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. 2025 May;88(2):537-544.
doi: 10.1007/s12020-025-04183-1. Epub 2025 Feb 2.

Whole-body effective half-life of radioiodine in children and young adults with papillary thyroid cancer

Yizhuo Wei  1 , Wei Zhang  1 , Taipeng Du  1 , Yu Wang  1 , Bin Liu  2
Affiliations

Whole-body effective half-life of radioiodine in children and young adults with papillary thyroid cancer

Yizhuo Wei et al. Endocrine. 2025 May.

Abstract

Purpose: The lack of radioiodine-131 (RAI) kinetic study is a serious challenge for rational dosing for children and young adults (CYAs) with papillary thyroid cancer (PTC). The present study was conducted to investigate the whole-body effective half-life (EHL) and absorbed dose in RAI ablative therapy of CYAs with PTC.

Methods: In the period 2017-2022, all consecutive PTC patients 20 years or younger prepared for ablative RAI therapy after thyroid hormone withdrawal were prospectively recruited. Serial whole-body dose-rate measurements after administration were performed to deduce whole-body RAI retention. Calculations based on the deduced whole-body retention and the schema of Medical Internal Radiation Dosimetry were derived to determine whole-body EHL and absorbed doses. A multivariate linear regression analysis was employed to assess the association between whole-body EHL and potential predictors.

Results: A total of 52 patients (median age 17 years [range, 6-20 years]) were recruited. The mean whole-body EHL (±SD) was 10.3 (3.3) hours (median, 9.4 h [range, 6.3-21.7 h]). In univariable linear regression analysis, whole-body EHL was significantly associated with gender, body surface area (BSA) and body mass index (p < 0.05). Creatinine, Cystatin C, glomerular filtration rate (GFR) and positive post-ablation scintigraphy approached significance with respect to EHL (p ≤ 0.2 and ≥0.05). At multivariable analysis, BSA, GFR and positive post-ablation scintigraphy was associated with EHL. A median activity of 3.7 GBq of RAI (range, 1.85-7.40 GBq) was administered and a median whole-body absorbed dose of 0.22 Gy was delivered (range, 0.11-0.79 Gy).

Conclusion: A wide variation of whole-body EHL was observed in CYAs with PTC treated with RAI. The whole-body EHL is significantly longer in CYAs with larger BSA, decreased GFR and presence of extra-thyroidal disease. Understanding these predictors may improve our ability to dosing strategies in RAI therapy of CYAs with PTC.

Keywords: Children and young adults; Papillary thyroid cancer; Radioiodine-131 therapy; Whole-body absorbed dose; Whole-body effective half-life.

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Conflict of interest statement

Compliance with ethical standards. Conflict of interest: The authors declare no competing interests. Ethical approval and consent to participate: The original survey protocol was approved by the Institutional Review Board of West China Hospital, Sichuan University. The requirement of written informed consent was waived by the ethics committee. Consent for publication: All authors read the manuscript and agreed to its publication.

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