Nuklearmedizin 2018; 57(04): 124-136
DOI: 10.1055/s-0038-1649554
DGN-Handlungsempfehlung (S1-Leitlinie)
Georg Thieme Verlag

Iod-131-Ganzkörperszintigraphie beim differenzierten Schilddrüsenkarzinom

Stand: 7/2017 – AWMF-Registernummer: 031–013Iodine-131 whole-body scintigraphy in differentiated thyroid carcinoma
Frederik A. Verburg
1   Universitätsklinikum Gießen und Marburg, Standort Marburg, Klinik für Nuklearmedizin
,
Frank Grünwald
2   Klinik und Poliklinik für Nuklearmedizin der Universität Frankfurt
,
Michael Lassmann
3   Klinik und Poliklinik für Nuklearmedizin der Universität Würzburg
,
Heribert Hänscheid
3   Klinik und Poliklinik für Nuklearmedizin der Universität Würzburg
,
Markus Luster
1   Universitätsklinikum Gießen und Marburg, Standort Marburg, Klinik für Nuklearmedizin
,
Markus Dietlein
4   Klinik und Poliklinik für Nuklearmedizin des Universitätsklinikums Köln
› Author Affiliations
Further Information

Korrespondenzadresse

Deutsche Gesellschaft für Nuklearmedizin
Nikolaistraße 29
37073 Göttingen
Phone: +49 (0)551 48857-401   
Fax: +49 (0)551 48857-401   

Publication History

Publication Date:
20 August 2018 (online)

 

Zusammenfassung

Die Version 4 der Verfahrensanweisung für die Iod-131-Ganzkörperszintigraphie beim differenzierten Schilddrüsenkarzinom ist ein Update der Version 3, die im Jahr 2007 durch die Deutsche Gesellschaft für Nuklearmedizin (DGN) und die Deutsche Gesellschaft für Medizinische Physik (DGMP) publiziert wurde. Diese Verfahrensanweisung beschreibt mit primärer Zielsetzung die fachgerechte Durchführung der Ganzkörperszintigraphie nach Applikation einer diagnostischen bzw. therapeutischen I-131-Aktivität. Die aktualisierten Indikationen zur I-131-Ganzkörperszintigraphie werden in der Verfahrensanweisung aufgelistet. Neue Erkenntnisse bezüglich der Beziehung zwischen verabreichter Aktivität und Bildqualität wurden in der aktualisierten Verfahrungsanweisung berücksichtigt. Die Verfahrensanweisung wurde von einer repräsentativen Expertengruppe im Konsensverfahren verabschiedet. Sie entspricht damit einer Verfahrensanweisung der ersten Stufe (S1) nach den Kriterien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Zusätzlich wurden Indikationsstellung, Zeitpunkt und Aktivitätswahl für die diagnostische Ganzkörperszintigraphie im erweiterten Kollegenkreis am 30. November 2012, am 19. April 2013 und am 23. April 2015 bei Tagungen der Arbeitsgemeinschaft Schilddrüse der Deutschen Gesellschaft für Nuklearmedizin ausführlich diskutiert.


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Summary

Version 4 of the procedural guideline for Iodine-131 whole-body scintigraphy (WBS) in differentiated thyroid carcinoma is an update of the version 3, which was published by the “Deutsche Gesellschaft für Nuklearmedizin” (DGN) and the “Deutsche Gesellschaft für Medizinische Physik” (DGMP) in 2007. This procedural guideline advises on how to best perform I-131 whole body scintigraphy after I-131 therapy or after application of a diagnostic I-131 activity. The updated relevant medical indications for I-131 whole body scintigraphy are given in this procedural guideline. Novel insights on the relationship bet¬ween activity and image quality were incorporated in the updated recommendations. A representative expert group has discussed and reached consensus on the procedural guideline; the development of this procedural guideline therefore fulfils the criteria for level S1 (first step) within the classification of the German Workgroup of Scientific Medical Societies (“Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften”; AWMF). Additionally, indications for WBS, timing and activity for WBS were discussed by the working group “Thyroid” of the DGN on November 30th 2012, April 19th, 2013 and on April 23rd, 2015.


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Weitere Beteiligte

Deutsche Gesellschaft für Medizinische Physik (DGMP)


  • Literatur

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Korrespondenzadresse

Deutsche Gesellschaft für Nuklearmedizin
Nikolaistraße 29
37073 Göttingen
Phone: +49 (0)551 48857-401   
Fax: +49 (0)551 48857-401   

  • Literatur

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  • 2 Bachelot A, Leboulleux S, Baudin E, Hartl DM, Caillou B, Travagli JP, Schlumberger M. Neck recurrence from thyroid carcinoma: serum thyroglobulin and high-dose total body scan are not reliable criteria for cure after radioiodine treatment. Clin Endocrinol (Oxf) 2005; 62: 376-379.
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  • 5 Castro MR, Bergert ER, Goellner JR, Hay ID, Morris JC. Immunohistochemical analysis of sodium iodide symporter expression in metastatic differentiated thyroid cancer: correlation with radioiodine uptake. J Clin Endocrinol Metab 2001; 86: 5627-5632.
  • 6 Chiovato L, Latrofa F, Braverman LE, Pacini F, Capezzone M, Masserini L, Grasso L, Pinchera A. Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens. Ann Intern Med 2003; 139: 346-351.
  • 7 Chung JK, Park YJ, Kim TY, So Y, Kim SK, Park DJ, Lee DS, Lee MC, Cho BY. Clinical significance of elevated level of serum antithyroglobulin antibody in patients with differentiated thyroid cancer after thyroid ablation. Clin Endocrinol (Oxf) 2002; 57: 215-221.
  • 8 Cooper DS, Doherty GM, Haugen BR. et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009; 19: 1167-1214.
  • 9 de Meer SG, Vriens MR, Zelissen PM, Borel RI, de Keizer B. The role of routine diagnostic radioiodine whole-body scintigraphy in patients with high-risk differentiated thyroid cancer. J Nucl Med 2011; 52: 56-59.
  • 10 de Pont C, Halders S, Bucerius J, Mottaghy F, Brans B. (124)I PET/CT in the pretherapeutic staging of differentiated thyroid carcinoma: comparison with posttherapy (131)I SPECT/CT. Eur J Nucl Med Mol Imaging. 2013
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  • 15 Feine U, Lietzenmayer R, Hanke JP, Wohrle H, Muller-Schauenburg W. [18FDG whole-body PET in differentiated thyroid carcinoma. Flipflop in uptake patterns of 18FDG and 131I]. Nuklearmedizin 1995; 34: 127-134.
  • 16 Freudenberg LS, Frilling A, Kuhl H, Muller SP, Jentzen W, Bockisch A, Antoch G. Dual-modality FDG-PET/CT in follow-up of patients with recurrent iodine-negative differentiated thyroid cancer. Eur Radiol 2007; 17: 3139-3147.
  • 17 Freudenberg LS, Jentzen W, Görges R, Petrich T, Marlowe RJ, Knust J, Bockisch A. 124I-PET dosimetry in advanced differentiated thyroid cancer: therapeutic impact. Nuklearmedizin 2007; 121-128.
  • 18 Gerard SK, Cavalieri RR. I-123 diagnostic thyroid tumor whole-body scanning with imaging at 6, 24, and 48 hours. Clin Nucl Med 2002; 27: 1-8.
  • 19 Geworski L, Lottes G, Reiners C, Schober O. Empfehlungen zur Qualitätskontrolle in der Nuklearmedizin. Stuttgart: Schattauer; 2009
  • 20 Giovanella L, Ceriani L, De Palma D, Suriano S, Castellani M, Verburg FA. Relationship between serum thyroglobulin and 18FDG-PET/CT in 131I-negative differentiated thyroid carcinomas. Head Neck 2012; 34: 626-631.
  • 21 Giovanella L, Treglia G, Ceriani L, Verburg F. Detectable thyroglobulin with negative imaging in differentiated thyroid cancer patients. What to do with negative anatomical imaging and radioiodine scan? Nuklearmedizin 2014; 53: 1-10.
  • 22 Giovanella L, Treglia G, Sadeghi R, Trimboli P, Ceriani L, Verburg FA. Unstimulated highly sensitive thyroglobulin in follow-up of differentiated thyroid cancer patients: a meta-analysis. J Clin Endocrinol Metab 2014; 99: 440-447.
  • 23 Giovanella L, Trimboli P, Verburg FA, Treglia G, Piccardo A, Foppiani L, Ceriani L. Thyroglobulin levels and thyroglobulin doubling time independently predict a positive (18)F-FDG PET/CT scan in patients with biochemical recurrence of differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 2013; 40: 874-880.
  • 24 Gotthardt M, Stubinger M, Pansegrau J, Buchwald B, Goecke J, Pfestroff A, Corstens FH, Behr TM. Decrease of (99m)Tc-uptake in autonomous thyroid tissue in Germany since the 1970s. Clinical implications for radioiodine therapy. Nuklearmedizin 2006; 45: 122-125.
  • 25 Hanscheid H, Lassmann M, Buck AK, Reiners C, Verburg FA. The limit of detection in scintigraphic imaging with I-131 in patients with differentiated thyroid carcinoma. Phys Med Biol 2014; 59: 2353-2368.
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