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Radioiodine Therapy of Benign Thyroid Diseases

  • Alfredo CampennìEmail author
  • Desiree Deandreis
  • Monica Finessi
  • Rosaria Maddalena Ruggeri
  • Sergio Baldari
Chapter

Abstract

Thyrotoxicosis represents a clinical condition that results from excess thyroid hormone(s) levels and action in peripheral tissues, either with or without increased synthesis of thyroid hormone(s) by the gland. It has multiple different etiologies and potential therapies; therefore, an accurate diagnosis is mandatory for appropriate treatment.

131-Radioiodine has been used since 1941 to cure hyperthyroidism due to toxic thyroid disease [diffuse or (multi)-nodular].

From its first use, millions of people have been treated worldwide and today it represents the first example of “theranostic” radiotracer [(−ve)-beta electrons to obtain the therapeutic effect, gamma-emission to show its distribution in the gland].

131-Radioiodine therapy has two main aims: the first is to correct hyperthyroidism (by fixed or calculated dose) reaching a euthyroid state [the optimal result for patients affected by (multi)-nodular toxic disease] or a hypothyroid state (the optimal result for patients with diffuse toxic disease); the second is to reduce whole gland or toxic (multi)-nodular volume.

Despite RAI therapy being a safe and generally well-tolerated treatment, either acute or late side effects (e.g., radiation thyroiditis, sialadenitis, worsening or appearance of orbitopathy) may occur, principally related to insufficient clinical control of hyperthyroidism and active thyroid orbitopathy due to Graves’ disease.

The purpose of this chapter is to provide advice to nuclear medicine physicians in evaluating patients with benign thyroid disease for 131-radioiodine therapy.

Diagnosis of hyperthyroidism and clinical management, along with advantages, optimal activities, and possible side effects of 131-radioiodine therapy, are discussed.

Keywords

Hyperthyroidism 131-Radioiodine therapy Benign thyroid disease Side effects 131-Radioiodine activity 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alfredo Campennì
    • 1
    Email author
  • Desiree Deandreis
    • 2
  • Monica Finessi
    • 2
  • Rosaria Maddalena Ruggeri
    • 3
  • Sergio Baldari
    • 1
  1. 1.Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine UnitUniversity of MessinaMessinaItaly
  2. 2.Department of Medical Sciences, Nuclear Medicine UnitUniversity of TurinTurinItaly
  3. 3.Department of Clinical and Experimental Medicine, Unit of EndocrinologyUniversity of MessinaMessinaItaly

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