Recombinant Human Thyrotropin-Aided Radioiodine Therapy in Patients with Metastatic Differentiated Thyroid Carcinoma
Figure 4
A 58-year-old patient with papillary thyroid carcinoma and poorly differentiated carcinoma. (a) An rxWBS taken 48 hrs after application of 5.5 GBq of 131-I under THW, in 2004: pathologic uptake is seen in the mid-thoracic vertebrae, throughout the right hemithorax, in 2 foci in the anterior left hemithorax, and in the lower lumbar vertebrae. (b) One year later: an rxWBS taken 48 hours after an rhTSH-aided RIT with 5.5 GBq of 131-I in the same patient, demonstrates progressive disease despite a total 9 of RITs (3 rhTSH-aided) with a cumulative activity of 49.6 GBq, EBR, and chemotherapy: pathologic uptake in the thoracic and lumbar vertebrae, as well as the bilateral pathologic accumulation in the thorax are larger and more intense, new foci of pathological uptake are seen in the right side of the neck, in the third lumbar vertebra, and faintly in the left pelvis. (c) A bone scan of the same patient, performed 4 months after the last rhTSH-aided 131-I treatment: osteolytic lesions are clearly visible in the left sacroiliac joint, and in the Th6–Th8 and L3–L5 vertebral segments. Additionally, faint osteolytic lesions may be suspected in the 5th right rib anteriorly and in the L1 and S1 vertebra.
