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. 2020 Oct 15;10(5):235-242.
eCollection 2020.

Effectiveness of radioactive iodine (131I) in the treatment of Graves' disease: single center experience in Assiut University hospital

Nsreen Ra Mohamadien  1 , Mohamed Hm Sayed  1
Affiliations

Effectiveness of radioactive iodine (131I) in the treatment of Graves' disease: single center experience in Assiut University hospital

Nsreen Ra Mohamadien et al. Am J Nucl Med Mol Imaging. .

Abstract

To evaluate the effectiveness of radioactive iodine (131I) therapy in patients with Graves' disease (GD) in Assiut University Hospital. We retrospectively evaluated two hundred and seven patients with GD, after their therapy with 131I. Before therapy all the included patients underwent neck ultrasound, hormonal assay and 99mTechnetium-pertechntate (99mTc) thyroid scintigraphy to evaluate percentage uptake of the thyroid gland, after therapy all patients followed up clinically and laboratory every 3 months for at least one year to detect outcome; where euthyroid or hypothyroid status denotes successful therapy. Successful outcome obtained in 165/207 patients representing 79.7% of the study population while in the remaining 42 (20.3%) patients a second dose was required. In Univariate analysis only dose of 131I and previous thyroid surgery are the important factors (P value = 0.003 and 0.001 respectively). We concluded that 131I therapy is highly effective and cost-effective method for treatment of GD, higher doses are associated with higher success rate.

Keywords: Graves’ disease; radioactive iodine (131I) therapy.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Thyroid uptake, Patient’s first thyroid scan (A) showed diffuse goiter and a 42.6% 99mTc-pertechnetate uptake. This was followed by administration of a 555 MBq (15 mCi) of 131I. Subsequent follow up showed persistent suppression of TSH and elevation of FT3 and FT4, and ATDs was reintroduced. 6 months after 131I therapy, Patient’s second thyroid scan (B) showed a 6.7% 99mTc-pertechnetate uptake. Consequently, a second dose of 370 MBq (10 mCi) 131I was administrated. Three months later, laboratory workup showed overt hypothyroidism (TSH: 75 uIU/mL, FT3: 1.04 pg/mL, and FT4: 0.35 ng/dL), and levothyroxine replacement therapy was initiated.
Figure 2
Figure 2
Outcome of 131I treatment in 207 hyperthryoid patients.
Figure 3
Figure 3
The pattern of changes in serum concentrations of thyroid function studies following 131I therapy. Comparison of the mean serum levels of TSH (left), FT3 (middle), and FT4 (right) at baseline, 3 months and 6 months after 131I therapy between those who successfully treated with a single dose of 131I and those who experienced 131I treatment failure.
See this image and copyright information in PMC

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