RE: medical misadministration to child

["North, David" <DNorth@LIFESPAN.ORG>]

Speaking as someone who has been involved in clinical nuclear medicine for

almost 30 years, I can state that it is indeed common to image the thyroids

of euthyroid adults (rare for children). It is really the only way to

evaluate the functional status of one or more nodules which may have been

picked up by palpation or ultrasound. A prescribed activity of 4 uCi of

I-131 is quite reasonable for an uptake study on a child, given that 10 uCi

would be a common dose for an I-131 uptake on an adult. One question would

be why I-131 was used rather than I-123, but I think the latter is

contraindicated if part of the thyroid gland is suspected to be substernal.

Sodium pertechnetate-Tc99m can be used for thyroid imaging and uptakes, but

it is only trapped by the thyroid, not organified into hormone, and released

unchanged. So, you don't get a complete picture of the function.



David L. North, Sc.M., DABR

Medical Physics

Main Bldg Rm 317

Rhode Island Hospital

593 Eddy St.

Providence, RI 02903

(401)444-5961

dnorth@lifespan.org





> ----------

> From: 	John Jacobus

> Sent: 	4, April 2003 16:08

> To: 	William V Lipton; North, David

> Cc: 	radsafe@list.vanderbilt.edu

> Subject: 	Re: medical misadministration to child

> 

> An even better question is why was the scan being done.  It is not common

> to perform a diagnostic scan on a euthyroid patient, adult or child.  If

> the suspision is that the thyriod is cancerous, the thyroid would have

> been surgically removed and I-131 given to destroy any remenants that

> remained.  

> 

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