98-3-13-Conference RAI

      Consensus in the Use of 131 I Therapy
         in Differentiated Thyroid Cancer
                            Fatemeh Rahmani.MD
                                        Research Institute for Endocrine Science
                                   Shahid Beheshti University Of Medical Science

Remnant ablation

use of 131-I to destroy normal residual functioning thyroid tissue

(1)Facilitating the interpretation of subsequent Tg levels

(2)Increasing the sensitivity of detection of locoregional and/or metastatic
    disease on subsequent follow-up RAI WBS

(3)Maximizing the therapeutic effect of any subsequent 131-I treatments
 
(4)Facilitating a postablation scan that may identify additional sites of
    disease that were not identified on the preablation scan or suspected if
    a preablation scan was not performed

Adjuvant treatment
Use of 131-I to destroy unknown microscopic thyroid cancer and/or suspected but unproved residual thyroid cancer to potentially decrease recurrence and mortality from thyroid cancer.

Treatment
Use of 131-I to destroy known locoregional and/or distant metastasis with the objectives of potential cure, reduced recurrence and mortality from thyroid cancer, and/or palliation

Tools for risk classifications

●TNM  anc prognostic scoring tools such a MASIC (metastases, age,
  completeness of resection, invasion, and size) for prediction of
  disease specific mortality

●Clinico-pathological staging system for prediction of recurrence

●Dynamic reclassification

●Majority(70-85%) of patients are at low-risk of mortality

●Higher risk :minority

●AJCC/IUCC staging :Predict risk of mortality ,not recurrence

●For assesemenf of risk of recurrence :A three-level stratification can be
  used