Radionuclide Therapy of Thyroid Tumors Rossella Elisei, Laura Agate, Sara Mazzarri, Valeria Bottici, Federica Guidoccio, Eleonora Molinaro, Giuseppe Boni, Marco Ferdeghini, and Giuliano Mariani Contents Primary Treatment of Differentiated Thyroid Cancer ............................................ 3 Surgery ................................................ 3 Adjuvant Ablation of Postsurgical Remnants with 131 I-Iodide ......................................... 3 Side Effects of Radioiodide Therapy ................. 8 Evaluation of Success of Thyroid Remnant Ablation ........................................... 11 Levothyroxine Therapy ............................. 11 Follow-Up ............................................. 13 Measurement of Serum Tg ............................ 13 Whole-Body Scintigraphy with 131 I-Iodide .......... 14 Neck Ultrasound ...................................... 15 Other Diagnostic Procedures .......................... 15 Management of Locoregional Recurrences ........ 17 Management of Distant Metastases ................ 20 Advanced DTC Refractory to Radioiodide Treatment ......................................... 24 Reinduction of the Ability to Take Up Iodine ........ 24 Conventional Chemotherapy .......................... 25 New Targeted Therapies .............................. 25 External Beam Radiation Therapy .................... 26 Treatment of Anaplastic Thyroid Cancer .......... 27 Initial Treatment of Medullary Thyroid Cancer ............................................ 27 Follow-Up of Medullary Thyroid Cancer .......... 28 Radionuclide Imaging in Recurrent MTC ......... 28 Treatment for Recurrent or Persistent MTC ...... 32 References ............................................ 34 R. Elisei (*) • L. Agate • V. Bottici • E. Molinaro Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy e-mail: rossella.elisei@med.unipi.it S. Mazzarri • F. Guidoccio • G. Boni • G. Mariani Regional Center of Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy M. Ferdeghini Nuclear Medicine Unit, Department of Diagnostics and Public Health, University of Verona, Verona, Italy # Springer International Publishing Switzerland 2016 H.W. Strauss et al. (eds.), Nuclear Oncology , DOI 10.1007/978-3-319-26067-9_49-1 1