Radioiodine uptake in thyroid cancer patients after diagnostic application of low-dose 131I

The aim of this study was to investigate the influence of the diagnostic administration of 74 MBq 131I on subsequent uptake of therapeutic radioiodine in thyroid cancer patients. Retention measurements were performed using a whole-body counter in 24 patients 6 weeks after total thyroidectomy. Profile scans were performed 2, 24, 48 and 72 h after the administration of the diagnostic dose and 72 h after the administration of the ablation-therapeutic dose (4.4 GBq). The mean ( +/- S.D.) effective half-life of the diagnostic dose in thyroid remnants was 40.3 +/- 23.0 h. The uptake in the thyroid remnants of the subsequent ablation dose 72 h after administration was 30.4 +/- 19.8% of that predicted from the diagnostic study. The greater reduction in uptake was associated with the longer half-life of iodine and higher uptake in the thyroid remnants at 24 h, with a longer interval between surgery and administration of the diagnostic dose and a shorter period between administration of the diagnostic and ablation doses. Our results show that a diagnostic dose of 74 MBq 131I markedly reduces thyroid uptake of an ablation dose of 131I. This should be taken into account during radiation dose planning whenever a quantitative dosimetric study is to be performed.