• 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.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.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.2
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• pp.132-140
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• 2006

Well-differentiated thyroid cancer is the most common endocrine malignancy with an increasing incidence. Most patients with well-differentiated thyroid caner have a favorable prognosis with high survival rate. While surgery and radioiodine therapy is sufficient treatment for the majority of patients with differentiated thyroid cancer, a minority of these patients experiences progressive, life-threatening growth and metastatic spread of the disease. Because there is no prospective controlled study to evaluate the differences of management of thyroid cancer, it is hard to choose the best treatment option. And there are still lots of controversies about the management of this disease, such as surgical extent, proper use of radioiodine for remnant ablation and therapy, use of rhTSH instead of withdrawal of thyroid hormone, long-term follow-up strategy, thyroglobulin as a tumor marker, etc. In this review, recent data related to these conflicting issues and recent advances in diagnosis, radioiodine therapy and long-term monitoring of well-differentiated thyroid cancer are summarized.

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.32-42
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• 1996

This study was desinged to evaluate the effect of radioactive iodine-131 therapy in differentiated thyroid carcinoma treated at the Presbyterian Medical Center, Chonju during the 20-year period from 1975 to 1994. The authors reviewed 246 patients who received radioactive iodine-131. An analysis of the therapeutic response and survival rates of the 246 patients has been carried out. The male to female ratio was 1 : 3.6. The peak incidence was in the 4th and 6th decades. The histologic findings in the 246 patients were papillary adenocarcinoma in 200 cases, follicular adenocarcinoma in 29 cases, mixed type in 14 cases, and others in 3 cases. Combined treatment modalities of 246 patients consisted of sugery and radioiodine in 222 cases, surgery with radioiodine and external irradiation in 11 cases, and surgery with radioiodine, external irradiation and chemotherapy in 5 cases. 42 of the 246 cases showed recurrence and the commonest type of combined treatment for recurrent case was surgery followed by radioiodine-131. The highest accumulated total dosage of radioiodine-131 was 480mCi in that case femoral metastasis was noticed. The most common locoregional metastatic site was ipsilateral cervical node, and neighbouring muscle, vessel, trachea, recurrent layngeal nerve, in order of frequency. The determinate 10-year survival rate was 91.8% in the group receiving surgery followed by radioiodine-13l and 71.4% in patients receiving surgery, radioiodine-13l with XRT. The determinate 10-year survival rate was better for patients under 40 years of age who received radioiodine as compared to patients over 40 year of age(85.7% vs. 33.3%). The most usual primary therapeutic dosage in the group of cervical lesion was 90$\sim$120mCi after surgery.

• Korean Journal of Veterinary Research
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• v.28 no.2
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• pp.391-396
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• 1988

Appreciable radiation exposures certainly occur in the workers who handle radioiodine in biochemical research, nuclear medicine diagnostics with the development of nuclear industries. But in the case of occurring the nuclear accidents, the early medical treatment of radiation injury should be necessary but little was reported in korea till now. Accordingly, to achieve of the basic data for protective roles and medical treatment of radiation injury, the present studies were carried out to evaluate the decontamination of radioiodine by the administration of the antithyroid drugs. The results observed are summarized as follows: 1. The administration of sodium iodide and potassium iodide results in rapid excretion of radioiodine and reduction of the whole body retention than the saline-only group. 2. Reguarding to thyroid protective effects, sodium iodide, potassium iodide and saline were effected significant in order. 3. In the control(saline) group, if administered with enough fluids, the whole body retention of radioiodine is reduced temporary shifts. But as far as radioprotective effects is concerned, saline was not more in the protective effects than the other groups. In conclusion, in case of nuclear accidents, if being administered sodium iodide and saline as quickly as possible, the radioprotective effects against the radiation hazard might be markedly increased in the internal contamination of radioiodine.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.39.1-39.6
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• 2019

Background: Radioiodine therapy has been widely used for thyroid disease patients, but hyposalivation and xerostomia may occur in 10~30% of patients. Sialocentesis is a procedure that removes inflammatory substances in the salivary duct and expands the duct for the secretion and delivery of saliva. In this study, thyroid disease patients treated with radioactive iodine were selected among the patients with xerostomia who visited the hospital, and the effect of sialocentesis was compared and analyzed. And then, comparison between the radioiodine therapy-experienced group and the non-radioiodine therapy-experienced group was conducted. Results: In this study, we studied xerostomia patients who underwent radioiodine therapy due to thyroid diseases and who underwent sialocentesis at the Korea University Anam Hospital. Sialocentesis is conducted by one surgeon. The study also compares the clinical symptoms before and after the surgery. After the procedure, the discomfort due to xerostomia was reduced, and the symptom was improved effectively. Conclusions: The results of this study showed that sialocentesis has a clinical effect in the treatment of xerostomia, which is a side effect of radioiodine therapy. In addition, the possibility of further clinical application of sialocentesis in the future is found.

• 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.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.259-279
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• 2009

Radioiodine ablation therapy has been considered to be a standard treatment for patient with differentiated thyroid cancer after total thyroidectomy. Patients may need to be hospitalized to reduce radiation exposure of other people and relatives from radioactive patients receiving radioiodine therapy. Medical staffs, nursing staffs and technologists sometimes hesitate to contact patients in radioiodine therapy ward. The purpose of this paper is to introduce radiation dosimetry, estimate radiation dose from patients and emphasize the safety of radiation exposure from patients treated with high dose radioiodine in therapy ward. The major component of radiation dose from patient is external exposure. However external radiation dose from these patients treated with typical therapeutic dose of 4 to 8 GBq have a very low risk of cancer induction compared with other various risks occurring in daily life. The typical annual radiation dose without shielding received by patient is estimated to be 5 to 10 mSv, which is comparable with 100 to 200 times effective dose received by chest PA examination. Therefore, when we should keep in mind the general principle of radiation protection, the risks of radiation exposure from patients are low and the medical personnel are considered to be safe from radiation exposure.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.7-12
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• 1989

The pain, swelling of salivary glands and dry mouth are not infrequent complication of the high dose radioiodine treatment in the patients with differentiated thyroid cancer. The purpose of this study was, by the dynamic salivary scintigraphy, to observe the change of the salivary function after the high dose $(150\sim200mci)$ radioiodine treatment. From May 1987 to April 1988, the dynamic salivary scintigraphy with 5mci of $^{99m}Tc-pertechnetate$ and gamma camera was performed before and 7 days after the radiolodine treatment in 7 patients with differentiated thyroid cancer. Just after the dynamic scintigraphy, the stimulation test with vitamin C solution of pH3.0 and poststirnulation scintigraphy were done, and the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were calculated for each gland. There was positive correlation between the radioactivity uptake index and excretion fraction after the stimulation. The salivary clearance after the stimulation was $18.96{\pm}8.95ml/min$ in the pretreatment state, and $14.37{\pm}7.7ml/min$ after the radioioine treatment. After the radioiodine treatment, the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were significantly reduced in the parotid glands, but only the excretion fraction was reduced in the submandibular glands. The more the pretreatment salivary clearance after the stimulation was, the % change after the treatment was smaller. Further studies on the relation between the radiation dose in the salivary glands and the change of their function, and the long-term observation for the recovery of function are expected.