Radiation Dose in the Selection of 131I or Surgical Treatment for Toxic Thyroid Adenoma

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Abstract
Clinicians, by their patterns of referral to colleagues in nuclear medicine or surgery, may influence the selection of 131I vs. surgical treatment for patients with toxic thyroid adenoma. The information presented is intended to aid them in making an informed choice. As nodule size of an adenoma increases from 2 to 6 cm, the amount of radioiodine administered to the patient to deliver the same dose (30,000 rad to the nodule center, assuming a 30% uptake) increases from 5.6 to 135 mCi. Concurrently, the suppressed thyroid tissue receives a radiation dose as high as 2300 rad. Despite these potentially carcinogenic doses, few patients with radioiodine-induced thyroid tumors were reported. Possible reasons for this were discussed. For young patients with large nodules, surgery is preferred.