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Radiotoxicity After Iodine-131 Therapy for Thyroid Cancer Using the Micronucleus Assay

Departments of Radiology and Radiological Science, Toyama Medical and Pharmaceutical University, Toyama; Department of Nuclear Medicine, Kanazawa University, Kanazawa; Department of Radiology, Asahikawa Medical University, Asahikawa, Japan; Nuclear Medicine Service, Veterans Affairs Health Sciences, Palo Alto, California; Department of Radiology, Stanford University School of Medicine, Stanfor, California

Correspondence: For correspondence or reprints contact: Naoto Watanabe, MD, Department of Radiology, Toyama Medical and Pharmaceutical University, Sugitani 2630, Toyama city, Japan 930-0152.

ABSTRACT

The purpose of the present study was to evaluate the degree of cytological radiation damage to lymphocytes after ¹³¹I therapy using the cytokinesis-blocked micronucleus assay. The chromosomal damage to lymphocytes induced by ¹³¹I in vivo should result in augmentation of the cells with micronuclei. Methods: We studied 25 patients with differentiated thyroid carcinoma who were treated with 3.7 GBq of ¹³¹I. Isolated lymphocytes collected from patients 1 wk after therapy were harvested and treated according to the cytokinesis-blocked method of Fenech and Morley. The micronucleus number of micronuclei per 500 binucleated cells were scored by visual inspection. As controls, lymphocytes from the same patients before therapy were also studied. In an in vitro study, lymphocytes from three patients at least 3 mo after therapy were exposed to doses varying from 0.25 to 1 Gy and studied with the same method. Results: The mean number (mean ± s.d.) of micronuclei after treatment was significantly increased (p < 0.05) as compared to control subjects (15.7 ± 2.7 vs. 5.4 ± 1.4). Since there was an interval ranging from 6 to 20 mo (mean 11.8 mo) between the present and the last radioiodine therapy, no significant effect on the frequency of micronucleus with cumulative radiation exposure of ¹³¹I to lymphocytes was detected. Internal radiation absorbed doses estimated for 25 patients were 0.33 ± 0.09 Gy in this external irradiation study. Conclusion: The relatively low frequency of lymphocyte micronuclei induced by ¹³¹I in vivo and lack of significant effect on the frequency of lymphocyte micronuclei with cumulative ¹³¹I supported the contention that short-term nonstochastic damage of this therapy with 3.7 GBq of ¹³¹I in thyroid cancer patients is minimal and reversible.

Key Words: micronucleus assay • differentiated thyroid carcinoma • radioiodine therapy • radiotoxicity

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