A study of the possibility of curing Graves?? disease based on the desired reduction of thyroid mass (volume) as a consequence of 131I therapy: a speculative paper

Objectives. This study is to assess the prognostic value ofTc99m-pertechnetate thyroid scintigraphy for predicting the outcomes of fixed low dose of radioiodine therapy (RIT) in a cohort of Chinese Graves’ disease (GD) patients.Materials and Methods. This is a retrospective study of GD patients who received RIT with a single dose of radioiodine (5 mCi). All the patients receivedTc99m-pertechnetate thyroid scintigraphy prior to RIT. Thyroid mass,Tc99m-pertechnetate uptake, gender, age at diagnosis, duration of the disease, ophthalmopathy, and serum levels of FT4, FT3, TT4, and TT3 prior to RIT were analyzed as potential interference factors for outcomes of RIT.Results. One hundred and eighteen GD patients who completed RIT were followed up for 12 months. The outcomes (euthyroidism, hypothyroidism, and hyperthyroidism) were found to be significantly associated with thyroid mass andTc99m-pertechnetate uptake. Patients with thyroid mass ≤ 40.1 g orTc99m-pertechnetate uptake ≤ 15.2% had higher treatment success.Conclusions. A fixed low dose of 5 mCi radioiodine seems to be practical and effective for the treatment of Chinese GD patients with thyroid mass ≤ 40.1 g andTc99m-pertechnetate uptake ≤ 15.2%. This study demonstratesTc99m-pertechnetate thyroid scintigraphy is an important prognostic factor for predicting the outcomes of RIT.

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Planning of 131I Therapy for Graves Disease Based on the Radiation Dose to Thyroid Follicular Cells

Journal of Nuclear Medicine ◽

10.2967/jnumed.108.053934 ◽

2008 ◽

Vol 49 (12) ◽

pp. 2026-2030 ◽

Cited By ~ 7

Author(s):

D. Eterovic ◽

Z. Antunovic ◽

V. Markovic ◽

D. Grosev

Keyword(s):

Radiation Dose ◽

131I Therapy ◽

Graves Disease ◽

Follicular Cells ◽

Thyroid Follicular Cells

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R-CHOP-Associated Graves’ Hyperthyroidism

Case Reports in Oncology ◽

10.1159/000501714 ◽

2019 ◽

Vol 12 (2) ◽

pp. 581-588 ◽

Cited By ~ 1

Author(s):

Natalie Mora ◽

Katherine N. Vu ◽

Thanh D. Hoang ◽

Vinh Q. Mai ◽

Mohamed K.M. Shakir

Keyword(s):

Thyroid Dysfunction ◽

B Cell Lymphoma ◽

Laboratory Evaluation ◽

Graves Disease ◽

Thyroid Mass ◽

Pet Ct ◽

Patient Reported ◽

Persistent Fatigue ◽

Radiation Induced ◽

Oncologic Treatment

Radiation-induced thyroid dysfunction following oncologic treatment is not uncommon, however limited literature data has been found on patients that underwent chemotherapy only. A change in thyrometabolic autoimmune status is also a rare entity. We present a case of newly diagnosed Graves’ thyrotoxicosis following a successful R-CHOP (Rituximab, Cyclophosphamide, Doxorubicine, Vincristine and Prednisone) treatment in a patient with concurrent abdominal and thyroid diffuse large B-cell lymphoma (DLBCL). Following chemotherapy, PET CT showed resolution of FDG-avid thyroid nodule as well as no evidence of the thyroid mass on repeat ultrasound. Her thyroid function also normalized. During her follow-up visit, patient reported significant unintentional weight loss and persistent fatigue over the past couple months. Repeat laboratory evaluation revealed TSH 0.005 mIU/mL, FT4 6.73 ng/dL and thyroid stimulating immunoglobulin (TSI) 535 (ref <140%). She was started on methimazole followed by radioactive iodine therapy. This unique case of Graves’ disease following R-CHOP treatment in patients with known Hashimoto’s and thyroid lymphoma is one of the first to be reported in the literature. The swing of pendulum from Hashimoto’s to Graves’ disease is very uncommon. As clinicians, we need to continue monitoring for clinical and biochemical thyroid dysfunction in this subset of population.

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A case report of 131I therapy for Graves’ disease patient with hemiagenesis

Medicine ◽

10.1097/md.0000000000014606 ◽

2019 ◽

Vol 98 (8) ◽

pp. e14606 ◽

Cited By ~ 1

Author(s):

Xuehui Liu ◽

Jianping Zhang ◽

Zhaowei Meng ◽

Hongxu Yu ◽

Zhimin Gao ◽

...

Keyword(s):

Case Report ◽

Disease Patient ◽

131I Therapy ◽

Graves Disease

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International Differences in Approaches to 131I Therapy for Graves' Disease: Case Selection and Restrictions Recommended to Patients in Japan, Korea, and China

Thyroid ◽

10.1089/thy.1997.7.217 ◽

1997 ◽

Vol 7 (2) ◽

pp. 217-220 ◽

Cited By ~ 29

Author(s):

TAN TOMINAGA ◽

NAOKATA YOKOYAMA ◽

SHIGENOBU NAGATAKI ◽

BO YOUN CHO ◽

CHANG-SOON KOH ◽

...

Keyword(s):

131I Therapy ◽

Graves Disease ◽

International Differences ◽

Case Selection ◽

Disease Case

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Radiation Safety Precautions in 131I Therapy of Graves' Disease Based on Actual Biokinetic Measurements

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2015-1682 ◽

2015 ◽

Vol 100 (8) ◽

pp. 2934-2941 ◽

Cited By ~ 4

Author(s):

Bin Liu ◽

Rong Tian ◽

Weiai Peng ◽

Ying He ◽

Rui Huang ◽

...

Keyword(s):

Radiation Safety ◽

131I Therapy ◽

Graves Disease

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The influence of non-radioactive iodine (127I) on the outcome of radioiodine (131I) therapy in patients with Graves’ disease and toxic nodular goitre

Nuclear Medicine Review ◽

10.5603/nmr.2011.0003 ◽

2011 ◽

Vol 14 (1) ◽

pp. 9-15 ◽

Cited By ~ 2

Author(s):

Franciszek Rogowski ◽

Saeid Abdelrazek ◽

Piotr Szumowski ◽

Anna Zonenberg ◽

Adam Parfienczyk ◽

...

Keyword(s):

Radioactive Iodine ◽

131I Therapy ◽

Graves Disease ◽

Nodular Goitre ◽

Toxic Nodular Goitre

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Survey of Practice: The Current Extent of Adjunctive Use of Lithium in the UK During Radioactive Iodine Therapy for Hyperthyroidism

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1721 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A843-A844

Author(s):

Younes R Younes ◽

Benjamin C T Field

Keyword(s):

Nuclear Medicine ◽

Significant Proportion ◽

131I Therapy ◽

Definitive Treatment ◽

Favorable Effect ◽

Graves Disease ◽

Nice Guideline ◽

Therapeutic Procedures ◽

The Uk

Abstract Background: The latest United Kingdom National Institute for Health and Care Excellence (NICE) guideline recommends 131I as first-line definitive treatment for Graves’ disease in patients who are unlikely to achieve remission with antithyroid medication. A small but significant proportion of patients have recurrence of hyperthyroidism after 131I therapy. Lithium enhances thyroidal iodine retention and thus increases radiation dose delivered to the thyroid gland during 131I therapy. While clinical trial findings with adjuvant Lithium have not been universally positive, several studies have demonstrated a favorable effect on cure rate, speed of cure and stabilization of thyroid hormone status during131I therapy. Aim: To determine the extent to which Lithium is used as an adjunct to 131I therapy for hyperthyroidism in the UK. Methods: We conducted a survey of 82 nuclear medicine departments and 236 consultant endocrinologists in National Health Service (NHS) hospitals across the UK. Results: Responses were received from 43 departments and 64 endocrinologists. Ten nuclear medicine departments reported that they do not perform therapeutic procedures. Amongst the remainder, only one department stated that Lithium is considered routinely as an adjunct to 131I for selected patients. Amongst consultant endocrinologists, only two indicated that they use Lithium as an adjunct to 131I therapy. Conclusions: Owing to mixed trial evidence and a lack of guideline support for adjunctive Lithium with 131I, its use is not widespread the UK at present. However, some researchers report that it might offer faster control of hyperthyroidism and reduce the amplitude of post-therapy thyroid function fluctuations. As these could be important determinants not only of quality of life but also of safety of treatment, our findings may be valuable to those planning randomized controlled trials of adjunctive Lithium with 131I therapy for Graves’ disease.

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