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Pretherapeutic dosimetry in patients affected by metastatic thyroid cancer using I-124 PET/CT sequential scans for I-131 treatment planning

Pettinato, Cinzia, Spezi, Emiliano, Nanni, Cristina, Grassetto, Gaia, Monari, Fabio, Allegri, Vincenzo, Civollani, Simona, Cima, Simona, Zagni, Paolo, Mazzarotto, Renzo, Colletti, Patrick M., Rubello, Domenico and Fanti, Stefano 2014. Pretherapeutic dosimetry in patients affected by metastatic thyroid cancer using I-124 PET/CT sequential scans for I-131 treatment planning. Clinical Nuclear Medicine 39 (8) , E367-E374. 10.1097/RLU.0000000000000490

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Abstract

Purpose: This study evaluates the use of sequential 124I PET/CT for predicting absorbed doses to metastatic lesions in patients with differentiated thyroid cancer undergoing 131I therapy. Methods: From July 2011 until July 2013, 30 patients with metastatic differentiated thyroid cancer were enrolled. Each participant underwent PET/CT at 4, 24, 48, and 72 hours with 74 MBq of 124I. Blood samples and whole-body exposure measurements were obtained to calculate blood and red marrow doses. Activity concentrations and lesion volumes obtained from PET/CT were used to evaluate tumor doses with medical internal radiation dose formalism and spheres modeling. Mean administered 131I therapeutic dose was 5994 MBq (range, 1953–11,455 MBq). Results: 124I PET/CT demonstrated all lesions detected by posttherapy 131I whole-body scans. Mean dose rates for blood, red marrow, and lesions were as follows: 0.07 ± 0.02 mGy/MBq, 0.05 ± 0.02 mGy/MBq, and 46.5 ± 117 mGy/MBq, respectively. Despite the high level of thyroid-stimulating hormone and CT detectable lesions, 15 of 30 patients did not show any abnormal 124I uptake. Conclusions: The quantitative value of 124I PET/CT allows simple and accurate evaluation of lesion dosimetry following medical internal radiation dose formalism. Negative 124I PET/CT predicts absence of iodine avidity, potentially allowing avoidance of therapeutically ineffective 131I administration.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Publisher: Lippincott, Williams & Wilkins
ISSN: 0363-9762
Last Modified: 21 Feb 2019 15:56
URI: http://orca.cardiff.ac.uk/id/eprint/72525

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