ABSTRACT
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.
Subject(s)
Thyroid Neoplasms , Thyroid Nodule , Humans , Iodine Radioisotopes/therapeutic use , Thyroid Neoplasms/radiotherapy , Thyroid Neoplasms/surgery , Thyroidectomy , Treatment OutcomeABSTRACT
Imaging of the spine is an essential prerequisite in the clinical workup of spine disease. Conventional radiography (CR) is still used as a basic diagnostic tool and enables an initial diagnosis to clarify symptomatology. Advanced cross-sectional techniques such as magnetic resonance imaging and computed tomography enable a dedicated diagnostic workup only of complex spinal pathologies. Due to its enormous innovation and broad availability, multidetector computed tomography could replace spinal CR in the diagnostic workup of acute and multiply injured patients. Nuclear medicine bone scans and positron emission tomography serve as screening studies and are an adjunct to morphologic radiological imaging. This review article summarizes the radiological and nuclear medicine imaging modalities and their diagnostic and therapeutic significance for diagnostic workup of common spinal disorders.
