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Diagnostic and Therapeutic Implications of Long-Term Radioisotope Scanning in the Management of Thyroid Cancer

Wadsworth Veterans Administration Hospital and UCLA School of Medicine, Los Angeles, California

Correspondence: For reprints contact: G. T. Krishnamurthy, Nuclear Medicine Service, Wadsworth Veterans Administration Hospital, Wilshire and Sawtelle Blvds., Los Angeles, Calif. 90073.

ABSTRACT

The diagnostic significance of long-term post ¹³¹I ablation scanning was evaluated in 18 patients with thyroid cancer. Each patient had been treated with surgery followed by total ablation of tumor tissue with ¹³¹I. Patients were followed by means of annual scans for the first 5 years and thereafter by scans every 2 years. Followup intervals were 10–21 years (mean, 14 years) after the ¹³¹I treatment. Tumor recurrence occurred in some patients 5 or more years after continued absence of tumor for the first 5 years.

Since tumor recurrence is more common in those patients who had tumor metastases initially, it is recommended that diagnostic scanning be continued annually for all thyroid cancer patients for the first 5 years and beyond this period for those with initial tumor metastasis. It is also recommended that the patient who shows recurrence be treated with ¹³¹I until total ablation is again achieved. There have been no long-term harmful effects associated with therapeutic doses of ¹³¹I for either initial or recurrent thyroid cancer in the dose range employed in this series of patients.