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Variations in radioiodine ablation: decision-making after total thyroidectomy

Journal Paper/Review - Nov 9, 2019

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Citation
Maas O, Weidner S, Walter M, Schaefer N, Rottenburger C, Kneifel S, Kamel M, Haldemann A, Giovanella L, Engel-Bicik I, Brühlmeier M, Blautzik J, Panje C, Maas M, Forrer F, Putora P. Variations in radioiodine ablation: decision-making after total thyroidectomy. Eur J Nucl Med Mol Imaging 2019
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Journal Paper/Review (English)
Journal
Eur J Nucl Med Mol Imaging 2019
Publication Date
Nov 9, 2019
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Issn Electronic
1619-7089
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BACKGROUND
The role of radioiodine treatment following total thyroidectomy for differentiated thyroid cancer is changing. The last major revision of the American Thyroid Association (ATA) Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer in 2015 changed treatment recommendations dramatically in comparison with the European Association of Nuclear Medicine (EANM) 2008 guidelines. We hypothesised that there is marked variability between the different treatment regimens used today.

METHODS
We analysed decision-making in all Swiss hospitals offering radioiodine treatment to map current practice within the community and identify consensus and discrepancies. RESULTS AND CONCLUSION: We demonstrated that for low-risk DTC patients after thyroidectomy, some institutions offered only follow-up, while RIT with significant activities is recommended in others. For intermediate- and high-risk patients, radioiodine treatment is generally recommended. Dosing and treatment preparation (recombinant human thyroid stimulation hormone (rhTSH) vs. thyroid hormone withdrawal (THW)) vary significantly among centres.