Die Behandlung von Erkrankungen der Schilddrüse (SD) mit radioaktiven Jod-Isotopen
nimmt seit der ersten Berichterstattung in den 1940er-Jahren einen bedeutenden Stellenwert
in der Nuklearmedizin ein [1]. Die Radiojodtherapie (RIT) kann als ein Vorreiter der personalisierten Medizin
angesehen werden [2]. Die Therapie der SD ist ein gutes Beispiel für die interprofessionelle Zusammenarbeit
zwischen Ärzten, Radiopharmazeuten, Medizinisch-technischen Radiologieassistenten
(MTRA), Medizinphysik-Experten (MPE) und weiteren klinischen Berufsgruppen.
Abstract
A large proportion of benign thyroid diseases can be successfully treated by oral
application of a single dose of radioiodine therapy I-131. The pre-therapeutic radioiodine
test as well as the subsequent radioiodine therapy should be carried out in an optimal
patient-specific therapy concept. Depending on the diagnosis, the target dose D for
the planning volume of the addressed thyroid parenchyma is determined in Gray. For
the calculation of the therapy activity, the parameters planning volume, target dose,
effective half-life and radioiodine uptake are particularly relevant. The planning
volume is usually determined by sonografic measurements according to the model of
the rotational ellipsoid. Unfortunately, the method has a very limited accuracy for
large deformed organs and retrosternal parts. For an accurate estimation of the thyroid
radioiodine uptake and the effective half-life of the radiopharmaceutical used, reproducible
measurements at a dedicated thyroid measurement station are necessary. The calculation
of the therapy activity is based on the Marinelli formula and was adapted in the current
DIN 6861–1 for international standardisation according to MIRD ( = medical internal
radiation dose). For the protection of humans and the environment, radioiodine therapy
is carried out at a nuclear medicine therapy unit.
Schlüsselwörter
Radiojodtherapie - Marinelli-Formel - Schilddrüse - Tracer-Uptake - Dosimetrie - DIN 6861–1
Keywords
Radioiodine therapy - Marinelli formula - Thyroid - tracer uptake - dosimetry - DIN 6861–1
