Improved radiation protection of the thyroid gland with thyroxine, methimazole, and potassium iodide during diagnostic and therapeutic use of radiolabeled metaiodobenzylguanidine in children with neuroblastoma

Hanneke M. Van Santen, Jan De Kraker, Berthe L.F. Van Eck, Jan J.M. De Vijlder, Thomas Vulsma

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)

Abstract

BACKGROUND. During radiolabeled metaiodobenzylguanidine (MIBG) administration in children with neuroblastoma, the thyroid is protected from 1231/311I uptake by potassium iodide. Despite this protection, up to 64% of patients develop thyroid dysfunction. The authors introduce a new method of radiation protection for the thyroid gland. METHODS. In a prospective cohort study, 34 children with neuroblastoma who received MIBG were given thyroxine, methimazole, and potassium iodide for protection of the thyroid gland. Protection started 1 day before the start of diagnostic 123I-MIBG and was continued until 4 weeks after the last therapeutic 131I-MIBG dose. Follow-up measurements were performed every 3 months after the protection was stopped. Visualization of the thyroid on MIBG images was reviewed by three nuclear medicine physicians. Results were compared with a historic control group of children who had received potassium iodide for thyroid protection during MIBG administration. RESULTS. After a mean follow-up of 19 months, there were 23 evaluable patients. Thyroid function was normal in 86% of survivors compared with 44% of children in the historic control group (P = 0.011; Pearson chi-square test). Scintigraphic visualization of the thyroid diminished substantially after the new protection (21.5% vs. 5.3%, respectively; P = 0.000). CONCLUSIONS. The results of the current study indicate that compared with potassium iodide alone, combined thyroxine, methimazole, and potassium iodide protect the thyroid more effectively against radiation damage from 123/131I during diagnostic and therapeutic MIBG administration in children with neuroblastoma.

Original languageEnglish
Pages (from-to)389-396
Number of pages8
JournalCancer
Volume98
Issue number2
DOIs
Publication statusPublished - 15 Jul 2003
Externally publishedYes

Keywords

  • 3-iodobenzylguanidine
  • Hypothyroidism
  • Neuroblastoma
  • Radiation damage
  • Radiation protection
  • Thyroid gland

Fingerprint

Dive into the research topics of 'Improved radiation protection of the thyroid gland with thyroxine, methimazole, and potassium iodide during diagnostic and therapeutic use of radiolabeled metaiodobenzylguanidine in children with neuroblastoma'. Together they form a unique fingerprint.

Cite this