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Radioiodine Therapy of Benign Thyroid Diseases

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Nuclear Medicine Therapy

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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.

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Authors and Affiliations

  1. Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Messina, Italy

    Alfredo Campennì & Sergio Baldari

  2. Department of Medical Sciences, Nuclear Medicine Unit, University of Turin, Turin, Italy

    Desiree Deandreis & Monica Finessi

  3. Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Messina, Messina, Italy

    Rosaria Maddalena Ruggeri

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  1. Alfredo Campennì
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  2. Desiree Deandreis
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  4. Rosaria Maddalena Ruggeri
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  5. Sergio Baldari
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Correspondence to Alfredo Campennì .

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  1. Nuclear Medicine and PET/CT Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

    Luca Giovanella

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Campennì, A., Deandreis, D., Finessi, M., Ruggeri, R.M., Baldari, S. (2019). Radioiodine Therapy of Benign Thyroid Diseases. In: Giovanella, L. (eds) Nuclear Medicine Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-17494-1_2

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