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Clinical efficacy of radioiodine therapy in multinodular toxic goiter, applying an implemented dose calculation algorithm

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Abstract

Radioiodine is a common therapeutic option for Multinodular Toxic Goiter (MTG). We evaluated an algorithm for personalized radioiodine activity calculation. Ninety-three (28 male, 65 female; 43–84 years) patients with MTG eligible for radioiodine treatment (131I-iodide) were studied. The quantity of 131I-iodide to be administered was estimated by Thyroid Volume Reduction (TVR) algorithm, developed for Graves’ disease. It takes into account 131I uptake, its effective half-life (T 1/2eff), thyroid volume, and its expected reduction during treatment. A comparison with the activity calculated by other dosimetric protocols and the “fixed” activity method was performed. 131I uptake was measured by external counting, thyroid volume by ultrasonography (US), thyroid stimulating hormone (TSH), and thyroid hormones by standard immunometric methods. In a follow-up of 6–120 months, remission of hyperthyroidism after a single 131I-iodide treatment was observed in 76 patients (64 euthyroid, 12 hypothyroid). The thyroid volume reduction observed by US after the treatment fairly correlated with what predicted by our model; T 1/2eff was highly variable and critically affected dose calculation. The administered activities (median 526 MBq, range 156–625 MBq) were slightly lower than the “fixed” activities (600 MBq) and with respect to the other protocols’ prescriptions (−15/38 %); the median 131I activity administered to relapsed patients (605 MBq) was significantly greater (P = 0.01) with respect to the dose administered to cured patients (471 MBq). Our study shows that an effective cure of MTG can be obtained with relatively low 131I activities and probably with a relatively low incidence of hypothyroidism, using TVR method.

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Acknowledgments

This work was partially supported by a Grant from Fondazione CARIGE, Genoa, Italy.

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Authors and Affiliations

  1. Endocrinology Unit and Autoimmunity Laboratory, IRCCS AOU Sa Martino – IST, Di.M.I. Genoa University, Viale Benedetto XV, 6 I-16132, Genoa, Italy

    Mara Schiavo, Laura Camerieri, Giampaola Pesce & Marcello Bagnasco

  2. Medical Physics Unit, IRCCS AOU San Martino – IST, Genoa, Italy

    Maria Claudia Bagnara & Cristina Reitano

  3. Nuclear Medicine Unit, IRCCS AOU San Martino – IST, Genoa University, Genoa, Italy

    Elena Pomposelli & Mauro Caputo

  4. Endocrinology Unit, IRCCS AOU San Martino – IST, Di.M.I. Genoa University, Genoa, Italy

    Massimo Giusti

Authors
  1. Mara Schiavo
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  2. Maria Claudia Bagnara
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  3. Laura Camerieri
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  4. Elena Pomposelli
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  5. Massimo Giusti
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  6. Giampaola Pesce
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  7. Cristina Reitano
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  8. Mauro Caputo
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  9. Marcello Bagnasco
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Correspondence to Marcello Bagnasco.

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Schiavo, M., Bagnara, M.C., Camerieri, L. et al. Clinical efficacy of radioiodine therapy in multinodular toxic goiter, applying an implemented dose calculation algorithm. Endocrine 48, 902–908 (2015). https://doi.org/10.1007/s12020-014-0398-4

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  • DOI: https://doi.org/10.1007/s12020-014-0398-4

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