Comparison between low and high radioactive iodine (131I) reablation dose in patients with papillary thyroid cancer

Abstract

AIM: The aim of this study was to assess ablation outcome after a second ablation dose and compare the ablation rate after low and high reablation doses of iodine-131 (131I) after failure of the first ablation with 3700 MBq. PATIENTS AND METHODS: The study included 81 patients with papillary thyroid cancer; they failed to achieve complete ablation after a first ablative dose of 3700 MBq. Their first follow-up 131I whole-body scan carried out 6-9 months after ablation showed small residual functioning tissue in the thyroid bed, with no functioning metastases. This is associated with unsuppressed serum thyroglobulin level (Tg) higher than 2 ng/ml. The patients received a second ablation dose, which was low (1110 MBq) in 37 patients and high in the remaining 44 patients (2960 MBq in 36 patients and 3700 MBq in eight patients). A whole-body scan and Tg level assessment were carried out 6-9 months later. The criteria for complete ablation included absence of residual functioning thyroid tissue and a Tg level lower than 2 ng/ml. RESULTS: The overall successful complete ablation rate after the second reablation dose was 75%. This was achieved in 27 of 37 patients (73%) who received a low reablation dose and in 34 of 44 patients (77%) who received a high reablation dose; no statistically significant difference was found between the two groups (P>0.05). CONCLUSION: In patients with papillary thyroid cancer who failed to achieve complete ablation after the first ablation dose of 3700 MBq, the overall complete ablation rate after both a low and a high second 131I dose was 75%, with no statistically significant difference in ablation rate between low (1110 MBq) and high (2960 and 3700 MBq) doses (73 and 77%, respectively).