核医学教学课件：Iodine-131 treatment for Differentiated Thyroid Carcinoma.ppt

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Thyridcancer
Papillarythyroidcarcinoma
Follicularthyroidcarcinoma
Others:medullarythyroidcancer,anaplasticthyroidcancer.
Etiology
Priorexposuretoradiation
Dietaryfactors
Genetic,endocrineandimmunity
Clinicalfeatures
Solitarythyroidnoduleinanteriorcervicaltriangle.
Tobediscoveredbyaccidentoronroutinephysicalexamination.
Painlessandmovesdruingdeglutition
Diagnosis
Fine-needleaspirationofthyroidnodules
Thyroidradioactivescan
Ultrasound
CTorMRI
pathology
Treatment
Surgical
therapy
iodine-131
therapy
thyroid
hormone
Treatment
Surgeryistoclearupprimarylesion,mostnormalthyroidtissueandregionalmetastases.
131Iistoablatetheremnantthyroidtissueandmetastases
Lifelongthyroidhormonereplacementistopreventhypothyroidismandrelapse
Principle
Thyroidglandaccumulate131I.
Welldifferentiatedthyroidcancerscantakeup131I.
Theβ-radiationdestroythosecancerlesions.
Whydopatientsneed131Itherapy?
Therearestillsomeminimumcancersintheremnantthyroidtissue.
Ifweablatetheremnanttissue,itisbettertofindmetastases.
Examinethelevelofthyroglobulin.
Higherablationdosedetectremnantormetastasesbetterthandiagnosticdose.
Wholebodyscanafterfirst131Itherapy
Wholebodyscanaftersecond131Itherapy