Re: The scan --> Betty

[Guest guest]

Hi Betty,

" I'm also a little puzzled at this protocol, "

Looks as though you're going to have 2 for comparison purposes. Sounds like

good-medicine, to me.

Nick

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(Dr. )

Date: Sat, 13 May 2000 07:41:19 -0400

Subject: Re: Scan procedure question

Diane,

When you are given a dose of radioiodine for scanning, the dose is taken up by

thyroid tissue and thyroid cancer rapidly. Much of the uptake is done within 4

hours. However, the dose also distributed in the rest of the body such as the

blood and tissue fluid sorrounding the thyroid tissue.

The reason for waiting 2-3 days is to let the urinary excretion of radioiodine

eliminate background radioactivity from the blood and non-thyroidal tissues

while the radioiodine in the thyroid tissues is essentially stuck. This leads to

increased contrast between normal and abnormal sites. If you scan too early the

difference in uptake between normal and abnormal areas may be too low to detect.

Scanning later increases the ability to detect abnormal tissue, not because more

gets into the thyroid tissue, but because less is in the surrounding tissue.

You are correct that most of the dose is gone from your body at the time of

imaging. Successful imaging and successful therapy is often based on 1-2% of the

dose doing the " work " and 98-99% of the dose being excreted.

So scans done earlier (1 day after a dose) detect less cancer than scans done

later (3 days after a dose).

Jeff

Diane & Rob Blaszka wrote:

> I had a thought today as I was driving my car and reflecting on this thyca

> journey. It seems like a lot of annual scans miss things that are later

> picked up by other tests. Common scanning practice is to give patients 2-5

> mci and then scan 2 or 3 days later. Due to the half-life and quickly

> diminishing RAI, isn't most of it gone by the time the scan rolls around?

> Believe me, I want to trust my clean scans. But it just seems odd to me that

> they wait (in my case, I usually take the pill on Friday and scan on

> Monday) -- and I know the scans tend to miss things a bit too often. Maybe

> Ian, one of the doctors or someone can clarify? Thanks! (I really have to

> stop thinking as I drive.)

> -- Diane, TT 11/8, pap with lymph mets, 128 mci RAI 1/99, bit of dirt, 2

> clean scans since but some swollen neck nodes I fret about.

> Re: Back and freaked out

>

> > G.

> >Welcome back. I'm sorry I don't have any advise, but I really feel for you.

> I

> >had 4 tiny spots in my lungs on a CT chest scan (without contrast) last

> fall (be

> >sure that all your tests are 'without contrast' or it will negate future

> RAIs for

> >a year). No one so far, can tell me what they are including a 'lung

> expert'.

> >The lung guy told me all questionable spots should first be treated with

> RAI and

> >watched. I had a tg of 32 while hypo in Feb but both of my scans have been

> clean

> >so far. So I am in a similar position of having 'something' but not

> knowing what

> >it is. I'm having another 200mci in 2 weeks because of the tg. Maybe

> thoughs

> >spots will light up, but maybe they won't. It's hard enough to deal with

> thyca

> >as it is, but when an aspect of it is a mystery it's extremely difficult.

> >

> >Best of Luck,

> >Rita

> >Toronto, ON

> >dx 1/99, tt 2/99 pap with tall cells,

> >met 9 lymph nodes,

> >4/99 RAI 150mci, clean scan

> >2/00 test dose (5mci) RAI , clean scan

> >on 26/5/00 I'm having 200mci

> >

> >

> >

> >

> >CaneWrites@... wrote:

> >

> >> Hi all, so much for burying my head in the sand. Only six weeks or so

> off

> >> the list and already I find I need you again.

> >>

> >> My scan in March was said to be " unremarkable " and I'm hoping that that

> >> wasn't a mistake. Since the scan I started having an odd back pain that

> kept

> >> getting worse. My regular doc thought it was a urinary tract infection

> but

> >> didn't show up on urine dip. Went to ER a few weeks ago and they said it

> was

> >> a kidney infection and loaded me on antibiotics. Still got worse. Went

> to

> >> urologist, they sent me for ultrasound and radiologist says cyst on

> kidney.

> >> Had a CT of the abdomen last week, now they're saying no problem with

> kidneys

> >> but hey you have several small tumors on your liver!

> >>

> >> I am totally freaking out about this. I know it's probably unrelated to

> >> thyca, but I also know follicular thyca likes to go the liver. If anyone

> >> here knows anything about liver mets and how they're diagnosed, how they

> >> feel, etc. please share. I'm having a nuclear medicine scan next week to

> see

> >> more detail on these things and my moronic endo is supposedly getting the

> >> radiologist to take another look at the films to verify that there wasn't

> >> unusual uptake in the liver.

> >>

> >> Speaking of moronic endos, some of you may remember how furious I was

> that

> >> mine never called to tell me the results of that March scan. I ended up

> >> getting the results by having my family doc call the nuclear med dept. to

> get

> >> them. Well, when I called the endo with this latest crisis (I was

> planning

> >> to never see him again, but hadn't told him yet) his nurse told me they

> have

> >> no record of my ever having that scan! Can you believe this! No wonder

> they

> >> never called. I can't believe they would order a scan and just not

> notice

> >> not hearing how it went. I wish I had gone ahead and found a new one so

> I

> >> wouldn't have to deal with these idiots at all!

> >>

> >> Anyway, thanks for letting me vent after all this time away and please

> tell

> >> me your liver met experiences.

> >>

> >> G. (dx. foll. 10/98, partial lobectomy 9/98, tt 12/98, 29.9 mCi RAI

> >> 2/99, " dirty " scan 4/99, clean bone scan 5/99, supposedly clean scan

> 3/00, on

> >> .175 synthroid)

> >

> >

> >

> >

--

A. , MD

Nuclear Medicine, A-72 (Fax)

Albany Medical Center (Beeper)

Albany, NY 12203 cooperj@...

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At 10/26/01 09:56 AM, you wrote:

>Hi everyone,

>

>I rarely post to the list but sit here and soak up everyone's posts. It's

>finally time for my first scan one year after my I131 treatment (how's that

>for bypassing the acronym controversy?). I took 3 mCi of I131 yesterday

>morning and was expecting to scan on Monday. Instead, they told me that

>they do two scans and that I have to come back on Monday and Thursday. I

>was really crushed because I was expecting everything to be over on Monday

>and that I might possibly make them tell me the results then and there so

>that I can plan the rest of my life. Now I feel like my life is on hold

>for another week since I don't think I can get them to give me results

>immediately if they have to compare two scans.

>

>I feel really guilty for being so disappointed at this news and I don't

>think I can explain my disappointment to my friends but I thought that all

>of you would understand. I'm also a little puzzled at this protocol, not

>that I have anything against it since it seems to me that the more scans,

>the more information they have. However, I was off thyroid hormone (I

>turned down cytomel) for four weeks and on LID for a week before I took my

>dose. My TSH was 94. Anyway, this means that I would be off levoxyl and

>on LID for at least another two weeks after the scan. If my doctor had

>waited six weeks and had me do the LID two weeks prior, that would mean

>being off hormone for EIGHT weeks and on LID for a whole month!

>

>I have to admire all of you that go through that. I go crazy!

>

>Betty

>mailto:bettyy@...

>

>

>

>

>For more information regarding thyroid cancer visit www.thyca.org. If you do

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>

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