Quantitative external counting techniques enabling improved diagnostic and therapeutic decisions in patients with well-differentiated thyroid cancer.

Abstract

A quantitative technique is described which allows the physician to predict more accurately whether a recurrent or metastatic well-differentiated thyroid carcinoma is amenable to radioiodine-131 therapy or is better treated by other means. A calibrated uptake probe and scaler system is used to obtain conjugate view (i.e., diametrically opposed) counting rates for both the whole body and for any areas of abnormal uptake (lesion) at 24,48 annd 72 hours following the administration of 2 mCi 131l. Quantitative calculations accounting for patient attenuation, lesion size and geometrical factors then provide a determination of the lesion uptake as well as the effective half-life of 131l in the lesion. The radiation dose which would be delivered to the lesion by a given therapeutic amount of 131l may then be calculated to help determine the desirability of 131l treatment. The results of patient studies indicate the potential benefit of such quantitative evaluation.