Predictive factors of failure in a fixed 15 mCi 131I-iodide therapy for Graves' disease

Clin Nucl Med. 2012 Jun;37(6):550-4. doi: 10.1097/RLU.0b013e31824851d1.

Abstract

Purpose: To investigate the factors influencing the success rate in a fixed, 15 mCi approach for treatment of Graves' hyperthyroidism.

Material and methods: The thyroid function outcome (hyperthyroidism or euthyroidism/hypothyroidism) was verified at least 1 year after radioiodine therapy (RIT) retrospectively and compared with presenting clinical characteristics and pre-RIT parameters in 87 patients treated with I-iodide for Graves' disease in a tertiary care center.

Results: After RIT, 16 patients (18.4%) became euthyroid, 54 patients (62.1%) became hypothyroid, and 17 (19.5%) remained hyperthyroid. We found no statistically significant association between thyroid function outcome and gender (P = 0.50), ophthalmopathy (P = 0.69), drug used (methimazole or propylthiouracil; P = 1.00), maintenance or withdrawal of thionamides pre-RIT (P = 0.98), or 99mTc sodium pertechnetate thyroid uptake prior to RIT (P = 0.75). The only variable associated with the success rate was thyroid mass <62 g (P < 0.001).

Conclusions: Our study has shown that a fixed 15 mCi approach for treatment of Graves' disease was effective, but high failure rates were observed in patients presenting larger goiters, particularly those with estimated thyroid mass >62 g.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Graves Disease / pathology
  • Graves Disease / radiotherapy*
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Logistic Models
  • Male
  • Middle Aged
  • Organ Size / radiation effects
  • Retrospective Studies
  • Thyroid Gland / pathology
  • Thyroid Gland / radiation effects
  • Treatment Failure
  • Young Adult

Substances

  • Iodine Radioisotopes