|
KMID : 1202020100030010001
|
|
Journal of Korean Thyroid Association
2010 Volume.3 No. 1 p.1 ~ p.7
|
|
|
Research on the Management of Thyroid Carcinoma Using Nuclear Medicine Technique
|
|
Chung June-Key
|
|
|
Abstract
|
|
|
|
After specific accumulation of iodide in the thyroid gland was found, nuclear medicine techniques including radioactive iodine have been important roles in the management of differentiated thyroid cancer. For the detection of cancer recurrence/metastasis after thyroidectomy, serum Tg measurement is the most sensitive modality. However, it is affected in the presence of anti-Tg antibody. Persistently elevated anti-Tg antibody levels appear to serve as a useful marker for residual cancer. A significant number of differentiated thyroid cancer patients had negative Tg level with negative anti-Tg antibody despite a positive radioiodine scan finding. Diffuse liver uptake on whole-body scan without thyroid remnant or metastasis suggests hidden metastases. FDG PET scan localizes metastatic sites in radioiodine scan-negative carcinoma patients with high accuracy. We found that lung metastases were completely resolved in 35%, and partially resolved in 40% after I-131 therapy. The treatment to bone metastasis needed combination therapy with surgical resection or external radiation therapy. When patients are refractory to the conventional fixed dose of I-131 therapy, the administration dose could be increased within maximal safe dose based on radiation dose to the bone marrow. The other could be using retinoic acid to induce re-differentiation and to restore the accumulation of radioiodine in cancer cells. NIS activity is the molecular basis of radioiodine therapy in thyroid cancer. Several medications have been investigated to enhance the expression of NIS gene and protein. The recent cloning and characterization of the NIS gene has paved the way for the development of novel radionuclide gene therapy. This novel therapy is being improved by several modified approaches, and can be applied in the near future.
|
|
|
KEYWORD
|
|
|
Thyroid cancer, Radioiodine, Nuclear medicine, Treatment, Gene therapy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|
|