Checklist for registration for patients and referring physicians can be found here.
For further information you can download the Brochure for radioiodine therapy download.
At our nuclear medicine therapy ward, radioiodine is used in individually dosed capsule form for the following indications:
The aim is to achieve normal thyroid function by eliminating autonomous thyroid tissue.
The dosage is determined individually on the basis of a radioiodine test carried out beforehand.
CHECKLIST AUTONOMY
To the make an appointment for the radioiodine test and therapy stay, the following documents/information are required:
- Current documentation of the metabolic situation (in vitro thyroid values), i.e. a suppressed control loop (bTSH<0.1mU/l)
- Thyroid scintigraphy under documented suppression conditions (not older than 6 months), to assess the functionally relevant autonomic tissue (bring original printout)
- Thyroid ultrasonography, to determine the total/nodular volume
- Lack of suspected malignancy in nodules (from scintigraphy, sonographic follow-up and/or cytology)
- Exclusion of pregnancy
- No history of iodine contamination (X-ray contrast media, iodine-containing medication)
- Reports on previous treatment of the thyroid gland (medication, surgery, radioiodine)
The aim is to eliminate hyperthyroidism by eliminating the thyroid gland (ablative concept).
The dosage is determined individually on the basis of a radioiodine test carried out beforehand. If possible, the therapy should be carried out without thyrostatic medication. In the case of florid disease, close coordination takes place in order to discontinue the medication 3 days before a short radioiodine test, which is then followed by therapy as quickly as possible.
If there are risk factors for endocrine orbitopathy (clinical symptoms, smoker, large thyroid gland), treatment is carried out under cortisone protection.
CHECKLIST M. BASEDOW
To the make an appointment for the radioiodine test and therapy stay, the following documents/information are required:
- Confirmation of diagnosis of Graves' disease (Clinical Department, hyperthyroidism, TSH receptor antibodies, sonography/scintigraphy)
- Documentation of a recurrent or persistent course of hyperthyroidism despite thyrostatic medication
- Current in vitro thyroid values, incl. autoantibodies
- Thyroid scintigraphy (not older than 6 months), to assess the functionally relevant tissue (bring original printout)
- Current thyroid sonography, to determine the therapy volume
- absence of suspected malignancy in nodules (from scintigraphy, sonographic follow-up and/or cytology)
- Exclusion of pregnancy
- No history of iodine contamination (X-ray contrast media, iodine-containing medication)
- Reports on previous treatment of the thyroid gland (medication, surgery, radioiodine)
- Information regarding endocrine orbitopathy (if applicable, last ophthalmologic findings, previous treatments, nicotine abuse as a risk factor)
The aim is to reduce the volume, if possible while maintaining normal thyroid function.
The dosage is determined individually on the basis of a radioiodine test carried out beforehand.
CHECKLIST FOR GOITER REDUCTION
To the make an appointment for the radioiodine test and therapy stay, the following documents/information are required:
- Documentation of a complicated goitre, with relative/absolute contraindication to surgical treatment
- Imaging of the trachea, or internal differential diagnosis to exclude other causes of shortness of breath
- Current in vitro thyroid values
- Thyroid scintigraphy (not older than 6 months), to assess the functional volume (bring original printout)
- Thyroid ultrasonography, to determine the total volume
- Lack of suspected malignancy in nodules (from scintigraphy, sonographic follow-up and/or cytology)
- Exclusion of pregnancy in the absence of iodine contamination in the medical history (X-ray contrast media, iodine-containing medication)
- Reports on previous treatment of the thyroid gland (medication, surgery, radioiodine)
The aim is to eliminate residual thyroid tissue or tumor tissue after total thyroidectomy for differentiated (papillary or follicular) thyroid carcinoma.
A further aim is to exclude or detect metastases as a basis for planning further therapy/follow-up care.
The dosage is determined individually, taking into account the postoperative situation, sonographic findings and a pre-therapeutic low-dose iodine whole-body diagnosis.
The therapy is carried out in hypothyroidism under endogenous TSH stimulation.
CHECKLIST FOR RESIDUAL ABLATION IN SD CARCINOMA
To the appointment for the therapy stay, the following documents/information are required:
- Surgical reports of the thyroidectomy(ies)
- Histology report of the surgical specimens
- Inpatient discharge letters after thyroidectomy
- Current thyroid function for documentation of TSH stimulation (target: bTSH >30mU/l)
- Pregnancy exclusion
- lack of iodine contamination
- Reports on further pre-treatment of the thyroid gland (medication, surgery, radioiodine)
The aim is to monitor success after residual ablation or to exclude/detect local recurrence/metastases in the aftercare of differentiated thyroid carcinomas.
Standardized iodine whole-body diagnostics are performed under inpatient conditions, if necessary in combination with extended SPECT-CT diagnostics or, if iodine-negative tumour tissue is suspected, with supplementary FDG PET-CT.
Diagnostics are preferably performed under exogenous stimulation with recombinant TSH as a gentle alternative to hypothyroidism.
CHECKLIST RADIOIODINE WHOLE-BODY DIAGNOSTICS FOR SD CANCER
Patients are often already known to us due to presentations in our SD cancer outpatient clinic . In these cases appointment no further documentation is required.
To the making an appointment for cases not yet known to the clinic, the following documents/information are required:
- Necessity of the scan as part of routine follow-up care or in the case of a concrete suspicion of recurrence
- Information on the previous course (initial diagnosis/therapy, initial staging, further full-body scans, previous follow-up care) including CD of previous therapies
- Pregnancy exclusion
- Lack of iodine contamination
The aim is to eliminate vital, iodine-storing tumor tissue in local recurrence/metastases of differentiated thyroid carcinomas.
The prerequisite is the clear detection of iodine-storing tumor tissue in a previous iodine whole-body diagnosis under inpatient conditions, if possible in combination with extended SPECT-CT diagnostics.
Patients are often already known to us through presentations in our SD carcinoma special outpatient clinic. In these cases appointment no further documentation is required.
To making an appointment For cases not yet known to the clinic, an individual decision is made in the most complex situations, based on individual consultation with the referrer, if necessary with the involvement of interdisciplinary cooperation partners at the MHH.
CHECKLIST FOR WHOLE-BODY RADIOIODINE THERAPY FOR METASTATIC/RECURRENT DIFFERENTIATED THYROID CARCINOMA
Patients are often already known to us through presentations in our SD carcinoma outpatient clinic . In these cases appointment no further documentation is required.
To the making an appointment for cases not yet known to the clinic, the following documents/information are required:
- Need for a scan as part of routine aftercare or in the event of a concrete suspicion of recurrence
- Surgery report, histology/pathology findings, discharge letters from the thyroidectomy
- Doctor's letters from the preliminary nuclear medicine treatments
- Information on previous course (initial diagnosis/therapy, initial staging, further whole-body scans, previous follow-up care) including CD of previous therapies
- Pregnancy exclusion
- lack of iodine contamination