Comparative evaluation of low and high radioiodine doses in differentiated thyroid carcinoma management: A multicenter study

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Iodine-131 (131I) therapy plays a crucial role in the ablation of thyroid remnants in differentiated thyroid cancer (DTC), although there remains ongoing debate concerning the appropriate dosage. This study aims to compare the effects of low and high doses of radioiodine (RAI) in the management of DTC. For this purpose, 100 adult patients with verified DTC histology who had either total or nearly total thyroidectomy were injected with either 1.1 GBq (30 mCi) or 3.7 GBq (100 mCi) of radioiodine (131I). Those patients were categorized as low or intermediate risk following the American Thyroid Association (ATA) recommendations. Retrospective data was manipulated from multiple center units nuclear medicine in Saudi Arabia on equal numbers of selected male and female patients, with ages in the range from 20 to 66 years with an average of 40.72 ± 11.49. According to the tumour-node-metastasis (TNM) classification, the most tumours (T) stages in both groups were T1 or T2, with 80% in the high-dose group and 86% in the low-dose group. After the radioiodine therapy (RIT), the thyroglobulin (Tg) levels were below 10 ng/ml across both groups (72 % in the high-dose group and 66 % in the low-dose group). There was no discernible therapeutic distinction between patients with low and moderate risks in terms of treatment efficacy. The results revealed that the RIT with a low-dose ablation success rate (78%) is almost the same as the high-dose ablation success rate (82%). Therefore, this indicates that both the low and high-dose ablation effectively reduce Tg levels and achieve successful ablation.