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Related Experiment Video

Updated: Jan 8, 2026

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
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Combination Radiopharmaceutical Therapy and Radiotherapy for Thyroid Cancer: Dosimetry-Driven Precision Medicine.

Ian R Marsh1, Harry Quon1, Prasanna Santhanam2

  • 1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|December 18, 2025
PubMed
Summary

This study shows combining radioactive iodine (RAI) therapy with external beam radiation therapy (EBRT) can effectively treat differentiated metastatic thyroid cancer in patients with low RAI uptake. This precision medicine approach delivers targeted tumoricidal doses safely.

Keywords:
dosimetryradiopharmaceutical therapyrefractorythyroid cancertreatment planning

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Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiation Oncology

Background:

  • Differentiated metastatic thyroid cancer treatment relies on radioactive iodine (131I) therapy, targeting the NaI symporter.
  • Treatment efficacy decreases in patients with reduced or variable NaI symporter expression.
  • External beam radiotherapy (EBRT) is a standard treatment for various cancers.

Purpose of the Study:

  • To investigate a combined radiopharmaceutical therapy (RPT) and EBRT strategy for thyroid cancer patients with low 131I uptake.
  • To achieve a tumoricidal absorbed dose (AD) of 80 Gy while maintaining safe normal-organ ADs.
  • To illustrate a precision medicine approach for personalized RPT-EBRT treatment planning.

Main Methods:

  • Utilized a tracer administration of RPT to calculate patient-specific administered activity (AA) for therapy.
  • Ensured organ-at-risk ADs remained below toxicity thresholds.
  • Calculated tumor and organ-at-risk ADs for combined therapy planning by radiation oncology medical physicists.

Main Results:

  • Precision medicine approach resulted in an AA ranging from 14.3 to 19.5 GBq.
  • Combined RPT-EBRT therapy delivered doses ranging from 73 to 147 Gy to selected lesions.
  • Demonstrated feasibility of combined therapy in patients with reduced radioiodine uptake.

Conclusions:

  • Combined RPT-EBRT is feasible for thyroid cancer patients with low radioiodine uptake, delivering higher therapeutic doses than standard 131I alone.
  • Patient variability in clearance kinetics necessitates personalized approaches.
  • Further multicenter trials are required to assess clinical benefit of precision-adjusted administered activity.