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Optimization of Ablative Dose for Thyroid Cancer

Author(s): Farias de Lima, Fabiana. | Gregory Stabin, Michael. | Jamil Khoury, Helen.

Journal: Alasbimn Journal
ISSN 0717-4055

Volume: 9;
Issue: 36;
Date: 2007;
Original page

Keywords: Thyroid ablation therapy | SPECT | I-131 | metabolismo

This investigation proposes a protocol for planning of thyroid ablation therapy for individual patients, based on individual patient metabolic data and measured thyroid remnant masses. Using SPECT, I-131 uptake and clearance was studied in 9 patients who had undergone thyroidectomies, and the optimum activity for their therapy was calculated and compared to the established fixed activity of 3.7 GBq (100 mCi), which normally would have been assigned. It was observed that 7 of the patients could have received reduced activities of 131I (from 0.8-3.2 GBq (20-87 mCi)). In addition, 3 patients could have received low enough activities to have been discharged from the hospital. To facilitate the calculations of the optimum therapeutic activity of 131I for individual patients, a computer program was created (PlanDose). This protocol of calculated optimal patient-specific 131I activities allows a better determination of the necessary ablative dose for patients with differentiated carcinoma of the thyroid, and is an important example of optimization of the practice of radiation protection.Esta investigación propone un protocolo de planificación individualizada de dosis ablativas basado en el metabolismo individual del paciente y en la medida de la masa de los remanescientes tiroideanos. Utilizando SPECT, el metabolismo de I-131 fue estudiado en 9 pacientes tiroidectomizados, y la actividad optima para la terapia fue calculada y comparada con la actividad fija establecida de 3.7 GBq (100 mCi), que és en general administrada. Fue observado que 78% de las pacientes podrian tener recibido actividades reduzidas de 131I (de 0.8-3.2 GBq (20-87 mCi)). Además, 33% destes pacientes podrian recibir actividades tan bajas que no necesitarian internamiento hospitalar. Visando facilitar los calculos de la actividad terapeutica optima de 131I hacia pacientes individuales, un programa de planificación de dosis simples y rápido fue criado (PlanDose). Este protocolo de cálculo de actividades de 131I específicas para el paciente permite una mejor determinación de la dosis ablativa necesaria en caso de pacientes con carcinoma diferenciado de la tiroide, y és un ejemplo de optimización de la práctica de protección radiologica.

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