the unity in Korean phantoms (interquartile range = 0.47-1.28; mean = 0.96; median = 0.69). The S values provided in the current study will be extensively utilized in iodine internal dosimetry for Koreans.

Mass Interception Fractions and Weathering Half-lives of Iodine-131 and Radiocesium in Leafy Vegetables Observed after the Fukushima Daiichi Nuclear Power Plant Accident

  • Tagami, Keiko;Uchida, Shigeo
    • Journal of Radiation Protection and Research
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    • v.46 no.4
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    • pp.178-183
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    • 2021
  • Background: This study was carried out to provide environmental transfer parameter values to estimate activity concentrations of these radionuclides in agricultural crops when direct contamination occurred. Materials and Methods: Mass interception fractions (FBs) and weathering half-lives (Tws) of 131I and radiocesium were calculated using openly available monitoring data obtained after the Fukushima Daiichi Nuclear Power Plant accident. FB is the ratio between the initial radioactivity concentration of a radionuclide retained by the edible part of the plant (Bq·kg-1 fresh weight [FW]) and the amount of deposited radionuclide in that area (Bq·m-2). Tw values can be calculated using activity concentrations of crops decreased with time after the initial contamination. Results and Discussion: Calculated FB and Tw values for 131I and radiocesium were mostly obtained for leafy vegetables. The analytical results showed that there was no difference of FBs between 131I and radiocesium by t-test; geometric mean values for leafy vegetables cultivated under outdoor conditions were 0.058 and 0.12 m2·kg-1 FW, respectively. Geometric mean Tw value of 131I in leafy vegetables grown under outdoor conditions was 8.6 days, and that of radiocesium was 6.6 days; there was no significant difference between Tw values of these radionuclides by Wilcoxon rank sum test. Conclusion: There was no difference between 131I and radiocesium for FBs and Tws. By using these factors, we would be able to carry out a rough estimation of the activity concentrations of 131I and radiocesium in the edible part of leafy crops when a nuclear accident occurred.