ABSTRACT
Radioactive iodine scan is a quite specific method used for many years in differentiated thyroid cancer (DTC). However, combination of neck ultrasonography and serum thyroglobulin and anti-thyroglobulin has a high sensitivity in detection of disease. Furthermore, this method has gained an important role in routine clinical practice in follow-up of DTC, because it is a relatively cheap, practical and easily achievable method, with no radiation exposure. With the spread of the single photon emission computed tomography/computed tomography in the whole world, the place for radioiodine scan has been questioned again. Radioiodine scan has become a more frequently used method in clinical practice both in dosimetric applications, at early period after radioactive iodine therapy an long term follow-up with higher accuracy rates and proven prognostic importance.
Keywords:
Radioactive iodine, I-131, I-123, radionuclide imaging, thyroid cancer
References
1Goldsmith SJ. Targeted Radionuclide Therapy: A Historical and Personal Review. Semin Nucl Med 2020;50:87-97.
2Tuttle RM, Ahuja S, Avram AM, et al. Controversies, Consensus, and Collaboration in the Use of 131I Therapy in Differentiated Thyroid Cancer: A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association. Thyroid 2019;29:461-470.
3Lee SW. SPECT/CT in the Treatment of Differentiated Thyroid Cancer. Nucl Med Mol Imaging 2017;51:297-303.
4Verburg FA, Schmidt M, Kreissl MC, et al. [Procedural guideline for Iodine-131 whole-body scintigraphy in differentiated thyroid carcinoma (version 5)]. Nuklearmedizin 2019;58:228-241.
5Bartel Chair TB, Magerefteh S, Avram AM, et al. SNMMI Procedure Standard for Scintigraphy for Differentiated Thyroid Cancer. J Nucl Med Technol 2020;48:202-209.
6Haugen BR, Pacini F, Reiners C, et al. A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer. J Clin Endocrinol Metab 1999;84:3877-3885.
7Giovanella L, Duntas LH. MANAGEMENT OF ENDOCRINE DISEASE: The role of rhTSH in the management of differentiated thyroid cancer: pros and cons. Eur J Endocrinol 2019;181:133-145.
8Piccardo A, Puntoni M, Ferrarazzo G, et al. Could short thyroid hormone withdrawal be an effective strategy for radioiodine remnant ablation in differentiated thyroid cancer patients? Eur J Nucl Med Mol Imaging 2018;45:1218-1223.
9Barbaro D, Boni G, Meucci G, et al. Recombinant human thyroid-stimulating hormone is effective for radioiodine ablation of post-surgical thyroid remnants. Nucl Med Commun 2006;27:627-632.
10Caresia AP, Castell Conesa J, Obions Alfonso G, et al. Estudio comparativo entre la utilización de TSH recombinante y la estimulación endógena con TSH. Valoración en el seguimiento de los pacientes con carcinoma diferenciado de tiroides [Comparison of administration of rhTSH with withdrawal of thyroid hormone. Follow-up of patients with differentiated thyroid carcinoma]. Rev Esp Med Nucl 2006;25:236-241.
11Mishra A, Pradhan PK, Gambhir S, Sabaretnam M, Gupta A, Babu S. Preoperative contrast-enhanced computerized tomography should not delay radioiodine ablation in differentiated thyroid carcinoma patients. J Surg Res 2015;193:731-737.
12Padovani RP, Kasamatsu TS, Nakabashi CC, et al. One month is sufficient for urinary iodine to return to its baseline value after the use of water-soluble iodinated contrast agents in post-thyroidectomy patients requiring radioiodine therapy. Thyroid 2012;22:926-930.
13Sohn SY, Choi JH, Kim NK, et al. The impact of iodinated contrast agent administered during preoperative computed tomography scan on body iodine pool in patients with differentiated thyroid cancer preparing for radioactive iodine treatment. Thyroid 2014;24:872-877.
14Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214.
15Luster M, Clarke SE, Dietlein M, et al. Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2008;35:1941-1959.
16Bakheet SM, Hammami MM. Patterns of radioiodine uptake by the lactating breast. Eur J Nucl Med 1994;21:604-608.
17Hammami MM, Bakheet S. Radioiodine breast uptake in nonbreastfeeding women: clinical and scintigraphic characteristics. J Nucl Med 1996;37:26-31.
18Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016;26:1-133.
19Hilditch TE, Dempsey MF, Bolster AA, McMenemin RM, Reed NS. Self-stunning in thyroid ablation: evidence from comparative studies of diagnostic 131I and 123I. Eur J Nucl Med Mol Imaging 2002;29:783-788.
20Lundh C, Lindencrona U, Postgård P, Carlsson T, Nilsson M, Forssell-Aronsson E. Radiation-induced thyroid stunning: differential effects of (123)I, (131)I, (99m)Tc, and (211)At on iodide transport and NIS mRNA expression in cultured thyroid cells. J Nucl Med 2009;50:1161-1167.
21Siddiqi A, Foley RR, Britton KE, et al. The role of 123I-diagnostic imaging in the follow-up of patients with differentiated thyroid carcinoma as compared to 131I-scanning: avoidance of negative therapeutic uptake due to stunning. Clin Endocrinol (Oxf) 2001;55:515-521.
22Gerard SK, Cavalieri RR. I-123 diagnostic thyroid tumor whole-body scanning with imaging at 6, 24, and 48 hours. Clin Nucl Med 2002;27:1-8.
23Song HC, Chong A. Post-therapeutic I-131 whole body scan in patients with differentiated thyroid cancer. Ali G editor 12. 2011:231-250.
24Verburg FA, Aktolun C, Chiti A, et al. Why the European Association of Nuclear Medicine has declined to endorse the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2016;43:1001-1005.
25Tsai CJ, Cheng CY, Shen DH, et al. Tc-99m imaging in thyroidectomized differentiated thyroid cancer patients immediately before I-131 treatment. Nucl Med Commun 2016;37:182-187.
26Lassmann M, Hänscheid H, Chiesa C, et al. EANM Dosimetry Committee series on standard operational procedures for pre-therapeutic dosimetry I: blood and bone marrow dosimetry in differentiated thyroid cancer therapy. Eur J Nucl Med Mol Imaging 2008;35:1405-1412.
27Klubo-Gwiezdzinska J, Van Nostrand D, Atkins F, et al. Efficacy of dosimetric versus empiric prescribed activity of 131I for therapy of differentiated thyroid cancer. J Clin Endocrinol Metab 2011;96:3217-3225.
28Verburg FA, Hänscheid H, Biko J, et al. Dosimetry-guided high-activity (131)I therapy in patients with advanced differentiated thyroid carcinoma: initial experience. Eur J Nucl Med Mol Imaging 2010;37:896-903.
29Israel O, Iosilevsky G, Front D, et al. SPECT quantitation of iodine-131 concentration in phantoms and human tumors. J Nucl Med 1990;31:1945-1949.
30Riggs SJ, Green AJ, Begent RH, Bagshawe KD. Quantitation in 131I-radioimmunotherapy using SPECT. Int J Cancer Suppl 1988;2:95-98.
31Dewaraja YK, Ljungberg M, Green AJ, et al. MIRD pamphlet No. 24: Guidelines for quantitative 131I SPECT in dosimetry applications. J Nucl Med 2013;54:2182-2188.
32Sherman SI, Tielens ET, Sostre S, Wharam MD Jr, Ladenson PW. Clinical utility of posttreatment radioiodine scans in the management of patients with thyroid carcinoma. J Clin Endocrinol Metab 1994;78:629-634.
33Fatourechi V, Hay ID, Mullan BP, et al. Are posttherapy radioiodine scans informative and do they influence subsequent therapy of patients with differentiated thyroid cancer? Thyroid 2000;10:573-577.
34Souza Rosário PW, Barroso AL, Rezende LL, et al. Post I-131 therapy scanning in patients with thyroid carcinoma metastases: an unnecessary cost or a relevant contribution? Clin Nucl Med 2004;29:795-798.
35Schneider DF, Ojomo KA, Chen H, Sippel RS. Remnant uptake as a postoperative oncologic quality indicator. Thyroid 2013;23:1269-1276.
36Mustafa M, Kuwert T, Weber K, et al. Regional lymph node involvement in T1 papillary thyroid carcinoma: a bicentric prospective SPECT/CT study. Eur J Nucl Med Mol Imaging 2010;37:1462-1426.
37Verburg FA, de Keizer B, Lips CJ, Zelissen PM, de Klerk JM. Prognostic significance of successful ablation with radioiodine of differentiated thyroid cancer patients. Eur J Endocrinol 2005;152:33-37.
38Verburg FA, Stokkel MP, Düren C, et al. No survival difference after successful (131)I ablation between patients with initially low-risk and high-risk differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2010;37:276-283.
39Thies ED, Tanase K, Maeder U, et al. The number of 131I therapy courses needed to achieve complete remission is an indicator of prognosis in patients with differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 2014;41:2281-2290.
40Torlontano M, Crocetti U, D’Aloiso L, et al. Serum thyroglobulin and 131I whole body scan after recombinant human TSH stimulation in the follow-up of low-risk patients with differentiated thyroid cancer. Eur J Endocrinol 2003;148:19-24.
41Bachelot A, Leboulleux S, Baudin E, et al. Neck recurrence from thyroid carcinoma: serum thyroglobulin and high-dose total body scan are not reliable criteria for cure after radioiodine treatment. Clin Endocrinol (Oxf) 2005;62:376-379.
42Cailleux AF, Baudin E, Travagli JP, Ricard M, Schlumberger M. Is diagnostic iodine-131 scanning useful after total thyroid ablation for differentiated thyroid cancer? J Clin Endocrinol Metab 2000;85:175-178.
43Mazzaferri EL, Robbins RJ, Spencer CA, et al. A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 2003;88:1433-1441.
44Pacini F, Capezzone M, Elisei R, Ceccarelli C, Taddei D, Pinchera A. Diagnostic 131-iodine whole-body scan may be avoided in thyroid cancer patients who have undetectable stimulated serum Tg levels after initial treatment. J Clin Endocrinol Metab 2002;87:1499-1501.
45Robbins RJ, Chon JT, Fleisher M, Larson SM, Tuttle RM. Is the serum thyroglobulin response to recombinant human thyrotropin sufficient, by itself, to monitor for residual thyroid carcinoma? J Clin Endocrinol Metab 2002;87:3242-3247.
46Schlumberger M, Berg G, Cohen O, et al. Follow-up of low-risk patients with differentiated thyroid carcinoma: a European perspective. Eur J Endocrinol 2004;150:105-112.
47de Meer SG, Vriens MR, Zelissen PM, Borel Rinkes IH, de Keizer B. The role of routine diagnostic radioiodine whole-body scintigraphy in patients with high-risk differentiated thyroid cancer. J Nucl Med 2011;52:56-59.
48Winter M, Winter J, Heinzel A, et al. Timing of post 131I ablation diagnostic whole body scan in differentiated thyroid cancer patients. Less than four months post ablation may be too early. Nuklearmedizin 2015;54:151-157.
49Mallick U, Harmer C, Yap B, et al. Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer. N Engl J Med 2012;366:1674-1685.
50Schlumberger M, Catargi B, Borget I, et al. Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med 2012;366:1663-1673.
51Shattuck TM, Westra WH, Ladenson PW, Arnold A. Independent clonal origins of distinct tumor foci in multifocal papillary thyroid carcinoma. N Engl J Med 2005;352:2406-2412.
52Spencer CA. Clinical review: Clinical utility of thyroglobulin antibody (TgAb) measurements for patients with differentiated thyroid cancers (DTC). J Clin Endocrinol Metab 2011;96:3615-3527.
53Verburg FA, Luster M, Cupini C, et al. Implications of thyroglobulin antibody positivity in patients with differentiated thyroid cancer: a clinical position statement. Thyroid 2013;23:1211-1225.
54Chiovato L, Latrofa F, Braverman LE, et al. Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens. Ann Intern Med 2003;139:346-351.
55Chung JK, Park YJ, Kim TY, et al. Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol (Oxf) 2002;57:215-221.
56Kim TY, Kim WB, Kim ES, et al. Serum thyroglobulin levels at the time of 131I remnant ablation just after thyroidectomy are useful for early prediction of clinical recurrence in low-risk patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 2005;90:1440-1445.
57Kim WG, Yoon JH, Kim WB, et al. Change of serum antithyroglobulin antibody levels is useful for prediction of clinical recurrence in thyroglobulin-negative patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 2008;93:4683-4689.
58Pacini F, Mariotti S, Formica N, et al. Thyroid autoantibodies in thyroid cancer: incidence and relationship with tumour outcome. Acta Endocrinol (Copenh) 1988;119:373-380.
59Riemann B, Uhrhan K, Dietlein M, et al. Diagnostic value and therapeutic impact of (18)F-FDG-PET/CT in differentiated thyroid cancer. Results of a German multicentre study. Nuklearmedizin 2013;52:1-6.
60Ciappuccini R, Heutte N, Trzepla G, et al. Postablation (131)I scintigraphy with neck and thorax SPECT-CT and stimulated serum thyroglobulin level predict the outcome of patients with differentiated thyroid cancer. Eur J Endocrinol 2011;164:961-969.
61Wong KK, Zarzhevsky N, Cahill JM, Frey KA, Avram AM. Incremental value of diagnostic 131I SPECT/CT fusion imaging in the evaluation of differentiated thyroid carcinoma. AJR Am J Roentgenol 2008;191:1785-1794.
62Schmidt D, Szikszai A, Linke R, Bautz W, Kuwert T. Impact of 131I SPECT/spiral CT on nodal staging of differentiated thyroid carcinoma at the first radioablation. J Nucl Med 2009;50:18-23.
63Spanu A, Solinas ME, Chessa F, Sanna D, Nuvoli S, Madeddu G. 131I SPECT/CT in the follow-up of differentiated thyroid carcinoma: incremental value versus planar imaging. J Nucl Med 2009;50:184-190.
64Avram AM. Radioiodine scintigraphy with SPECT/CT: an important diagnostic tool for thyroid cancer staging and risk stratification. J Nucl Med 2012;53:754-764.
65Maruoka Y, Abe K, Baba S, et al. Incremental diagnostic value of SPECT/CT with 131I scintigraphy after radioiodine therapy in patients with well-differentiated thyroid carcinoma. Radiology 2012;265:902-909.