From the Research
The recommended dose for radioiodine (radioactive iodine or I-131) ablation is 30 millicuries (mCi) for low to intermediate risk thyroid cancers, as it has been shown to have similar ablation success to higher doses of 100 mCi, while being safer, more cost-effective, and more convenient for patients and healthcare providers. This dose can be used for thyroid remnant ablation after thyroidectomy for differentiated thyroid cancer, with higher doses of 100-200 mCi reserved for more aggressive disease or metastases. The specific dose should be individualized based on factors including the patient's diagnosis, thyroid size, presence of metastases, and renal function, as supported by studies such as 1.
Prior to treatment, patients should follow a low-iodine diet for 1-2 weeks and stop taking thyroid hormone replacement (if applicable) to increase TSH levels, which enhances radioiodine uptake, as discussed in 2. Pregnancy must be excluded before administration, and patients should avoid close contact with others, especially pregnant women and children, for several days after treatment due to radiation exposure risks. The effectiveness of radioiodine therapy is based on the selective uptake of iodine by thyroid tissue, allowing targeted destruction of remaining thyroid cells while minimizing damage to other tissues.
Some key points to consider when determining the dose of radioiodine for ablation include:
- The patient's risk of recurrence, with higher doses used for patients with more aggressive disease or metastases, as seen in 3
- The presence of metastases, which may require higher doses of radioiodine, as discussed in 4
- The patient's renal function, as impaired renal function may affect the clearance of radioiodine, as mentioned in 5
- The potential side effects of radioiodine, including salivary dysfunction and radiation exposure risks, as highlighted in 3.
Overall, the choice of radioiodine dose for ablation should be individualized based on the patient's specific needs and risk factors, with the goal of achieving successful ablation while minimizing potential side effects and risks.