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This Article Accepted manuscript (PDF) All Versions of this Article: EJE-08-0062v1 159/3/301    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Verkooijen, R. Articles by Stokkel, M. PubMed PubMed Citation Articles by Verkooijen, R. Articles by Stokkel, M.

The success rate of I-131 ablation in differentiated thyroid cancer: comparison of uptake-related and fixed-dose strategies

R Verkooijen, Nuclear Medicine, LUMC, Leiden, United Kingdom
F Verburg, UMCU, Wuerzburg, Germany
J van Isselt, UMCU, Utrecht, Netherlands
K Lips, UMCU, Utrecht, Netherlands
J Smit, Endocrinology, Leiden University Medical Center, Leiden, Netherlands
M Stokkel, Nuclear Medicine, LUMC, Leiden, 2300 RC, Netherlands

Correspondence: Marcel Stokkel, Email: m.p.m.stokkel{at}lumc.nl

Abstract

Introduction: The aim of the present study was to compare the success rate of an uptake-related ablation protocol in which the dose depends on an I-131 24-h neck uptake measurement and a fixed-dose ablation protocol in which the dose depends on tumour stage.

Methods: All differentiated thyroid carcinoma patients with M0 disease who had undergone (near-) total thyroidectomy followed by I-131 ablation were included. In the uptake-related ablation protocol, 1100 MBq (uptake >10%), 1850 MBq (uptake 5-10%) and 2800 MBq (uptake <5%) were used. In the fixed-dosage ablation strategy, 3700 MBq (T1-3, N0 stage) and 5550 MBq (N1 and/or T4 stage) were applied. We used I-131 uptake on whole-body scintigraphy and thyroglobulin (Tg)-off values to evaluate the ablation 6-12 months after treatment. Results: In the uptake-related ablation protocol, 60 out of 139 (43%) patients were successfully treated vs. 111 out of 199 for the fixed-dose ablation protocol (56%) (p = 0.022). The differences were not statistically significant for patients with T4 (p=0.581) and/or N1 (p=0.08) disease or for patients with T4N1 tumour stage (p=0.937).

Conclusion: The fixed-dose I-131 ablation protocol is more effective in ablation of the thyroid remnant in differentiated thyroid carcinoma patients than an uptake-related ablation protocol. This difference is not observed in patients with a N1 and/or T4 tumour stage.