From the Guidelines
I-131 treatment is recommended for the hot nodule with 14% uptake, with a typical dose range of 10-30 millicuries (mCi) of I-131, and the exact dose determined based on nodule size, patient age, and other individual factors. The treatment is usually administered orally as a single dose. Patients should follow radiation safety precautions for 3-7 days post-treatment, including limiting close contact with others, especially pregnant women and children. Side effects may include temporary neck pain or swelling, and there's a risk of developing hypothyroidism in the future. Thyroid function should be monitored regularly post-treatment, typically starting at 4-6 weeks. This treatment is effective because the hot nodule preferentially absorbs the radioactive iodine, leading to localized destruction of the overactive thyroid tissue while largely sparing normal thyroid function 1.
Some key points to consider when treating a hot nodule with I-131 include:
- The dose of I-131 should be individualized based on the size of the nodule and the patient's age 1
- Radiation safety precautions should be followed for 3-7 days post-treatment to minimize exposure to others 1
- Thyroid function should be monitored regularly post-treatment to assess for potential hypothyroidism 1
- The treatment is generally well-tolerated, but side effects such as temporary neck pain or swelling can occur 1
It's also important to note that the treatment of hot nodules with I-131 is a common practice, and the benefits of treatment, including reducing the risk of thyroid cancer and improving quality of life, should be weighed against the potential risks, such as radiation exposure and hypothyroidism 1.
In terms of specific dosing, a moderate dose of 15-20 mCi is often suitable for a nodule with 14% uptake, but the exact dose should be determined based on individual patient factors, such as nodule size and patient age 1.
Overall, I-131 treatment is a effective and commonly used treatment for hot nodules, and can help to improve quality of life and reduce the risk of thyroid cancer.
From the Research
Treatment for Hot Nodule with 14% Radioactive Iodine (I-131) Uptake
- The treatment for a hot nodule with 14% radioactive Iodine (I-131) uptake is not directly stated in the provided studies, but we can look at the treatment options for similar conditions.
- For toxic adenoma, which is one of the main causes of hyperthyroidism, surgery is considered the treatment of choice in an endemic goitre area 2.
- Radiofrequency ablation (RFA) is also a promising treatment for symptomatic hyperactive thyroid nodules, with a low risk of permanent hypothyroidism 3.
- Radioiodine (I-131) therapy is commonly used to treat hyperthyroidism, but the optimal activity of I-131 administered for ablation therapy remains unknown in a long-term follow-up 4.
- In the case of Grave's disease, transient hypothyroidism can occur after I-131 therapy, and the development of transient hypothyroidism and its hormonal pattern do not influence long-term thyroid function 5.
Treatment Options
- Surgery: considered the treatment of choice for patients with toxic adenoma in an endemic goitre area 2.
- Radiofrequency ablation (RFA): a promising treatment for symptomatic hyperactive thyroid nodules, with a low risk of permanent hypothyroidism 3.
- Radioiodine (I-131) therapy: commonly used to treat hyperthyroidism, but the optimal activity of I-131 administered for ablation therapy remains unknown in a long-term follow-up 4.
Considerations
- The incidence of hyperthyroidism and toxic adenoma is high in surgically treated patients with nodular goitre 2.
- Fine-needle aspiration biopsy (FNA) is the standard test to determine whether surgical removal of a detected nodule is recommended 6.
- The optimal activity of I-131 administered for ablation therapy remains unknown in a long-term follow-up 4.