Structured hydration accelerates I-131 clearance, reduces bladder dose, and enables earlier discharge.

Area of Science:

• Nuclear Medicine
• Oncology
• Endocrinology

Background:

• Optimal hydration strategies for radioactive iodine (I-131) therapy are not well-defined.
• The balance between enhancing I-131 clearance and maintaining therapeutic efficacy requires investigation.

Purpose of the Study:

• To assess if a high-hydration regimen accelerates I-131 clearance.
• To determine if increased hydration reduces radiation exposure to non-target organs.
• To evaluate the impact on isolation time and therapeutic outcomes.

Main Methods:

• Prospective cohort study involving 456 women with papillary thyroid carcinoma undergoing I-131 therapy.
• Comparison between a high-hydration group (approx. 2500 ml/day) and a low-hydration group (approx. 1900 ml/day).
• Key metrics included I-131 effective half-life, discharge time, bladder dose, and reproductive outcomes.

Main Results:

• High hydration significantly reduced I-131 effective half-life (22.4 vs. 28.0 h) and bladder cumulative dose (18.5 vs. 22.1 mGy).
• Patients in the high-hydration group were discharged earlier (median 2.0 vs. 3.0 days).
• Therapeutic efficacy (tumor uptake) and short-term reproductive outcomes were comparable; benefits were greater in obese patients.

Conclusions:

• A structured high-hydration regimen effectively accelerates I-131 clearance and reduces radiation exposure.
• This approach facilitates earlier patient discharge without compromising treatment efficacy or reproductive safety.
• Tailored hydration protocols, especially for obese patients, are recommended to optimize I-131 therapy management.