• Title/Summary/Keyword: Radioiodine therapy

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Comparison of Presentation and Clinical Outcome between Children and Young Adults with Differentiated Thyroid Cancer

  • Wang, Jian-Tao;Huang, Rui;Kuang, An-Ren
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7271-7275
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    • 2014
  • Background: The aim of the present study was to evaluate the presentation, clinical course and outcome between children and young adults with differentiated thyroid cancer (DTC) treated in our hospital. Materials and Methods: The medical records of 145 patients with DTC who underwent surgery followed by radioiodine and thyroid hormone (TSH) suppression were retrospectively reviewed. The follow up was between January 2006 and June 2012. These patients consisted of 38 children (age${\leq}18y$) and 107 young adult patients (age${\leq}30y$). The clinical characteristics and outcome were analyzed and compared, and the progression-free survival (PFS) was evaluated using the Kaplan-Meier method. Results: At initial diagnosis, a greater degree of extra thyroidal extension was found in children than adults patients (p<0.001). However, there was no significant difference between the two groups with regard to the tumor size and the presence of lymph node or distant metastasis (p=0.172, p=0.050 and p=0.068, respectively). The extent of surgery and the cumulative or mean dose of radioiodine were similar in both groups. During the follow up, the overall survival rate was 100% for both groups, and the PFS rate was similar in children and in young adults group (log rank test, ${\chi}^2$=0.126, p=0.723). Conclusions: In comparison to the young adult patients, DTC in children presents with more aggressive behavior, but outcomes are similar between the two groups after the intensive management of surgery followed by radioiodine and TSH suppression therapy.

The Evaluation on Reuse Period of Patient's Clothes and Sheet After Radioiodine Therapy (방사성 요오드 치료환자의 환의 및 시트에 대한 재사용주기 평가)

  • Kim, Yeong Seon;Seo, Myung Deok;Lee, Wan Kyu;Kim, Ki Joon;Song, Jae Beom
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.12-17
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    • 2012
  • Purpose : The patient's clothes and sheet after radioiodine therapy must be disposed of by related regulation. That must be disposed of as radioactive wastes, but that is reusing after radioactivity decay by keeping for the certain period of time. In general, The minimum storage period calculate by standard of take radioactive substance out of radiation controlled area based on measured surface contamination level. But the measurements of surface contamination level are able to differ by measurement method. In this paper, I wish to calculate the minimum storage period of patient's clothes and sheet after radioiodine therapy by measure nuclide concentration offered by the regulation on self-disposal of radioactive wastes. Materials and Methods : The whole area of patient's clothes and sheet measured 31 patients(male:9 patients, female:22 patients), who had radioiodine therapy(3.7 GBq:13 patients, 5.55 GBq:16 patients, 7.4 GBq:2 patients) from july 2011 to march 2012. The minimum storage period is calculated by the regulation on self-disposal of radioactive waste(100 Bq/g) and standard of take radioactive substance out of radiation controlled area(4 kBq/m2) Results : The minimum storage period of pillow sheet, upper uniform, lower uniform by standard of take radioactive substance out of radiation controlled area were each 4.6 days, 63days, 78 days. The minimum storage period of pillow sheet, upper uniform, lower uniform by the regulation on self-disposal of radioactive waste were each 18.1 days, 43 days, 62 days. Conclusion : We can verify that patient's clothes and sheet after radioiodine therapy exists a great deal of radioactive contamination. The minimum storage period calculation of patient's clothes and sheet is better suited to applying nuclide concentration offered by the regulation on self-disposal of radioactive waste. I recommend, To keep for at least 2 months of the patient's clothes and sheet contaminated radioactivity, for prevent contamination and unnecessary radiation exposure.

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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.

A study on the Hematologic Effects of Radioactive Iodine($^{131}I$) Therapy on Various Thyroid Diseases (방사성동위원소옥소(放射性同位元素沃素)($^{131}I$)의 치료량(治療量)이 갑상선종환자(甲狀腺腫患者)의 혈액상(血液像)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Kim, Myung-Jae;Kim, Noe-Kyeong;Lee, Jung-Sang;Choi, Keun-Chul;Lee, Ryong-Woo;Kim, Kee-Won;Kang, Shin-Il
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.1
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    • pp.51-58
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    • 1969
  • To clarify the hematologic effects of the radioiodine ($^{131}I$) in therapeutic doses ($5{\sim}10$ mCi) on the various thyroid patients, authors studied the peripheral blood pictures of 396 goitrous patients before and after radioiodine ($^{131}I$) administrations in the Isotope Clinic of Seoul National University Hospital. Among these 396 cases of goiters, we gave 5 to 10 mCi of radioiodine ($^{131}I$) with single or fractionated administrations. The blood pictures of peripheral blood were repeated after 3 months in 40 cases of 65 cases who had been treated with $^{131}I$. The blood pictures of non-treated thyroid patients were compared with that of normal Korean values to clarify any difference between normal and goiter. The blood pictures of hyperthyroid patients treated with $^{131}I$ therapy were compared with the blood pictures of non-treated thyroid patients. The results were as following: 1) The incidence according to type: Toxic diffuse goiter: 35.4% Nontoxic nodular goiter: 29.7% Euthyroid: 13.8% Nontoxic diffuse goiter: 12.6% Hypothyroidism: 4.3% Thyroiditis($\bar{s}$ subacute form): 1.8% Toxic nodular goiter: 1.4% Malignancy: 1.0% 2) Age incidence: The range of distribution was 11 to 71 years. The peak incidence was found in the 4th decade of life. $80.6{\sim}82.6%$ of those 396 cases were found among the 3rd, 4th and the 5th decades of life. 3) Sex incidence: Sex ratio of male:female was 1:7.8. 4) The most outstanding findings in peripheral blood before treatment were decreased erythrocyte count and hemoglobin value in all types of thyroid diseases, especially in. the cases of hypothyroidism and thyroiditis. Hook worm-infested patients showed no significant difference in erythrocytes and hemoglobin values from those of other hook worm free patients. 5) Total leukocytes count was within normal range. Differential count of W.B.C. showed increased percentile of lymphocyte in diffuse toxic goiter and thyroiditis. 6) 39 cases of diffuse goiter treated with $^{131}I$ toxic showed amelioration in the anemia and restoration to normal range of lymphocyte count in association with increased percentile of neutrophiles 3 months after administration, except a case of toxic nodular goiter. One can observe anemia in slight degree, and increased lymphocytes count in hypothyroidism. Therapeutic dose of radioiodine ($^{131}I$) does not result any residual effect on the hematopoietic function. Radioiodine ($^{131}I$) therapy resulted in improvement of thyroid function in association of amelioration of pevious abnormal blood pictures. 7) Authors did not observe any myxedema resulted from radioiodine therapy during the 3 months period in this study.

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Detection for Residual Thyroid Tissue and Metastatic Lesion after Total Thyroidectomy in Patients with Differentiated Thyroid Cancer: Comparison between Tc-99m Pertechnetate Sean and High Dose I-131 Therapy Sean (분화 갑상선암 환자의 수술후 잔여갑상선조직 및 전이병소의 진단: Tc-99m Pertechnetate 스캔과 고용량 옥소 치료 후 I-131 스캔의 비교)

  • Lee, Joo-Ryung;Ahn, Byeong-Cheol;Jeong, Shin-Young;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.120-127
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    • 2003
  • Purpose: To evaluate diagnostic sensitivity of nuclear imaging in the detection of residual thyroid tissue and metastatic lesion, we have compared neck scintigrams with Tc-99m pertechnetate (Tc-99m scan) and high dose I-131 iodide (I-131 scan) in patients with differentiated thyroid cancer. Subjects and Methods: One hundred thirty-five thyroidectomized patients for differentiated thyroid cancer were enrolled in this study. Twenty-three had a previous history of radioiodine therapy. Planar and pin-hole images of anterior neck with Tc-99m were acquired at 20 minutes after injection, followed by I-131 scan three days after high-dose radioiodine therapy within 7 days interval. Patients were asked to discontinue thyroid hormone replacement more than 4 weeks. Results: All subjects were in hypothyroid state. Seventy out of 135 patients (51.9%) showed concordant findings between Tc-99m and I-131 scans. I-131 scan showed higher number of uptake foci in all of 65 patients showing discordant finding. Tc-99m scan showed no thyroid bed uptake in 34 patients, whereas 23 of them (67.6%) showed bed uptake in I-131 scan. Tc-99m scan did not show any uptake in thyroid bed in 11 of 112 patients without previous history of radioiodine therapy, but 9 of them showed bed uptake in I-131 scan. Tc-99m scan showed no bed uptake in all of the 23 patients with previous history of radioiodine therapy, in contrast 14 of them (60.9%) showed bed uptake in I-131 scan. Conclusion: These results suggest that Tc-99m scan has poor detectability for residual thyroid tissue or metastatic lesion in thyroidectomized differentiated thyroid cancer patients, compared to high dose I-131 therapy scan. Tc-99m scan could not detect any remnant tissue or metastatic lesion in patients with previous history of radioiodine treatment, especially.

A Case of Ectopic Parathyroid Adenoma Detected by 201 Thallium Scintiscan (201 Thallium Scintiscan으로 확인된 이소성 부갑상선 선종의 1예)

  • Shong, Young-Kee;Lee, Myung-Chul;Cho, Bo-Youn;Koh, Chang-Soon;Min, Hun-Ki;Oh, Seung-Keun
    • The Korean Journal of Nuclear Medicine
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    • v.21 no.1
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    • pp.75-78
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    • 1987
  • A 57 year old female patient was diagnosed as primary hyperparathyroidism after incidental finding of hypercalcemia. She was treated with radioiodine for Graves disease twenty years ago. Preoperative localization procedures with sonography and CT were unrevealing but 201 thallium scintiscan clearly demonstrated ectopic parathyroid adenoma which was confirmed by surgery. Brief review of the preoperative parathyroid localization procedure was done and the relationship between radioiodine therapy and hyperparathyroidism was discussed.

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Minimized Radiation Dose of Patients Receiving High Dose Radioiodine(I-131) Therapy (고용량 방사성옥소(I-131) 치료환자의 피폭선량 저감화 연구)

  • Lee, Gui-Won
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.435-442
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    • 2007
  • The number of thyroid diseases treated with radioiodine(I-131) is increasing steadily. The sharp increase in patients who require high dose radioiodine therapy greatly increased the need for new therapy rooms. Accordingly, interest in radiation exposure is rising as well, and is a major psychological stress factor for the patient and those who come in close contact with the patient. This study aimed to minimize the radiation exposure on discharge. Based on various previous reports, the decision for discharge should be individualized depending on many factors related to the patient's living or working environment. Educating patients repeatedly on the importance of sufficient oral hydration, while the adequate amount was relative to the patient's individual condition, greatly lowered the detected radiation measurement within the same admission period. In some cases, the period of admission could be abbreviated.

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