Abstract
In the present series of studies, the long-term (four year) effect of 80 Gy of131I treatment was evaluated in patients with hyperthyroid Graves’ disease whose thyroid volumes have been accurately estimated with a high resolution ultrasound scanner. One year after131I treatment, 23.1 % (3 out of 13 patients) remained hyperthyroid, 69.2% (9 out of 13) became euthyroid, and 7.7% (1 out of 13) were in a hypothyroid state. Since three patients in a hyperthyroid state one year after treatment were subsequently treated with either antithyroid drugs or additional131I treatment, the remaining ten patients (9 euthyroid and 1 hypothyroid patients) have been followed up for three more years. Two patients developed a hypothyroid state three years after treatment and one patient four years after treatment. Overall, 60% (6 out of 10 patients) were in a euthyroid state and 40% (4 out of 10) in a hypothyroid state, four years after 80 Gy131I treatment. There was no significant difference between eu- and hypothyroid groups in the sex ratio, age, radiation dose, therapeutic dose, thyroid gland volume, 24-hr131I uptake, the effective half-life of131I in the thyroid or the duration of hyperthyroidism.
In our preliminary studies, the incidence of late hypothyroidism in our131I treatment is similar to those previously reported. These suggest that uncertain factor(s), such as inhomogeneity of iodine distribution in the thyroid, unequal sensitivity of the thyroid cells to the radiation, and/or persistent destructive effects of the autoimmune process may influence the long-term effect of131I treatment of Graves’ disease.
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Werner SC, Quinby EH, Schmidt CS: Clinical experience in diagnosis and treatment of thyroid disorders with radioactive iodine (eight-day half life).Radiology 51: 564–578, 1948
Sato K:131I therapy of Graves’ disease using lithium.Jpn J Nucl Med 20: 171–176, 1983 (in Japanese)
Soley MH, Miller ER, Foreman N: Treatment with radioiodine I131. In Brookhaven Conference Report, N.Y., Associated Universities, Inc, pp 29–35, 1948
Koyanagi H, Ishikawa N, Ro Z, et al: Comparison of the weight of the thyroid gland by ultrasound with that by scintigraphy.Folia Endocrinol Japon 60: 1039, 1984 (in Japanese)
Yokoyama N, Nagayama Y, Kakezono F, et al: Determination of the volume of the thyroid gland by a high resolution ultrasonic scanner.J Nucl Med 27: 1475–1479, 1986
Nagayama Y, Ashizawa K, Matsuo K, et al: Radioiodine (131I) therapy of Graves’ disease: use of the new high resolution ultrasonic scanner for the determination of the accurate weight of the thyroid gland.Endocrinol Japon 36: 359–365, 1989
Segal RL, Silver S, Yokalem SB, et al: Myxedema following radioactive iodine therapy of hyperthyroidism.Am J Med 31: 354–364, 1961
Beling U, Einhorn J: Incidence of hypothyroidism and recurrence following I131 treatment of hyperthyroidism.Acta Radiol 56: 275–288, 1961
Green M, Wilson GM: Thyrotoxicosts treated by surgery or iodine-131. With special reference to development of hyperthyroidism.Brit Med J 1: 1005–1010, 1964
Dunn JT, Chapman EM: Rising incidence of hypothyroidism after radioactive iodine therapy in thyrotoxicosis.N Engl J Med 290: 141–143, 1974
Sridama V, McCormick M, Kaplan EL, Fauchet R, DeGroot LJ: Long-term follow-up study of compensated low-dose131I therapy for Graves’ disease.N Engl J Med 311: 426–432
DeGroot LJ, Mangklabruks A, McCormick M: Comparison of RA131I treatment protocol for Graves’ disease.J Endocrinol Invest 13: 111–118, 1990
Blahd WH, Hays MT: Graves’ disease in the male.Arch Intern Med 129: 33–40, 1972
Balls KF, Chamberlin RH, Rose E, Gorson RO, Blont HC: The treatment of thyrotoxicosis with radioiodine.Radiology 64: 858–865, 1955
Franco VH, Quina MG: Pneumothyroid: new procedure for determining mass of thyroid gland for radioiodine treatment of hyperthyroidism.Brit J Radiol 29: 434–439, 1956
Hagen G A, Quellette RP, Chapman EM: Com parison of high and low dosage levels of131I in the treatment of thyrotoxicosis.N Engl J Med 277: 559–562, 1967
Smith RN, Wilson GM: Clinical trials of different doses of131I in treatment of thyrotoxicosis.Brit J Med 1: 129–132, 1967
Glennon JA, Gordon ES, Samin GT: Hypothyroidism after low dose131I treatment of hyperthyroidism.Ann Intern Med 76: 721–723, 1972
Rapport B, Caplan R, DeGroot LJ: Low-dose sodium iodine I-131 therapy in Graves’ disease.JAMA 224: 1610–1613, 1973
Cevallos JL, Hagen GA, Maloof F, Chapman EM: Low-dose131I therapy of thyrotoxicosis (diffuse goiters).N Engl J Med 290: 141–143, 1974
Yamamoto M, Totsuka Y, Kojima I: Outcome of patients with Graves’ disease after long-term medical treatment guided by triiodothyronine (T3) supprestest.Clin Endocrinol 19: 467–471, 1983
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Tsuruta, M., Nagayama, Y., Yokoyama, N. et al. Long-term follow-up studies on Iodine-131 treatment of hyperthyroid graves’ disease based on the measurement of thyroid volume by ultrasonography. Ann Nucl Med 7, 193–197 (1993). https://doi.org/10.1007/BF03164966
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DOI: https://doi.org/10.1007/BF03164966