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A Comparison of 1850 (50 mCi) and 3700 MBq (100 mCi) 131-Iodine Administered Doses for Recombinant Thyrotropin-Stimulated Postoperative Thyroid Remnant Ablation in Differentiated Thyroid Cancer

Department of Internal Medicine, Endocrinology and Metabolism and Biochemistry (T.P., M.G.C., E.G., C.C., F.P.), Section of Endocrinology and Metabolism, and Department of Radiology (L.B., A.V.), Section of Nuclear Medicine, University of Siena, 53100 Sienna, Italy; and Unit of Nuclear Medicine (E.B., F.C., F.F.) and Department of Fisica Sanitaria (S.F., A.P., G.R.), Hospital of Macerata, 62100 Macerata, Italy

Address all correspondence and requests for reprints to: Furio Pacini, M.D., Section of Endocrinology and Metabolism, Department of Internal Medicine, Endocrinology and Metabolism and Biochemistry, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100 Siena, Italy. E-mail: pacini8{at}unisi.it.

Objective: Recently, a multicenter study in differentiated thyroid cancer (DTC) patients showed that 3700 MBq 131-iodine (¹³¹I) after recombinant human TSH (rhTSH) had a successful thyroid ablation rate similar to that obtained after thyroid hormone withdrawal. We investigated whether 1850 MBq ¹³¹I had a similar successful rate to 3700 MBq in patients prepared with rhTSH.

Design: A total of 72 patients with DTC were randomly assigned to receive 1850 (group A, n = 36) or 3700 MBq (group B, n = 36) ¹³¹I after rhTSH. One injection of 0.9 mg rhTSH was administered for 2 consecutive days; ¹³¹I therapy was delivered 24 h after the last injection, followed by a posttherapy whole-body scan. Successful ablation was assessed 6–8 months later.

Results: Successful ablation (no visible uptake in the diagnostic whole-body scan after rhTSH stimulation) was achieved in 88.9% of group A and B patients. Basal and rhTSH-stimulated serum thyroglobulin was undetectable (<1 ng/ml) in 78.9% of group A and 66.6% of group B patients (P = 0.46). Similar rates of ablation were obtained in both groups also in patients with node metastases.

Conclusion: Therapeutic ¹³¹I activities of 1850 MBq are equally effective as 3700 MBq for thyroid ablation in DTC patients prepared with rhTSH, even in the presence of node metastases.

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