Abstract
The long-term effects of two schedules of radioiodine therapy in patients with toxic multinodular goitre were evaluated. Forty-five patients (group A) were treated with low doses and 58 patients (group B) with calculated doses adjusted for thyroid weight (1.85–3.70 MBq/g) and radioactive iodine uptake. Follow-up (mean ± SEM) was 4.3 ± 0.2 years and 5.2 ± 0.3 years, respectively (P>0.1). At the end of follow-up, hyperthyroidism was successfully reversed in 73% (group A) and 88% (group B). In each group, hypothyroidism was present in 7%. The total dose per gram of thyroid tissue was not significantly different in groups A and B (2.1 ± 0.2 vs 2.7 ± 0.2 MBq/g). However, for patients treated with calculated doses the number of 131I administrations was significantly lower (1.3 ± 0.1) than for patients treated with low doses (2.2 ± 0.2), and the percentage of patients who were adequately treated with a single dose was more than twice as high (66% in group B versus 27% in group A). Euthyroidism was reached within a significantly shorter time after treatment with calculated doses (median time 0.6 years in group B vs 1.5 years in group A; life table analysis). It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a low risk of post-treatment hypothyroidism and that calculated (higher) doses appear to be preferable to low doses.
Similar content being viewed by others
References
Sridama V, McCormick M, Kaplan EL, Faucher R, DeGroot LJ. Long-term follow-up study of compensated low-dose 131I therapy for Graves' disease. N Engl J Med 1984;311: 426–432
Goolden AWG, Stewart JSW. Long-term results from graded low dose radioactive iodine therapy for thyrotoxicosis. Clin Endocrinol 1986;24: 217–222
Seed L, Jaffé B. Results of treatment of toxic goiter with radioactive iodine. J Clin Endocrinol 1953;13: 107–119
Eller M, Silver S, Yohalem S, Segal R. The treatment of toxic nodular goiter with radioactive iodine: 10 years' experience with 436 cases. Ann Intern Med 1960;52: 976–1013
Lamberg B, Hernberg C, Wahlberg P, Hakkila R. Treatment of toxic nodular goitre with radioactive iodine. Acta Med Scand 1959;165:245–258
Dunn J, Chapman E. Rising incidence of hypothyroidism after radioactive-iodine therapy in thyrotoxicosis. N Engl J Med 1964;271: 1037–1042
Nofal M, Beierwaltes W, Patno M. Treatment of hyperthyroidism with sodium iodide I 131. JAMA 1966;197: 605–610
Viherkoski M, Lamberg B, Hernberg C, Niemi E. Treatment of toxic nodular and diffuse goitre with radioactive iodine. Acta Endocrinol (Copenh) 1970;64: 159–170
Glanzmann C, Kaestner F, Horst W. Therapie der Hyperthyreose mit Radio-Isotopen des Jods: Erfahrungen bei über 2000 Patienten. Klin Wochenschr 1975;53: 669–678
Heinze HG, Schenk F. 131J-Therapie der Hyperthyreose. Nuklearmedizin 1977;16: 1–12
Bliddal H, Hansen JM, Rogowski P, Johansen K, Friis T, Siersbaek-Nielsen K. 131I treatment of diffuse and nodular toxic goitre with or without antithyroid agents. Acta Endocrinol (Copenh) 1982;99: 517–521
Holm LE, Lundell G, Israelsson A, Dahlqvist I. Incidence of hypothyroidism occurring long after iodine-131 therapy for hyperthyroidism. J Nucl Med 1982;23: 103–107
Hoeschel M, Heinze HG. 131J-Therapie des Morbus Basedow und der nicht-immunogenen Hyperthyreose. Nuklearmedizin 1984;23: 143–149
Wiener JD. Long-term follow-up after iodine-131 treatment for Plummer's disease (autonomous goitre). Clin Nucl Med 1985;10: 256–259
Jensen M, Gharib H, Naessens J, Heerden van J, Mayberry E. Treatment of toxic multinodular goitre (Plummer's disease): surgery or radioiodine? World J Surg 1986;10: 673–680
Moser E, Pickardt CR, Mann K, et al. Ergebnisse der Radiojod-Behandlung von Patienten mit immunogener und nichtimmunogener Hyperthyreose bei Anwendung unterschiedlicher Herddosen. Nuklearmedizin 1988;27: 98–104
Danaci M, Feek CM, Notghi A, Merrick MV, Padfield PL, Edwards CRW. 131I radioiodine therapy for hyperthyroidism in patients with Graves' disease, uninodular goitre and multinodular goitre. NZ Med J 1988;101: 784–786
Kinser JA, Roesler H, Furrer T, Grütter D, Zimmermann H. Nonimmunogenic hyperthyroidism: cumulative hypothyroidism incidence after radioiodine and surgical treatment. J Nucl Med 1989;30: 1960–1965
Veneman TF, Weymer M, Tjabbes T, Haeften van TW. Relevance of cause of hyperthyroidism in determining its management. Neth J Med 1989;35: 303–308
Berding G, Schicha H. Ergebnisse der Radiojodtherapie der manifesten Hyperthyreose und der autonomen Struma mit Euthyreose. Nuklearmedizin 1990;29: 158–165
DeGroot LJ. Graves' disease diagnosis and treatment. Multinodular goiter. In: DeGroot LJ, Stanbury JB, eds. The thyroid and its diseases, 4th edition. New York: Wiley; 1975: 314–367,637–665
Doering P Gewichtsbestimmung der menschlichen Schilddrüse mit der Szintigraphie. Klin Wochenschr 1957;35: 944
SAS (Statistical Analyzing System) user's guide: statistics, version 5 edition. Cary, NC 27511-8000: SAS Institute Inc.; 1985
Huysmans D, Corstens F, Kloppenborg P. Long-term follow-up in toxic solitary autonomous thyroid nodules treated with radioactive iodine. J Nucl Med 1991;32: 27–30
Studer H, Gerber H. Toxic multinodular goiter. In: Braverman L, Utiger R, eds. Werner und Ingbar's the thyroid, 6th ed. Philadelphia: Lippincott; 1991: 692
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Huysmans, D.A.K.C., Hermus, A.R.M.M., Corstens, F.H.M. et al. Long-term results of two schedules of radioiodine treatment for toxic multinodular goitre. Eur J Nucl Med 20, 1056–1062 (1993). https://doi.org/10.1007/BF00173483
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00173483