Radioiodine Therapy of Hyperthyroidism in Graves’ Disease

Part of the Medical Radiology book series (MEDRAD)


Iodine-131 (131I) has been used to treat Graves’ disease (GD) since the 1940s. Over the years, we have witnessed a paradigm shift in the goal of radioactive iodine (RAI) therapy, from aiming for sustained euthyroidism to an ablative approach resulting in early hypothyroidism. With the emergence of data in support of its safety profile, RAI is no longer withheld from women of child-bearing age, and there is increasing adoption of this modality as the first-line treatment of choice for GD. For the management of pediatric GD, however, many physicians continue to refrain from using RAI. There is no standard approach to 131I therapy planning. Differences in opinion among physicians regarding issues, such as patient selection (in particular those with ophthalmopathy), prescription algorithms, and the need for adjuvant thyrostatic medication account for the lack of standardized protocols. Today, 131I is widely available, easily administered and is a cost-effective treatment option for GD. The challenge remains for nuclear medicine physicians to refine our treatment protocols so that patients are cured in as short a time as possible while ensuring that the treatment is optimized with respect to radiation safety; that is, observing the “as low as reasonably achievable” principle.


Thyroid Cancer Thyroid Volume American Thyroid Association Hyperthyroid Patient 131I Therapy 


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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Nuclear Medicine and PETSingapore General HospitalSingaporeSingapore

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