Clinical Efficacy of A Single Dose Radioiodine Therapy for Hyperthyroidism

Objective: Radioiodine is a safe, cheap, and recognized permanent treatment option for patients with hyperthyroidism. Despite, the extensive use of radioiodine therapy in hyperthyroidism there is no consensus regarding the optimal dose of radioiodine. To evaluate the clinical efficacy and our clinical experience with the use of a single dose radioiodine therapy for hyperthyroidism in our institution.Methods: A total of 274 patients who received a single dose of radioactive iodine therapy for hyperthyroidism at our institution between 2007-2015 were retrospectively reviewed. Of these, 186 patients had Graves’ disease (GD), 73 patients had Plummer’s disease (PD), and 15 patients had a single toxic adenoma (STA). All patients received between 10-30mCi of oral radioiodine capsule. The efficacy of therapy was determined 3 months post-therapy using serum thyroid function test, weight and heart rate measurements. Therapy success refers to patients whose outcome was euthyroidism and hypothyroidism post-therapy and treatment failure where patients still manifested with persistent hyperthyroidism.Results: The efficacy of a single dose of radioiodine 3months post-therapy varies with the type of hyperthyroidism, 96% for Graves’s disease, 92% for Plummer’s disease and 100% in single toxic adenoma.Conclusion: Our study showed that a single dose of radioactive iodine therapy 3 months post-therapy is 96% efficient in all types of hyperthyroidism. However, we observed that patients at risk of therapy failure 3month post-therapy included, large thyroid gland prolong antithyroid drug usage and male gender.

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Factors Affecting and Outcome of Radioactive Iodine Therapy in Hyperthyroidism: A study at Institute of Nuclear Medicine & Allied Sciences (INMAS), Sylhet

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i1.35568 ◽

2018 ◽

Vol 19 (1) ◽

pp. 19-23

Author(s):

Kamrun Nahar ◽

Papia Akhter

Keyword(s):

Radioactive Iodine ◽

Antithyroid Drug ◽

Nodular Goiter ◽

Fixed Dose ◽

Graves Disease ◽

Radioactive Iodine Therapy ◽

Cure Rate ◽

Toxic Adenoma ◽

Significant Difference ◽

One Year

Objective: Radioactive iodine therapy (RIT) is the most commonly used modality to treat hyperthyroidism and is indeed in most cases, the treatment of choice. The aim of this study was to assess the clinical outcome one year after radioactive Iodine-131 (RAI -131) therapy and to identify the factors associated with response of the therapy.Patients and Methods: A total 107 hyperthyroid patients were included in this study. All patients were pre-treated with anti-thyroid drugs (ATD). A fixed dose of 8 mCi of radioiodine was given to the patients with Graves’ disease, 12 mCi to patients with single toxic adenoma and 15 mCi to patients with toxic multi-nodular goiter . The patients were done serum FT4 initially and followed up with serum T3, T4, and TSH at three months , six months and one year of RAI therapy . The clinically and biochemically euthyroid and hypothyroid patients were considered as cure of the disease.Results : The cure rate was about 94.7% seen in female patients and 93.8% in male ( P=0.92), 93.6% in younger age group (below 40 years) and 95.0% of the older patients ( P=1.51), 95.5% of the patients who were taking ATD for more than one year and 92.7% of the patients who were taking ATD for less than one year before therapy( P=1.95), 95.4 % of the patients who had initial FT4 level less than 35 pmol/L and 92.7 % of the patients who had high initial FT4 ( P=1.54). Cure rate of Graves’ disease was 45/53 (92.5%), multi-nodular goiter 41/43 (95.3% ) and for single toxic adenoma was 11/11 (100% ) (P= 0.65). The incidence of radioiodine induced hypothyroidism was 6.5 % at three months, 13.1 % at six months and 15.0 % at one year. Overall incidence of cure rate of RAI therapy after one year was 101 (94.4 %).Conclusion: No statistically significant difference was found in the cure rate when sex, age, duration of pretreatment with antithyroid drug, initial FT4 level and cause of hyperthyroidism were considered. From this study it can be concluded that cure rate of RAI therapy is quite good and the pretreatment factors have little influence on the final outcome.Bangladesh J. Nuclear Med. 19(1): 19-23, January 2016

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Faculty Opinions recommendation of Impact of lithium on efficacy of radioactive iodine therapy for Graves' disease: a cohort study on cure rate, time to cure, and frequency of increased serum thyroxine after antithyroid drug withdrawal.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.2813959.2479058 ◽

2010 ◽

Author(s):

Furio Pacini ◽

Stefania Marchisotta

Keyword(s):

Cohort Study ◽

Radioactive Iodine ◽

Drug Withdrawal ◽

Antithyroid Drug ◽

Graves Disease ◽

Radioactive Iodine Therapy ◽

Cure Rate ◽

Serum Thyroxine

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Outcome of Fixed Dose of Radioiodine Therapy in Hyperthyroid Patients at NINMAS

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v20i1.36853 ◽

2018 ◽

Vol 20 (1) ◽

pp. 37

Author(s):

Sharmin Quddus ◽

Fatima Begum ◽

Nasreen Sultana ◽

Rahima Perveen ◽

Tapati Mandal ◽

...

Keyword(s):

Nuclear Medicine ◽

Single Dose ◽

Thyroid Function ◽

Radioactive Iodine ◽

Radioiodine Therapy ◽

Thyroid Stimulating Hormone ◽

Fixed Dose ◽

Free Triiodothyronine ◽

Toxic Goiter ◽

Hyperthyroid Patients

Objective: The modified fixed doses of radioactive iodine (RAI) in different types of hyperthyroidism had been practiced at National Institute of Nuclear Medicine & Allied Science (NINMAS) according to Society of Nuclear Medicine Bangladesh (SNMB) protocol since 2002 which was upgraded in 2015. The objective of the study was to observe the treatment outcome in modified fixed dose on previous protocol. Patients and Methods: In the present study the outcome of radioiodine therapy of hyperthyroid patients was retrospectively evaluated in 1349 consecutive primary hyperthyroid patients treated from January 2010 to December 2014 at NINMAS. Diagnosis of hyperthyroidism was done by thyroid function test; thyroid stimulating hormone (TSH), free triiodothyronine (FT3) & free thyroxine (FT4), 99m Technetium scan, thyroid radioiodine uptake and ultrasound imaging of thyroid gland. All patients received a fixed dose (8-29 m Ci) of radioactive iodine (RAI) depending on types of hyperthyroidism, visual assessment of gland size and severity of disease at diagnosis. They were followed up at 2 months of therapy, then every three months intervals for first year and thereafter 6 monthly up to 5 years or as needed during fluctuation of thyroid function.Results: Among the study population, 832 patients had diffuse toxic goiter (Graves’ disease), 369 patients were diagnosed as toxic multinodular goiter and 148 patients with single toxic nodule. At one year follow-up, permanent hypothyroidism occurred in 61.62% of patients and the cumulative incidence of hypothyroidism progressively increased up to 79.25% after 5 years. Cure or success of RAI therapy was considered as attainment of euthyroid state or hypothyroid state. About 11.26 % patients received more than single dose.Conclusion: Fixed dose RAI therapy is very much cost effective mode of treatment for primary hyperthyroidism with ~89% success by giving single dose.Bangladesh J. Nuclear Med. 20(1): 37-40, January 2017

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Effect of Single Dose of Radioiodine Therapy on Volume Reduction of Thyroid Gland in Hyperthyroidism

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v21i2.40357 ◽

2019 ◽

Vol 21 (2) ◽

pp. 87-91

Author(s):

Shamrukh Khan ◽

Faridul Alam ◽

Fatima Begum ◽

Sadia Sultana ◽

Zeenat Jabin ◽

...

Keyword(s):

Single Dose ◽

Thyroid Gland ◽

Radioactive Iodine ◽

Volume Reduction ◽

Radioactive Iodine Therapy ◽

Short Term ◽

Hormone Levels ◽

Toxic Goiter ◽

Primary Hyperthyroidism ◽

Hormone Assay

Introduction: Radioactive iodine therapy (RAIT) in patients with hyperthyroidism (HT) causes apoptosis of thyrocytes to bring about restoration of thyroid function. The aim of the study was to find the short term extent of reduction of thyroid gland volume (TGV) by non-invasive quantitative assessment using ultrasound imaging (USG). Patients and Methods: This prospective study was conducted on a group of patients who had received RAIT due to primary hyperthyroidism at National Institute of Nuclear Medicine & Allied Sciences (NINMAS). Pre-therapy work up included hormone assay and baseline measurement of TGV by US before administration of appropriate fixed dose RAIT. Short term follow-up with hormone assay and serial measurements of TGV on two occasions were done at three and six months following the RAIT. Observed temporal changes of parameters were analyzed using appropriate statistics. Results: Total 117 patients with primary hyperthyroidism had received RAIT with diagnosis of diffuse toxic goiter in 86 patients, toxic multinodular goiter in 21 cases and single toxic nodular goiter in 10 cases. There was a decline of mean TGV from the baseline level of 24 ml to 14 ml at three months followed by a further decline to 9.1 ml at six months. Thus the volume reduction of thyroid gland was calculated to be 42% at three months and 62% at six months. The volume reduction was observed to be in a correlative trend with the normalization of hormone levels. The proportion of patients who showed persistent hyperthyroidism till the study end point was 23%. Conclusion: Single dose of radioactive iodine therapy resulted in reduction of TGV up to 62% till six months after RAIT while 23% patients showed persistent hyperthyroidism. The correlative trend of volume reduction with normalization of hormone levels indicates potentiality of TGV to emerge as an adjunct to conventional assessment of treatment efficacy following RAIT. Bangladesh J. Nuclear Med. 21(2): 87-91, July 2018

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