Reston, Va. - The Society of Nuclear Medicine and Molecular Imaging (SNMMI) has issued an updated practice guideline on the treatment of thyroid cancer patients with I-131 (sodium iodide). Published in the October issue of The Journal of Nuclear Medicine, the guideline serves as an educational tool designed to assist trained practitioners in evaluating patients for therapy with I-131 for benign or malignant diseases of the thyroid gland, performing this treatment in a safe and appropriate manner, understanding and evaluating the pathological conditions resulting from the therapy, and reporting the outcomes of therapy.

"A great deal was changed in this new version of the guideline for I-131 therapy," said Edward B. Silberstein, MD, lead author of the guideline. "We have defined the levels of risk of thyroid cancer to patients which help determine the treatment needed, addressed the adverse effects of therapy, detailed the guidelines and regulations for patient release after I-131 therapy, and much more."

Oral administration of I-131 has been a commonly accepted procedure for treatment of benign and malignant disorders of the thyroid since the 1940s. Physicians responsible for treating thyroid cancer patients should have an understanding of the clinical pathophysiology and natural history of the disease processes, be familiar with alternative forms of therapy, and be able to collaborate closely with other physicians involved in the management of the patient's condition. The treating physician should either see patients in consultation with the physician assuming overall management of the patient's condition or be prepared to assume that role. In the United States, the treating physician should be board-certified in nuclear medicine or be able to document equivalent training, competency, and experience in the safe use and administration of therapeutic I-131.

Licensure to possess I-131 and regulations regarding the release of patients treated with radioiodine, while governed by the Nuclear Regulatory Commission, vary from jurisdiction to jurisdiction. Physicians engaged in therapy with I-131 must be knowledgeable about, and in compliance with, all applicable laws and regulations. The facility in which treatment is performed must have appropriate personnel, radiation safety equipment, and procedures available for waste handling and disposal, monitoring personnel for accidental contamination, and controlling spread of I-131 to conform to state and federal regulations. All physicians engaged in therapy have a duty to ensure that their knowledge and competencies are up to date.

The SNMMI practice guideline for I-131 therapy for thyroid cancer reviews common clinical indications; qualifications and responsibilities of personnel; procedures and specifications of the examination; documentation and reporting; equipment specifications, quality control and improvement, safety, infection control and patient education concerns; and radiation dosimetry.

"In addition, we've also highlighted 14 issues that require further clarification, such as the diagnostic role of alternative imaging agents for thyroid cancer, the frequency and length of long-term follow-up after I-131 therapy, and others. SNMMI will work to address these issues in future versions of the guideline," noted Silberstein.

Each practice guideline, representing a policy statement by SNMMI, undergoes a thorough consensus process in which it has been subjected to extensive review, requiring the approval of the Committee on Guidelines and SNMMI Board of Directors. SNMMI emphasizes that the safe and effective use of diagnostic nuclear medicine imaging requires specific training, skills, and techniques, as described in each document.

The American Cancer Society estimates that in 2012, nearly 56,500 cases of thyroid cancer will be diagnosed and more than 1,700 people will die from the disease. Thyroid cancer is commonly diagnosed at a younger age than most other adult cancers; 80 percent of newly diagnosed thyroid cancer patients are under 65 years of age.

The full guideline "SNM Practice Guideline for Therapy of Thyroid Disease with I-131 3.0" can be found at www.snmmi.org/guidelines. SNMMI has also created a patient pamphlet to complement this guideline, titled "Guidelines for Patients Receiving Radioiodine Treatment," available in the SNMMI Store at www.snmmi.org.

Authors of the guideline "SNM Practice Guideline for Therapy of Thyroid Disease with I-131 3.0" include Edward B. Silberstein, UC Health University Hospital, Cincinnati, Ohio; Abass Alavi, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Helena R. Balon, Beaumont Health System, Royal Oak, Michigan; Susan E.M. Clarke, Guy's Hospital, London, United Kingdom; Chaitanya Divgi, Columbia University Medical Center, New York, New York; Michael J. Gelfand, Cincinnati Children's Medical Center, Cincinnati, Ohio; Stanley J. Goldsmith, New York-Presbyterian/Weill Cornell Medical Center, New York, New York; Hossein Jadvar, University of Southern California, Los Angeles, California; Carol S. Marcus, University of California at Los Angeles, Los Angeles, California; William H. Martin, Vanderbilt University Medical Center, Nashville, Tennessee; J. Anthony Parker, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Henry D. Royal, Mallinckrodt Institute of Radiology, St. Louis, Missouri; Salil D. Sarkar, Jacobi Medical Center, Bronx, New York; Michael Stabin, Vanderbilt University, Nashville, Tennessee; and Alan D. Waxman, Cedars-Sinai Medical Center, Los Angeles, California.

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About the Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to raising public awareness about nuclear medicine and molecular imaging, a vital element of today's medical practice that adds an additional dimension to diagnosis, changing the way common and devastating diseases are understood and treated and helping provide patients with the best health care possible.

SNMMI's more than 19,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.

Media Contact:
Susan Martonik
(703) 652-6773
smartonik@snmmi.org