Procedure guideline for radioiodine test (Version 3)

Dietlein, Markus; Dressler, J.; Eschner, W.; Laßmann, Michael; Leisner, B.; Reiners, C.; Schicha, H.; Nuklearmedizin, für die Deutsche Gesellschaft für

doi:10.1160/nukmed-0283

Cited by 18 publications

(10 citation statements)

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“…The RIUT was performed one week before combined therapy as described in the guidelines by Dietlein et al [17]. After administration of a test capsule with a dose of 2 -4 MBq I-131, the course of activity was monitored by measuring the residual activity in the thyroid 2, 48 and 96 hours after administration.…”

Section: Radioactive Iodine Uptake Test (Riut)mentioning

confidence: 99%

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Korkusuz

Happel²,

Gruenwald

2015

Fortschr Röntgenstr

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Purpose: Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. Materials and Methods: 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves? disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928?MHz. Results: TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up.?One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of?26.4?ml ??7.9?ml (30.5?% ??4.6?% (p?

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Section: Radioactive Iodine Uptake Test (Riut)mentioning

confidence: 99%

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Korkusuz

Happel²,

Gruenwald

2015

Fortschr Röntgenstr

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“…Moreover, in the past, activities of as low as 0.2 MBq have been shown to be sufficient for 131 I RAIU measurement (15). In the presented setting, standard activities of 3 MBq of 131 I were used according to current guidelines (9,10). However, 124 I activity reduction may be desirable for decreasing the inherent material costs.…”

Section: Discussionmentioning

confidence: 99%

“…The initial thyroid diagnostic was performed according to current guidelines (anamnesis; measurement of thyroidstimulating hormone, free T3, and free T4; neck ultrasound; and planar 99m Tc-pertechnetate scintigraphy) (8)(9)(10).…”

Section: Study Protocolmentioning

confidence: 99%

Assessment of Minimum ¹²⁴I Activity Required in Uptake Measurements Before Radioiodine Therapy for Benign Thyroid Diseases

et al. 2016

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This study aimed to assess a hypothetical minimum administered activity of 124 I required to achieve comparability between pretherapeutic radioiodine uptake (RAIU) measurements by 124 I PET/CT and by 131 I RAIU probe, the clinical standard. In addition, the impact of different reconstruction algorithms on 124 I RAIU and the evaluation of pixel noise as a parameter for image quality were investigated. Methods: Different scan durations were simulated by different reconstruction intervals of 600-s list-mode PET datasets (including 15 intervals up to 600 s and 5 different reconstruction algorithms: filtered-backprojection and 4 iterative techniques) acquired 30 h after administration of 1 MBq of 124 I. The Bland-Altman method was used to compare mean 124 I RAIU levels versus mean 3-MBq 131 I RAIU levels (clinical standard). The data of 37 patients with benign thyroid diseases were assessed. The impact of different reconstruction lengths on pixel noise was investigated for all 5 of the 124 I PET reconstruction algorithms. A hypothetical minimum activity was sought by means of a proportion equation, considering that the length of a reconstruction interval equates to a hypothetical activity. Results: Mean 124 I RAIU and 131 I RAIU already showed high levels of agreement for reconstruction intervals of as short as 10 s, corresponding to a hypothetical minimum activity of 0.017 MBq of 124 I. The iterative algorithms proved generally superior to the filteredbackprojection algorithm. 124 I RAIU showed a trend toward higher levels than 131 I RAIU if the influence of retrosternal tissue was not considered, which was proven to be the cause of a slight overestimation by 124 I RAIU measurement. A hypothetical minimum activity of 0.5 MBq of 124 I obtained with iterative reconstruction appeared sufficient both visually and with regard to pixel noise. Conclusion: This study confirms the potential of 124 I RAIU measurement as an alternative method for 131 I RAIU measurement in benign thyroid disease and suggests that reducing the administered activity is an option. CT information is particularly important in cases of retrosternal expansion. The results are relevant because 124 I PET/CT allows additional diagnostic means, that is, the possibility of performing fusion imaging with ultrasound. 124 I PET/CT might be an alternative, especially when hybrid 123 I SPECT/CT is not available.

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“…The therapeutic approach to Graves’ disease initially consists of an inhibition of thyroid hormone synthesis by thyrostatic medication 3 , 8 , 11 , 12 . Methimazole and the methimazole analogue carbimazole are commonly used for anti-thyroid treatment 13 – 15 .…”

Section: Introductionmentioning

confidence: 99%

The influence of thionamides on intra-thyroidal uptake of 131I during radioiodine-131 treatment of Graves’ disease

Happel,

Bockisch,

Leonhäuser

et al. 2023

Sci Rep

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Graves’ disease is one of the most common causes of hyperthyroidism. Guideline recommendations advocate the intake of thionamides for at least 1 year. If hyperthyroidism persists, subsequent radioiodine-131 treatment (RIT) is a therapeutic option. Thionamides are known to influence intra-thyroidal bio-kinetics of iodine and should therefore be discontinued at least 3 days prior to RIT if possible. However, the required therapeutic activity has to be calculated individually by pre-therapeutic measurement of the uptake prior to RIT [radioiodine-131 uptake test (RIUT)] in Germany according to national guidelines. Therefore, the aim of this study was to quantify the influence of thionamides on intra-therapeutic uptake. A cohort of 829 patients with Graves’ disease undergoing RIUT and RIT was analysed. Patients were subdivided into three groups. Group A: patients with carbimazole medication (n = 312), group B: patients with methimazole medication (n = 252) and group C: patients without thionamides (n = 265). Group A and B were further subdivided depending on the reduction of dosage of thionamides. In order to analyse the influence of thionamides, the variance of the determined individual extrapolated maximum intra-thyroidal uptake (EMU) between RIUT and RIT within the single groups and within the subgroups was statistically evaluated. When administering an equal dose of thionamides or no thionamides in RIUT and RIT (groups A1, B1 and C) no significant differences were detected when comparing EMU in RIT to EMU in RIUT (p > 0.05). In the subgroups A2–A4 (reduced dosage of carbimazole prior to RIT) EMU was significantly increased in RIT compared to RIUT [21% for a reduction of 0 to < 10 mg/d (A2), 39% for a reduction of 10–15 mg/d (A3) and 80% for a reduction of > 15 mg/d (A4)]. In the subgroups B2–B4 (reduced dosage of methimazole prior to RIT) EMU was as well significantly increased in RIT compared to RIUT [26% for a reduction of 0 to < 10 mg/d (B2), 36% for a reduction of 10–15 mg/d (B3) and 59% for a reduction of > 15 mg/d (B4)]. A significant dose-dependent increase of EMU in RIT compared to EMU in RIUT in patients discontinuing or reducing thionamides was detected. Therefore, thionamides should be discontinued at least 2 days prior to RIUT in order to achieve the designated target dose more precisely and to minimize radiation exposure of organs at risk.

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Procedure guideline for radioiodine test (Version 3)

Cited by 18 publications

References 0 publications

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Assessment of Minimum ¹²⁴I Activity Required in Uptake Measurements Before Radioiodine Therapy for Benign Thyroid Diseases

The influence of thionamides on intra-thyroidal uptake of 131I during radioiodine-131 treatment of Graves’ disease

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Procedure guideline for radioiodine test (Version 3)

Cited by 18 publications

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Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Combination of Ultrasound-Guided Percutaneous Microwave Ablation and Radioiodine Therapy in Benign Thyroid Disease: A 3-Month Follow-Up Study

Assessment of Minimum 124I Activity Required in Uptake Measurements Before Radioiodine Therapy for Benign Thyroid Diseases

The influence of thionamides on intra-thyroidal uptake of 131I during radioiodine-131 treatment of Graves’ disease

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Assessment of Minimum ¹²⁴I Activity Required in Uptake Measurements Before Radioiodine Therapy for Benign Thyroid Diseases