Individualized treatment of differentiated thyroid cancer: The value of surgery in combination with radioiodine imaging and therapy – A German position paper from Surgery and Nuclear Medicine

Matthias Schmidt; Peter Bartenstein; Jan Bucerius; Markus Dietlein; Alexander Drzezga; Ken Herrmann; Constantin Lapa; Kerstin Lorenz; Thomas J. Musholt; James Nagarajah; Christoph Reiners; Carsten O. Sahlmann; Michael C. Kreissl

doi:10.1055/a-1783-8154

Nuklearmedizin - NuclearMedicine, Inhaltsverzeichnis

Nuklearmedizin 2022; 61(02): 87-96
DOI: 10.1055/a-1783-8154

Position Paper

Individualized treatment of differentiated thyroid cancer: The value of surgery in combination with radioiodine imaging and therapy – A German position paper from Surgery and Nuclear Medicine

Artikel in mehreren Sprachen: English | deutsch

Autor*innen

Matthias Schmidt

¹Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany

¹²Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)

¹³Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
Peter Bartenstein

²Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany

¹³Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
Jan Bucerius

³Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany
Markus Dietlein

¹Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany

¹³Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
Alexander Drzezga

¹Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Cologne, Cologne, Germany
Ken Herrmann

⁴Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen and German Cancer Consortium (DKTK), Essen, Germany
Constantin Lapa

⁵Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany

¹¹Member of the Board, German Society of Nuclear Medicine (DGN e. V.)
Kerstin Lorenz

⁶Department of Visceral, Vascular and Endocrine Surgery, Martin Luther University of Halle Wittenberg, Faculty of Medicine, Halle, Germany

¹⁴Member of the surgical working group for endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)
Thomas J. Musholt

⁷Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany

¹⁴Member of the surgical working group for endocrinology (CAEK) of the German society for general and visceral surgery (DGAV)
James Nagarajah

⁸Department of Medical Imaging, Nuclear Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Netherland

¹²Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)

¹³Guideline Committee, German Society of Nuclear Medicine (DGN e. V.)
Christoph Reiners

⁹Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
Carsten O. Sahlmann

³Department of Nuclear Medicine, University Medical Center Göttingen, Göttingen, Germany

¹²Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)
Michael C. Kreissl

¹⁰Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, Otto von Guericke University, Magdeburg, Germany

¹²Thyroid Committee, German Society of Nuclear Medicine (DGN e. V.)

Abstract

A consensus statement about indications for post-surgical radioiodine therapy (RIT) in differentiated thyroid cancer patients (DTC) was recently published by the European Thyroid Association (ETA) [1]. This publication discusses indications for RIT on the basis of an individual risk assessment. Many of the conclusions of this consensus statement are well founded and accepted across the disciplines involved. However, especially from the perspective of nuclear medicine, as the discipline responsible for indicating and executing RIT, some of the recommendations may require further clarification with regard to their compatibility with established best practice and national standards of care. Assessment of the indications for RIT is strongly dependent on the weighing up of benefits and risks. On the basis of longstanding clinical experience in nuclear medicine, RIT represents a highly specific precision medicine procedure of proven efficacy with a favorable side-effect profile. This distinguishes RIT significantly from other adjuvant oncological therapies and has resulted in the establishment of this procedure as a usually well-tolerated, standard safety measure. With regard to its favorable risk/benefit ratio, this procedure should not be unnecessarily restricted, in the interest of offering reassurance to the patients. Both patients’ interests and regional/national differences need to be taken into account. We would therefore like to comment on the recent consensus from the perspective of authors and to provide recommendations based on the respective published data.

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Referenzen

References
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