Thyroid Cancer

Thyroid Cancer Imaging - I-123/I-131 Planar & SPECT/CT and F-18 FDG PET/CT

Patient Preparation

Recommended withdrawal times for various medications before diagnostic imaging or therapy with radioactive iodine is described below. (Click below to enlarge the table.)

Well-Differentiated Thyroid Cancer

Backlog

Razfar A et al. Clinical Usefulness of Positron Emission Tomography–Computed Tomography in Recurrent Thyroid Carcinoma. Arch Otolaryngol Head Neck Surg. 2010;136(2):120-125. (AOHNS link)

Shammas A et al. 18F-FDG PET/CT in Patients with Suspected Recurrent or Metastatic Well-Differentiated Thyroid Cancer. J Nucl Med 2007; 48(2): 221-226. (JNM link)

Management (DTC)

Society of Nuclear Medicine Procedure Guideline for Scintigraphy for Differentiated Papillary and Follicular Thyroid Cancer. SNM.

Therapy (DTC)

Society of Nuclear Medicine Procedure Guideline for Therapy of Thyroid Disease with Iodine-131 (Sodium Iodide). Version 2.0. SNM.

Medullary Thyroid Cancer

Backlog

Ong SC et al. Diagnostic Accuracy of 18F-FDG PET in Restaging Patients with Medullary Thyroid Carcinoma and Elevated Calcitonin Levels. J Nucl Med 2001; 42(1): 77-78. (JNM link)

Notes

According to recent NEJM articles, Thyrogen as a preparation for iodine uptake is "non-inferior" to TH Withdrawal (THW) for Stage I and II DTC. There is not enough data to say this for Stage III and IV DTC, so THW is the preferred method of preparation.
- SM at Endocrinology MDTB 7/2014

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