• Title/Summary/Keyword: Radioiodine

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RADIOIODINE TREATMENT OF THYROID CANCER; RESULTS OF 88 CASES

  • Oyamada, Hiyoshimaru
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.1
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    • pp.29-36
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    • 1985
  • The results of radioiodine treatment of 88 patients are reported. As in the case presented above, careful follow-up with continuous administration of adequate amount of thyroid hormone is very important. To check whether recurrent lesions have appeared or not, scintigrams with test dose of $I^{131}$, usually 1 to 10 mCi, are taken in general. However, it is important that there is a fact that administration of much larger dose (30 to 100 mCi) of $I^{131}$ may result in presenting additional lesions on the scintigrams. Recently, clinical usefulness of serum thyroglobulin determination has been mentioned in literatures from the standpoint of follow-up study of patients after radioiodine treatment. Although this technique seems to be valuable, we have to be aware of the possibility of fluctuation of data which may occur in connection with administration of thyroid hormone. Finally, I would like to say that radioiodine treatment is an effective method for thyroid cancer if patients are adequately selected. However, radioiodine treatment itself is sometimes not enough from the standpoint of radiation dose to the lesions. In such cases, we should not hesitate to consider combination therapy with other modalities. Therefore, in order to overcome this undesirable disease, cooperation between nuclear medicine specialists and other oncologists, such as radiotherapists, is necessary.

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Thymic Radioiodine Uptake Mimicking Metastatic Papillary Carcinoma in the Anterior Mediastinum (갑상선암 환자에서 전종격동의 전이성 암처럼 보이는 흉선의 방사성옥소 섭취)

  • Park, Chan-H.;Lee, Myoung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.87-89
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    • 2002
  • A 30 year-old female patient with papillary thyroid carcinoma received her fifth radioiodine ablation therapy after the subtotal thyroidectomy. The scan, which was peformed one week after the last therapy, revealed residual uptake in the thyroid bed and uptake in the anterior mediastinum suggesting metastasis. However, further evaluation of the thorax with chest CT and camera-based FDG PET confirmed normal thymus without metastatic focus. Occasionally thymus remains intact in adult and has avidity for I-131 and FDG. Therefore, normal thymus (instead of metastasis) should be considered in patients with well differentiated thyroid carcinoma and anterior mediastinal radioiodine uptake.

Management of Severe Fatigue Induced by Tyrosine Kinase Inhibitor in Radioiodine Refractory Thyroid Cancer (방사성요오드 불응성 갑상선암에서 티로신키나아제 억제제 투여로 유발된 중증 피로감의 관리)

  • Ahn, Byeong-Cheol
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.75-77
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    • 2018
  • Tyrosine kinase inhibitor is known to prolong progression free survival in radioiodine refractory thyroid cancer patients. Fatigue/asthenia/malaise is one of most common adverse events by the tyrosine kinase inhibitor treatment, and management of the adverse event is important to keep the drug medication longer which is essential for the survival benefit. In the case report, a radioiodine refractory thyroid cancer patient receiving tyrosine kinase inhibitor experienced severe fatigue, and a pathologic fracture of right humerus occurred by slipping down which was tightly linked with the adverse event of the drug. The pathologic fracture was surgically well managed and the adverse event was well controlled by supportive managements combined with dose reduction of the tyrosine kinase inhibitor. The drug administration to the patient was kept more than 1 year without progression of the disease.

Maximum Value Calculation of High Dose Radioiodine Therapy Room (고용량 방사성옥소 치료 병실의 최대치 산출)

  • Lee, Kyung-Jae;Cho, Hyun-Duck;Ko, Kil-Man;Park, Young-Jae;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.28-34
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    • 2010
  • Purpose: According to increment of thyroid cancer recently, patients of high dose radioiodine therapy were accumulated. Taking into consideration the acceptance capability in the current facility, this study is to calculate the maximum value of high dose radioiodine therapy in patients for treatment. Materials and Methods: The amount and radioactivity of waste water discharged from high dose radioiodine therapy in patients admitted at present hospital as well as the radiation density of the air released into the atmosphere from the high dose radioiodine therapy ward were measured. When the calculated waste water's radiation and its density in the released air satisfies the standard (management standard for discharge into water supply 30 Bq/L, management standard for release into air 3 $Bq/m^3$) set by the Ministry of Education, Science and Technology, the maximum value of treatable high dose radioiodine therapy in patients was calculated. Results: When we calculated in a conservative view, the average density of radiation of waste water discharged from treating high dose radioiodine therapy one patient was 8 MBq/L and after 117 days of diminution in the water-purifier tank, it was 29.5 Bq/L. Also, the average density of radiation of waste water discharged from treating high dose radioiodine therapy two patients was 16 MBq/L and after 70 days of diminution in the water-purifier tank, it was 29.7 Bq/L. Under the same conditions, the density of radiation released into air through RI Ventilation Filter from the radioiodine therapy ward was 0.38 $Bq/m^3$. Conclusion: The maximum value of high dose radioiodine therapy in patients that can be treated within the acceptance capability was calculated and applied to the current facility, and if double rooms are managed by improving the ward structure, it would be possible to reduce the accumulated treatment waiting period for radioiodine therapy in patients.

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Optimization of Inpatient Management of Radioiodine Treatment in Korea (우리나라에서 방사성옥소입원치료 관리 최적화)

  • Park, Min-Jae;Kim, Jung-Hyun;Jang, Jung-Chan;Kim, Chang-Ho;Jeong, Jae-Min;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.261-266
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    • 2008
  • We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after longterm retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer.

Determination of counting efficiency considering the biodistribution of 131I activity in the whole-body counting measurement

  • MinSeok Park ;Jaeryong Yoo;Minho Kim ;Won Il Jang ;Sunhoo Park
    • Nuclear Engineering and Technology
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    • v.55 no.1
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    • pp.295-303
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    • 2023
  • Whole-body counters are widely used to assess internal contamination after a nuclear accident. However, it is difficult to determine radioiodine activity due to limitations in conventional calibration phantoms. Inhaled or ingested radioiodine is heterogeneously distributed in the human body, necessitating time-dependent biodistribution for the assessment of the internal contamination caused by the radioiodine intake. This study aims at calculating counting efficiencies considering the biodistribution of 131I in whole-body counting measurement. Monte Carlo simulations with computational human phantoms were performed to calculate the whole-body counting efficiency for a realistic radioiodine distribution after its intake. The biodistributions of 131I for different age groups were computed based on biokinetic models and applied to age- and gender-specific computational phantoms to estimate counting efficiency. After calculating the whole-body counting efficiencies, the efficiency correction factors were derived as the ratio of the counting efficiencies obtained by considering a heterogeneous biodistribution of 131I over time to those obtained using the BOMAB phantom assuming a homogeneous distribution. Based on the correction factors, the internal contamination caused by 131I can be assessed using whole-body counters. These correction factors can minimize the influence of the biodistribution of 131I in whole-body counting measurement and improve the accuracy of internal dose assessment.

Current Opinions on the Radioiodine Treatment of Graves' Hyperthyroidism (Graves병 갑상선 기능항진증에서 방사성 옥소 치료의 지견)

  • Lee, Sang-Woo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.6
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    • pp.341-354
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    • 2003
  • Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainity and debate. Early side effects are uncommon and readily managable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

Histological Changes of the Ovary and the Uterus of Guinea pigs Administerd Radioiodine (방사성옥소(131I)가 Guinea pig의 난소조직과 자궁조직에 미치는 영향)

  • Lee, Heung Shik;Lee, Kang Wook;Shin, Kwang Soon
    • Korean Journal of Veterinary Research
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    • v.13 no.1
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    • pp.1-4
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    • 1973
  • This experiment was performed in order to investigate the effect of radioiodine upon the uterus and the ovary of guinea pigs. The animals were injected single dose of 4. 5 mCi of radioiodine per kg of body weight. They were sacrificed on various time intervals; 1, 7, 14, 28, 42 and 56 days after the injection. The results were as follows: 1. In the ovary, the follicle cells and the ova were degenerated with lapse of time after the injection. 2. In the uterus, hyperplasia of the lamina propria of the endometrium and atrophy of the myometrium were observed in accordance with time after the injection.

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Management of Bleeding Induced by Tyrosine Kinase Inhibitor in Radioiodine Refractory Thyroid Cancer (방사성요오드 불응성 갑상선암에서 티로신키나아제 억제제 투여로 유발된 출혈 이상 반응 관리)

  • Shin, Dong Yeob
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.71-74
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    • 2018
  • Adverse events such as hemoptysis and gastrointestinal hemorrhage during tyrosine kinase inhibitor treatment are relatively rare, but the severity of the bleeding can be higher than other common adverse events. It is necessary to educate patients about its possibility so that they can be found early. In this case report of radioiodine refractory thyroid cancer patient, hemoptysis and gastrointestinal bleeding has occurred following lenvatinib administration. Drug interruption and dose modification and dose interruption were required in addition to management for bleeding itself. It is necessary to confirm the high risk of bleeding before the administration of tyrosine kinase inhibitors, and to appropriately control the follow-up interval and drug dosage accordingly.

The Change of the Salivary Function after the High Dobe Radioiodine Treatment in the Patients with Differentiated Thyroid Cancer (갑상선암 환자의 방사성옥소 치료 후 타액선 기능의 변동)

  • Lim, S.M.;Hong, S.W.;Lee, J.O.;Kang, T.W.
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.1
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    • pp.7-12
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    • 1989
  • The pain, swelling of salivary glands and dry mouth are not infrequent complication of the high dose radioiodine treatment in the patients with differentiated thyroid cancer. The purpose of this study was, by the dynamic salivary scintigraphy, to observe the change of the salivary function after the high dose $(150\sim200mci)$ radioiodine treatment. From May 1987 to April 1988, the dynamic salivary scintigraphy with 5mci of $^{99m}Tc-pertechnetate$ and gamma camera was performed before and 7 days after the radiolodine treatment in 7 patients with differentiated thyroid cancer. Just after the dynamic scintigraphy, the stimulation test with vitamin C solution of pH3.0 and poststirnulation scintigraphy were done, and the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were calculated for each gland. There was positive correlation between the radioactivity uptake index and excretion fraction after the stimulation. The salivary clearance after the stimulation was $18.96{\pm}8.95ml/min$ in the pretreatment state, and $14.37{\pm}7.7ml/min$ after the radioioine treatment. After the radioiodine treatment, the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were significantly reduced in the parotid glands, but only the excretion fraction was reduced in the submandibular glands. The more the pretreatment salivary clearance after the stimulation was, the % change after the treatment was smaller. Further studies on the relation between the radiation dose in the salivary glands and the change of their function, and the long-term observation for the recovery of function are expected.

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