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Objectives: I-123 is considered an ideal isotope for diagnostic studies. A significant advantage of I-123 over I-131 is that, the radiation dose delivered is about 100-fold less. Consequently, potential ‘‘stunning’’ because of the dosimetry procedure prior to treatment would be less concerning. However, its relatively short half-life makes it impractical for a prolonged bio kinetic study. The aim of the current study was to assess the relationship between actual I-131 retention and the success rate of I-131 ablation in patients with differentiated thyroid carcinoma (DTC) following I-123 whole body scan (WBS). Patients and methods: 23 consecutive patients with newly diagnosed DTC (21 papillary, and 2 Follicular), underwent total or near total thyroidectomy, followed by I123 WBS, and subsequent I-131 ablation were enrolled in current study. The whole body external exposure rate from the patient at 1 meter was measured immediately after ingestion of I-131, after 24 and 48 hours, using a calibrated Victoreen 451P ionization chamber survey meter (Fluke Biomedical, USA). The retained activity at 48h and the whole body effective half-life for each patient were then calculated. Patients were classified according to their follow up data after 6 months into two groups; those who have successful ablation (Negative WBS and an undetectable serum thyroglobulin level in Egyptian J. Nucl. Med., Vol. 13, No. 1, December 2016 59 the absence of antithyroglobulin antibodies), and those who need reablation (Positive WBS and/ or elevated serum Thyroglobulin). Results: Of the 23 patients studied, 15 were considered to have successful ablation and 8 still need reablation. No significant difference regarding age, gender, histopathology, and activity of I-131 ablation dose between both groups. The retained I-131 activity at 48 hours was 13.50±3.87% of the administered dose, and the effective halflife was 16.37±2.43 hours for patients who have successful ablation compared to 7.79±3.28% (p =0.002), and 12.64±2.27 hours (p = 0.002) respectively for patients who need re-ablation. Conclusions: We found a significantly higher retained I-131 activity at 48 hours and longer effective half-life among patients successfully ablated compared to those who need re-ablation, and recommend dosimetry adjusted I-131 ablation dose whenever feasible accordingly .

egyptian journal of nuclear medicine

Relationship Between Actual I-131 Retention and the Success Rate of I-131 Ablation in Differentiated Thyroid Carcinoma. Sayed, M.H.1, 2, Aljuneidi, B.M.3, Yasir, M.A.4 1Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 2Department of Nuclear Medicine, Almana General Hospital, Dammam. 3Department of Radiology and Medical Imaging, Almana General Hospital, Khobar, 4Department of Endocrinology, Almana General Hospital, Khobar, Saudi Arab