{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:11:16Z","timestamp":1760159476758,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["KMUH109\u20109 M44","KMUH110\u20100R51","KMUH111\u20101R48","KMUH112\u20102R51"],"award-info":[{"award-number":["KMUH109\u20109 M44","KMUH110\u20100R51","KMUH111\u20101R48","KMUH112\u20102R51"]}],"id":[{"id":"10.13039\/501100011645","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["110\u20102314\u2010B\u2010037\u2010120","111\u20102628\u2010B\u2010037\u2010007","112\u20102314\u2010B\u2010037\u2010034\u2010","113\u20102314\u2010B\u2010037\u2010035"],"award-info":[{"award-number":["110\u20102314\u2010B\u2010037\u2010120","111\u20102628\u2010B\u2010037\u2010007","112\u20102314\u2010B\u2010037\u2010034\u2010","113\u20102314\u2010B\u2010037\u2010035"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>After total thyroidectomy for pediatric differentiated thyroid cancer (DTC), the subsequent radioactive iodine (RAI) treatment is a robust therapy, the dosing of which is a major concern. This study was designed to evaluate the \u201cas high as safe administration\u201d (AHASA) principle of RAI treatment in pediatric DTC patients based on the maximum tolerance activity (MTA) of blood to certify dosimetry via a simple algorithm method. Twenty pediatric DTC patients were enrolled and received RAI treatment empirical dosing based on risk stratification after total thyroidectomy. The MTA concentration in the blood was estimated by the modified H\u00e4nscheid equation. About 6 (30%) patients had tumors larger than 4\u2009cm, 10 (50%) patients had lateral cervical lymph node metastasis, and 4 (20%) patients had recurrent\/persistent thyroid cancer and received more than two RAIs. Five (25%) pediatric patients who had higher serum thyroglobulin antibodies levels at initial diagnosis exhibited aggressive clinical manifestations. Body weight\u2010based doses showed wide variability, and the Dutch recommended dose showed underdosing. In addition, lower body weight was associated with a significantly higher blood absorption dose (<jats:italic>R<\/jats:italic>\n<jats:sup>2<\/jats:sup>\u2009=\u20090.3849, <jats:italic>p<\/jats:italic>\u2009=\u20090.014). No severe adverse effects were observed in patients who received empirical RAI dosage according to the AHASA principle. The presentation of pediatric DTC can be advanced and aggressive. Empirical RAI dosing based on risk stratification is a simple, safe and effective method. In compliance with the AHASA principle, for prepubertal patients with very low body weight, it is necessary to calculate the blood MTA for RAI dose adjustment.<\/jats:p>","DOI":"10.1002\/kjm2.70056","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T09:31:09Z","timestamp":1748511069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimation the Maximum Tolerance Activity of Blood by a Simple Algorithm Method in Pediatric Differentiated Thyroid Cancer Patients Treated With Empirical <scp>Radioactive Iodine<\/scp> Dosing Based on Risk Stratification"],"prefix":"10.1002","volume":"41","author":[{"given":"Yu\u2010Wen","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6429-9038","authenticated-orcid":false,"given":"Cheng\u2010Hsun","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Otorhinolaryngology, Kaohsiung Medical University, Gangshan Hospital Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Che\u2010Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Otorhinolaryngology, School of Post\u2010Baccalaureate Medicine and School of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng\u2010Yu","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery E\u2010Da Hospital  Kaohsiung Taiwan"},{"name":"School of Medicine, College of Medicine I\u2010Shou University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hon\u2010Man","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun\u2010Der","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih\u2010Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Pathology, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yung\u2010Chang","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Faculty of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu\u2010Yen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Otorhinolaryngology, Kaohsiung Medical University, Gangshan Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Otorhinolaryngology, School of Post\u2010Baccalaureate Medicine and School of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-3290"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/wjnm.WJNM_15_19"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.09.042"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.02.033"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0460"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-20-0191"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28141"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2015.10.006"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/105072502753522356"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/61\/11\/4316"},{"issue":"5","key":"e_1_2_7_12_1","first-page":"546","article-title":"Individualized Dosimetry in the Management of Metastatic Differentiated Thyroid Cancer","volume":"53","author":"Chiesa C.","year":"2009","journal-title":"Quarterly Journal of Nuclear Medicine and Molecular Imaging"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0520"},{"issue":"1","key":"e_1_2_7_14_1","first-page":"143","article-title":"Prediction of Absorbed Dose to Normal Organs in Thyroid Cancer Patients Treated With 131I by Use of 124I PET and 3\u2010Dimensional Internal Dosimetry Software","volume":"48","author":"Kolbert K. S.","year":"2007","journal-title":"Journal of Nuclear Medicine"},{"issue":"5","key":"e_1_2_7_15_1","first-page":"899","article-title":"Blood and Bone Marrow Dosimetry in Radioiodine Therapy of Thyroid Cancer","volume":"46","author":"Sgouros G.","year":"2005","journal-title":"Journal of Nuclear Medicine"},{"key":"e_1_2_7_16_1","first-page":"171","article-title":"The Relation of Radioiodine Dosimetry to Results and Complications in the Treatment of Metastatic Thyroid Cancer","volume":"87","author":"Benua R. S.","year":"1962","journal-title":"American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine"},{"key":"e_1_2_7_17_1","first-page":"1317","volume-title":"Frontiers in Thyroidology","author":"Benua R. S.","year":"1986"},{"issue":"4","key":"e_1_2_7_18_1","first-page":"648","article-title":"Iodine Biokinetics and Dosimetry in Radioiodine Therapy of Thyroid Cancer: Procedures and Results of a Prospective International Controlled Study of Ablation After rhTSH or Hormone Withdrawal","volume":"47","author":"H\u00e4nscheid H.","year":"2006","journal-title":"Journal of Nuclear Medicine"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-008-0761-x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-09-0076"},{"key":"e_1_2_7_21_1","unstructured":"Y. W.Chen Y. C.Lai H. M.Chen andP. J.Hsiao \u201cThe Clinical Utility of Estimated Blood Dosimetry by Remote External Radiation Measurement of Whole\u2010Body Radioiodine Retention and Formulated Calculation in the Advanced DTC Patients During Hospitalization \u201dRSNA 2011 Abstract 2011."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2021.0317"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1955.01270080137023"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1740"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.14310\/horm.2002.1261"},{"key":"e_1_2_7_26_1","article-title":"Clinical and Pathological Implications of Concurrent Autoimmune Thyroid Disorders and Papillary Thyroid Cancer","author":"Cunha L. L.","year":"2011","journal-title":"Journal of Thyroid Research"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes10090723"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-15-0408"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13164051"},{"issue":"10","key":"e_1_2_7_30_1","first-page":"1587","article-title":"Empiric Radioactive Iodine Dosing Regimens Frequently Exceed Maximum Tolerated Activity Levels in Elderly Patients With Thyroid Cancer","volume":"47","author":"Tuttle R. M.","year":"2006","journal-title":"Journal of Nuclear Medicine"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-21-0217"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/instruments3030039"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.118.217638"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.108.052464"}],"container-title":["The Kaohsiung Journal of Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/kjm2.70056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T04:52:19Z","timestamp":1760158339000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/kjm2.70056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/kjm2.70056"],"URL":"https:\/\/doi.org\/10.1002\/kjm2.70056","archive":["Portico"],"relation":{},"ISSN":["1607-551X","2410-8650"],"issn-type":[{"type":"print","value":"1607-551X"},{"type":"electronic","value":"2410-8650"}],"subject":[],"published":{"date-parts":[[2025,5,29]]},"assertion":[{"value":"2024-10-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70056"}}