Hyperthyroidism with radioactive iodine-131

We looked into the restorative records of patients with Graves’ hyperthyroidism who were treated with iodine-131 between 1996 and 2002. Of the 135 patients, satisfactory data was gotten on the comes about of at slightest 24-month follow-up in 70 of them. Iodine-131 was given in a single measurements at a rate (200 microcuries/g of organ weight redressed to 100% iodine take-up after 24 hours). Methimazole treatment was suspended a week some time recently the organization of iodine-131. Treatment was considered fruitful with either or hypothyroidism. In follow-up examinations conducted after 12 months of application of the treatment, 81.2% of treatment victory rates were found, whereas in examinations conducted after 24 months, the rate come to 88.3%. This near the rates shown in the various sources.

Gender differences in estimating I-131 thyroid uptake from Tc-99m thyroid uptake for benign thyroid disease

Objective: For radioactive Iodine-131 (131I) treatments of thyroid diseases, increased efficacy has been reported for personalized dosimetry treatments. The measurement of Iodine-131 thyroid uptake (131IU) is required in these cases. This study aims to investigate whether 99mTc thyroid uptake (99mTcU) may be used in place of 131IU for implementing personalised treatments. Methods: A retrospective study of 152 benign thyroid disease 131I treatments was carried out during 2012–2020; 117 treatments were for female patients while 35 were for male patients diagnosed with either Graves’ disease, multinodular goitre or toxic nodules. Results: A statistically significant correlation was found between 131IU and 99mTcU data, with the data more correlated for male than female patients (r = 0.71 vs 0.38, p-value < 0.001). Patient age and time difference between the two respective uptake measurements significantly influenced the uptake correlation in females but not for the male cohort, although there was no significant difference between the parameters across gender. Thyroid diagnosis and hormone levels showed a significant correlation with uptakes in both genders. Estimating 131IU based on 99mTcU was shown to be predictive for male but not in female patients (R2 = 91% vs 16%). Conclusion: Estimating 131IU based on 99mTcU is not recommended for females at our centre. Males reported good correlation, but a larger sample would be needed for validation. Advances in knowledge: The initial findings showed a significant gender difference in benign thyroid uptake parameters at our centre, highlighting the potential need for gender consideration when planning 131IU patient management and when reporting studies results.

Evaluation of Serum Tumor Markers Variation, Following The Radioactive Iodine Therapy in Patients with Differentiated Thyroid Cancer

Introduction: Radioactive iodine is the effective therapy in thyroid cancer. The aim of this study is to evaluate the serum tumor markers in patients under the therapy with radioactive iodine 131. Material and Methods: 45 cases of female patients aged 16-60 years with thyroid cancer surgery referred to the nuclear medicine department of Nemazi hospital for (iodine treatment after surgery) were selected. The selection was on the basis of interviewing and information of patients is consent forms. Only patients with thyroid cancer and referred for the first time without any other diseases were chosen for this study. The selected patients were prescribed a dose of 150 m Ci of I-131. From each patient, 4 mL of chelated serum for serological studies on tumor markers and 2 mL of oxalated serum for spectrophotometry studies on cell death were used in three stages. The first stage before the iodine therapy, the second stage, after 48 hours, and the third stage, 30 days after radioiodine therapy were studied and the results were evaluated by the one-way repeated measures ANOVA test. Results: According to the results of dependent paired T-Test, AFP, in the periods before, 48 hours and 1 month after radioiodine therapy, respectively were 3.46 ± 1.21 and 3.74 ± 1.37 and 3.76 ± 1.25 (p <0.0005). About CA 19-9 in the periods before, 48 hours and one month after radioiodine therapy, the results were 9.30 ± 6.32, 9.95 ± 6.92 (p = 0.040) and 11.26 ± 7.49 (p <0.0005) respectively. About CEA, the results were 1.60 ± 0.60, 1.47 ± 0.55 and 2.23 ± 0.69 (p <0.0005), respectively. In the case of tumor marker CA 15-3 results were 15.53 ± 6.48 and 1.60 ± 0.60 and 15.68 ± 6.52 (p = 0.014), respectively and in the case of ALP, results were 124.22 ± 5 and 122.2 ± 6 and 116.7 ± 7 (p <0.0005), respectively. Conclusion: According to the same studies and the acquired results, it can be concluded that the tumor markers CEA and CA19-9 are more acceptable and sustainable for monitoring the malignancy and progressive disease in patients with thyroid cancer. The decreasing ALP is normal and transient. The increase of AFP and CA15-3 is not even statistically reliable. It is recommended that the period of iodine therapy and falsely elevated tumor markers can be informed to the doctor, during the gastrointestinal studies in patients with thyroid cancer, in order to prevent wrong decisions on the treatment process.

A Comparison between High Ablative Versus Usual Dosages of Iodine-131 in Inducing Hypothyroidism After One Year of Therapy in Hyperthyroid Patients

Background: Radioactive iodine-131 therapy is highly effective in treating patients with hyperthyroidism. An ablative dose is preferred by a number of endocrinologists, and, a fixed dose protocol seems to be better than a calculated dose in real practice. Objective: To check for hypothyroidism in hyperthyroid patients one year after RAI therapy, comparing between the results of high ablative versus usual dosages of RAI-131. Methods: This study included 174 hyperthyroid patients, 101 males and 73 females, divided into 2 groups, the first consisted of 162 patients given a usual fixed dose of RAI while the second consisted of 12 patients given a high fixed ablative dose of RAI. The study lasted about 2 years from August 2000 till July 2002 in the Specialized Centre for Endocrinology & Diabetes, Baghdad. Results: Out of 162 patients in the first group, 11 patients (6.8%), developed hypothyroidism compared to 4 patients out of 12 (33.3% ) in the second group ( p < 0.05). Conclusion: A high ablative dose RAI has a better outcome regarding hypothyroidism than a usual dose, although, endocrinologists have different opinions regarding this issue.

Evaluation of Serum Tumor Markers Variation, following the Radioactive Iodine Therapy in Patients with Differentiated Thyroid Cancer

Introduction: Radioactive iodine is the effective therapy in thyroid cancer. The aim of this study is to evaluate the serum tumor markers in patients under the therapy with radioactive iodine 131. Material and methods: 45 cases of female patients aged 16-60 years with thyroid cancer surgery referred to the nuclear medicine department of Nemazi hospital for (iodine treatment after surgery) were selected. The selection was on the basis of interviewing and information of patients is consent forms. Only patients with thyroid cancer and referred for the first time without any other diseases were chosen for this study. The selected patients were prescribed a dose of 150mCi of I-131.From each patient, 4 mL of chelated serum for serological studies on tumor markers and 2 mL of oxalated serum for spectrophotometry studies on cell death were used in three stages. The first stage before the iodine therapy, the second stage, after 48 hours, and the third stage, 30 days after radioiodine therapy were studied and the results were evaluated by the one-way repeated measures ANOVA test. Results: according to the results of dependent paired T-Test, AFP, in the periods before, 48 hours and 1 month after radioiodine therapy, respectively were 3.46±1.21 and 3.74±1.37 and 3.76±1.25 (p <0.0005). About CA 19-9 in the periods before, 48 hours and one month after radioiodine therapy, the results were 9.30±6.32, 9.95±6.92 (p = 0.040) and 11.26±7.49 (p <0.0005) respectively. About CEA, the results were 1.60±0.60, 1.47±0.55 and 2.23±0.69 (p <0.0005), respectively. In the case of tumor marker CA 15-3 results were 15.53±6.48 and 1.60±0.60 and 15.68±6.52 (p = 0.014), respectively and in the case of ALP, results were 124.22±5 and 122.2±6 and 116.7±7 (p <0.0005), respectively. Conclusion: According to the same studies and the acquired results, it can be concluded that the tumor markers CEA and CA19-9 are more acceptable and sustainable for monitoring the malignancy and progressive disease in patients with thyroid cancer. The decreasing ALP is normal and transient. The increase of AFP and CA15-3 is not even statistically reliable. It is recommended that the period of iodine therapy and falsely elevated tumor markers can be informed to the doctor, during the gastrointestinal studies in patients with thyroid cancer, in order to prevent wrong decisions on the treatment process.