Prediction of radiation dosimetry in patients with thyroid cancer using a Gamma camera

Radioiodine in the thyroid or cervical metastases, and therefore radiation dosimetry, can be determined using a probe and phantom. This approach is not ideal for quantitating radioiodine and dosimetry for sites elsewhere in the body. The authors have studied the use of gamma camera methods in association with I-123 to predict the distribution of I-131 and its dosimetry in 3 patients with metastatic thyroid cancer. Images and urine were obtained after administration of tracer I-123 and treatment I-131 to each patient. The geometric mean of counts from anterior and posterior total body camera scans were used to determine body clearance. Organ or metastasis radioactvity and dosimetry were quantitated using planar images and SPECT. Uptake, clearance and dosimetry of structures, such as thyroid and nodular metastases in the lung, could be determined. In summary, a gamma camera method for improved quantitation of radioiodine distribution in the body has been explored. It provides quantitative pharmacokinetics which give better estimates of distribution of radiation dose. This information offers a less empirical approach to the treatment of thyroid cancer with I-131, and other cancers with radiolabeled antibodies