Dosimetry in Advanced Thyroid Cancer: A Piece of a Puzzle?

Thyroid cancer demonstrates variable prognosis depending on disease severity with low-risk tumors showing excellent survival rates and high-risk cases facing poorer outcomes. Radioactive iodine therapy is the standard treatment. However, individualized dosing is still debated. Despite the international guidelines recommend high activities for metastatic disease, there is still a potential risk of overtreatment or undertreatment. Dosimetry calculates absorbed radiation to optimize treatment minimizing toxicity. Challenges influencing treatment response include patient variability, genetic mutations, tumor microenvironment, and pharmacokinetics. On the other hand, emerging technologies promise to standardize and improve dosimetry, refining theragnostic approaches and enabling personalized therapies.