Course of Time and Extent of The Thyroid Volume Reduction after Radioiodine Therapy in Graves Disease and Autonomous Goiter

1997 ◽  
pp. 519-522
Author(s):  
B. Dederichs ◽  
J. E. Klink ◽  
R. Otte ◽  
H. Schicha
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Volume Reduction ◽  
Graves Disease

Characterization of radioiodine therapy failures in Graves’ disease

2001 ◽  
Vol 40 (01) ◽  
pp. 1-6 ◽  
Author(s):  
M. Zimny ◽  
M. Schreckenberger ◽  
P. Reinartz ◽  
B. Nowak ◽  
E. Ostwald ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Absorbed Dose ◽  
Stepwise Logistic Regression ◽  
Graves Disease ◽  
Significant Variable ◽  
Absorbed Energy ◽  
Volume Function ◽  
Energy Dose

Summary Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves’ disease without simultaneous Carbimazole. Method: 226 patients with a confirmed diagnosis of Graves’ disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), 1-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ±76.6 Gyvs. 285.2 ±82.1 Gy, ρ <0.005), but with no significant differences regarding age, thyroid volume, function or TRAb (all ρ >0.2). Of the 14 failures, η = 8 reached an absorbed dose <200 Gy and η = 1 a dose <250 Gy, although 5 of the failures reached an absorbed dose of >250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p <0.005), but no influence of initial thyroid volume, function, TRAb value, age (all ρ >0.2) or gender (p = 0.13). Two-tailed Fisher’s exact test showed no significant influence of gender on success rates (failures/successes: male 1 /36, female 13/176, ρ = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves’ disease without simultaneous Carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy.

Guideline for radioiodine therapy for benign thyroid diseases (version 3)

2004 ◽  
Vol 43 (06) ◽  
pp. 217-220 ◽  
Author(s):  
J. Dressler ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
Chr. Reiners ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Thyroid Diseases ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Co Morbidity ◽  
History Of ◽  
Individual Decisions ◽  
Prophylactic Use ◽  
Benign Thyroid

SummaryThe version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves’ disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves’ disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient’s preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients’ preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3rd version.

Influence of compensated radioiodine therapy on thyroid volume and incidence of hypothyroidism in Graves' disease

1995 ◽  
Vol 238 (6) ◽  
pp. 491-497 ◽  
Author(s):  
Birte Nygaard ◽  
L. HEGEDÜS ◽  
M. GERVIL ◽  
H. HJALGRIM ◽  
B. M. HANSEN ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Graves Disease

scholarly journals Predictors of the efficacy of radioiodine therapy of Graves’ disease in children and adolescents

2020 ◽  
Vol 66 (4) ◽  
pp. 68-76
Author(s):  
Pavel O. Rumyantsev ◽  
Vladimir A. Saenko ◽  
Dali S. Dzeytova ◽  
Alexey A. Trukhin ◽  
Marina S. Sheremeta ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Statistical Analysis ◽  
Children And Adolescents ◽  
Radioiodine Therapy ◽  
Antithyroid Drug ◽  
Thyroid Volume ◽  
Tsh Receptor ◽  
Rank Test ◽  
Graves Disease ◽  
Fisher Exact Test

RATIONALE: Insufficient world–wide clinical experience in radioiodine therapy (RIT) for Graves’ disease (GD) in children and adolescents, and limited knowledge of the predictors of RIT efficacy.AIMS: Analysis and identification of the most significant predictors of the efficacy of RIT in children and adolescents with Graves’ disease.MATERIALS AND METHODS: A total of 55 patients (48 females and 7 males) aged from 8 to 18 years receiving primary RIT for GD were enrolled. RIT planning was based on the dosimetric method. Analyzed parameters included gender, age, ultrasound thyroid volume before and 6 months after treatment, the presence of endocrine ophthalmopathy, duration of antithyroid drug (ATD) therapy, relapse of thyrotoxicosis after ATD dose reduction, blood fT3, fT4 and TSH levels initially and at 1, 3, 6 months after treatment, TSH receptor Ab initially and at 3 and 6 months after treatment, thyroid 99mTc–pertechnetate uptake at 10–20 minutes (%), maximum thyroid 131I uptake (%), specific 131I uptake (MBq/g) and therapeutic 131I activity (MBq). Fisher exact test, non–parametric Mann–Whitney test, Wilcoxon signed–rank test, logistic regression modelling, ROC–analysis, proportional hazard model (the Cox regression), the Kaplan–Meier method and log–rank test were used for statistical analysis as appropriate.RESULTS: Six months after RIT, hypothyroidism was achieved in 45 (81.8%), euthyroid state – in 2 (3.6%), and in 8 (14.6%) patients thyrotoxicosis persisted. On univariate statistical analysis, the smaller thyroid volume, higher fT4 and lower TSH receptor Ab levels, lower 99mTc–pertechnetate uptake and higher specific 131I uptake were associated with hypothyroidism. On multivariate logistic regression analysis, the older patient’s age (p=0.011), smaller thyroid volume (p=0.003) and higher fT4 (p=0.024) were independent predictors of RIT efficacy. Thyroid volume was also the only variable associated with achievement of hypothyroidism in time after RIT (p=0.011).CONCLUSION: The efficacy of dosimetry–based RIT in children and adolescents with GD 6 months after treatment was 81.2%. Older patients’ age, smaller thyroid volume and higher fT4 level were independent predictors of therapy success. Smaller thyroid volume was also a predictor of the favorable time–related outcome. Statistical models obtained in this work may be used to prospectively estimate the chance of efficient RIT for GD in pediatric patients.

Radioiodine therapy of Graves’ disease — a dosimetric comparison of different strategies concerning antithyroid drugs

2001 ◽  
Vol 40 (04) ◽  
pp. 111-115 ◽  
Author(s):  
V. Urbannek ◽  
E. Voth ◽  
D. Moka ◽  
H. Schicha
Keyword(s):  
Half Life ◽  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Absorbed Dose ◽  
The Body ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroid Metabolism ◽  
Group A ◽  
Group B

SummaryAim: Premedication with antithyroid drugs (ATD) compared to patients not pretreated with ATD causes a higher failure rate of radioiodine therapy (RITh) or demands higher therapeutical dosage of radioiodine (Rl). For clinical reasons and because of accelerated iodine metabolism in hyperthyreosis a compensated thyroid metabolism is desirable. Aim of this study was to investigate the influence of ATD on the biokinetics of Rl in case of Graves’ disease in order to improve RITh of patients pretreated with ATD. Methods: 385 consecutive patients who underwent RITh because of Graves’ disease for the first time were included: Group A (n = 74): RITh under continuous medication with ATD; Group B (ç = 111): Application of Rl under continuous medication with ATD, in case of insufficient Rl-uptake or shortened effective Rl-half-life ATD were stopped 1-5 days after RITh; Group C (n = 200): ATD were stopped 2 days prior to RITh in all patients. We examined the influence of ATD on Rl-uptake and effective Rl-half-life as well as the absorbed dose achieved on the thyroid in dependence of thyroid volume and applied Rl-dosage [TEQ - therapy efficiency quotient, (2)]. Results: In the Rl-pretest (all patients under ATD) the Rl-uptake was comparable in all three groups. During RITh Rl-uptake, effective Rl-half-life and therefore the TEQ were significantly higher in Group C as compared to Groups A and B (ñ <0,001, respectively). In Group B the medication with ATD was stopped in 61 of 111 cases 1-5 days after RITh. In this subgroup the effective Rl-half-life increased from 4,4 ± 1,7 d to 5,1 ± 1,6 d after stopping of ATD (ñ = 0,001). Conclusion: Stopping of ATD 2 days prior to RITh leads to an increased efficiency of about 50% compared to RITh carried out under ATD and therefore to a clear reduction of radiation exposure to the rest of the body with equal absorbed doses of the thyroid. Stopping of ATD shortly after RITh increases efficiency in case of short effective Rl-half-life, but it is inferior to stopping ATD 2 days prior to RITh.

Results of a risk adapted and functional radioiodine therapy in Graves’ disease

2005 ◽  
Vol 44 (06) ◽  
pp. 238-242 ◽  
Author(s):  
V. Neumann ◽  
U. Staub ◽  
P. Groth ◽  
H. Künstner ◽  
C. Schümichen ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Therapeutic Failure ◽  
Graves Disease ◽  
Clinical Parameters ◽  
Target Dose ◽  
Therapeutic Success ◽  
Thyroid Metabolism ◽  
First Time

SummaryAim of this study was to find out, if results of a functional orientated radioiodine therapy in Graves’ disease could be optimized using a risk adopted dose concept. Patients, method: 351 patients with Graves’ disease were treated for the first time between 11/97 and 8/01. The basic dose was 125 Gy, which was increased up to 250 Gy in a cumulative manner depending on clinical parameters (initial thyroid metabolism, thyroid volume, immunoreactivity). Two different methods of dosimetry were used. Occasional thyreostasis was withdrawn two days before the radioiodine test was started. Follow up was done on average 8 ± 2,4 (4-17,2) months. TSH ≥0,27 μIU/mL confirmed as a measure of the success. Results: With improved pretherapeutic dosimetry and a mean target dose of 178 ± 31 Gy (n=72) therapeutic success occurred in 66,7%, in 51,4% euthyreosis was restalled and in 15,3% of patients hypothyroidism was seen (TSH >4,20 μIU/mL). With simplified pretherapeutic dosimetry and a mean target dose of 172 ± 29 Gy (n=279) results were moderately impaired (63,8%, 40,1% and 23,7%). With increasing target dose therapeutic failure increased, as unsufficiently adopted risk factors for therapeutic failure turned out the initial thyroid metabolism, the TcTU(s) as the (h)TRAb titer. Conclusion: Functional orientated RIT can be optimized by including illness specific characteristics, principal limitations are a high initial thyroid metabolism, a large thyroid volume and a high (h)TRAb-titer.

Radioiodine therapy for thyroid volume reduction of large goitres

2009 ◽  
Vol 30 (6) ◽  
pp. 466-471 ◽  
Author(s):  
Juliane Bachmann ◽  
Carsten Kobe ◽  
Seher Bor ◽  
Ilka Rahlff ◽  
Markus Dietlein ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Volume Reduction

Graves' disease and radioiodine therapy

2008 ◽  
Vol 47 (01) ◽  
pp. 13-17 ◽  
Author(s):  
W. Eschner ◽  
F. Sudbrock ◽  
I. Weber ◽  
K. Marx ◽  
M. Dietlein ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Inclusion Criteria ◽  
Thyroid Dose ◽  
Point Measure ◽  
The Mean ◽  
Age And Sex

SummaryAim: This study was performed to determine the results of ablative radioiodine therapy (RIT) when the achieved dose in the thyroid was above 200 Gy and to characterize predictive factors for treatment outcome. Patients, methods: A total of 571 consecutive patients were observed for 12 months between July 2001 and June 2004. Inclusion criteria were a confirmed diagnosis Graves' disease, compensation of hyperthyroidism and withdrawal of antithyroid drugs two days before preliminary radioiodine-testing and RIT. The intended dose was 250 Gy and the therapeutically achieved dose was calculated from serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The relation between success rate and the achieved dose, thyroid volume, age and sex of patients, TSH- and TRAb-values and presence of ophthalmopathy was analysed. Results: Relief from hyperthyroidism was achieved in 96% of patients who received more than 200 Gy, even for thyroid volumes >40 ml. The success of ablative RIT was not influenced by age or sex of patients, or by TSH- or TRAb values or concomitant ophthalmopathy. The mean achieved dose in the thyroid was 298 Gy with a standard deviation of 74.6 Gy. Conclusion: To achieve a dose of over 200 Gy with the above standard deviation, we recommend calculating an intended dose of 250 Gy and using a dosimetric approach with early and late uptake values in the radioiodine test, to allow early therapeutic intervention should the posttherapeutic thyroid dose fall unexpectedly below 200 Gy.

Sign in / Sign up

Export Citation Format

Share Document