• Title/Summary/Keyword: radioiodine treatment

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Management of Hypertension and Proteinuria after Treatment with Lenvatinib for Radioiodine Refractory Papillary Thyroid Carcinoma: a Case Report (렌바티닙 사용과 관련된 고혈압과 단백뇨의 관리: 증례 보고)

  • Song, Eyun;Kim, Won Gu
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.78-81
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    • 2018
  • Lenvatinib, an oral multi-kinase inhibitor, is a valuable treatment option for advanced differentiated thyroid carcinoma. However, severe treatment-related adverse events occur up to 30% of the patients receiving lenvatinib, making it a challenge for clinicians to maintain this drug and therefore affecting the outcome of therapy. Blood vessel related events, such as hypertension or proteinuria, are among the most frequent adverse events. We present a case of 65-year-old man with radioactive iodine refractory papillary thyroid carcinoma with cervical lymph node metastasis and tracheal invasion receiving lenvatinib who developed proteinuria and worsening of hypertension. Management with repeated dose reductions and using supportive medications allowed this patient to continue lenvatinib with his disease stably controlled. Early detection of patients at risk for these adverse events and cautious administration of lenvatinib at appropriate level are crucial in managing patients receiving lenvatinib.

Investigations of the External Dose Rate (${\mu}Sv/h$), the Residual Activity (mCi) and the Excretion Rate (%) of Thyroid Cancer Patients Hospitalized for 3700 MBq (100 mCi) $^{131}I$ Radioiodine Treatment ($^{131}I$ 3700 MBq (100 mCi) Therapy 입원 환자의 선량률(${\mu}Sv/h$), 잔류량(mCi), 배설률(%) 측정)

  • Bae, Gi-Han;Kim, Hwa-Joong;Choi, Jae-Jin;Lee, Won-Guk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.48-55
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    • 2009
  • Purpose: As Korean nuclear law doesn't have any clear guideline about the dose and the external dose rate(uSv/h) requiring hospitalization in radioactive iodine treated patients, the patients are discharged when they meet the guideline of IAEA Basic Safety Standards(BSS). We measured external dose rate(${\mu}Sv/h$) of inpatient underwent 3700MBq (100 mCi) $^{131}I$ radioiodine treatment and considering external dose rate(${\mu}Sv/h$), residual activity(mCi) and excretion rate(%) we found the time for RA to be lowered from 3700MBq (100 mCi) to 1110 MBq (30 mCi) to give reference to set a guideline for discharge. Materials and Methods: Forty-two patients underwent thyroidectomy and scheduled for radioiodine treatment, who received 3700MBq (100 mCi) of $^{131}I$ orally and had no renal disease were examined. After 1, 2, 4, 8, and 20, 24, 40 hours iodine uptake and before/after the urination, the external dose rate(${\mu}Sv/h$) measured using FH40G-L(Thermo Fisher Scientific Inc., MA) at a distance and a height of 1 m for 20 sec on the average. Results and Conclusions: At 20 hours, the external dose rate was decreased to $49{\pm}13\;{\mu}Sv$/h, namely, 78% of administrated radioactivity was excreted and 814 MBq (30 mCi) was residual, and it met the accepted limit for discharge of (IAEA, BSS) under 1110 MBq (30 mCi) (1 m at 66 uSv/h).

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Value of the Serum Thyroglobulin Level Alteration at the First High Dose Radioiodine Treatment in Patients with Differentiated Thyroid Carcinoma (분화성갑상선암에서 최초 고용량 방사성요오드 치료시 혈청 갑상선글로불린 수치 변화의 의의)

  • Nam, Hyun-Yeol;Kim, In-Joo;Kim, Yong-Ki;Kim, Seong-Jang;Jun, Sung-Min;Kim, Bum-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.294-300
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    • 2009
  • Purpose: The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. Materials and Methods: A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. Results: RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P = 0.03, the THW group; P = 0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0$\leq$5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. Conclusion: We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients.

Evaluation of Stability using Monte Carlo Simulation in 2 People Isolation Treatment Room of Radiation Iodine (몬테카를로 모의 모사를 이용한 방사성옥소 2인 치료병실의 안전성 평가)

  • Jang, Dong-Gun;Ko, Sung-Jin;Kim, Chang-Soo;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.385-390
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    • 2016
  • Radioactive iodine treatment that uses the 2 people isolation room is to cause unnecessary radiation exposure between patients. This research is to be tested safety of 2 people Isolation treatment room and dose-rate through conservative perspective except physiology characteristic and biology information on the assumption that patient have iodine without excretion in 2 people isolation treatment room. This research shows that 364 keV gamma rays emitted by the radioiodine was to determine that the air layer about 30 cm or lead shield 3 mm a half-layer. In addition, In addition, patients in the distance, and lead shielding, length of hospital stay (48 hours) for external radiation exposure that is received from the other patients, two of treatment as appears to be lower than the legal isolation standard dose less than 5 mSv isolation room effective analyzed that manageable.

Radioactive Iodine Therapy Room a Part University Hospital of the Actual Conditions of Safety Management Consideration (일부 대학병원 방사성옥소 치료병실의 안전관리로 본 실태 고찰)

  • Han, Sang-Hyun;Lee, Sang-Ho
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.373-381
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    • 2012
  • Using Radioiodine therapy of thyroid cancer in the past have been used for decades as many look forward to continuing treatment be used, and the current outlook of in korea 2010 based on the number of Iodine therapy room is operated by 124, but still is lacking. So many hospitals opened their therapy room, but importantly, increasing number of treatment rather than therapy room current treatment is that it must be preceded by the proper administration of the. Therefore therapy room expansion, discussions about before now being applied therapy room safety management standards, and a part university hospital based safety management standards by examining how well kept and that the therapy room to the use of the overall safety management research on the actual condition were discussed.

Clinical Prognostic Score for Predicting Disease Remission with Differentiated Thyroid Cancers

  • Somboonporn, Charoonsak;Mangklabruks, Ampica;Thakkinstian, Ammarin;Vatanasapt, Patravoot;Nakaphun, Suwannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2805-2810
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    • 2016
  • Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

Results of Radioiodine Treatment for Distant Metastases of Differentiated Thyroid Carcinoma (분화성 갑상선암의 원격 전이에서 방사성옥소 치료 성적)

  • Kim, Yu-Kyeong;Chung, June-Key;Kim, Seok-Ki;Yeo, Jung-Seok;Park, Do-Joon;Jeong, Jae-Min;Lee, Dong-Soo;Cho, Bo-Youn;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.107-118
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    • 2000
  • Purpose: To evaluate the effectiveness of radioiodine treatment for metastatic thyroid carcinoma, we reviewed results of radioactive iodine treatment in patients with functional lung or bone metastases. Materials and Methods: Of 760 patients who were treated for differentiated thyroid cancer between 1984 and 1998, we detected pulmonary metastases and bone metastases in 76 patients (10.0%) and 20 patients (2.6%), respectively. Among them, we could evaluate the effectiveness of I-131 therapy in 53 patients with lung metastases and 15 patients with bone metastases. Results: Of 53 patients who received I-131 therapy with a mean cumulative dose of 26.2 GBq (1.1-84.4 GBq) for pulmonary metastases, metastatic lung lesions completely resolved in 19 patients (35.8%) and improved in 22 patients (41.5%). In 13 of 19 patients with complete remission of pulmonary metastases, the total accumulated dose of I-131 was less than 18.5 GBq. We found 43 sites of metastatic bone lesions in 15 patients with bone metastases. Of 29 lesions which received I-131 therapy, metastatic lesions improved in 14 sites (48.3%), but did not change or progress in 15 sites (51.7%) despite the I-131 therapy. Three lesions were completely cured with a combination treatment of surgery(${\pm}$ external radiotherapy) and I-131 therapy, and the other 11 lesions improved. Conclusion: Radioactive iodine treatment gives favorable results for pulmonary metastases. However, for bone metastases, there might be a need to use combination therapy including I-131 and surgery or external irradiation.

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Radio-Iodinated arbutin for tumor imaging

  • Huynh, Phuong Tu;Ha, Yeong Su;Lee, Woonghee;Yoo, Jeongsoo
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.3 no.2
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    • pp.72-79
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    • 2017
  • Arbutin is a hydroquinone derivative with a glucose moiety. As a tyrosinase inhibitor, it is widely used as a skin-whitening cosmetic agent for the treatment of cutaneous hyperpigmentary disorders, such as melasma and freckles. In the medical field, many studies have addressed the use of arbutin in various tumors, but the mechanism for tumor uptake of arbutin is still unclear. In this paper, we radiolabeled arbutin using radioiodine and studied its pharmacokinetics and tumor uptake via biodistribution experiments and single-photon emission computed tomography (SPECT) imaging. Radiolabeled $^{131}I-arbutin$ was stable for up to 24 h in PBS and serum. Biodistribution studies and SPECT imaging indicated high uptake of the compound in the bladder and kidneys shortly after injection. Twenty-four hours post-injection, significant deiodination was observed. Apart from high thyroid uptake, selective tumor uptake was clearly observed. The tumor-to-muscle and tumor-to-blood ratios were 26 and 9, respectively.

Follicular Thyroid Carcinoma Associated with Macroscopic Vascular Invaion and Intraluminal Tumor Thrombosis in Great Cervical Veins : Two Case Reports (경부의 주정맥 침범과 암성 혈전을 보인 여포상 갑상선암 2예)

  • Lim Jun-Sup;Lee Jan-Dee;Yun Ji-Sup;Lim Chi-Young;Nam Kee-Hyun;Chang Hang-Seok;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.58-61
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    • 2006
  • Differentiated thyroid carcinomas are rarely associated with macroscopic vascular invasion and intraluminal tumor thrombus in great cervical veins. The best treatment for such cases appears to be a total thyroidectomy with en-block resection of the involved vessels, followed by postoperative radioiodine therapy(RI). We report two cases of follicular thyroid carcinoma with vascular invasion and intraluminal tumor thrombosis in great cervical veins that were successfully treated using complete surgical resection and postoperative RI.

Evaluation of decontamination factor of radioactive methyl iodide on activated carbons at high humid conditions

  • Choi, Byung-Seon;Kim, Seon-Byeong;Moon, Jeikwon;Seo, Bum-Kyung
    • Nuclear Engineering and Technology
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    • v.53 no.5
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    • pp.1519-1523
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    • 2021
  • Radioactive iodine (131I) released from nuclear power plants has been a critical environmental concern for workers. The effective trapping of radioactive iodine isotopes from the off-gas stream generated from nuclear facilities is an important issue in radioactive waste treatment systems evaluation. Numerous studies on retaining methyl iodide (CH3I131) by impregnated activated carbons under the high content of moisture have been extensively studied so far. But there have been no good results on how to remove methyl iodide at high humid conditions up to now. A new challenge is to introduce other promising impregnating chemical agents that are able to uptake enough radioactive methyl iodide under high humid conditions. In order to develop a good removal efficiency to control radioiodine gas generated from a high humid process, activated carbons (ACs) impregnated with triethylene diamine (TEDA) and qinuclidine (QUID) were prepared. In addition, the removal efficiencies of the activated carbons (ACs) under humid conditions up to 95% RH were evaluated by applying the standard method specified in ASTM-D3808. Quinuclidine impregnated activated carbon showed a much higher decontamination factor above 1,000, which is enough to meet the regulation index for the iodine filters in nuclear power plants (NPPs).