Advanced SearchSearch Tips
Comparable Ablation Efficiency of 30 and 100 mCi of I-131 for Low to Intermediate Risk Thyroid Cancers Using Triple Negative Criteria
facebook(new window)  Pirnt(new window) E-mail(new window) Excel Download
 Title & Authors
Comparable Ablation Efficiency of 30 and 100 mCi of I-131 for Low to Intermediate Risk Thyroid Cancers Using Triple Negative Criteria
Fatima, Nosheen; Zaman, Maseeh uz; Zaman, Areeba; Zaman, Unaiza; Tahseen, Rabia;
  PDF(new window)
Background: There is controversy about ablation efficacy of low or high doses of radioiodine-131 (RAI) in patients with differentiated thyroid cancers (DTC). The purpose of this prospective study was to determine efficacy of 30 mCi and 100 mCi of RAI to achieve successful ablation in patients with low to intermediate risk DTC. Materials and Methods: This prospective cross sectional study was conducted from April 2013 to November 2015. Inclusion criteria were patients of either gender, 18 years or older, having low to intermediate risk papillary and follicular thyroid cancers with T1-3, N0/N1/Nx but no evidence of distant metastasis. Thirty-nine patients were administered 30 mCi of RAI while 61 patients were given 100 mCi. Informed consent was acquired from all patients and counseling was done by nuclear physicians regarding benefits and possible side effects of RAI. After an average of 6 months (range 6-16 months; 2-3 weeks after thyroxin withdrawal), these patients were followed up for stimulated TSH, thyroglobulin (sTg) and thyroglobulin antibodies, ultrasound neck (U/S) and a diagnostic whole body iodine scan (WBIS) for ablation outcome. Successful ablation was concluded with stimulated Tg< 2ng/ml with negative antibodies, negative U/S and a negative diagnostic WBIS (triple negative criteria). ROC curve analysis was used to find diagnostic strength of baseline sTg to predict successful ablation. Results: Successful ablation based upon triple negative criteria was 56% in the low dose and 57% in the high dose group (non-significant difference). Based on a single criterion (follow-up sTg<2 ng/ml), values were 82% and 77% (again non-significant). The ROC curve revealed that a baseline sTg level had the highest diagnostic strength to predict successful ablation in all patients. Conclusions: We conclude that 30 mCi of RAI has similar ablation success to 100 mCi dose in patients with low to intermediate risk DTC. A baseline is a strong predictor of successful ablation in all patients. Low dose RAI is safer, more cost effective and more convenient for patients and healthcare providers.
Radioiodine ablation;differentiated thyroid cancer;successful ablation;low dose;high dose;
 Cited by
Barbaro D, Verburg FA, Luster M, Reiners C, Rubello D (2010). ALARA in rhTSH stimulated post-surgical thyroid remnant ablation: what is the lowest reasonably achievable activity? Eur J Nucl Med Mol Imaging, 37, 1251-4. crossref(new window)

Cooper DS, Doherty GM, Haugen BR, et al. (2006). Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 16, 1-33. crossref(new window)

Fatima N, Zaman MU, Ikram M, et al (2014). Baseline stimulated thyroglobulin level as a good predictor of successful ablation after adjuvant radioiodine treatment for differentiated thyroid cancers. Asian Pac J Cancer Prev, 15, 6443-47. crossref(new window)

Fatima N, Zaman MU, Zaman A, et al (2016). Factors predicting early release of thyroid cancer patients from the isolation room after radioiodine-131 treatment. Asian Pac J Cancer Prev, 17, 125-9. crossref(new window)

Hackshaw A, Harmer C, Mallick UH, et al (2007). 131I activity for remnant ablation in patients with differentiated thyroid cancer: a systematic review. J Clin Endocrinol Metab, 92, 28-38. crossref(new window)

Haymart MR, Banerjee M, Stewart AK, et al (2011). Use of radioactive iodine for thyroid cancer. JAMA, 306, 721-8. crossref(new window)

Haugen BR, Alexander EK, Bible KC, et al (2016). 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 26, 1-133 crossref(new window)

Iyer NG, Morris LG (2011). Rising incidence of second cancers in patients with low-risk (T1N0) thyroid cancer who receive radioactive iodine therapy. Cancer, 117, 4439-46. crossref(new window)

Maenpaa HO, Heikkonen J, VaalavirtaL, Tenhunen M, Joensuu H (2008). Low vs. high radioiodine activity to ablate the thyroid after thyroidectomy for cancer: a randomized study. PLoS One, 3, 1885. crossref(new window)

Mallick U, Harmer C, Yap B, et al (2012). Ablation with lowdose radioiodine and thyrotropin alfa in thyroid cancer. N Engl J Med, 366, 1674-85. crossref(new window)

Pacini F, Schlumberger M, Dralle H, et al (2006). European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol, 154, 787-803. crossref(new window)

Rubino C, de Vathaire F, Dottorini ME, et al (2003). Second primary malignancies in thyroid cancer patients. Br J Cancer, 89, 1638-44. crossref(new window)

Sawka AM, Thephamongkhol K, Brouwers M, et al (2004). Clinical review 170: a systematic review and metaanalysis of the effectiveness of radioactive iodine remnant ablation for well-differentiated thyroid cancer. J Clin Endocrinol Metab, 89, 3668-76. crossref(new window)

Sherman SI (2003). Thyroid carcinoma. Lancet, 361, 501-11. crossref(new window)

Schlumberger M, Catargi B, Borget I, et al (2012). Strategies of Radioiodine Ablation in Patients with Low-Risk Thyroid Cancer. N Engl J Med, 366, 1663-73. crossref(new window)

Zaman MU, Fatima N, Padhy AK, et al (2013). Controversies about radioactive iodine-131 remnant ablation in low risk thyroid cancers: are we near a consensus? Asian Pac J Cancer Prev, 14, 6209-13. crossref(new window)