• Journal of Oral Medicine and Pain
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• v.43 no.3
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• pp.84-86
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• 2018

Salivary and lacrimal gland dysfunction is relatively frequent after radioiodine therapy. In most cases this is a transient side effect, but in some patients it may persist for a long period or appear late. Radioiodine ($^{131}I$) therapy is often administered to patients following total thyroidectomy to treat well-differentiated follicular cell-derived thyroid cancer. In addition to the thyroid, $^{131}I$ accumulates in the salivary glands, giving rise to transient or permanent salivary gland damage. Salivary gland dysfunction following radioiodine therapy can be caused by radiation damage. But, it also may be associated with $Sj{\ddot{o}}gren$ syndrome (SS) developed after radioiodine therapy. It would be recommended that the evaluation for SS including anti-SSA/Ro and anti-SSB/La should be considered before and after radioiodine therapy.

• The Korean Journal of Nuclear Medicine
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• v.35 no.6
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• pp.393-397
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• 2001

Surgery, radioiodine therapy, and thyroxine treatment represent established therapeutic measures of proven efficacy for the treatment of well-differentiated thyroid cancer. However, in some cases, dedifferentiation is noted and it makes tumors refractory to conventional treatment. Recently, retinoic acid redifferentiation therapy was evaluated in several in vitro and in vivo studios. We report a patient with papillary carcinoma in whom metastatic lesions became radioiodine negative on high-dose therapy. Redifferentiation therapy with retinoic acid induced radioiodine uptake in some of metastatic tissues. Side effects such as xerostomia and cheilosis were mild. We recommend retinoic acid redifferentiation therapy as an option for the treatment of thyroid cancer with negative radioiodine uptake after high-dose radioiodine therapy.

• 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.

• 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.

• 대한두경부종양학회:학술대회논문집
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• 2005.05a
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• pp.78-80
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• 2005

• The Korean Journal of Nuclear Medicine
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• v.14 no.2
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• pp.35-40
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• 1980

In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ($^{131}I$) and 31 patients with treatment of $^{131}I$ alone. The $^{131}I$ treatment was limited to older age, above 20 years of age, and not employed in patients with pregnancy and lactation. The patients treated with antithyroid belonged to relatively younger age, and also milder in symptoms and thyroid function tests. The remission rate of antithyroid therapy group was 97.8% within 16 months. Among them the early remission rate occured within 4 months was found to be 21.7%. The combined therapy group, having prescribed more severe cases, showed the remission rate to be 75% within 16 months. The remission rate of $^{131}I$ therapy group revealed 90.9% within 16 months. Among them the early remission rate taking place within 4 months disclosed 16.7%. The side effects of antithyroid drug, propylthiouracil, were noted as follows: itching (2.7%) skin rashes (1.3%), and adverse enlargement of goiter (10.7%). The side effects $^{131}I$ therapy were transient hypothyroidism(3.9%) permanent hypothyroidism (7.8%) and itching (2.0%).

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2523-2527
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• 2014

Background: Serum thyroglobulin detection plays an essential role during the follow-up of thyroid cancer patients treated with total/near total thyroidectomy and radioiodine ablation. The aim of this retrospective study was to evaluate the relationship between stimulated serum thyroglobulin (Tg) level at the time of high dose $^{131}I$ ablation and risk of recurrence, using a three-level classification in patients with differentiated thyroid cancer (DTC) according to the ATA guidelines. Also we investigated the relationship between postoperative stimulated Tg at the time of ablation and DxWBS results at 8-10 months thereafter. Materials and Methods: Patients with radioiodine accumulation were regarded as scan positive (scan+). If there was no relevant pathological radioiodine accumulation or minimal local accumulation in the thyroid bed region, this were regarded as scan negative (scan-) at the time of DxWBS. We classified patients in 3 groups as low, intermediate and high risk group for assessment of risk of recurrence according to the revised ATA guidelines. Also, we divided patients into 3 groups based on the stimulated serum Tg levels at the time of $^{131}I$ ablation therapy. Groups 1-3 consisted of patients who had Tg levels of ${\leq}2ng/ml$, 2-10 ng/ml, and ${\geq}10ng/ml$, respectively. Results: A total of 221 consecutive patients were included. In the high risk group according to the ATA guideline, while 45.5% of demonstrated Scan(+) Tg(+), 27.3% of patients demonstrated Scan(-) Tg(-); in the intermediate group, the figures were 2.3% and 90.0% while in the low risk group, they were 0.6% and 96.4%. In 9 of 11 patients with metastases (81.8%), stimulated serum Tg level at the time of radioiodine ablation therapy was over 10, however in 1 patient (9.1%) it was <2ng/mL and in one patient it was 2-10ng/mL (p=0.005). Aggressive subtypes of DTC were found in 8 of 221 patients and serum Tg levels were ${\leq}2ng/ml$ in 4 of these 8. Conclusions: We conclude that TSH-stimulated serum thyroglobulin level at the time of ablation may not determine risk of recurrence. Therefore, DxWBS should be performed at 8-12 months after ablation therapy.

• 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.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.119-122
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• 2008

Radioiodine (I-131) Therapy has been known one of the methods treated with hyperthyroidism and thyroid tumor, using a separate ward. This technique has been already used for several decades, and its clinical efficacy proven. Today, Radioiodine takes a form of capsule through continuous development, so, 30 odd domestic hospitals run about 63 separate wards. And, its demands would increase continuously; because of tending upwards the patients had thyroid cancer. However, various kinds of wastes originate from a procedure of radioiodine therapy. Especially, when their radioactivity exceed permissible level (4 Bq/$cm^2$) set by Nuclear laws of the Republic of Korea, it regards as radioactive wastes, then, managed separately from origination to the last disposal.

• 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.