Variations in radioiodine ablation: decision-making after total thyroidectomy

O Maas; F Forrer; M Maas; C M Panje; J Blautzik; M Brühlmeier; I Engel-Bicik; L Giovanella; A Haldemann; M E Kamel; S Kneifel; C Rottenburger; N Schaefer; M A Walter; S Weidner; P M Putora

doi:10.1007/s00259-019-04557-4

Variations in radioiodine ablation: decision-making after total thyroidectomy

Eur J Nucl Med Mol Imaging. 2020 Mar;47(3):554-560. doi: 10.1007/s00259-019-04557-4. Epub 2019 Nov 9.

Authors

O Maas¹, F Forrer², M Maas², C M Panje³, J Blautzik⁴, M Brühlmeier⁵, I Engel-Bicik⁶, L Giovanella⁷, A Haldemann⁸, M E Kamel⁹, S Kneifel¹⁰, C Rottenburger¹¹, N Schaefer¹², M A Walter¹³, S Weidner¹⁴, P M Putora^{3

15}

Affiliations

¹ Department of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland. olechristopher.maas@kssg.ch.
² Department of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.
³ Department of Radiation Oncology, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland.
⁴ Department of Radiology and Nuclear Medicine, Hislanden Klinik St. Anna, St. Anna-Strasse 32, 6006, Luzern, Switzerland.
⁵ Nuclear Medicine and PET-Centre, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland.
⁶ Department of Nuclear Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
⁷ Department of Nuclear Medicine and PET-Centre, Regional Hospital Lugano and Bellinzona, Via Officina 3, 6500, Bellinzona, Switzerland.
⁸ Department of Radiology and Nuclear Medicine, Stadtspital Triemli, Birmensdorferstrasse 497, 8063, Zurich, Switzerland.
⁹ Department of Nuclear Medicine, Hôpital du Valais, Av. Grand-Champsec 80, 1951, Sion, Switzerland.
¹⁰ Department of Nuclear Medicine, Cantonal Hospital Graubünden Chur, Loëstrasse 170, 7000, Chur, Switzerland.
¹¹ Department of Radiology and Nuclear Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
¹² Department of Nuclear Medicine, University Hospital Lausanne, Rue de Bugnon 46, 1011, Lausanne, Switzerland.
¹³ Department of Nuclear Medicine, University Hospital Geneva, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
¹⁴ Department of Nuclear Medicine, Inselspital Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
¹⁵ Department of Radiation Oncology, University of Bern, Bern, Switzerland.

PMID: 31707428
DOI: 10.1007/s00259-019-04557-4

Abstract

Background: The role of radioiodine treatment following total thyroidectomy for differentiated thyroid cancer is changing. The last major revision of the American Thyroid Association (ATA) Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer in 2015 changed treatment recommendations dramatically in comparison with the European Association of Nuclear Medicine (EANM) 2008 guidelines. We hypothesised that there is marked variability between the different treatment regimens used today.

Methods: We analysed decision-making in all Swiss hospitals offering radioiodine treatment to map current practice within the community and identify consensus and discrepancies. RESULTS AND CONCLUSION: We demonstrated that for low-risk DTC patients after thyroidectomy, some institutions offered only follow-up, while RIT with significant activities is recommended in others. For intermediate- and high-risk patients, radioiodine treatment is generally recommended. Dosing and treatment preparation (recombinant human thyroid stimulation hormone (rhTSH) vs. thyroid hormone withdrawal (THW)) vary significantly among centres.

Keywords: Decision Making; Radioiodine; Thyroidectomy; Treatment.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Iodine Radioisotopes / therapeutic use
Thyroid Neoplasms* / radiotherapy
Thyroid Neoplasms* / surgery
Thyroid Nodule*
Thyroidectomy
Treatment Outcome

Substances

Iodine Radioisotopes