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A retrospective study on the transition of radiation dose rate and iodine distribution in patients with I-131-treated well-differentiated thyroid cancer to improve bed control shorten isolation periods

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Abstract

Objective

To evaluate for how long patients should be isolated after I-131 treatment for thyroid cancer according to the guidelines issued by the Japanese Ministry of Welfare.

Methods

We reviewed 92 therapies performed in 76 patients who were administered I-131 at our hospital from July 2007 to September 2009. Fifty-six patients were given 2220 or 2960 MBq I-131 at the first therapy, and 29 patients underwent 36 repeated therapies using 2960, 3700, 5550 or 7400 MBq I-131. We surveyed radioactivity for a 1 cm dose equivalent rate at 1 m intervals at 30 and 48 h after administration of I-131, obtained planar scintigrams at 48 h, and surveyed radioactivity repeatedly until it fell to under 30 μSv/h.

Results

The radioactivity was under 30 μSv/h at 30 h in 51 out of 92 cases (55%). Among the remaining 41 (45%) cases, 27 (29%) and 32 (35%) cases showed decreased radioactivity under 30 μSv/h at 48 and 72 h, respectively, and it remained higher than 30 μSv/h at 72 h in another 9 cases (10%). In 5 (38%) of the 13 cases with bone metastasis, the radioactivity remained over 30 μSv/h after 72 h, and scintigrams showed strong accumulation in bone metastases. Among the 27 cases demonstrating below 30 μSv/h at 48 h, 26 showed radioactivity being below 50 μSv/h at 30 h, while it was above 50 μSv/h at 30 h in all 14 cases which demonstrated above 30 μSv/h at 48 h. We compared the radioactivity levels of 27 cases under 30 μSv/h at 48 h and 14 cases over 30 μSv/h at 48 h using a cutoff value of under 50 μSv/h at 30 h to release patient at 48 h, the positive predictive value and negative predictive value were 100 and 93%, respectively, and radioactivity was found to differ significantly (P < 0.001).

Conclusions

To predict external radiation levels at 48 h, it is helpful to consider external radiation levels at 30 h after treatment. Consideration of intracellular uptake in thyroid cancer, especially in cases of bone metastases, digestive tract function, and renal function, is important for predicting isolated period.

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References

  1. Higashi T, Kudo T, Kinuya S. Radioactive iodine (131I) therapy for differentiated thyroid cancer in Japan: current issues with historical review and future perspective. Ann Nucl Med. (in press, 2012). doi:10.1007/s12149-011-0553-4.

  2. Subcommittee on Survey of Nuclear Medicine Practice in Japan, Medical Science and Pharmaceutical Committee, Japan Radioisotope Association. The present state of nuclear medicine practice in Japan—a report of the 6th nationwide survey in 2007 (in Japanese). Radioisotope. 2008;57:491–558.

  3. Subcommittee on Radioisotope Therapy of Thyroid Cancer, Japanese Society of Nuclear Medicine. A report of radioiodine therapy for thyroid cancer (in Japanese). Isotope News (published by Japan Radioisotope Association). 2010;672:25–9.

  4. Tsuchimochi S, Nakajo M, Umanodan T, Fukushima N, Shigaki S, Kiku TA. Study on the isolation period of patients with metastatic thyroid cancer treated by 131I according a new guideline. Kaku Igaku (Jpn J Nucl Med). 2001;38:747–54. (in Japanese).

    CAS  Google Scholar 

  5. Uchida Y. Radionuclide therapy. Rad Fan. 2010;8:69–72. (in Japanese).

    Google Scholar 

  6. Tanaka C, Fujita T, Misaki T, Yokoyama H, Shirakawa S, Kasagi K, et al. Evaluation of safety standards in patients treated with 131I for metastasis from differentiated thyroid cancer. Jpn J Nucl Med Technol (published by Japanese society of Nuclear Medicine Technology). 1998;18:72–8. (in Japanese).

    Google Scholar 

  7. Baba S, Okazaki A, Hamano K, Ito T, Nozaki K, Kobayashi M, et al. Days of hospital treatment and 131I therapy for differentiated thyroid cancer patients—presumption under the measurement of 1 cm dose equivalent rate. Jpn J Radiol Technol (published by Japanese Association of Radiological Technologists). 1997;44:441–6. (in Japanese).

    Google Scholar 

  8. Maxon HR III, Englaro EE, Thomas SR, Hertzberg VS, Hinnefeld JD, Chen LS, et al. Radioiodine-131 therapy for well-differentiated thyroid cancer—a quantitative radiation dosimetric approach: outcome and validation in 85 patients. J Nucl Med. 1992;33:1132–6.

    PubMed  Google Scholar 

  9. Beierwaltes WH, Rabbani R, Dmuchowski C, Lloyd RV, Eyre P, Mallette S. An analysis of “ablation of thyroid remnants” with I-131 in 511 patients from 1947 to 1984: experience at University of Michigan. J Nucl Med. 1984;25:1287–93.

    PubMed  CAS  Google Scholar 

  10. Maxon HR, Thomas SR, Hertzberg VS, Kereiakes JG, Chen IW, Sperling MI, Saenger EL. Relation between effective radiation dose and outcome of radioiodine therapy for thyroid cancer. N Engl J Med. 1983;309:937–41.

    Article  PubMed  CAS  Google Scholar 

  11. Koong SS, Reynolds JC, Movius EG, Keenan AM, Ain KB, Lakshmanan MC, Robbins J. Lithium as a potential adjuvant to 131I therapy of metastatic, well differentiated thyroid carcinoma. J Clin Endocrinol Metab. 1999;84:912–6.

    Article  PubMed  CAS  Google Scholar 

  12. Remy H, Borget I, Leboulleux S, Guilabert N, Lavielle F, Garsi J, et al. 131I effective half-life and dosimetry in thyroid cancer patients. J Nucl Med. 2008;49:1445–50.

    Article  PubMed  CAS  Google Scholar 

  13. Venencia CD, Germanier AG, Bustos SR, Giovannini AA, Wyse EP. Hospital discharge of patients with thyroid carcinoma treated with 131I. J Nucl Med. 2002;43:61–5.

    PubMed  CAS  Google Scholar 

  14. North DL, Shearer DR, Hennessey JV, Donovan GL. Effective half-life of 131I in thyroid cancer patients. Health Phys. 2001;81:325–9.

    Article  PubMed  CAS  Google Scholar 

  15. Kita T, Yokoyama K, Higuchi T, Kinuya S, Taki J, Nakajima K, et al. Multifractional analysis on the short-term side effects occurring within 96 h after radioiodine-131 therapy for differentiated thyroid carcinoma. Ann Nucl Med. 2004;18:345–9.

    Article  PubMed  Google Scholar 

  16. Van Nostrand D, Nertze J, Atkins F. Side effect of “radiation dose” iodine-131 therapy for metastatic well-differentiated thyroid carcinoma. J Nucl Med. 1986;27:1519–27.

    PubMed  Google Scholar 

  17. Seabold JE, Ben-Haim S, Pettit WA, Gurli NJ, Rojeski MT, Flanigan MJ, et al. Diuretic-enhanced I-131 clearance after ablation therapy for differentiated thyroid cancer. Radiology. 1993;187:839–42.

    PubMed  CAS  Google Scholar 

  18. Menzel C, Kranert WT, Döbert N, Diehl M, Fietz T, Hamscho N, et al. rhTSH stimulation before radioiodine therapy in thyroid cancer reduces the effective half-life of 131I. J Nucl Med. 2003;44:1065–8.

    PubMed  CAS  Google Scholar 

  19. Turner JH. Outpatient therapeutic nuclear oncology. Ann Nucl Med. (in press, 2012). doi:10.1007/s12149-011-0566-z.

  20. Kinuya S. A nuclear power plant accident in Fukushima: what should we do? Ann Nucl Med. (in press, 2012). doi:10.1007/s12149-011-0555-2.

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Authors and Affiliations

  1. Department of Radiology, Sapporo Medical University, S-1 W-16, Chuo-Ku, Sapporo, 060-8543, Japan

    Naoya Yama, Koh-ichi Sakata, Hideki Hyodoh, Mitsuharu Tamakawa & Masato Hareyama

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  1. Naoya Yama
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  2. Koh-ichi Sakata
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  3. Hideki Hyodoh
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  4. Mitsuharu Tamakawa
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Correspondence to Naoya Yama.

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Yama, N., Sakata, Ki., Hyodoh, H. et al. A retrospective study on the transition of radiation dose rate and iodine distribution in patients with I-131-treated well-differentiated thyroid cancer to improve bed control shorten isolation periods. Ann Nucl Med 26, 390–396 (2012). https://doi.org/10.1007/s12149-012-0586-3

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