Differentiated Thyroid Cancer and Radioactive Iodine: Past, Present and Future

Jaetae Lee; Il Jo

doi:10.11106/ijt.2019.12.2.71

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Lee and Jo: Differentiated Thyroid Cancer and Radioactive Iodine: Past, Present and Future

Review Article

International Journal of Thyroidology 2019; 12(2): 71-78.

Published online: 30 November 2019

DOI: https://doi.org/10.11106/ijt.2019.12.2.71

Differentiated Thyroid Cancer and Radioactive Iodine: Past, Present and Future

Jaetae Lee, Il Jo

Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.

Correspondence: Jaetae Lee, MD, PhD, Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5586, Fax: 82-53-200-3419, jaetae@knu.ac.kr

Received 30 September 2019 Revised 14 November 2019 Accepted 14 November 2019

The Korean Thyroid Association

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radioiodine has been known as an important and safe armamentarium in the diagnosis and treatment of differentiated thyroid cancer (DTC) for more than 70 years. The 2015 guidelines from the American Thyroid Association (ATA) for adults with thyroid nodules and DTC seem to be the most comprehensive guidelines in the thyroid cancer field. The 2015 ATA guidelines provided an advance in evidence-based management of DTC, and resulted in a significant change in the patterns of practice regarding the application of the radioiodine. However, the 2015 ATA guidelines also provoked much controversy because a substantial portion of the recommendations announced were not based on sufficiently strong evidence. While the number of radioiodine administrations in Korea in the year of 2018 has decreased to a level less than 50% of that in 2013, in this review, we address some of the current issues and controversies regarding the application of radioiodine for the diagnosis, ablation and treatment of DTC, especially related to the 2015 ATA guidelines. Possible strategies for the achievement of better quality in radioiodine imaging and improvement in treatment efficiency that can be used in the near future are also discussed here.

Keywords: Differentiated thyroid cancer, Radioactive iodine, 2015 ATA guidelines

Figures and Tables

Fig. 1

Changes in the number of admission room designated for radionuclide treatment between 2007 and 2012.

Fig. 2

Changes in the number of thyroid surgery for thyroid cancer between 2010 and 2017.

Fig. 3

Changes in the number of patients who had I-131 treatment for differentiated thyroid cancer.

Table 1

Classification of recommendations in 2015 ATA guideline according to the levels of quality evidence

ATA: American Thyroid Association

Table 2

Martinique principles

Cited from Reference 34.

Acknowledgments

This work was supported by a grant of the Korea Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (Grant Number: HI16C1501).

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