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DOI: 10.1530/EJE-08-0062
European Journal of Endocrinology, Vol 159, Issue 3, 301-307
Copyright © 2008 by European Society of Endocrinology
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CLINICAL STUDIES

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

Robbert B T Verkooijen1,2,*, Frederik A Verburg2,*, Johannes W van Isselt2, Cornelis J M Lips3, Jan W Smit4 and Marcel P M Stokkel1

1 Division of Nuclear MedicineDepartment of Radiology, Leiden University Medical Center, C4-Q, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands, Departments of2 Nuclear Medicine3 EndocrinologyUniversity Medical Center Utrecht, Utrecht, The Netherlands4 Department of Endocrinology and MetabolismLeiden University Medical Center, Leiden, The Netherlands

(Correspondence should be addressed to M P M Stokkel; Email: m.p.m.stokkel{at}lumc.nl)

* R B T Verkooijen and F A Verburg contributed equally to this work

Introduction: The aim of the 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 (uptake >10%), 1850 (uptake 5–10%) and 2800 MBq (uptake <5%) were used. In the fixed-dosage ablation strategy, 3700 (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-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 versus 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.






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