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[Guest guest]

Barb,

You wrote:

>

> Thanks for your opinion Chuck. So, if I'm understanding you right, the

> MRI will not reveal everything that needs to be known?...

It can visualize tumor boundaries, which could guide the surgeon.

However, ultrasound can do that more cheaply.

> ... Is there a

> possibility that if the nodules are benign, this test could activate

> them and make them malignant?...

No, malignancy is a multi-step process. A truly benign nodule is not

waiting for a dietary level of iodine, even radioactive iodine, to

trigger a change to malignancy. The dosage (and radiation exposure)

involved in ablation is a different story. There is some increase in

risk from that sort of dose, but since almost of it is concentrated in

the thyroid, most of the risk is destroyed along with the tissue.

Surrounding tissue is relatively safe, unless you have already had

nuclear procedures or an unusual amount of diagnostic exposure.

This is not to say that a benign growth cannot become malignant. I am

just saying a dietary level of iodine isn't going to cause it, even if

it is slightly radioactive.

Chuck

[Guest guest]

You are correct, I was referring to the radioactive iodine from the CT scan, and

not the gamma  spec camera. Also the CT scan gives I think I recall about 150

times the radiation of an xray.

 

I was in afib for most of today, and I'm too exhausted right now. 

<>Roni

Immortality exists!

It's called knowledge!

 

Just because something isn't seen

doesn't mean it's not there<>

> I know what you're saying, it's still possible since we all react

> differently. Some people's thyroids

> react to the iodine in a CT scan and some don't.

It's not a CT, but a gamma spec camera. The amount of iodine used is

truly tiny, less than the RDA. All they do with it is trace where it

ends up, whether the nodules take up more or less than the surrounding

tissue.

When they use an iodine based dye injected for a CT scan, it is not

radioactive, but the radiation opaque chemicals do cause reactions, some

severe. I suspect you are thinking of this radio-opacity rather than

radioactive iodine.

>

> One question I do have about the needle biopsy, could this procedure

> precipitate any leaks of

> cells into the surrounding area while withdrawing the needle or even

> with the initial penetration?

In principle, yes, but the technique is designed to minimize the risk by

aspirating while penetrating, so everything that is loosened gets

vacuumed out with the blood. Our big concern with Mike was that every

needle biopsy would require he spend a week fighting the protocol to

remove and then restore his blood thinners. We decided to just go ahead

and do the thyroidectomy. In hindsight, this was a good move, since his

nodules were malignant.

The radioactive iodine used for the ablation is much greater than that

for the scan. I could barely detect the signal from Mike's earlier scan,

but the ablation dose pegged my meters for over a week. I have fairly

sensitive meters.

I could still detect his thyroid two weeks after the ablation when they

checked for any spread and found none.

Chuck

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