WorldWideScience

Sample records for augmented radioiodine therapy

  1. Radioiodine therapy

    International Nuclear Information System (INIS)

    Torres, J.F. Jr.; Deliso, H.B.

    1992-01-01

    For over 40 years now, radioiodine ( 131 I) has remained one of the most useful radionuclide for diagnosis and therapy in Nuclear Medicine. The wide application of radioiodine in the study of the thyroid gland and in the management of its disorders has been most rewarding. The medical literature is replete with reports of its efficacy, failures, and complications, but most of these studies have been conducted among Caucasian persons and in relatively affluent societies. Very few reports are available from the less developed and economically depressed areas of the world where thyroid disorders abound or and are even endemic. This chapter is an attempt to highlight the use of radioactive iodine therapy in the developing countries, particularly those in the Asian region

  2. Radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Torres, Jr, J F; Deliso, H B

    1993-12-31

    For over 40 years now, radioiodine ({sup 131}I) has remained one of the most useful radionuclide for diagnosis and therapy in Nuclear Medicine. The wide application of radioiodine in the study of the thyroid gland and in the management of its disorders has been most rewarding. The medical literature is replete with reports of its efficacy, failures, and complications, but most of these studies have been conducted among Caucasian persons and in relatively affluent societies. Very few reports are available from the less developed and economically depressed areas of the world where thyroid disorders abound or and are even endemic. This chapter is an attempt to highlight the use of radioactive iodine therapy in the developing countries, particularly those in the Asian region

  3. Time to reconsider nonsurgical therapy of benign nontoxic multinodular goitre. Focus on recombinant human TSH (rhTSH) augmented radioiodine therapy

    DEFF Research Database (Denmark)

    Fast, Søren; Nielsen, Viveque; Bonnema, Steen

    2009-01-01

    alternatives are needed. Until recently, levothyroxine therapy was the preferred non-surgical alternative, but due to low efficacy and potential side-effects, it is not recommended for routine use in recent international guidelines. Conventional radioiodine (131I)-therapy has been used for two decades......, which makes 131I-therapy less feasible. Another challenge is the negative correlation between initial goitre size and goitre volume reduction (GVR). With its ability to more than double the thyroid 131I-uptake, recombinant human TSH (rhTSH) increases the absorbed radiation dose and thus enhances the GVR...... efficacy. Thus, although in its infancy, and still experimental, rhTSH-augmented 131I-therapy may profoundly alter the nonsurgical treatment of benign non-toxic MNG....

  4. Radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Andres-Barrenechea, E.C.

    2001-01-01

    A ten year study (1988-98) was done at the Veterans Memorial Medical Center on radioiodine (RAI) therapy for hyperthyroidism. A total of 162 patients received 131-I after careful selection hence was included in this study. A predominantly female population was seen (81%) compared to only (19%) males. The most frequent age group were in the third and fourth decades of life. Those included had clinical manifestations of thyrotoxicosis aside from the abnormal thyroid function tests and elevated RAI uptake. Almost all were given antithyroid drugs and beta-blockers prior to RAI ablation. Doses ranged from 7 to 12 mCi depending on gland size and degree of toxicity. Success rate of treatment was 92% which meant that the symptoms were abated and there was shrinkage of the thyroid gland after a single dose of iodine. The most common short term complications were sialitis and local neck tenderness while hypothyroidism was the commonest long term complication. (author)

  5. Teenage hyperthyroidism and radioiodine therapy

    International Nuclear Information System (INIS)

    Hussain, F.A.; Nisa, L.; Hoque, M.; Jehan, A.H.

    2007-01-01

    Full text: Objective: To assess the efficacy of radioiodine therapy in teenage patients with hyperthyroidism. Method: The medical records of 28 patients (age range 16 -18 years) were purposely selected from a pool of 3637 hyperthyroid patients treated with radioiodine during the period January 1982 to December 2006. Data for analysis included the age, sex, clinical symptoms, type of hyperthyroidism, antithyroid medications received, doses of radioiodine therapy given and the outcome of the therapy after one and five years. Results: The mean age of the patients treated for hyperthyroidism was 17.60 ± 0.73 years and 82 % were females. The most common type of hyperthyroidism was Graves' disease (75%). All patients were pre-treated with antithyroid drugs for variable duration periods (6 months to 2 years). The mean administered dose of radioiodine was 10.69 ± 2.77 mCi. The dose of I-131 was calculated on the basis of gland size and morphology (assessment by palpation and scintigraphy) and percentage of radioactive iodine uptake. Effective control of hyperthyroidism after radioiodine treatment occurred in 60.72% patients with a single dose, 35.71% required a second dose and 3.57% required more than two doses. Frequency of early hypothyroidism within one year was 38.09 % in Graves' disease and 33.33% in toxic multinodular goiter. Most patients (66.66%) in the toxic nodule group remained euthyroid up to one year after I-131 therapy. Overall incidence rates of hypothyroidism after 1 year and 5 years of radioiodine therapy were 32.14% and 75%, respectively. Conclusion: Hyperthyroidism in the teen group of patients was effectively controlled with radioiodine. There were no early side effects. The only long-term effect was hypothyroidism. Appearance of early/late hypothyroidism showed a direct relationship with the type of hyperthyroidism and the dose of radioiodine administered. In general, patients with Graves' disease showed a greater tendency in the evolution of early

  6. Endocrine ophthalmopathy and radioiodine therapy

    International Nuclear Information System (INIS)

    Karlsson, F. Anders

    2006-01-01

    Endocrine ophthalmopathy is to some degree present in most patients with Graves' disease. In few cases, a severe form of the condition develops and in the majority of these cases, the course of the eye problems has been influenced by the treatment for thyrotoxicosis. In this regard, radioiodine therapy has been increasingly recognized as carrying a special risk. Here, the current understanding of endocrine ophthalmopathy and the risks associated with the development of severe eye disease are discussed. The results of a retrospective investigation of patients with severe eye disease in our hospital, and the experience with corticosteroid administration following radioiodine in order to reduce the risk of ophthalmopathy, are also presented

  7. Radioiodine therapy and subsequent pregnancy

    International Nuclear Information System (INIS)

    Brandao, Carmen Dolores G.; Miranda, Angelica E.; Corres, Nilson Duarte; Sieiro Neto, Lino; Corbo, Rossana; Vaisman, Mario

    2007-01-01

    Objectives: To evaluate abortion and fetal congenital anomaly rates in women previously submitted to radioiodine therapy for differentiated thyroid carcinoma. Study design: A case-control study of 108 pregnant women, 48 cases whose pregnancies were evaluated after they had undergone radioiodine therapy for differentiated thyroid carcinoma, and the control group consisted of 60 healthy pregnant women. Results: Of a total of 66 pregnancies, 14 conceived within the first year, 51 one or more years after the last administration of 131 I, the medical record of one patient was not available. The interval between the last radioiodine therapy administration and conception ranged from 1 month to 10 years. There were a total of 4 miscarriages, 2 of them for unknown reasons. There was one case of congenital anomaly and two preterms birth. Nine women presented the following pregnancy events: placental insufficiency, hypertensive crisis, placental detachment, risk of miscarriage, preterm labour and four miscarriages. No statistical difference was observed between the studied and control groups. Conclusion: Radioiodine was followed by no significant increase in untoward effects in neither the pregnancy nor the offspring. (author)

  8. Radioiodine therapy of thyroid autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

    2002-08-01

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. {sup 131}I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  9. Radioiodine therapy of thyroid autonomy

    International Nuclear Information System (INIS)

    Reiners, Christoph; Schneider, Peter

    2002-01-01

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131 I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  10. Radioiodine therapy and thyrostatic drugs and iodine

    Energy Technology Data Exchange (ETDEWEB)

    Moka, D.; Dietlein, M.; Schicha, H. [Department of Nuclear Medicine, University of Cologne, Joseph Stelzmannstrasse 9, 50924 Koeln (Germany)

    2002-08-01

    Radioiodine therapy is now the most common definite treatment for persistent hyperthyroidism. The outcome of radioiodine therapy depends mainly on the absorbed energy dose in the diseased thyroid tissue. The administered activity and the resulting target dose in the thyroid depend on both the biokinetics of radioiodine and the actual therapeutic effect of radioiodine in the thyroid. Thyrostatic drugs have a major influence on the kinetics of radioiodine in the thyroid and may additionally have a radioprotective effect. Pre-treatment with thyrostatic medication lowers the effective half-life and uptake of radioiodine. This can reduce the target dose in the thyroid and have a negative influence on the outcome of the therapy. Discontinuation of medication shortly before radioiodine administration can increase the absorbed energy dose in the thyroid without increasing the whole-body exposure to radiation as much as would a higher or second radioiodine administration. Furthermore, administration of non-radioactive iodine-127 2-3 days after radioiodine administration can also increase the effective half-life of radioiodine in the thyroid. Thus, improving the biokinetics of radioiodine will allow lower activities to be administered with lower effective doses to the rest of the body, while achieving an equally effective target dose in the thyroid. (orig.)

  11. Radioiodine Therapy for Graves’ Disease

    International Nuclear Information System (INIS)

    Makhdomi, B.K.

    2015-01-01

    Treatment of grave diseases include Antithyroid medications, Iodine-131 therapy and Surgery. First patient treated with radioiodine (Iodine-130) in 1941, while Iodine-131 therapy was introduced in 1946. Factors affecting treatment include Iodine uptake; Size of goitre; Length of time I-131 is retained in the gland; Homogeneity of distribution within the gland; Radiosensitivity of thyroid cells and Drug interactions. Some side effects include Transient sore throat or mild dysphagia; Exacerbation of ophthalmopathy; Radiation thyroiditis and no increase in incidence of thyroid cancer and Leukemia or other malignancies. There no harmful effect upon Health of progeny; Fertility and Reproductive history

  12. Radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Barrenechea, E.C.A.

    1996-01-01

    The introduction of I-131 in 1946 for the treatment of hyperthyroidism marked a historic event. It ushered in the era of radionuclides in medicine and led to the birth of nuclear medicine. Today I-131 has become one of the most commonly used agents for the treatment of hyperthyroidism. Ninety percent (90%) of its effect is due to beta radiation and 10% is due to gamma radiation. The mechanism of action is production of radiation thyroiditis (3-10 days) and chronic gland atrophy (over a period of 3 years). To achieve the necessary dosage levels, four considerations are needed: maximum amount of I-131 taken by the thyroid gland, size of tissue to be irradiated, effective half life of the isotope in the thyroid and relative sensitivity of the thyroid to I-131. There are two kinds of dosing - the preferred dose where 160 μCi/gram of tissue of given (15-20μCi) or the usual dose 80 μCi/gram - (2 to 15 mCi). In giving these dosages, four basic approaches are utilized and two major principles are applied. However, precision in the calculation of I-131 dose makes very little difference in the outcome in any individual patients. The inherent sensitivity of the thyroid to radiation seems to vary widely for unknown reasons. The success in treatment is high with incidence of cure as follows: 70-86% in single dose; 10-20% using 2 doses and less than 5% required 3 doses or more. Adjunctive therapy in the forms of antithyroid drugs, beta blocker and steroids may be needed. There are short and long term complications where hypothyroidism is the most important complication. Long term follow-up is advocated by FT4 and TSH determinations. There is an unknown risk of malignancy and genetic damage. Finally, I-131 has been a choice of treatment for hyperthyroidism with some considerations in the U.S.A., Europe, and Asia. It is rapidly effective, predictable and inexpensive. Several studies on the experience will be discussed. (author)

  13. Results of radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Gabriel, A.

    1980-01-01

    Between 1971 and 1977, 102 hyperthyroidism patients were treated with 131 I. The average age of the patients was 64 years. In 78 patients, hyperthyroidism was due to decompensated autonomous adenoma, 24 patients presented with diffuse hyperthyroidism. The patients were observed for 14 to 24 months. Until early 1976, diagnosis and therapy success assessment were based on thyroid scintiscanning, radioiodine two-phase tests, PBI 131 , T 4 tests, and T 3 tests. Since 1976, the radioiodine two-phase test has been replaced by the TRH test, the TRH-RIA, and the T 4 -RIA. The patients were given 3 to 25 mCi 131 I. In 88 cases, euthyroidism was reached after a single therapy; in 8 cases, after two therapies; in 1 case, after three therapies; in 4 cases, after 4 therapies; in 1 case, after 5 therapies. Euthyroidism was thus reached in 96% of all cases after 131 I therapy of hyperthyroidism. (orig./MG) [de

  14. The history of radioiodine therapy beginnings

    Directory of Open Access Journals (Sweden)

    Pavel Olegovich Rumiantsev

    2016-03-01

    Full Text Available This report contains historical review of radioiodine therapy invention and clinical implementation for the treatment of patients with diffuse toxic goiter and differentiated thyroid cancer. In 1923 Henry Plummer has strongly recommended to prescribe stable iodine in patients with Grave’s diseases after surgery in order to prevent thyrotoxic storm. Radioactive isotopes of iodine for the first time were obtained by Enrico Fermi in 1934 in laboratory. Clinical implementation of radioiodine was started in 40th years of past century. In 1940 experimentally have been shown that thyroid gland with Grave’s disease accumulated as much as 80% of radioiodine administered activity. Saul Hertz was the first physician who used radioactive iodine in January, 1941 with purpose to treat diffuse toxic goiter patients. Samuel Seidlin was first who used radioiodine in March, 1943 to treat patient with functioned differentiated thyroid cancer metastases. In Russia radioiodine treatment of patients started since 1982 in Medical Radiological Research Centre (former Institute of Medical Radiology, Obninsk.

  15. Guideline for radioiodine therapy for benign thyroid diseases (version 4)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Moser, E.; Reiners, C.; Schneider, P.; Schober, O.

    2007-01-01

    Version 4 of the guideline for radioiodine therapy for benign thyroid diseases includes an interdisciplinary consensus ondecision making for antithyroid drugs, surgical treatment and radioiodine therapy. The quantitative description of a specific goiter volume for radioiodine therapy or operation was cancelled. For patients with nodular goiter with or without autonomy, manifold circumstances are in favor of surgery (suspicion on malignancy, large cystic nodules, mediastinal goiter, severe compression of the trachea) or in favor of radioiodine therapy (treatment of autonomy, age of patient, co-morbidity, history of prior subtotal thyroidectomy, profession like teacher, speaker or singer). For patients with Graves' disease, radioiodine therapy or surgery are recommended in the constellation of high risk of relapse (first-line therapy), persistence of hyperthyroidism or relapse of hyperthyroidism. After counseling, the patient gives informed consent to the preferred therapy. The period after radioiodine therapy of benign disorders until conception of at least four months was adapted to the European recommendation. (orig.)

  16. Differentiated thyroid carcinoma referred for radioiodine therapy

    International Nuclear Information System (INIS)

    Al-Balawi, Ibrahim A.; Meir, Hadir M.; Yousef, Mohammad K.; Nayel, Hala A.; Al-Mobarak, Mohammad F.

    2001-01-01

    The current work was conducted to study the disease status and treatment results of patients with differentiated thyroid carcinoma referred for radioactive iodine therapy. Retrospective review of 78 patients with differentiated thyroid carcinoma referred for radioiodine therapy in the Nuclear Medicine Unit, King Abdulaziz Hospital and Oncology Center, Jeddah, Kingdom of Saudi Arabia. Analysis of the clinicopathologic characteristics, age correlation to different risk factors, treatment protocol and results were performed. Seventy seven percent were female and the female to male ratio was 3.5:1. The age of patients ranged between 13-63 years with a median age of 36 years. Cervical lymph node involvement was detected in 22 patients (25%). Papillary carcinoma was encountered in 78 patients (90%) and follicular carcinoma in 9 patients (10%). Analysis of the clinicopathologic characteristics showed no statistically significant difference between patients in the different age groups except for extrathyroid extension and lymph node involvement. Patients older than 45 years had a statistically significant lower incidence of nodal involvement and higher incidence of extra thyroid extension (P<0.02). In the current study we used a high dose method (Radioiodine-131 dose 75-100mCi) for thyroid remnant ablation after thyroidectomy (total or near total) in 67 patients. An Iodine 131 dose of 150 mCi was used in 12 patients with radioiodine-avid cervical lymph nodes and in 3 patients with gross residual tumor. In 4 patients with distant metastases an Iodine 131 dose of 200 mCi was used. For the whole study group the 5 year overall survival and disease-free survival was 96% and 88%. The current study, as with many other retrospective studies, concluded that despite the fact that differentiated thyroid carcinoma is among the most curable cancers, some patients are still at high risk for recurrent disease and associated mortality. (author)

  17. Radiation protection principles for radioiodine therapy

    International Nuclear Information System (INIS)

    Reiners, C.; Lassmann, M.

    1999-01-01

    In Germany, approximately 30,000 treatments with radioiodine are performed yearly on patients with benign or malignant thyroid diseases. These are carried out generally in specialized therapy wards which are equipped with radiation protection facilities. Ambulant (fractionated) radioiodine treatment is not permitted in Germany. More recently, the situation has been that the discharge of patients is permitted, when they have spent a stay of at least 48 hours in the ward without the dose rate exceeding 3.5 μSv/hour at 2 meters distance from them, corresponding to 1 mSv/year (this correlates to a residual activity in the body of the patient of 250 MBq). The radiation exposure of personnel in the therapy ward due to both external and internal exposure lies within a range of a few mSv per year. According to recent studies, the exposure to family members and close friends via external exposure, inhalation or incorporation does not exceed the effective dose of 1 mSv/year. This value has been laid down in a recommendation by the European Union as the dose constraint for children; for adults younger than 60 years of age, 3 mSv are recommended, for older persons 15 mSv. (orig.) [de

  18. Thyrotoxicosis and radioiodine therapy: Does the dose matter?

    Directory of Open Access Journals (Sweden)

    Andrew Collier

    2012-01-01

    Full Text Available There are 3 treatment options for thyrotoxicosis: Antithyroid drugs, Surgery and radioiodine. The choice of treatment varies geographically. Radioiodine therapy is preferred in the United States. The aim of radioiodine is to destroy sufficient thyroid tissue to cure the hyperthyroidism. There is a lack of consensus towards what dose of radioiodine should be used. Several methods are used to determine the dose. In our practice we administer 400 MBq to patients with Graves and in patients with large multinodular goiter, we would administer 800 MBq.

  19. Radioiodine therapy for differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.; Rajashekharrao, B.

    1999-01-01

    Radioiodine ( 131 I) therapy has been in use for the treatment of thyroid diseases. Although the use of 131 I has been in vogue for a long time, its use in therapy for well-differentiated thyroid cancer is still controversial. This is because, thyroid cancers (TC) are generally slow growing tumors, with low mortality and normal spans of survival. To record recurrence and mortality, long-term follow-up studies over a period of two to three decades are needed to establish definite conclusions on the acceptable modes of treatment. The most reliable conclusions regarding 131 I treatment are obtained from studies reported on a large series of patients followed over a period of 3 decades or more from a single institute with a more or less unchanged protocol of management

  20. Follow up of Graves' Opthalmopathy after radioiodine therapy

    International Nuclear Information System (INIS)

    Miah, M.S.R.; Paul, A. K.; Rahman, H.A.

    2002-01-01

    Graves' ophthalmopathy may first appear or worsen during or after treatment for hyperthyroidism. We followed up 158 Graves' hyperthyroid patients treated with radioiodine of which 49 had Grave's' ophthalmopathy during presentation in Nuclear Medicine Centre, Khulna during the period from 1995 to 2000. The aim of our study is to see the effect of radioiodine in Graves' ophthalmopathy. All the patients received radioiodine at fixed dose regime ranged from 7 mCi to 12 mCi. The duration of follow up was at least 12 months Graves' ophthalmopathy patients, 4 (4/49 i.e., 8.2%) showed exaggeration of ophthalmopathy and the rest (45/49 i.e., 91.8%) remained unchanged. None of ophthalmopathy developed among any of Graves' hyperthyroid or disappeared after radioiodine treatment during follow up period. From the study we concluded that eye changes in Graves' hyperthyroidism remain unchanged or exaggerated after radioiodine therapy and needs ophthalmologist care.(author)

  1. Three cases of respiratory failure after I-131 radioiodine therapy

    International Nuclear Information System (INIS)

    Watanabe, Ken; Uchiyama, Masayuki; Fukuda, Kunihiko

    2016-01-01

    We report three cases of respiratory failure after I-131 radioiodine therapy. All cases involved relapsed cervical lesions, and two showed edema of the larynx. Emergency tracheostomy was performed to treat the respiratory failure in one case while the others were treated conservatively. All patients showed improvements without after-effects. Patients who undergo I-131 radioiodine therapy, especially those with cervical lesions, should be carefully monitored for this rare complication after treatment. (author)

  2. Clinical experience with outpatient radioiodine therapy in hyperthyroidism

    International Nuclear Information System (INIS)

    Csenkey-Sinko, I.; Roka, R.; Sera, T.; Csernay, L.; Pavics, L.; Valkusz, Z.; Julesz, J.

    1999-01-01

    Since 1993, outpatient radioiodine therapy has been available in Hungary. The reported study evaluated the efficacy of outpatient radioiodine treatment in subjects with hyperthyroidism. The data on 238 patients with Graves' disease and 123 patients with thyroid autonomy were analyzed retrospectively. All patients were treated within the period 1994 - 1999. The activities of radioiodine were calculated individually. The dose applied in Graves' disease was 150 Gy, and that in thyroid autonomy was 300 Gy. The efficacy of the treatment was evaluated 3,6 and 12 months after radioiodine therapy. In patients with persistent hyperthyroidism, repeated therapy was performed. Overall,the radioiodine therapy was successful in 84% of the Graves' disease patients. In thyroid autonomy, treatment with 300 Gy was successful in 79% of the patients. The efficacy of radioiodine treatment was similar to the results of one-dose application. It was concluded that radioidine therapy with an absorbed dose of 150 Gy in Graves' disease and with an absorbed dose of 300 Gy in thyroid autonomy proved successful by the method applied. (author)

  3. Graves' disease and toxic nodular goiter - radioiodine therapy

    International Nuclear Information System (INIS)

    Schicha, H.; Dietlein, M.

    2002-01-01

    At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism. (orig.) [de

  4. Reduction of thyroid volume following radioiodine therapy for functional autonomy

    International Nuclear Information System (INIS)

    Luster, M.; Jacob, M.; Thelen, M.H.; Michalowski, U.; Deutsch, U.; Reiners, C.

    1995-01-01

    In a retrospective study we evaluated the data of 112 patients who underwent radioiodine treatment for functional autonomy of the thyroid at Essen University Hospital from 1988 to 1993. Therapeutic activities of radioiodine were administered after individual determination of activity for intended radiation doses (150-300 Gy) taking into consideration autonomously functioning volume, maximum uptake, and effective half-life. The achieved dose was calculated by means of measurement of the radioiodine kinetics during therapy. Depending on the type of autonomous function of the thyroid (solitary autonomously functioning nodule, multiple autonomously functioning nodules, autonomously functioning thyroid tissue) volume reductions between 39 and 46% were found approximately 6 months after treatment. (orig.) [de

  5. The optimal time of discontinuing methimazole before radioiodine therapy

    International Nuclear Information System (INIS)

    Moosavi, Z.; Zakavi, R.

    2001-01-01

    Hyperthyroidism is a common disease and one of the best methods for its treatment is radioiodine therapy with Treatment with antithyroid drugs brings patients to euthyroidism before radioiodine therapy. Antithyroid drugs should be discontinued before radioiodine therapy to increase thyroid uptake. The purpose of this study was to determine the optimal time of methimazole discontinuation. One hundred eighty four patients, who were referred for radioiodine therapy were classified in 3 groups according to the duration of methimazole discontinuation before thyroid uptake (RAIU) measurement. Group 1,2 and 3 were patients who discontinued methimazole (48-72 h rs), (72-120 h rs) and more than 120 h rs before RAIU measurement, respectively. Mean thyroid uptake in group 1, 2 and 3 was (64±151.1%), (60.1±14.1%) and (59.3±12.8), respectively. No significant difference was noted in thyroid uptake between these groups (F= 1.83, P<0.16). This study shows that 48-72 h rs of methimazole discontinuation before radioiodine therapy is enough and longer term abstention is not associated with higher uptake

  6. Influence of radioiodine therapy on urinary iodine excretion

    International Nuclear Information System (INIS)

    Meller, B.; Lauer, I.; Baehre, M.; Richter, E.

    1998-01-01

    In 214 patients with benign thyroid diseases the time-course of urinary iodine excretion (UIE) was investigated in order to identify changes after radioiodine therapy (RITh). Method: UIE was measured photometrically (cerium-arsenite method) and related to urinary creatinine on the first and last day of the radioiodine test and the three days, seven days, four weeks, and six months after 131 I administration. Results: As compared with the level found immediately before radioiodine therapy, median UIE had almost doubled four weeks after therapy and was still significantly elevated six months after therapy. This increase correlated significantly with the target volume as measured by scintigraphy and sonography. Conclusions: The persistent elevation of UIE for months after RITh is a measure of treatment-induced damage to thyrocytes. Therefore, in view of the unfavourable kinetics of iodine that follow it, RITh should if possible be given via a single-dose regime. (orig.) [de

  7. Our experience with radioiodine therapy of thyroid functional autonomies

    International Nuclear Information System (INIS)

    Kraft, Otakar

    2005-01-01

    Full text: In this paper the author presents his experience with radioiodine therapy of thyroid functional autonomies. The objectives of this study were to establish the efficacy and determine the adverse effects of radioiodine therapy of patients with thyroid functional autonomies. The main pathologic attribute of thyroid functional autonomies is the loss of regulation in the axis of hypothalamus-hypophysis-thyroid. The main cause of functional autonomy of the thyroid is iodine deficiency. Over a period of 30 years (1974-2004) 799 patients (age from 33 to 86 years; average age 58.7 years; the female: male ration was 7.4:1) with unifocal functional autonomy (UFA), multifocal functional autonomy (MFA) and disseminated functional autonomy (DFA) received at least one treatment of radioiodine. For diagnostics and the evaluation of radioiodine therapeutic effect of functional autonomies a thyroid scintigraphy is the basic and necessary procedure. In some patients a common scintigraphy with special imaging modulation, in some patients a scintigraphy after suppression or stimulation by means of thyroid hormones or TSH were done. We have also performed a thyroid ultrasonography, an assessment of a serum level of a total and free thyroxine, total triiodothyronine, TSH, radioiodine accumulation test, estimation of radioiodine effective half-life, in some patients TRH-TSH test. The follow-up examinations were done in all patients after 4-6 months, another examination after one year in 545 patients and after two years in 254 patients. One therapeutic dose received 733 patients (91.74%) and it was sufficient for an elimination of functional autonomies. Some patients were retreated if there was the evidence of small or no treatment effect and no elimination of functional autonomies. Two radioiodine treatments received 62 patients (7.76%) and three treatments 4 patients (0.5%). We advocate individual pre-therapeutic dosimetry to determine the activity necessary to achieve a

  8. Results of radioiodine therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Pronath, A.

    1982-01-01

    The goal of this work is the quantification of therapy results of a radioiodine therapy with Iodine 131 on 367 patients with the following benign thyroid diseases: euthyroidal struma, hyperthyroidism, hyperthyroidal struma and autonomous adenoma. 1. Euthyroidal struma - subjective improvement and objective diminution of the struma by 63%, subjective or objective improvement by 21% of the patients. Including the probable successful therapies the success rate was all together 90.1%. 2. Hyperthyroidism - after one-time/more-time (18.6%) radioiodine therapy the success rate was 71.5/85.7% including latent (8.6/10.0%) and manifest (7.1/8.5%) hypothroidism. 3. Hyperthyroidal struma - after one-time/more-time (16.9%) radioiodine therapy the success rate was 74.7/90.1% including latent (-/5.7%) and manifest (1.4/2.8%) hypothyroidism. 4. Autonomous adenoma - after one-time/two-time (5.2%) radioiodine therapy the success rate was 80.5/84.6% including 15.5% latent hypothyroidism. The results will be discussed in comparison to published data and to operation and thyrostatic treatment. (TRV) [de

  9. Radioiodine (I-131) therapy and the influence of antithyroid medication

    International Nuclear Information System (INIS)

    Duldulao, M.

    2007-01-01

    Full text: Radioiodine therapy began to play a major role in the management of hyperthyroidism as early as 1941. It later evolved to become what it is today, the treatment of choice for majority of patients who are suffering from Graves' disease and toxic nodular goiter. It is generally considered safe, inexpensive, effective, and devoid of major side effects. Despite the extensive experience with radioactive therapy, the adjunctive role of antithyroid medication remains controversial. Some authors claim that it has a positive influence on the outcome of radioiodine therapy while others insist otherwise. The reasons behind the adjunctive use of antithyroid medication include a more rapid attainment of euthyroid state and a decrease in the rise of developing thyroid crisis. However, a higher treatment failure rate is observed compared to radioiodine alone. This is due to the reputed radioprotective effect of the antithyroid medication. As a result, higher doses of I-131 are needed in order to obtain the desired effect but, unfortunately, that would also increase the radiation exposure to the rest of the body. The majority of clinicians would require discontinuation of the medication a few days before therapy to overcome these undesirable effects but the question is, is this safe? The issue of when antithyroid medication is warranted is a big question to the clinician. For optimal use of radioiodine therapy, appropriate selection criteria and good clinical judgment concerning pretreatment with antithyroid medication are required. Otherwise, we may put some patients into unnecessary increased risk and added cost. (author)

  10. Experience and outcome of radioiodine therapy in hyperthyroidism

    International Nuclear Information System (INIS)

    Miah, S.H.; Paul, A.K.; Rahman, H.A.

    2005-01-01

    Full text: Radioiodine is being increasingly used in the treatment of hyperthyroidism. The primary reasons for choosing radioiodine therapy are its effectiveness, ease of administration, relatively low cost and paucity of side effects. Here we presented our experiences and outcome of radioiodine therapy in hyperthyroidism in a divisional referral centre.We retrospectively analyzed 203 patients receiving radioiodine therapy for hyperthyroidism in Centre for Nuclear Medicine and Ultrasound, Khulna during the period from July 1994 to June 2004. All the patients had clinical signs and symptoms of hyperthyroidism as well as elevated triiodothyronine (T 3 ), thyroxine (T 4 ) and suppressed thyroid stimulating hormone (TSH). T 3 , T 4 and TSH were done in all cases. Radionuclide scan and ultrasound of thyroid gland, radioactive iodine uptake (RAIU), thyroid microsomal antibody (TMAb) and fine needle aspiration cytology (FNAC) was done in selected cases. We assessed all patients prior to radioiodine therapy. Elderly patients and all those with cardiac complications and severe hyperthyroidism were pretreated with a short course of antithyroid drug in full dosages until they were clinically and biochemically euthyroid. Ninety five patients were on antithyroid medication (Neomercazole) prior to radioiodine therapy. Antithyroid medication were stopped 3 days before radioiodine therapy and restarted 3 days later and continued for 1 to 2 months depending on patient's symptoms. The rest of the patients received either no treatment or beta-blocker prior to radioiodine therapy. Menstrual history was taken in female patients and pregnancy was excluded by ultrasonography in doubtful cases before administering radioiodine. The likely consequences of the treatment were fully explained to the patients and attendants, the usual precautions for radiation protection of the public and the necessity of the follow-up were discussed and verbal consent was taken before administering radioiodine

  11. The secondary hypothyroidism after radioiodine therapy and the replacement treatment

    International Nuclear Information System (INIS)

    Xu Ying; Xu Xiaohui

    2004-01-01

    The secondary hypothyroidism is the most important intercurrent disease after radioiodine therapy. The early hypothyroidism and the late hypothyroidism are incompletely different in pathogenesis. It needs researching further. there has not yet been an affirmable answer to choose the distillates from animal hypothyroid extract or complex preparation of levo-thyroxine in replacement treatment. (authors)

  12. Outcome of Radioiodine Therapy in a West African Population

    NARCIS (Netherlands)

    Onimode, Yetunde A; Ankrah, Alfred; Adedapo, Kayode S

    Hyperthyroidism continues to be a pressing public health concern in West Africa. Its prevalence in Africa has been quoted as 1.2%-9.9%, with Graves' disease as its most common cause. Radioiodine-131 (RAI) therapy of hyperthyroidism recently commenced in two government hospitals in Ghana and Nigeria.

  13. Chronic myeloid leukaemia following radioiodine therapy for carcinoma thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Bundi, R S; Scott, J S; Halnan, K E [Institute of Radiotherapeutics, Glasgow (UK)

    1977-01-01

    The majority of cases reported in the literature of leukemia following treatment of thyroid disease (thyrotoxicosis and carcinoma) are of acute variety. A description is given of the development of chronic myeloid leukemia in a case of carcinoma of the thyroid treated with radioiodine and megavoltage X-ray therapy. The case history contains details of radioiodine and X-ray doses administered over the years 1961 to 1972 to a male patient, on whom a right hemithyroidectomy was carried out in 1960. The results of blood counts are also recorded for the period up to 1973. The patient died, at 57, in 1974. A total of 860 mCi of /sup 131/I was administered and the first abnormal blood count was noted two months after the last therapeutic dose. Estimates have been made of blood and thyroid doses from /sup 131/I. There has been only one other report in the literature of the development of chronic myeloid leukemia following radioiodine therapy for carcinoma of the thyroid, and although the leukemogenic hazard of /sup 131/I cannot be ruled out for this patient, it is possible that the development of leukemia was coincidental rather than due to the radioiodine therapy.

  14. Radioiodine therapy and subsequent pregnancy; Gravidez apos radioiodoterapia

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Carmen Dolores G.; Miranda, Angelica E.; Corres, Nilson Duarte; Sieiro Neto, Lino; Corbo, Rossana; Vaisman, Mario [Hospital Universitario Clementino Fraga Filho (UFRJ), Rio de Janeiro, RJ (Brazil). Dept. of Endocrinology and Nuclear Medicine; Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil); Hospital dos Servidores do Estado do Rio de Janeiro, RJ (Brazil); E-mail: loloi@zaz.com.br

    2007-06-15

    Objectives: To evaluate abortion and fetal congenital anomaly rates in women previously submitted to radioiodine therapy for differentiated thyroid carcinoma. Study design: A case-control study of 108 pregnant women, 48 cases whose pregnancies were evaluated after they had undergone radioiodine therapy for differentiated thyroid carcinoma, and the control group consisted of 60 healthy pregnant women. Results: Of a total of 66 pregnancies, 14 conceived within the first year, 51 one or more years after the last administration of {sup 131}I, the medical record of one patient was not available. The interval between the last radioiodine therapy administration and conception ranged from 1 month to 10 years. There were a total of 4 miscarriages, 2 of them for unknown reasons. There was one case of congenital anomaly and two preterms birth. Nine women presented the following pregnancy events: placental insufficiency, hypertensive crisis, placental detachment, risk of miscarriage, preterm labour and four miscarriages. No statistical difference was observed between the studied and control groups. Conclusion: Radioiodine was followed by no significant increase in untoward effects in neither the pregnancy nor the offspring. (author)

  15. Guideline for radioiodine therapy for benign thyroid diseases (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Dressler, J.; Gruenwald, F.; Leisner, B.; Moser, E.; Reiners, C.; Schneider, P.; Schober, O.

    2004-01-01

    The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3 rd version. (orig.) [de

  16. Radioiodine

    International Nuclear Information System (INIS)

    Zaduban, M.

    1978-01-01

    The physical, chemical radiochemical and radiometric properties of radioiodine significant for the radiochemical analysis are summarized. The occurrence of iodine, especially in the biosphere organic part, the calculation of the amount of iodine radioisotopes formed under different conditions, the spectrometric and integral methods of measuring the radioactivity of the most important iodine radioisotopes, the methods of separating iodine and its respective chemical forms are described. (M.K.)

  17. Radio-iodine therapy and Helicobacter pylori infection

    International Nuclear Information System (INIS)

    Gholamrezanezhad, A.; Mirpour, S.; Saghari, M.; Abdollahzadeh, J.; Pourmoslemi, A.; Yarmand, S.

    2008-01-01

    Helicobacter pylori is the most important cause of gastritis and related morbidities. Following consumption, radioactive iodine accumulates considerably in the stomach. On the basis of this observation, we decided to determine whether the high radiation induced by radio-iodine in the stomach is effective in the eradication of this infection. All consecutive patients with differentiated thyroid carcinoma, who were referred for radio-iodine therapy [dose 117.1±24.4 mCi (4.3±0.9 GBq), range 100-200 mCi (3.7-7.4 GBq)], were enrolled. To detect H. pylori infection, the urease breath test (UBT) was performed 1-2 h before radio-iodine consumption and the test was repeated 2 months later. Of 88 patients, 71 had pre-treatment positive UBT. Of these, 23 patients had negative post-treatment result, which means a significant reduction (26.1%, 95% confidence interval (CI) 16.8-35.5%) in the number of positive UBT results in our treated population (32.4% of UBT-positive cases became UBT-negative). Considering the high prevalence of reinfection in developing countries, the therapeutic benefit would have been more considerable if the second UBT had been done with a lag time of less than 2 months. Although radio-iodine therapy is not a logical method for the treatment of patients suffering from H. pylori, our finding provides indirect evidence about the radiosensitivity of bacteria, the future clinical applications of which need to be further evaluated. Also this finding can be useful for the food industry, where radiation is used widely to sterilize food. Regarding the possibility of H. pylori suppression, we recommend not using UBT for screening for the infection for at least within 2 months following radio-iodine therapy. (author)

  18. Radioiodine therapy versus antithyroid medications for Graves' disease.

    Science.gov (United States)

    Ma, Chao; Xie, Jiawei; Wang, Hui; Li, Jinsong; Chen, Suyun

    2016-02-18

    Graves' disease is the most common cause of hyperthyroidism. Both antithyroid medications and radioiodine are commonly used treatments but their frequency of use varies between regions and countries. Despite the commonness of the diagnosis, any possible differences between the two treatments with respect to long-term outcomes remain unknown. To assess the effects of radioiodine therapy versus antithyroid medications for Graves' disease. We performed a systematic literature search in the Cochrane Library, MEDLINE and EMBASE and the trials registers ICTRP Search Portal and ClinicalTrials.gov. The date of the last search was September 2015 for all databases. Randomised controlled trials (RCTs) comparing the effects of radioiodine therapy versus antithyroid medications for Graves' disease with at least two years follow-up. Two authors independently screened titles and abstracts for relevance. One author carried out screening for inclusion, data extraction and 'Risk of bias' assessment and a second author checked this. We presented data not suitable for meta-analysis as descriptive data. We analysed the overall quality of evidence utilising the GRADE instrument. We included two RCTs involving 425 adult participants with Graves' disease in this review. Altogether 204 participants were randomised to radioiodine therapy and 221 to methimazole therapy. A single dose of radioiodine was administered. The duration of methimazole medication was 18 months. The period of follow-up was at least two years, depending on the outcome measured. For most outcome measures risk of bias was low; for the outcomes health-related quality of life as well as development and worsening of Graves' ophthalmopathy risks of performance bias and detection bias were high in at least one of the two RCTs.Health-related quality of life appeared to be similar in the radioiodine and methimazole treatment groups, however no quantitative data were reported (425 participants; 2 trials; low quality evidence

  19. Single dose planning for radioiodine-131 therapy of Graves' disease

    International Nuclear Information System (INIS)

    Kita, Tamotsu; Yokoyama, Kunihiko; Kinuya, Seigo; Taki, Junichi; Michigishi, Takatoshi; Tonami, Norihisa

    2004-01-01

    Patients with Graves' disease were studied one year after radioiodine-131 therapy to assess the relationship between the effectiveness of the therapy and the radioiodine doses used. Patients were classified into three groups according to thyroid function as hyperthyroidism, euthyroidism and hypothyroidism at one year after I-131 therapy. In these groups we compared the mean values of dose, dose per thyroid weight calculated with I-123 uptake before the therapy (pre D/W), dose per thyroid weight calculated with therapeutic I-131 uptake (post D/W), and absorbed dose. No significant differences were found between the three groups in terms of dose or pre D/W. The mean values of post D/W and absorbed dose in the non-hyperthyroid (euthyroid and hypothyroid) group were significantly greater than those in the hyperthyroid group. Post D/W of 6.3 MBq/g was a threshold separating the non-hyperthyroid group from the hyperthyroid group. There was no correlation between pre D/W and post D/W; however, the mean post D/W was significantly greater than the mean pre D/W. All patients with pre D/W above 6.3 MBq/g showed non-hyperthyroidism at one year after the radioiodine treatment. No indicators before the radioiodine therapy had significant relationships with the effectiveness of the therapy at one year after the treatment. However, the single therapy planned for setting the pre D/W above 6.3 MBq/g will certainly make the patients non-hyperthyroid. As this proposal of dose planning is based on a small number of patients, further study is needed. (author)

  20. Radioiodine therapy within the German DRG-system 2005

    International Nuclear Information System (INIS)

    Lorenz, R.; Dressler, J.

    2005-01-01

    With introduction of a diagnosis-related groups system (DRG-system) in Germany the previous duration of stay based refunding is also replaced for the radioiodine therapies by a performance oriented reimbursement system. Since the at first optional start of the DRG-system in 2003 the adaptations which take place every year should lead, up to the planned end of the convergence phase in 2009, to a transparent, fair and economical financing system of the stationary hospital service. The physician is responsible for the right and complete coding of the diagnoses and procedures, which serve as essential parameters for the determination of the diagnosis related group (DRG) of a hospital case. In the actual version of the year 2005 the DRG-system still supplies for radioiodine therapy of thyroid carcinoma some unclarity in the coding of the diagnosis, as well as clear inadequacy with the fair mapping of the therapy costs. (orig.)

  1. Radioiodine therapy in Graves` disease; Radioiodtherapie der Immunhyperthyreose

    Energy Technology Data Exchange (ETDEWEB)

    Schuemichen, C. [Rostock Univ., Zentrum fuer Radiologie, Klinik und Poliklinik fuer Nuklearmedizin (Germany)

    1997-12-01

    Analogous to subtotal struma resection, stable long-term results are attained with radioiodine therapy of immunohyperthyreosis only with an ablative therapy concept. Hypothyreosis is thus no longer an undesired or unavoidable side effect of radioiodine therapy, but constitutes part of the treatment principle. In addition to the negligible theoretical low late risk of radiation effect, an increase in immunostimulation is induced in the majority of patients by means of increased antigen presentation. In a minority of patients, this has detrimental effects on the treatment results and leads to a requirement for relatively high focal doses (200-300 Gy) to achieve a generally satisfactory therapeutic result. In individual cases, endocrine orbitopathy may be exacerbated or elicited. It is therefore recommended that radioiodine therapy of immunohyperthyreosis should be undertaken with cortisone protection as a matter of principle. (orig.) [Deutsch] In Analogie zur subtotalen Strumaresektion werden auch mit der Radioiodtherapie der Immunhyperthyreose nur mit einem ablativen Therapiekonzept stabile Langzeitergebnisse erzielt. Die Hypothyreose ist somit nicht laenger unerwuenschte oder unvermeidliche Nebenwirkung der Radioiodtherapie, sondern Bestandteil des Behandlungsprinzips. Neben dem vernachlaessigbar geringen theoretischen Spaetrisiko durch Strahleneinwirkung wird bei einem Grossteil der Patienten durch eine vermehrte Antigenpraesentation eine Zunahme der Immunstimulation induziert, die bei einem kleineren Teil der Patienten das Behandlungsergebnis beeintraechtigt und dazu fuehrt, dass relativ hohe Herddosen (200-300 Gy) fuer ein insgesamt zufriedenstellendes Behandlungsergebnis erforderlich werden. In Einzelfaellen kann hierdurch auch eine endokrine Orbitopathie verschlechtert oder neu ausgeloest werden. Es wird daher empfohlen, die Radioiodtherapie der Immunhyperthyreose grundsaetzlich unter Kortisonschutz vorzunehmen. (orig.)

  2. Radioiodine therapy of benign thyroid disorders: functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.

    2005-01-01

    In the last 15 years, several concepts have been developed to further improve the outcome of radioiodine therapy in functional thyroid autonomy. Results of radioiodine therapy in functional autonomy are considerably better than in Graves' disease. All of the currently-applied concepts offer healing rates of 75-100%, but they differ considerably in the hypothyreosis rates attained. The target volume can be precisely determined by sonography only in unifocal autonomy. In the case of multifocal and disseminated autonomy, the entire thyroid is taken as the target volume and the focal dose is reduced ('dosimetric compromise'). TcTUs-based dose concepts calculate the functionally autonomous volume from the TcTUs and replace the target volume by sonography, in the TcTUs-adapted dose concepts, sonographic target volume is left and the focal dose varied in dependence of the suppression uptake. The objective is to attain a high rate of success with a low rate of hypothyreosis. (orig.)

  3. Recombinant human thyrotropin-stimulated radioiodine therapy of nodular goiter allows major reduction of the radiation burden with retained efficacy

    DEFF Research Database (Denmark)

    Fast, Søren; Hegedüs, Laszlo; Grupe, Peter

    2010-01-01

    Context and Objective: Stimulation with recombinant human TSH (rhTSH) before radioiodine ((131)I) therapy augments goiter volume reduction (GVR). Observations indicate that rhTSH has a preconditioning effect beyond increasing thyroid (131)I uptake. We test the hypothesis that an equivalent GVR mi....... This approach is attractive in terms of minimizing posttherapeutic restrictions and in reducing the potential risk of radiation-induced malignancy....

  4. Radioiodine therapy in Graves' disease - A retrospective analysis

    International Nuclear Information System (INIS)

    Mittal, B.R.; Bhattacharya, A.; Dutta, P.; Bhansali, A.

    2007-01-01

    Full text: Radioiodine is a safe form of treatment for all patients with primary hyperthyroidism. The thyroid's unique capacity to store iodine (thus also radioiodine) makes it a natural target for radioiodine therapy. We retrospectively analyzed the outcome of radioiodine therapy in a cohort of 151 patients of primary hyperthyroidism treated on an outpatient basis in our institute from January 2001 to November 2006. Of these 151 patients, 113 (38 male, 75 female; age range: 17- 65 years) were of Graves' disease. The median duration of symptoms in these patients was 4 years. (Range: 3 months to 20 years). Diagnosis was established on basis of clinical, biochemical and scintigraphic features. All the patients were treated medically with Neomercazole (Carbimazole) for varying durations (median 3.5 years). The dose range varied from 5 to 80 mg per day (median 20 mg per day). Clinical assessment of thyroid size revealed 39 patients with grade 0, 14 with grade 1, 30 with grade 2, and 30 with grade 3 goiters. Pre-therapy radioactive iodine uptake was done in 28 patients, which showed median values of 50 % at 4 hrs, 57.45 % at 24 hrs, and 56.2 % at 48 hrs respectively. These patients were treated empirically with I-131 in a dose range of 5 to 15 mCi, depending upon the clinical presentation and the RAIU values. Remission of symptoms with a single dose therapy was noticed in 68 patients. Of the 83 patients, 15 became hypothyroid within 3 months. These patients were on Neomercazole for a varying period of 2 to 20 years, at a dose range of 10 to 80 mg per day. 14 patients achieved remission after 2 doses with a cumulative RAI dose in the range of 10 to 19 mCi, at a median period of 7 to 24 months. Eight patients still showed hyperthyroid activity even after a second dose and are on follow-up. Seven patients achieved remission with a cumulative dose range of 17 to 35 mCi at a median duration of 10 months. One patient of Graves' disease who took Neomercazole for 10 years, at

  5. Beyond radioiodine: novel therapies in advanced thyroid cancer

    International Nuclear Information System (INIS)

    Haugen, Bryan R.

    2004-01-01

    Full text: Thyroid cancer is a relatively common endocrine malignancy. Fortunately, many patients do well with standard therapy including surgery and radioiodine. A minority of patients have poorly differentiated thyroid carcinoma that is unresponsive to radioiodine therapy. Redifferentiation agents that 'reprogram ' these tumors to concentrate radioiodine would be of great value in treating patients with advanced thyroid cancer. The retinoid isotretinoin is the most extensively studied of these agents. It appears that 20-40% of patients respond to isotretinoin treatment by concentration of radioiodine in metastatic tumors, but the clinical utility of this redifferentiation is still unclear. In vitro studies suggest that the retinoid receptors RARβ and RXRγ are required for this effect. Abnormal DNA methylation may be an early event in thyroid tumorigenesis and methylation of the sodium iodide symporter (NIS) may play a role in loss of iodine concentration in these tumors. Inhibitors of methylation (5-azacytidine, phenylacetate and sodium butyrate) have been shown to increase NIS expression and iodine uptake in cell culture models, but published trials in humans are not yet available. Histone acetylation is required for efficient transcription of genes necessary for differentiated function. Proteins that cause histone deacetylation inhibit gene transcription and differentiated function. Inhibitors of histone deacetylation (depsipeptide, trichostatin A) have been shown to increase NIS expression and iodine uptake in poorly differentiated and undifferentiated cell lines. Finally, commonly used agents such as thiazolidine diones (diabetes) and HMG-CoA reductase inhibitors (hypercholesterolemia) have shown promise in preliminary in vitro studies in advanced thyroid cancer cell lines. Our own work has focused on receptor-selective retinoids and thiazolidine diones as potential therapy in patients with advanced thyroid cancer based on nuclear hormone receptor

  6. Characterization of radioiodine therapy failures in Graves' disease

    International Nuclear Information System (INIS)

    Sabri, O.; Zimny, M.; Schreckenberger, M.; Reinartz, P.; Nowak, B.; Ostwald, E.; Schaefer, W.; Block, S.; Setani, K.; Buell, U.

    2001-01-01

    Aim of this study was a characterization of radioiodine therapy (RIT) failures in Graves' disease without simultaneous carbimazole. Method: 226 patients with a confirmed diagnosis of Graves' disease received 686.8 ± 376.4 MBq of iodine-131 orally for thyroid ablation. Target dose was 250 Gy. All patients were followed up for 6 months. Therapy failures were compared with successes regarding possible influencing variables initial thyroid volume, thyroid function, immune activity (TRAb), I-131 uptake, effective half-life, absorbed energy dose, age and gender. Results: 212 of 226 patients (93.8%) were treated successfully, 14 (6.2%) showed a hyperthyroidism relapse within 6 months which required a second radioiodine therapy. A success rate of 92.5% (62/67) could also be achieved with 67 patients who were hyperthyroid at the time of RIT. Compared to the therapy successes, the 14 failures achieved significantly lower absorbed doses (223.8 ± 76.6 Gy vs. 285.2 ± 82.1 Gy, p 0.2). Of the 14 failures, n = 8 reached an absorbed dose 250 Gy. Stepwise logistic regression revealed only absorbed energy dose as a variable significantly influencing therapy success (p 0.2) or gender (p = 0.13). Two-tailed Fisher's exact test showed no significant influence of gender on success rates (failures/successes: male 1/36, female 13/176, p = 0.48). Conclusions: Except for the absorbed energy dose, no other significant variable influencing the outcome of radioiodine therapy in Graves' disease without simultaneous carbimazole could be found. It should be noted, though, that 5 therapy failures (2.2%) reached an absorbed energy dose of >250 Gy. (orig.) [de

  7. Primary hyperthyroidism--diagnosis and treatment. Indications and contraindications for radioiodine therapy.

    Science.gov (United States)

    Gurgul, Edyta; Sowinski, Jerzy

    2011-01-01

    Isotope therapy is one of the methods used in primary hyperthyroidism. The therapy is based on short-range beta radiation emitted from radioactive iodine. Radioiodine administration must always be preceded by pharmacological normalization of thyroid function. Otherwise, post-radiation thyrocyte destruction and thyroid hormones release may lead to hyperthyroidism exacerbation. Indications for radioiodine therapy in Graves-Basedow disease include recurrent hyperthyroidism after thyrostatic treatment or thyroidectomy and side-effects observed during thyrostatic treatment. In toxic nodule, isotope therapy is the first choice therapy. Radioiodine is absorbed only in autonomous nodule. Therefore, it destroys only this area and does not damage the remaining thyroid tissue. In toxic goitre, radioiodine is used mostly in recurrent nodules. Absolute contraindications for radioiodine treatment are pregnancy and lactation. Relative contraindications are thyroid nodules suspected of malignancy and age under 15 years. In patients with thyroid nodules suspected of malignancy, radioiodine treatment may be applied as a preparation for surgery, if thyrostatic drugs are ineffective or contraindicated. In children, radioiodine therapy should be considered in recurrent toxic goitre and when thyrostatic drugs are ineffective. In patients with Graves-Basedow disease and thyroid-associated orbitopathy, radioiodine treatment may increase the inflammatory process and exacerbate the ophthalmological symptoms. However, thyroid-associated orbitopathy cannot be considered as a contraindication for isotope therapy. The potential carcinogenic properties of radioiodine, especially associated with tissues with high iodine uptake (thyroid, salivary glands, stomach, intestine, urinary tract, breast), have not been confirmed.

  8. Radioiodine therapy in patients with Graves' disease and the effects of prior carbimazole therapy.

    Science.gov (United States)

    Karyampudi, Arun; Hamide, Abdoul; Halanaik, Dhanapathi; Sahoo, Jaya Prakash; Kamalanathan, Sadishkumar

    2014-09-01

    The use of radioiodine as the first line of treatment in Graves' disease is restricted in India because of its limited availability and an unrealistic risk perception associated with it. Additionally, the effectiveness of radioiodine ablation in Graves' disease is influenced by many factors. Prior medical antithyroid therapy is one such important factor. To analyze the efficacy of low dose radioiodine therapy (5 mCi) in treatment of naive patients of Graves' disease in comparison to that in which it was already primed with an antithyroid drug, carbimazole. A non-randomized, interventional study conducted in the Department of Medicine and Endocrinology of a tertiary care institute in South India. The study had two groups; Group A (36 treatment naive, uncomplicated Graves' disease patients) and B (34 Graves' disease patients on carbimazole prior to radioiodine therapy). Both groups had baseline clinical, biochemical evaluation and were reassessed at 3 and 6 months for evaluating the clinical status for possible documentation of cure. The cure rate was 61.1% in drug naive group and 58.8% in pretreated group at 6 months following radioiodine (P = 0.845). Higher baseline 999m technicium (99m Tc) uptake, male gender, BMI and higher baseline free thyroxine (fT4) level predicted treatment failure following radioiodine therapy. Administration of carbimazole prior to low dose radioiodine therapy does not alter the efficacy of radioiodine. Low fixed dose (5 mCi) of radioactive iodine may be a safe and effective primary therapeutic option in Graves' disease patients pretreated with antithyroid drugs.

  9. Radioiodine therapy in benign thyroid diseases

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Hegedüs, Laszlo

    2012-01-01

    inevitable in Graves' disease, whereas this risk is much lower when treating toxic nodular goiter. The side effect causing most concern is the potential induction of ophthalmopathy in predisposed individuals. The response to (131)I therapy is to some extent related to the radiation dose. However, calculation......, and they may even interact mutually and counteract each other. Numerous studies have evaluated the effect of (131)I therapy, but results have been conflicting due to differences in design, sample size, patient selection, and dose calculation. It seems clear that no single factor reliably predicts the outcome...

  10. Guideline for radioiodine therapy for benign thyroid diseases (version 3)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany); Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Gruenwald, F. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Frankfurt (Germany); Leisner, B. [Abt. fuer Nuklearmedizin des Allg. Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Abt. fuer Nuklearmedizin der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Muenster (Germany)

    2004-12-01

    The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3{sup rd} version. (orig.) [German] Die Version 3 der Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen stellt im Wesentlichen eine redaktionelle Ueberarbeitung der Version 2 dar. Im Kapitel Indikation und Empfehlungen fuer eine Radioiodtherapie, eine Operation oder eine thyreostatische Therapie bei gutartigen Schilddruesenerkrankungen basiert die Leitlinie auf einem interdisziplinaer abgestimmten Konzept. Die Entscheidungskriterien sind multifaktoriell und beruecksichtigen die Art der Schilddruesenerkrankung (Autonomie, Morbus Basedow, Struma, Rezidivstruma

  11. Thyroid emergencies following radioiodine therapy - Two case reports

    International Nuclear Information System (INIS)

    Tasmine, Sufia; Haque, Fatema Sultana; Karim, M. A.

    2002-01-01

    Thyrotoxicosis and well differentiated thyroid carcinomas are the two most common pathological conditions where radioiodine is used. Patients with well differentiated thyroid carcinomas are the candidates for post operative radio iodine therapy. It is currently the most popular and frequently used method of treatment. Its use is safe and cost effective. The results are usually eventless but in some exceptional cases emergencies that occurred after administration of I-131. One emergency occurred after I-131 administration for Graves' disease and the second case happened after therapeutic application of I-131 for treatment of local recurrences of thyroid cancer.(author)

  12. Transient hypothyroidism following radioiodine therapy for thyrotoxicosis

    International Nuclear Information System (INIS)

    Connell, J.M.C.; McCruden, D.C.; Alexander, W.D.; Hilditch, T.E.

    1983-01-01

    A prospective study of thyroid function including serial tracer radioisotope uptake measurements in 55 patients treated with 131 I therapy is described. Five patients had an episode of transient hypothyroidism within eight months of treatment: in three of these patients this was due to impaired organification of iodide, with normal iodide trapping by the thyroid (as measured by a twenty minute 123 I uptake) being preserved. In contrast, in all patients who developed permanent hypothyroidism, iodide trapping was markedly diminished and did not recover. It is suggested that hypothyroidism due to organification failure following 131 I therapy is potentially short-lived; where hypothyroidism is associated with gross impairment of iodide trapping, recovery is unlikely. Early iodine uptake measurements may be of value in selecting those patients whose hypothyroidism is transient and who do not require permanent thyroid hormone replacement. (author)

  13. Anti-thyrotropin receptor antibody levels after radioiodine therapy in patients of childbearing age with Graves' disease

    International Nuclear Information System (INIS)

    Takeuchi, Mizuho; Tojo, Katsuyoshi; Tajima, Naoko; Yoshimura, Hiroshi; Ito, Koichi

    2006-01-01

    Following radioiodine therapy for Graves' disease, transient elevation of anti-thyrotropin receptor antibody (TRAb) is observed. Elevation of TRAb causes neonatal hyperthyroidism. Serum TRAb levels before radioiodine therapy, 2 months to 1 year, 1 to 2 years, 2 to 3 years, and 3 to 4 years after radioiodine therapy were retrospectively analyzed in 25 women of childbearing age with Graves' disease. The normal range for TRAb is ≤15%. The one patient with serum TRAb levels <10% before radioiodine therapy did not have TRAb levels ≥50% after radioiodine therapy. However, in patients with serum TRAb levels of 10% to 30% before radioiodine therapy (n=8), TRAb were ≥50% in 75.0% 2 months to 1 year after radioiodine therapy, in 25.0% 1 to 2 years after, and in 37.5% 2 to 4 years after. In patients with serum TRAb levels of 30% to 50% before radioiodine therapy (n=3), TRAb levels were ≥50% in 33.3% 2 months to 1 year after radioiodine therapy and in 0.0% 1 to 4 years after. In patients with serum TRAb levels of 50% to 70% before radioiodine therapy (n=6), TRAb were ≥50% in 83.3% 2 months to 1 year after radioiodine therapy, in 66.6% 1 to 2 years after, and in 33.3% 2 to 4 years after. In patients with serum TRAb levels ≥70% before radioiodine therapy (n=7), TRAb levels were ≥50% in 100% 2 months to 1 year after radioiodine therapy, in 85.7% 1 to 2 years after, in 71.4% 2 to 3 years after, and in 57.1% 3 to 4 years after. Serum TRAb levels are more likely to be ≥50% after radioiodine therapy in patients with high serum TRAb levels before radioiodine therapy. (author)

  14. Radioiodine therapy of hyperthyroidism at 25 years experience in Vietnam

    International Nuclear Information System (INIS)

    Mai Trong Khoa; Phan Sy An; Phan Van Duyet; Tran Dinh Ha

    2004-01-01

    prevalence of hypothyroidism according to the doses of I-131 received (p > 0.05). No occurring thyroid nodules was detected on thyroid scintigrams and echosonograms of all patients. Before and after (3 months - 3 years) I-131 therapy the mean thyroid volume reduction was 66.1%. TSH receptor antibodies (TRAb) are recognized as cause of organ-specific autoimmune disorder in Graves' disease. So the long-term effects of 131 I treatment for Graves' disease on TRAb have been studied in Vietnam. The TRAb values decreased over a period of more than 2 years after 131I therapy for Graves' disease, and the TRAb values (negative or positive) before treatment may influence the long- term outcome of 1311 therapy. The overall success rate of therapy, recognized as the permanent resolution of hyperthyroidism was 98.7 % with 94.4% achieving resolution in not more than 2 dose.The main problem with radioiodine treatment is hypothyroidism and this is easily managed with L-thyroxine. In summary, radioiodine therapy for hyperthyroidism is safe, inexpensive and efficacious in Vietnam. (authors)

  15. Paradoxical effects of radioiodine therapy in functional thyroid autonomy and mild immunothyropathy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Rudolph, F.; Prillwitz, A.; Groth, P.; Schuemichen, C.

    1998-01-01

    Aim: To examine all cases with Graves' disease after radioiodine therapy of autonomously functioning thyroid tissue (AFFT) in order to find the cause. Methods: We retrospectively studied 1428 pts who were treated between 11/93 and 3/97 with radioiodine for AFTT and who underwent at least one control examination. Results: 15 (1.1%) of all pts developed Graves' disease 8.4 (4-13) months after radioiodine therapy. There was no direct suggestion of Graves' disease (TRAK negative, no endocrine ophthalmopathy) in any pt at the time of radioiodine therapy. More detailed analysis of anamnestic data, however, revealed evidence that immunothyropathy predated radioiodine therapy in 11 of the 15 pts. Paradoxical effects of radioiodine therapy manifested as an increase in immunothyropathy 14 pts, a deterioration in metabolism in 11 pts and a first occurrence of endocrine ophthalmopathy in 5 pts. Conclusion: Exacerbation of preexisting, functional primarily insignificant immunothyropathia is held responsible in most cases for the observed paradoxical effects after radioiodine therapy, resulting in radiation-induced manifest Graves' disease; however no therapeutical consequences are recommended. (orig.) [de

  16. Unfavourable effect of prolonged treatment with antithyroid drugs on radioiodine therapy outcome in Graves' hyperthyroidism

    OpenAIRE

    Rajić, Milena; Vlajković, Marina; Ilić, Slobodan; Stević, Miloš; Sekulić, Vladan; Zečević, Mila

    2014-01-01

    Radioiodine therapy (RIT) of Graves' hyperthyroidism (GH) is usually recommended after failure of primary therapy with antithyroid drugs (ATDs), which are commonly prescribed for up to 18-24 months. However, in our region, the prolonged ATDs treatment of the disease is very common. Thus, we assessed the efficacy of RIT after prolonged continual pretreatment with ATDs in Graves' hyperthyroidism. Therapy outcome using a single dose of radioiodine was evaluated after one year in 91 patients (f/m...

  17. Radioiodine therapy in non toxic multi nodular goitre, preliminary results

    International Nuclear Information System (INIS)

    Chiti, A.; Travaini, L.L.; Tadayyon, S.; Vannucchi, G.; Fugazzola, L.; Beck-Peccoz, P.

    2002-01-01

    Aim: Aim of our study was to assess the efficacy of 131 I therapy in patients (pts) affected by non toxic multinodular goitre (NTMG). NTMG is a thyroid disease with a high prevalence, especially in low-iodine intake regions. Treatment of NTMG often requires surgery. However, thyroidectomy may be risky in some patients and radioiodine therapy could be an alternative treatment to reduce thyroid volume. We also evaluated if lithium administration can improve the efficacy of radioiodine treatment in this pts. Material and Methods: We enrolled 39 pts (8 males, 31 females; mean age 59 y, range 40-79 y) affected by NTMG. Mean thyroid volume (TV) at ultrasound was of 46.8 ml (range 18.5-87.3). Pts were randomised in 2 groups. Group 1: iodine therapy + lithium therapy 900 mg/die for 6 days; Group 2: iodine therapy alone. We also define 3 clusters of pts by TV. A:15-30 ml; B:31-40 ml; C: > 40 ml. The 131 I activity (MBq) was calculated as follows: [4.44 (MBq) x 100/24 hours uptake (%)] x TV. All patients are evaluated for thyroid function and TV at 3, 6, 12, 18 and 24 months after treatment, since we postulate that major reduction in thyroid volume will occur 1 year after 131 I therapy. Results: Up to now 16 pts were treated with 131 I (mean activity: 512 MBq) and no side effects from 131 I and lithium therapy were reported. Four out of 5 pts evaluated at 3 months (2 of group 1 and 3 of group 2) had a reduction in TV (mean value: 8.8 ml). Five out of 10 pts had sub-clinical hyperthyroidism at 1 week, likely as a consequence of thyroid tissue destruction. Conclusion: Our preliminary results suggest the safety and effectiveness of 131 I treatment in NTMG. We expect to clarify the role of lithium administration in improving 131 I efficacy. This therapy could have a future role in patients with NTMG that can't be submitted to surgery

  18. The clinical value of immunosuppression in Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Chen Yue; Qiu Ling; Zhang Chunying; Long Shuiqing; Gan Xilun

    2001-01-01

    Objective: The chief clinical characteristics of Graves disease are hyperthyroidism and ophthalmopathy. To assess the values of using immunosuppression in Graves ophthalmopathy. Method: 415 patients with Graves hyperthyroidism were studied. They were randomly assigned to receive radioiodine, methimazole from 1.5 to 2 years, radioiodine followed by a 3-month course of prednisone. The changes in thyroid function and progression of ophthalmopathy were evaluated. Results: Among the 138 patients treated with radioiodine, 19 patients had new or worsening ophthalmopathy; 117 had no changes in their eyes; 2 patients had improvement in their eye disease. Among the 138 patients treated with methimazole, 3 patients had new or worsening ophthalmopathy; 133 had no changes in their eyes; 2 patients had improvement in their eye disease. Among the 139 patients treated with radioiodine and prednisone, no patient had new or worsening ophthalmopathy; 107 had no changes in their eyes; 32 patients had improvement in their eye disease. The frequency of improvement of ophthalmopathy was significantly higher in the radioiodine-prednisone group than in either the radioiodine group or the methimazole group (P<0.001 for both comparisons). Conclusions: The administration of prednisone after radioiodine therapy was associated with improvement of ophthalmopathy. Worsening of ophthalmopathy after radioiodine therapy is often transient and can be prevented by the administration of prednisone

  19. Thyroid-hormone concentrations after radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Tamagna, E.I.; Levine, G.A.; Hershman, J.M.

    1979-01-01

    Fourteen hyperthyroid patients (11 men, three women), ages 28 to 66, were followed with serial measurements of serum thyroid hormone levels for 1 mo after therapy with I-131. Twelve patients had diffuse toxic goiters (25 to 70 g in size); two patients had multinodular glands (40 to 100 g). The patients were taking no antithyroid medications; ten patients were treated with propranolol. All patients received the equivalent of 5000 rad, except the two with multinodular glands, who received larger doses. There was no consistent pattern of serum T 4 and T 3 levels after the I-131 therapy. For the entire group, there was no significant increase of the mean serum hormone concentration. One group (three patients) had a mean T 4 increase of 28% and a T 3 increase of 91% above baseline at Days 10--11. Seven patients had minimal increases of hormone levels at Days 2--3, and a third group (four paients) had no increase of thyroid hormones after I-131 therapy. The patients with no rise in hormone concentrations had smaller goiters than the other groups. There was no correlation of the dose of radioactive iodine, or of the initial hormone concentration, with the rises or declines of T 4 and T 3 levels after I-131 therapy. Radioiodine therapy caused no significant increase of serum T 4 and T 3 concentrations in the majority of patients

  20. Guideline for radioiodine therapy for benign thyroid diseases (version 4); Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen (Version 4)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany). Abteilung fuer Nuklearmedizin; Gruenwald, F. [Frankfurt Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Nuklearmedizinische Klinik der Henriettenstiftung des allgemeinen Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Nuklearmedizinische Klinik der Henriettenstiftung der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Schober, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    Version 4 of the guideline for radioiodine therapy for benign thyroid diseases includes an interdisciplinary consensus ondecision making for antithyroid drugs, surgical treatment and radioiodine therapy. The quantitative description of a specific goiter volume for radioiodine therapy or operation was cancelled. For patients with nodular goiter with or without autonomy, manifold circumstances are in favor of surgery (suspicion on malignancy, large cystic nodules, mediastinal goiter, severe compression of the trachea) or in favor of radioiodine therapy (treatment of autonomy, age of patient, co-morbidity, history of prior subtotal thyroidectomy, profession like teacher, speaker or singer). For patients with Graves' disease, radioiodine therapy or surgery are recommended in the constellation of high risk of relapse (first-line therapy), persistence of hyperthyroidism or relapse of hyperthyroidism. After counseling, the patient gives informed consent to the preferred therapy. The period after radioiodine therapy of benign disorders until conception of at least four months was adapted to the European recommendation. (orig.)

  1. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    International Nuclear Information System (INIS)

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo; Monte, Osmar; Silva, Marta Assumpcao de Andrada e; Duprat, Andre; Marone, Marilia; Almeida, Renata de; Iglesias, Alexandre

    2008-01-01

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  2. Body weight gain after radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Scheidhauer, K.; Odatzidu, L.; Schicha, H.

    2002-01-01

    Aim: Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Methods: Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. Results: All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. Conclusions: An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas. (orig.) [de

  3. [Body weight gain after radioiodine therapy in hyperthyroidism].

    Science.gov (United States)

    Scheidhauer, K; Odatzidu, L; Kiencke, P; Schicha, H

    2002-02-01

    Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas.

  4. Amifostine is a potent radioprotector of salivary glands in radioiodine therapy. Structural and ultrastructural findings

    International Nuclear Information System (INIS)

    Kutta, H.; Kampen, U.; Sagowski, C.; Brenner, W.; Bohuslavizki, K.H.; Paulsen, F.

    2005-01-01

    Background and purpose: salivary gland impairment following high-dose radioiodine treatment is well recognized. Since differentiated thyroid cancer has a good prognosis, reduction of long-term side effects is important. This study investigates the radioprotective effects of amifostine in salivary glands of rabbits receiving high-dose radioiodine therapy so as to obtain deeper insight in changes on the cellular and ultrastructural level. Material and methods: a total of 20 rabbits were investigated. High-dose radioiodine therapy applying 1 GBq 131 I was performed in 16 animals. Eight of these 16 animals received 200 mg/m 2 body surface amifostine prior to high-dose radioiodine therapy. Four additional rabbits served as controls, two receiving amifostine, the other two no treatment at all. Subsequently, salivary glands (submandibular and parotid glands, respectively) of all animals were examined by light and transmission electron microscopy. Results: parenchymal damage of both parotid and submandibular glands, specially acinar structures comprising cell organelles and nuclei, of animals pretreated with amifostine was much less pronounced than in animals without amifostine pretreatment. Conclusion: the results indicate that parenchymal damage in salivary glands induced by high-dose radioiodine therapy can significantly be reduced by amifostine. Therefore, amifostine therapy may increase quality of life in patients with differentiated thyroid cancer after radioiodine treatment. (orig.)

  5. Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.

    2005-01-01

    The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

  6. Stunning in radioiodine therapy of benign thyroid disease. Quantification and therapeutic relevance

    International Nuclear Information System (INIS)

    Krohn, T.; Meyer, P.T.; Knollmann, D.; Nowak, B.; Schaefer, W.M.; Ocklenburg, C.

    2008-01-01

    In radioiodine therapy of benign thyroid disease, a reduction of radioiodine uptake is known for consecutive administrations of 131I, which needs to be considered in therapy planning. Aim: Analysis of uptake reduction with regard on the time interval between radioiodine administration and the delivered dose to the thyroid tissue. Patients, methods: 200 patients were enrolled in the study and distributed into two groups (matched for diagnoses), each containing 32 patients with Graves' disease (target dose 250 Gy), 24 with focal (400 Gy), 44 with disseminated thyroid autonomy (150 Gy). In one group, a second fraction of radioiodine was given after 48 h (2d) due to an unexpected low radioiodine uptake or effective half-life, whereas in the other group the second fraction was given after 96 h (4d). Results: There was no significant difference between delivered doses due to the first fraction after four days: 2d: 86 ± 48 Gy (extrapolated) vs. 4d: 87 ± 41 Gy, p > 0.05. In 2d, delivered dose at time of second administration was significantly lower (51 μ 29 Gy) than in 4d (p < 0.01). The radioiodine uptake of the second fraction relative to the initial uptake was significantly lower in the 4d (4d: 63 ± 25% vs. 2d: 82 ± 24%, p < 0.01). In addition, a correlation between uptake reduction and delivered dose and an influence of the time interval between radioiodine administrations could be shown. Conclusions: Relative uptake of subsequent radioiodine fractions decreases with time after first administration and with increasing delivered dose to the thyroid. If a second fraction of 131I is given at an earlier time, the same therapeutic effect can be reached using lower amounts of activity, minimising radiation exposure and increasing efficiency of radioiodine therapy. (orig.)

  7. [Radioiodine 131I therapy of hyperthyroidism on an outpatient basis - safe, effective and economic option].

    Science.gov (United States)

    Jiskra, J; Kubinyi, J; Telička, Z

    2012-02-01

    Radioiodine 131I therapy of hyperthyroidism on an outpatient basis is widely accepted over the world. In Czech Republic, however, radioiodine therapy is still not enough used, and has been realized on an inpatient basis to date. Our work is the first analysis of the experiences with radioiodine therapy of hyperthyroidism on an outpatient basis in Czech Republic. Capsule with 550 MBq of 131I was administered orally in 39 hyperthyroid patients (32 women and 8 men, 21 with autoimmune Graves hyperthyroidism and 18 with toxic thyroid nodules, mean age 66.8 years). In 32 of them we evaluated effectiveness and complications of therapy after 12-42 months. We also compared financial costs of the radioiodine treatment on an outpatient basis with the treatment in hospitalization and with surgery. After the treatment, 9/32 (28 %) patients were euthyroid without thyrostatic/thyroxine treatment, 18/32 (60 %) patients were hypothyroid with thyroxine therapy, 2/32 (6 %) patients significantly decreased doses of thyrostatic drugs. In 2/32 (6 %) patients the treatment was ineffective. The effect of the treatment did not depend on the etiology and severity of hyperthyroidism, but decreased with thyroid volume. Patients with ineffective or only partially effective treatment had median of thyroid volume more than 40 ml. In 1 patient thyroid associated ophthalmopathy was moderately worsened. Other complications were not observed. If we compared financial costs in model with 1 patient, we found that the costs of radioiodine therapy on an outpatient basis (118.7 €) comprise only 16 % of the costs of radioiodine therapy in hospitalization (728 €) and only 25 % of the costs of surgery (475.6 €). Radioiodine 131I is effective and safe in the treatment of hyperthyroidism and the therapy on an outpatient basis is much cheaper choice. The therapy with 131I on an outpatient basis is not suitable in patients with thyroid volume more than 40 ml.

  8. Radioiodine therapy versus antithyroid drugs in Graves' disease: a meta-analysis of randomized controlled trials

    Science.gov (United States)

    Qin, Lan

    2016-01-01

    Objective: This meta-analysis was performed to compare radioiodine therapy with antithyroid drugs in terms of clinical outcomes, including development or worsening of ophthalmopathy, hyperthyroid cure rate, hypothyroidism, relapse rate and adverse events. Methods: Randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, SinoMed and National Knowledge Infrastructure, China, were systematically reviewed to compare the effects of radioiodine therapy with antithyroid drugs in patients with Graves' disease. Results were expressed as risk ratio with 95% confidence intervals (CIs) and weighted mean differences with 95% CIs. Pooled estimates were performed using a fixed-effects model or random-effects model, depending on the heterogeneity among studies. Results: 17 RCTs involving 4024 patients met the inclusion criteria and were included. Results showed that radioiodine treatment has increased risk in new ophthalmopathy, development or worsening of ophthalmopathy and hypothyroidism. Whereas, compared with antithyroid drugs, radioiodine treatment seems to have a higher hyperthyroid cure rate, lower recurrence rate and lower incidence of adverse events. Conclusion: Radioiodine therapy is associated with a higher hyperthyroid cure rate and lower relapse rate compared with antithyroid drugs. However, it also increases the risk of ophthalmopathy and hypothyroidism. Advances in knowledge: Considering that antithyroid drug treatment can be associated with unsatisfactory control of hyperthyroidism, we would recommend radioiodine therapy as the treatment of choice for patients with Graves' disease. PMID:27266544

  9. Lithium as an adjunct to radioiodine therapy in Graves' disease for prolonging the intrathyroidal effective half-life of radioiodine. Useful or not?

    Energy Technology Data Exchange (ETDEWEB)

    Dunkelmann, S.; Kuenstner, H.; Nabavi, E.; Eberlein, U.; Groth, P.; Schuemichen, C. [Rostock Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin, Zentrum fuer Radiologie

    2006-07-01

    Aim: Evaluation of intrathyroidal kinetics of radioiodine with and without lithium as adjunct with respect to the increase in radiation dose delivered to the thyroid. Patients, methods: 267 patients in three groups were included in the study. Group I with 227 patients served as control group, Group II with 21 patients and Group III with 19 patients were distinguished by an intrathyroidal half-life of radioiodine below 3.5 days in the diagnostic test. Patients in Group III received 885 mg lithium carbonate a day for 2 weeks as adjunct to radioiodine therapy. Both diagnostic and therapeutic radioiodine kinetics were followed up by at least 10 uptake measurements within a minimum of 48 h. Kinetics of radioiodine were defined mathematically as balance of the thyroidal iodine intake and excretion by a two-compartment model. Results: Under therapy the maximum uptake of radioiodine was reduced by nearly 10% in all groups, in Group I, the effective half-life as well as the product of maximum uptake x effective half-life as an equivalent of radiation dose independent of thyroid volume was lowered in the same magnitude. In Group II, the energy-dose equivalent remained constant under therapy. With adjunct lithium in Group III, the effective half-life was prolonged significantly by factor 1.61{+-}0.49 and the volume-independent energy-dose equivalent by factor 1.39{+-}0.37. No severe side effects of lithium were observed. Conclusion: Using lithium as adjunct to radio-iodine therapy increases the radiation dose delivered to the thyroid by 39% on average and nearly 30% of radioiodine activity can be saved in these patients. Lithium is recommended in patients with very short effective half-life in the diagnostic test in order to reduce the activity required and whole-body radiation dose. (orig.)

  10. Exhalation of I-131 after radioiodine therapy: time dependence and chemical form

    International Nuclear Information System (INIS)

    Schomaecker, K.; Fischer, T.; Eschner, W.; Gaidouk, M.I.; Schicha, H.

    2001-01-01

    Aim: The change of both amount and chemical forms of radioiodine exhaled in the air of rooms with patients on the therapy ward should be investigated depending on radioactivity applied, time after application, and kind of thyroid disease. Methods: The air of ward-rooms of 62 patients with thyroid carcinoma, Graves' Disease, and autonomy which received different therapy doses, was investigated with an portable constant air flow sampler. Different chemical iodine species (organic, elemental, aerosol bound) were collected during 8 hr in various filters until 3 days after application of the radioiodine capsule, according to their chemical form. The radioactivity in the filters was measured with a well counter on defined time points after application. Results: The radioactivity exhaled was between 0,008 and 0,03% related to activity of radioiodine applied. The percentage of radioiodine exhaled related to the activity applied, differed significantly depending on disease and changed as follows: Grave's disease > autonomy > carcinoma. The exhalation of radioiodine became stronger with increasing applied activities and showed an exponential decrease with time. The most part of radioiodine was present in organic bound form. This organic portion decreased with time in favour of the other iodine species. Conclusion: The degree of accumulation of radioiodine orally applied within thyroid seems to be in direct proportion to the extend of its exhalation. Further measurements directly in the breathing air of RIT-patients are necessary, in order to clarify the relationship between degree of thyroid uptake and quantity as well as chemical form of radioiodine exhaled. (orig.) [de

  11. Long-term efficacy of modified-release recombinant human TSH (MRrhTSH) augmented radioiodine (131I) therapy for benign multinodular goiter. Results from a multicenter international, randomized, placebo-controlled dose-selection study

    DEFF Research Database (Denmark)

    Fast, Søren; Hegedus, Laszlo; Pacini, Furio

    2014-01-01

    with 131I-therapy. Methods: In this phase II, single-blinded, placebo-controlled study, 95 patients (57.2±9.6 years old, 85% women, 83% Caucasians) with MNG (median size 96.0 ml (31.9 - 242.2 ml)) were randomized to receive placebo (n=32), 0.01 mg MRrhTSH (n=30) or 0.03 mg MRrhTSH (n=33), 24 hours before...... a calculated 131I activity. Thyroid volume (TV) and smallest cross-sectional area of trachea (SCAT) were measured (by CT-scan) at baseline, month 6 and month 36. Thyroid function and quality of life (QoL) was evaluated at 3 month and yearly intervals, respectively. Results: At 6 months, TV reduction...... was enhanced in the 0.03 mg MRrhTSH group (32.9% versus 23.1% in the placebo group, p=0.03), but not in the 0.01 mg MRrhTSH group. At month 36 the mean percent TV reduction from baseline was 44 ± 12.7% (SD) in the placebo group, 41 ± 21.0% in the 0.01 mg MRrhTSH-group and 53 ± 18.6% in the 0.03 mg MRrh...

  12. Graves' disease and toxic nodular goiter - radioiodine therapy; Morbus Basedow und Autonomie - Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Schicha, H.; Dietlein, M. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2002-04-01

    At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism. (orig.) [German] In dem vorliegenden Beitrag wird ueber die Radioiodtherapie gutartiger Schilddruesenerkrankungen referiert. Dies betrifft gesetzliche Regelungen in Deutschland, grundlegende Ueberlegungen zur Therapie benigner Schilddruesenerkrankungen, die Diskussion konservative versus definitive Therapieindikation der Hyperthyreose und schliesslich die Themenkomplexe Vorbereitung, Durchfuehrung, Ergebnisse, Nebenwirkungen und Komplikationen, Kosten sowie Nachsorge der Radioiodtherapie. Im Vordergrund steht die Abgrenzung der konservativen Therapieindikation gegenueber der primaeren Radioiodtherapie des Morbus Basedow in Deutschland. Waehrend in den USA 70-90% der Morbus-Basedow-Faelle primaer mit Radioiodtherapie behandelt werden, wird in Deutschland bei 90% zunaechst ein

  13. Influence of preceding diagnostic and therapeutic procedures on the radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Rendl, J.; Boerner, W.

    1991-01-01

    Before and until 3 weeks after application of nonionic CA iodine and the 20-min-technetium-thyroid-uptake was measured in serum and urine in 23 euthyroid patients, which were given intravenously nonionic CA during heart catheterization. Concerning the possible influence of iodine contamination on a subsequent radioiodine therapy the following aspects result from the study: the time interval between application of CA and therapy has to be at least 4-6 weeks to avoid dilution of the radioiodine by iodine being released from the contrast agents. The thyroid-uptake of Technetium or Iodine after administration of CA is not constant over time but reaches its original value only in a gradual way (60% of the initial value 3 weeks after the CA were given); that means, the iodine-uptake during, radioiodine therapy can be higher than it was at the time the dose was calculated. Concerning the possible influence of preceding therapeutic procedures on the therapy with radioiodine the pretreatment with antithyroid drugs plays the most important role. Antithyroid drugs of the thiourylene group have been shown by many study groups to have a radioprotective effect. Other large studies however could not demonstrate any effect of antithyroid medication on the results of radioiodine therapy. All studies so far existing have in common that they are not strongly randomized with regard to the patient groups, because generally only in severe cases of hyperthyroidism additional antithyroid drug treatment has been employed, therefore it might be the case that the radioprotective effect of antithyroid drugs may be caused only by selection artifacts. The contradictory results of the different studies justify the practical way in so far as there are no reasonable objections against the pretreatment with antithyroid drugs to restore euthyroidism before starting the therapy with radioiodine. (orig./MG) [de

  14. Strategies of radioiodine therapy for Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Lind, P. [Department of Nuclear Medicine and Endocrinology, PET Center Klagenfurt, LKH Klagenfurt (Austria)

    2002-08-01

    Several therapeutic options are available for the treatment of Graves' disease (GD), including long-term antithyroid drug medication (ATD), near-total resection (NTR) and radioiodine therapy (RIT). These treatments are used with different frequencies depending on geographical location, size of the goitre, age of the patient and experience of the physician. It should be noted that RIT is still being applied more frequently in the United States than in Europe. Despite the fact that RIT was introduced as long ago as 1941, several questions are still the subject of debate: Should a fixed dose or a calculated dose be used. If the dose is calculated, how many Grays (Gy) should be delivered to the thyroid? What is the goal of RIT in GD? Which factors, including ATD, influence the outcome of RIT? Is RIT appropriate in GD with Graves' ophthalmopathy (GO)? Although not all these questions have been answered yet, conclusions can be derived regarding a general strategy for use of RIT in GD. As with surgery, the goal of RIT in GD is euthyroidism with or without L-thyroxine medication. There is a clear advantage of dose calculation over use of a fixed dose because the only factor influencing the outcome is the dose delivered to a certain thyroid volume. To minimise recurrent hyperthyroidism, an ablative approach using a delivered dose of 250 Gy is widely accepted. Beside pretherapeutic T{sub 3} levels, thyroid volume and 24-h thyroid uptake, ATD may influence the outcome of RIT. Today it is accepted by most thyroidologists that, if ATD medication is necessary in overt hyperthyroidism, it should be withdrawn at least 2 days before RIT. In patients with GD and GO, RIT may worsen GO. If RIT is performed in GO it should be done under a 3-month steroid medication regimen. In conclusion, RIT can be considered an appropriate and cost-effective therapy in GD, although the decision regarding treatment should be taken on an individual basis, paying due respect to the course and

  15. Radioiodine therapy in toxic multinodular goiter- the influence of carbimazole therapy and dietary iodine on relapse rates

    International Nuclear Information System (INIS)

    Mitra, S.; Muthu, G.S.

    2007-01-01

    Full text: The relapse rate of radioiodine therapy in toxic multinodular goiter (TMNG) is reported to be around 34% at one year. The effect of antithyroid drugs on the response rate is controversial with studies reporting a higher relapse rate in patients pretreated with antithyroid drugs. Other studies report no influence of pretreatment with antithyroid drugs. The thyroid clinic at Tata Main Hospital is a referral center for thyroid disorders in Jamshedpur. 63 patients of TMNG (Group A) were treated with Radioiodine between 1995-2003. The demographic profile of these patients was as follows: M/F- 38%: 62%, 76% of patients were above 40 years, 85% had been on anti-thyroid drugs for more than 18 months. Fixed dose radioiodine in an oral dose varying from 5-10 mCi was given in all patients of Group A. 32.4 % of patients continued to be toxic or relapsed after a period of euthyroid status within 1 year of Radioiodine therapy. A change in protocol for radioiodine therapy was introduced in 2003. This included withdrawal of antithyroid drugs for one month before radioiodine therapy and the use of noniodized salt and abstinence from seafood in diet during this period. 33 TMN Goiter patients (Group B) followed this protocol before receiving Radioiodine. The dose of Radioiodine remained 5-10 mCi. The age and sex profile of Group A and B were comparable. However, Group B patients had been on antithyroid drugs for a shorter period (p< 0.001). The dose of Radioiodine in 94% of Group B patients was between 7-10mCi, whereas this was 63.4% in Group A. The rest of the patients had received a dose between 5-7 mCi. The relapse rate in Group B was 9.1% compared to 32.4% in Group A. Improvement in response rates with increase in Radioiodine dose remains controversial.P PThe better response rate in Group B patients may be attributed to the withdrawal of antithyroid drugs for one month before therapy and the reduction in dietary intake of Iodine for a month before therapy. However, a

  16. The role of multikinase inhibitors target therapy in radioiodine-resistant differentiated thyroid cancer

    Directory of Open Access Journals (Sweden)

    P O Rumyantsev

    2015-06-01

    Full Text Available About 5-15% of patients with differentiated thyroid cancer (DTC primary or within follow-up have had distant metastases or inoperable tumor mass that are resistant to radioiodine therapy as well as dramatically deteriorate survival prognosis. Other treatment modalities (radiotherapy, chemotherapy etc. also ineffective. Certain expectances are associated with target therapy with multikinase inhibitors with are selectively blocking onco-kinase molecular pathways. This review is devoted to analysis of those multikinase inhibitors which have been implemented in patients with radioiodine DTC. Comparative analysis of two most perspective multikinase inhibitors (sorafenib and lenvatinib with evaluation of efficacy and adverse effects was conducted. Both of them successfully underwent 3 rd phase of clinical trial and were recommended as treatment of choice in progressive radioiodine-resistant DTC patients.

  17. Radioiodine therapy in non-toxic multinodular goitre

    International Nuclear Information System (INIS)

    Miah, S.R.; Rahman, H.

    2007-01-01

    Full text: The effect of radioiodine in the treatment of non-toxic multinodular goitre has not been adequately evaluated. The aim of the study was to see the effect of radioiodine on thyroid size and function in patients with non-toxic multinodular goitre. We prospectively studied 55 non-toxic multinodular goitre patients treated with radioiodine of which 15 were males and 40 were females with age ranged from 25 years to 60 years (mean ± SD 40.45 ± 10.70 years) for a minimum of 12 months. Patients who were selected were those with local compression symptoms or for cosmetic reasons and the treatment was chosen because of a high operative risk or refusal to be operated on. Thyroid volume and T3, T4, TSH of all patients were determined before treatment and 6 months interval after treatment. Radioiodine was given in the dose ranged from 333 MBq (9 mCi) to 555 MBq (15 mCi) (mean ± SD 11.45 ± 2.04 mCi). The mean thyroid volume was reduced from 44.75 ± 37.44 ml to 28.76 ± 27.25 ml at 12 months (p < 0.001) i.e., reduced by 35.73%. Thyroid volume reduction at 6 months was 21.07%. Hypothyroidism occurred in 9.1% of the patients at 12 months. Side effects were few. Three cases developed radiation thyroiditis and two cases developed hyperthyroidism that was managed conservatively. It has been concluded that radioiodine is effective and well tolerated in the treatment of non-toxic multinodular goitre and may be the treatment of choice in elderly patients, in patients in whom surgery is contraindicated and in patients who are unwilling to undergo surgery. (author)

  18. The results of the radioiodine-therapy of benign thyroid diseases respecting the applied radiation dose

    International Nuclear Information System (INIS)

    Maier, C.

    1994-09-01

    452 patients with benign thyroid diseases had been explored after 6 weeks, 6 months, 1 year, 5 years and 10 years after undergone radioiodine treatment retrospectively with regard to the applied radiation dose. A relevant relation between the radiation dose and the rate of hypothyroidism could only be proved as a tendency. Treating hyperthyroidism with radioiodine, the rates of hypothyroidism after therapy were not caused by significantly higher radiation doses. Therefore suggestions to change the used radiation-doses basically cannot be made. The applied doses of radiation are sufficient to achieve a rather satisfactory effect in healing hyperthyroidism. Cases of malignancy after radioiodine therapy could not be found in this population. The effective half-life determination before therapy can be neglected, because there was found a significant difference between the pre-therapeutically estimated half-life and the post-therapeutically measured effective half-life of radioiodine. Instead, fixed values of effective half-life should be used for each group of benign thyroid diseases. The radiation therapy still seems to be an efficient treatment to cure benign thyroid diseases with rare side effects. It also can be applied to patients below the age of 40. Generally it is an alternative to drug-therapy or surgery, always considering the individual relation between gain and risk. In this respect good results can be obtained and a relapse of hyperthyroidism is hardly to expect. (author)

  19. Risk factors for persistent atrial fibrillation following successful hyperthyroidism treatment with radioiodine therapy.

    Science.gov (United States)

    Zhou, Zhen-Hu; Ma, Long-Le; Wang, Le-Xin

    2011-01-01

    To investigate the predicting factors for persistent atrial fibrillation (AF) following radioiodine therapy for hyperthyroidism. Standard 12-lead ECG and 24-h Holter monitoring were performed in 94 patients (38 males, mean age 46.1±8.2 years) with persistent AF following radioiodine therapy for hyperthyroidism. Left ventricular (LV) function was assessed with two-dimensional echocardiography. Euthyroidism or hypothyroidism was achieved in 81% and 19% of the patients, respectively, after radioiodine therapy. At the end of follow-up (1.6±1.3 years), LV ejection fraction in the 52 patients with LV dysfunction was increased from 39.3±3.3% to 59.0±5.5% (ptreatment paroxysmal AF, no AF was documented during the follow-up. In the 45 patients with pre-treatment persistent AF, AF was found in 27 (60%) during the follow-up. Multivariate logistic regression analysis showed that more than 55 years old in age (RR 2.76, 95% CI: 1.16-8.79, phyperthyroidism (RR 3.08, 95% CI: 1.22-11.41, ptreatment atrial fibrillation (RR 2.96, 95% CI: 1.31-7.68, phyperthyroidism and pre-treatment duration of AF are risk factors for persistent AF following radioiodine therapy.

  20. A randomized trial evaluating a block-replacement regimen during radioiodine therapy

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Grupe, Peter; Boel-Jørgensen, Henrik

    2011-01-01

    Eur J Clin Invest 2010 ABSTRACT: Background  Lack of consensus regarding the antithyroid drug regimen in relation to radioiodine ((131) I) therapy of hyperthyroidism prompted this randomized trial comparing two strategies. Design  Patients with Graves' disease (GD, n = 51) or toxic nodular goitre...

  1. Acute effects of radioiodine therapy on the voice and larynx of basedow-Graves patients

    Energy Technology Data Exchange (ETDEWEB)

    Isolan-Cury, Roberta Werlang; Cury, Adriano Namo [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP); Monte, Osmar [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Physiology Department; Silva, Marta Assumpcao de Andrada e [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Speech Therapy School; Duprat, Andre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department; Marone, Marilia [Nuclimagem - Irmanity of the Sao Paulo Santa Casa de Misericordia, SP (Brazil). Nuclear Medicine Unit; Almeida, Renata de; Iglesias, Alexandre [Sao Paulo Santa Casa de Misericordia, SP (Brazil). Medical Science School (FCMSCSP). Otorhinolaryngology Department. Endocrinology and Metabology Unit

    2008-07-01

    Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim of this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. Material and method: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laryngoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). Results: No statistically significant differences were found in voice characteristics in these three conditions. Conclusion: Radioiodine therapy does not affect voice quality. (author)

  2. Acute changes of peripheral thyroid hormone concentrations and serum thyroglobulin during radio-iodine therapy

    International Nuclear Information System (INIS)

    Wilhelm, K.R.; Steinbaecher, M.; Heilig, B.

    1986-01-01

    TT3, FT3 and FT4 concentrations were measured in 28 patients with hyperthyroidism before and during therapy with radioiodine. In addition, in some patients serum thyroglobulin was evaluated, too. Only in the patients with immunogenic hyperthyroidism FT3, FT4 and serum TG were elevated significantly within the first two days after radioiodine application. In the residual patients with diffuse autonomy, autonomous adenoma, and multifocal autonomy during the whole time of investigation there was no significant increase of the respective values. From these data it can be deducted that hyperthyroid storm is more likely to be provoked in patients with immunogenic hyperthyroidism compared to thyroidal autonomy. (orig.) [de

  3. Outcome of radioiodine therapy without, on or 3 days off carbimazole: a prospective interventional three-group comparison

    International Nuclear Information System (INIS)

    Walter, Martin A.; Christ-Crain, Mirjam; Mueller, Beat; Schindler, Christian; Mueller-Brand, Jan

    2006-01-01

    Carbimazole ameliorates hyperthyroidism but reduces radioiodine uptake and adversely affects the outcome of simultaneous radioiodine therapy. We explored whether withdrawal of carbimazole for 3 days can restore the outcome of radioiodine treatment without concurrent exacerbation of hyperthyroidism. By generating three groups with comparable radioiodine uptake, we also investigated whether the effect of carbimazole depends on the radioiodine uptake. Stratified by a radioiodine uptake >30%, 227 consecutive adult patients were prospectively assigned to radioiodine therapy (target dose 200 Gy) without, on or 3 days off carbimazole. Patients were clinically (Crooks-Wayne score) and biochemically (T 3 , fT 4 , TSH) followed up after 3, 6 and 12 months. Primary endpoint was outcome 12 months after radioiodine therapy. A total of 207 patients completed follow-up (toxic nodular goitre, n=117; Graves' disease, n=90). The overall success rate was 71.5%. Patients without and 3 days off carbimazole had similar biochemical (81.4% and 83.3%, respectively; p=0.82) and clinical outcomes [median (range) Crooks-Wayne score 0 (0-16) and 1 (0-10), respectively; p=0.73], which were both higher than in patients on carbimazole [42.6%, p 4 , T 3 and TSH. (orig.)

  4. Functional results of radioiodine therapy with a 300-GY absorbed dose in Graves' disease

    International Nuclear Information System (INIS)

    Willemsen, U.F.; Knesewitsch, P.; Kreisig, T.; Pickardt, C.R.; Kirsch, C.M.

    1993-01-01

    The aim of this study was to assess the results of high-dose radioiodine therapy given to 43 patients with recurrent hyperthyroidism due to Graves' disease between 1986 and 1992. We chose an intrathyroidal absorbed dose of 300 Gy and determined the applied activity individually, which ranged from 240 to 3120 MBq with a median of 752 MBq. Hperthyroidism was eliminated in 86% of cases after 3 months and in 100% after 12 months. No patient required a second radioiodine treatment. The incidnece of hyperthyroidism was 63% after 3 months and 93% after 18 months. Neither the pretherapeutic thyroid-stimulating immunoglobulin level nor the degree of co-existing endocrine ophthalmopathy was correlated with the time at which hypothyroidism developed. Patients with previous radioiodine therapy developed hypothyroidism earlier than patients with previous thyroid surgery. The results show that ablative radioiodine therapy with a 300-Gy absorbed dose is a very effective treatment of hyperthyroidism in Graves' disease, but it should be restricted to patients with recurrent hyperthyroidism combined with severe co-existing disorders or episodes of unfavourable reactions to antithyroid drugs. (orig.)

  5. Functional results of radioiodine therapy with a 300-GY absorbed dose in Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Willemsen, U.F. (Dept. of Nuclear Medicine, Dept. of Radiology, Muenchen (Germany)); Knesewitsch, P. (Dept. of Nuclear Medicine, Dept. of Radiology, Muenchen (Germany)); Kreisig, T. (Dept. of Nuclear Medicine, Dept. of Radiology, Muenchen (Germany)); Pickardt, C.R. (Dept. of Internal Medicine, Muenchen Univ. (Germany)); Kirsch, C.M. (Dept. of Nuclear Medicine, Dept. of Radiology, Muenchen (Germany))

    1993-11-01

    The aim of this study was to assess the results of high-dose radioiodine therapy given to 43 patients with recurrent hyperthyroidism due to Graves' disease between 1986 and 1992. We chose an intrathyroidal absorbed dose of 300 Gy and determined the applied activity individually, which ranged from 240 to 3120 MBq with a median of 752 MBq. Hperthyroidism was eliminated in 86% of cases after 3 months and in 100% after 12 months. No patient required a second radioiodine treatment. The incidnece of hyperthyroidism was 63% after 3 months and 93% after 18 months. Neither the pretherapeutic thyroid-stimulating immunoglobulin level nor the degree of co-existing endocrine ophthalmopathy was correlated with the time at which hypothyroidism developed. Patients with previous radioiodine therapy developed hypothyroidism earlier than patients with previous thyroid surgery. The results show that ablative radioiodine therapy with a 300-Gy absorbed dose is a very effective treatment of hyperthyroidism in Graves' disease, but it should be restricted to patients with recurrent hyperthyroidism combined with severe co-existing disorders or episodes of unfavourable reactions to antithyroid drugs. (orig.)

  6. Cost-effectiveness-analysis: radioiodine or antithyroid drugs as first-line therapy of hyperthyroidism due to Graves' disease

    International Nuclear Information System (INIS)

    Dietlein, M.; Moka, D.; Dederichs, B.; Schicha, H.; Hunsche, E.; Lauterbach, K.W.

    1999-01-01

    Aim: As first-line therapy of hyperthyroidism caused by Graves' disease antithyroid drugs are favoured in Europe, while radioiodine therapy is favoured in the USA. Radioiodine therapy has become more economic in Germany since the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines. Method: Sensitivity analyses took into account the long-term relapse rate of conservative or radioiodine therapy, use of diagnostic tests, level of health insurance, drops in productivity and a discount factor. Costing models included the costs of follow-up care over 30 years. The costs of the hospitalisation for radioiodine therapy were calculated for 300 patients, discharged with 250 MBq I-131 residual activity. Result: Antithyroid drugs were considered cost-effective when they achieved relapse rate of 50% or less, a cut in the number of tests needed and reduced working hours. Failure to meet any one of these conditions makes primary radioiodine therapy more cost-effective in 1593 of 1944 calculated costing models. Repeated conservative therapies will increase clearly the overall costs. Conclusion: Radioiodine is a cost-effective, first-line therapy in patients with a special risk of relapse after primary conservative therapy (goitre, younger patient, persistent elevated TSH-receptor-antibodies or Tc-uptake). (orig.) [de

  7. Outcome of radioiodine therapy without, on or 3 days off carbimazole: a prospective interventional three-group comparison

    Energy Technology Data Exchange (ETDEWEB)

    Walter, Martin A. [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland); University Hospital Basel, Division of Endocrinology, Diabetology and Clinical Nutrition, Basel (Switzerland); Christ-Crain, Mirjam; Mueller, Beat [University Hospital Basel, Division of Endocrinology, Diabetology and Clinical Nutrition, Basel (Switzerland); Schindler, Christian [University Hospital Basel, Institute of Social and Preventive Medicine, Basel (Switzerland); Mueller-Brand, Jan [University Hospital, Institute of Nuclear Medicine, Basel (Switzerland)

    2006-06-15

    Carbimazole ameliorates hyperthyroidism but reduces radioiodine uptake and adversely affects the outcome of simultaneous radioiodine therapy. We explored whether withdrawal of carbimazole for 3 days can restore the outcome of radioiodine treatment without concurrent exacerbation of hyperthyroidism. By generating three groups with comparable radioiodine uptake, we also investigated whether the effect of carbimazole depends on the radioiodine uptake. Stratified by a radioiodine uptake >30%, 227 consecutive adult patients were prospectively assigned to radioiodine therapy (target dose 200 Gy) without, on or 3 days off carbimazole. Patients were clinically (Crooks-Wayne score) and biochemically (T{sub 3}, fT{sub 4}, TSH) followed up after 3, 6 and 12 months. Primary endpoint was outcome 12 months after radioiodine therapy. A total of 207 patients completed follow-up (toxic nodular goitre, n=117; Graves' disease, n=90). The overall success rate was 71.5%. Patients without and 3 days off carbimazole had similar biochemical (81.4% and 83.3%, respectively; p=0.82) and clinical outcomes [median (range) Crooks-Wayne score 0 (0-16) and 1 (0-10), respectively; p=0.73], which were both higher than in patients on carbimazole [42.6%, p<0.001; Crooks-Wayne score 3 (0-30), p<0.03]. Time to achieve cure was delayed on carbimazole. No changes in thyroid hormone levels occurred after 3 days' discontinuation of carbimazole. Logistic regression revealed that all observed cure rates were independent of entity, sex, age, thyroid volume, radioiodine uptake, radioiodine half-life, fT{sub 4}, T{sub 3} and TSH. (orig.)

  8. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. (Univ. of Pisa (Italy))

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

  9. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A.

    1989-01-01

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment

  10. Radioiodine therapy within the German DRG-system 2005; Die Radioiodtherapie im DRG-System 2005

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, R. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Wuerzburg (Germany); Dressler, J. [Nuklearmedizinische Klinik Henriettenstiftung, Hannover (Germany)

    2005-06-01

    With introduction of a diagnosis-related groups system (DRG-system) in Germany the previous duration of stay based refunding is also replaced for the radioiodine therapies by a performance oriented reimbursement system. Since the at first optional start of the DRG-system in 2003 the adaptations which take place every year should lead, up to the planned end of the convergence phase in 2009, to a transparent, fair and economical financing system of the stationary hospital service. The physician is responsible for the right and complete coding of the diagnoses and procedures, which serve as essential parameters for the determination of the diagnosis related group (DRG) of a hospital case. In the actual version of the year 2005 the DRG-system still supplies for radioiodine therapy of thyroid carcinoma some unclarity in the coding of the diagnosis, as well as clear inadequacy with the fair mapping of the therapy costs. (orig.)

  11. Radioiodine Therapy Does Not Change the Atherosclerotic Burden of the Carotid Arteries

    DEFF Research Database (Denmark)

    La Cour, Jeppe Lerche; Andersen, Ulrik Bjørn; Sørensen, Christian Hjort

    2016-01-01

    of cerebrovascular events has been reported after radioiodine therapy. This study aimed to examine whether atherosclerosis develops early or late after radioiodine therapy of benign thyroid disease. METHOD: Patients treated for benign thyroid disorders (nontoxic goiter, adenoma, and hyperthyroidism) were examined...... effects, there was no difference in CIMT (p = 0.25) or presence of plaques (p = 0.70) between those treated with radioactive iodine and those treated with surgery (9.8 and 5.6 years since treatment, respectively). Furthermore, the level of thyrotropin (TSH) did not influence these atherosclerosis markers....... CONCLUSION: No early changes in CIMT were detected in patients treated with radioactive iodine for benign thyroid disease. No signs of late effects of radioactive iodine on CIMT or plaque presence were found after 10 years of follow-up. The radiation to the carotid arteries by radioactive iodine therapy...

  12. Influence of low- and high-dose radioiodine therapy on oxidative modification of fibrinogen

    International Nuclear Information System (INIS)

    Schweeger-Exeli, I.J.

    2001-10-01

    Fibrinogen plays a central role in the course of thrombosis and hemostasis. It is soluble in blood and tissue extracts and transformed into the insoluble fibrin network structure in the presence of thrombin. Fibrinogen in circulating blood consists of a population of slightly different molecules with a half-life of 3.5-4.5 days. Various environmental conditions may cause different types of modifications of the molecule leading to a different functional behavior. Introduction of carbonyl groups in amino acid side chains is known as a marker for protein oxidation. Radioiodine therapy, applied in patients suffering from hyperthyroidism or differentiated thyroid carcinoma, may cause an oxidative modification of fibrinogen by formation of free radicals in blood exposed to the radioactive agent 131I. The topic of my thesis was i. to develop a simple and not time consuming method for isolation of fibrinogen from small volumes of human plasma (∼ 6ml), ii. to assess, whether radioiodine therapy causes detectable introduction of carbonyl groups into the fibrinogen molecule, and iii. to analyze an association between thyroid hormone function, fibrinogen levels and protein oxidation by means of carbonyl content. Purification of fibrinogen from human plasma was possible by three different methods (ammonium sulphate/ethanol; glycine/ethanol; glycine). Plasma levels of fibrinogen (Clauss method) and protein carbonyl group content (2,4-DNPH - assay) were determined before and after radioiodine therapy. The results demonstrate a significant increase (p = 0.05) in carbonyl content of human fibrinogen in cancer patients treated with 131I. However, in patients with diagnosed hyperthyroidism values were not significantly altered. In carcinoma patients, baseline fT4 levels and the relative increase in carbonyl content of fibrinogen after radioiodine therapy were correlated (r = 0.83; p 0.005), whereas no such correlation was found in patients with hyperthyroidism. Plasma fibrinogen

  13. Effect of radioiodine therapy on pulmonary metastases from well-differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Yu Yongli; Jin Changqing; Chen Libo; Lu Hankui; Zhu Ruisen

    2002-01-01

    Objective: To investigate effect of radioiodine therapy on pulmonary metastases from well-differentiated thyroid cancer. Methods: Fifty-eight cases of pulmonary metastases were studied utilizing chest X-ray, pulmonary function test and 99 Tc m -DTPA aerosol clearance examination. Results: The data of pulmonary function test were of no difference between groups of various radiation doses cumulation (P > 0.05). The differences of vital capacity (VC), fast vital capacity (FVC) and forced expiratory volume in one second (FEV 1 ) were not remarkable between the two groups of male or female patients (P > 0.05), but the difference of maximal volume ventilation (MVV) was P 99 Tc m -DTPA aerosol clearance rates between various groups were of no difference (P > 0.05). Only for one female, 43 years old who had received an accumulative dose of 51.8 GBq radioiodine over an 8-yr period, her pulmonary function test showed evidence of restrictive lung disease, chest X-ray showed haziness and DTPA half-time clearance was 26.4 min, which is suggestive of interstitial fibrosis. Conclusion: The cumulative dose of radioiodine and gender of the patients had not statistically significant effects on the pulmonary function. Interstitial fibrosis must be carefully watched when the cumulative radioiodine dose is over 37 GBq

  14. Changes in the thyroid hormone level and blood profile after radioiodine therapy in Graves' disease

    International Nuclear Information System (INIS)

    Ogbac, R.V.

    2007-01-01

    Full text: Exacerbation of hyperthyroidism has been reported to occur as early as 3 days after administration of radioiodine (I-131) therapy. The hematological effects of radioiodine also have been reported but mainly confined in thyroid cancer cases wherein high doses are administered. This study was undertaken to determine the possible acute changes in the thyroid hormone concentration and blood picture of patients one week after therapy. Twelve hyperthyroid patients (8 females, 4 males), with ages ranging from 27-56 years, were followed with measurements of serum thyroid hormone levels and blood profile a week after I-131 therapy. All patients were pretreated with antithyroid medications. Radioiodine doses given ranged from 8 mCi up to 16 mCi, all based from the computed dose of 160 uCi/g. Only two out of twelve (2/12) exhibited an increase in FT3 level. Two patients showed a decrease while the remaining 8 patients showed no significant difference. Six out of 12 (50%) exhibited an increase in FT4 level. Five patients showed a decrease while only one had no significant difference. Hematologically, there were 5/12, 1/12, 3/12, 5/12 and 1/12 patients who showed a decrease in hemoglobin, hematocrit, RBC, WBC and platelet counts, respectively. Four out of 12, 2/12, and 1/12 patients, however, showed an increase in hemoglobin, RBC and platelet, respectively. The rest exhibited no significant change. FT4 level was observed to be more affected than FT3 levels but there was no consistent pattern established. A significant decrease in WBC count was observed. Although a high percentage of decreased hemoglobin was noted, no pattern was established. Radioiodine therapy caused no significant increase of serum FT3 and FT4 concentrations in the majority of patients after one week of therapy. In the followup of patients, determination of complete blood count of patients is also important. (author)

  15. The Effect of High Dose Radioiodine Therapy on Formation of Radiation Retinopathy During Thyroid Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Tülay Kaçar Güvel

    2014-10-01

    Full Text Available Objective: Non-thyroidal complication of high-dose radioiodine therapy for thyroid carcinoma might cause salivary and lacrimal gland dysfunction, which may be transient or permanent in a dose-dependent manner. However, radiation retinopathy complicating 131I therapy, has not been previously well characterized. The aim of this study was to evaluate the extent of retinal damage among patients who had received high doses of radioiodine treatment. Methods: Forty eyes of 20 patients (3 male, 17 female who received 250-1000 mCi during 131I therapy and on ophthalmological follow up for a year after the last treatment were included in the study. Mean age of the study group was 50 years (range 25-70 years. In ophthalmologic examination, visual acuity was measured in order to determine visual loss. Intraocular pressure was measured in all the patients. Then lens examination was carried out with slit lamp biomicroscopy in order to investigate cataract or partial lens opacities. Fundus observation was carried out through the dilated pupil with slit lamp biomicroscopy using 90 D noncontact lens. Result: The best corrected visual aquity with Snellen chart was found as 1.0 in 36 eyes (90% and between 0.6 and 0.9 (10% in 4 eyes (10%. At the biomicroscopic fundus examination, retinal hemorrhage consistent with radiation retinopathy, microaneurysm, microinfarction, edema or exudation, vitreus hemorrhage, partial or total optical disc pallor indicating papillopathy in the optic disc were not observed in any of the eyes. Conclusion: This result indicates that there is not any significant correlation between repeated high-dose radioiodine therapy and radiation retinopathy in differentiated thyroid carcinomas. Even though there is not a significant restriction in use of higher doses of radioiodine therapy in differentiated thyroid carcinoma, more extensive studies are needed in order to obtain more accurate data on possible occurrence of retinopathy.

  16. Radioiodine therapy in veterinary medicine: treatment of hyperthyroidism in a cat

    International Nuclear Information System (INIS)

    Reinartz, P.; Sabri, O.; Zimny, M.; Buell, U.

    1999-01-01

    A nine-year-old cat with symptoms of a distinct hyperthyroidism was presented at the University Hospital of the RWTH Aachen. The clinical symptoms as well as the diagnostic procedures performed at the hospital confirmed the diagnosis. After five weeks of thyreostatic medication a regular metabolism of the thyroid gland was established, followed by a radioiodine therapy with 70.3 MBq 131-iodine. Subsequently, the cat was hospitalized for two days before it could be released in good condition. Six weeks after treatment the former drastically reduced weight of the cat recovered to near normal. Even though the chemical analysis detected a discrete hyperthyroidism, clinical symptoms were no longer prominent. Three months after treatment, the final examination showed a regular metabolism of the thyroid gland without a specific thyroidal medication. The presented case illustrates that radioiodine therapy is a safe and efficient treatment of thyroidal dysfunctions in veterinary medicine. (orig.) [de

  17. Thyroid volume reduction following radioiodine therapy in patients with autonomous goitre and Graves' disease

    International Nuclear Information System (INIS)

    Dederichs, B.; Otte, R.; Klink, J.E.; Schicha, H.

    1996-01-01

    Aim: It is well known that radioiodine therapy (RITh) leads to a significant thyroid volume reduction (TVR). But until now only little data has been presented due to the course of time and the extent of TVR. Method: Therefore the data of 33 patients with Graves' disease (GD), 36 patients with multifocal (MAG) and 31 with solitary (SAG) autonomous goitre were analyzed retrospectively. Results: All the patients showed a highly significant (p [de

  18. [Results of radioiodine therapy in different forms of hyperthyroidism in relation to the planned dosage].

    Science.gov (United States)

    Moser, E

    1992-07-01

    The aim of this study was to assess the efficacy of radioiodine therapy (131J) in a large group (n = 925) of hyperthyroid patients treated at two major departments of nuclear medicine (Freiburg, abbr. FR, and Munich, abbr. M). 761 patients suffered from non-immunogenic hyperthyroidism (Plummer's disease) and the remaining 164 patients from immunogenic hyperthyroidism (Graves' disease). In these cases, radioiodine therapy using doses between 60 and 80 Gy proved ineffective, FR (80 Gy) recording 28% success and M (60 Gy) 54%. A dose of 150 Gy, however, is successful in more than 80% of the cases: FR 81%, M86%. However, the incidence rate of hypothyroidism increases consecutively with 150 Gy: FR 49%, M 62%. In patients suffering from Plummer's disease, the solitary autonomous nodule can be eliminated by radioiodine therapy (400 Gy) with a high rate of success (95%); the same applies to multinodular autonomous adenomas. The therapeutic concept applying a dose of 400 Gy to the total functional autonomous tissue (delineated by ultrasound) yields slightly better results (95%) than 150 Gy applied to thyroid gland (M88%, FR82%). This dosimetric compromise is a practicable alternative which is tolerably successful. In patients suffering from disseminated non-immunogenic hyperthyroidism, a dose of 150 Gy applied to the entire organ succeeds in 85% of the cases. The rate of hypothyroidism resulting from these dose recommendations is the lesser evil compared to residual or recurrent hyperthyroidism, since hypothyroid patients can be treated without any problem with thyroid hormones.

  19. Functional impairment of the salivary gland after high dose radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Spiegel, W.; Reiners, C.; Boerner, W.

    1986-06-01

    Radiation induced impairements of salivation, which are rather related to the more radio-sensitive parotides than to the submandibular glands according to our experience, occur in about 1/3 of the patients treated with 7,4-11,1 GBq (200-300 mCi) of I-131. Based on our results and experiences after percutaneous radiation therapy of the head and neck region, a total xerostomy (Sicca's syndrome) must already be expected at a focal dose of 40 Gy to the salivary gland parenchyma. Experience has shown that this cumulative radiation dose is reached at about 18,5 GBq (500 mCi) of I-131. The acute sialadenitis occuring a few days after therapeutic administration of radioiodine is mostly associated with minor complaints and therefore often escapes the patient's notice. During the onset of xerostomy, which is associated with a moderate reduction of salivation, the patients are surprisingly indolent. However, specific examinations including patient's history, palpation and functional scintigraphy enable early detection of radiation induced functional depression of the salivary glands, which should be accounted for in the assessment of indication for further radioiodine therapy. To prevent the severe consequences of xerostomy such as ageusia, dysphagia, epithelial lesion of the oral mucosa and loss of teeth, the patients under radioiodine therapy should be urged to see to sufficient fluid supply and to steadily stimulate salivation e.g. by sour drops, chewing gum or Emser pastilles.

  20. Effectiveness of radioiodine therapy in treatment of hyperthyroidism.

    Science.gov (United States)

    Alam, M N; Chakrabarty, R K; Akhter, M; Nahar, N; Swapan, M K; Alam, M M; Nahar, R; Sultana, N; Hallaz, M M; Alam, M M; Uddin, M M; Hossain, M A; Yasmin, S; Islam, M R

    2013-10-01

    The present non randomized clinical trial was conducted in the Center for Nuclear Medicine and Ultrasound, Mymensingh, Bangladesh for duration of one year. Total 30 patients with hyperthyroidism diagnosed by clinical and biochemical profile were included in the study. All patients received radioiodine treatment and regular follow up at 1st month, 3rd month, 6th month & 9th month were done to evaluate clinical and biochemical status and complications. Data were analyzed by computer with SPSS programme using 't' test and chi-square test. In the present study, out of 30 respondents more than three fourth of the respondents (76.6%) were in the age group of 31-50 years followed by less than 30 years are group (16.7%) and rest of respondents were in the age group of more than 50 years (06.7%). Mean±SD and range of age of the respondents were 39.80±10.02 years and 17-65 years respectively. Among the 30 respondents 11(36.7%) were male and 19(63.3%) were female. Male to female ratio was 1:1.73. Out of 30 patients 26(86.7%) presented with goiter and among them 21(80.8%) has diffused goiter and five (19.2%) had nodular goiter. Baseline mean±SD, median, range of serum T₃ level were 5.24±3.62, 4.34, 1.48-14.65nmol/L respectively. Base line mean±SD, median range of serum T₄ level were 192.25±99.17, 201.77, 1.75-336.25nmol/L respectively. Baseline mean±SD, median range of serum TSH level were 6.33±23.93, 0.15-0.07, 130.46nmol/L respectively. In the present study serum T₃, T₄ level among the respondents sharply decrease from baseline to 2nd follow up then gradually decrease from 2nd to 4th follow up. Serum TSH level gradually increases from baseline to 3rd follow up and then gradually decreases from 3rd to 4th follow up. The result showed radioiodine is an effective option for the treatment of thyrotoxicosis.

  1. Dosimetry in radioiodine therapy of benign thyroid diseases. Background and practice; Dosimetrie bei Radioiodtherapie benigner Schilddruesenerkrankungen. Hintergrund und Durchfuehrung

    Energy Technology Data Exchange (ETDEWEB)

    Bockisch, A.; Sonnenschein, W.; Jentzen, W.; Hartung, V.; Goerges, R. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin

    2008-09-15

    Radioiodine therapy of benign thyroid diseases (focal = [toxic adenoma], multifocal, disseminated autonomy, Grave's disease or clinical relevant goitre) needs to be and can be performed individually for each patient. Most frequently a radioiodine test is performed applying a small activity of iodine-131 ({sup 131}I). The paper discusses some protocols for pre- or posttherapeutic dosimetry and discusses their advantages and disadvantages. All are based on the volumetry of the target tissue as well as the radioiodine kinetics in the target volume what may be represented by maximum uptake and half life of iodine retention in the thyroid. Possible disturbances and measuring uncertainties of these parameters are presented and discussed. In spite of the discussed uncertainties in dosimetry, due to its high therapeutic width radioiodine therapy is a very successful procedure to cure hyperthyroidism or to reduce goitre volume with only little side effects. (orig.)

  2. Long-term impairment of the lacrimal glands after radioiodine therapy: a cross-sectional study

    International Nuclear Information System (INIS)

    Zettinig, Georg; Fueger, Barbara J.; Pirich, Christian; Dudczak, Robert; Hanselmayer, Georg; Nepp, Johannes; Hofmann, Andrea

    2002-01-01

    Impairment of the lacrimal glands after external radiation has been well documented, but there are only a few reports on the effects of radioiodine therapy on the lacrimal glands. Long-term effects of high-dose radioiodine therapy on tear secretion have not previously been studied. We investigated 175 eyes of 88 patients with a history of radioiodine therapy for thyroid carcinoma (68 females, 20 males; mean age 55±16 years, range 17-81 years) and compared them with a sex- and age-matched control group (n=39). All patients had been given at least 2.96 GBq iodine-131 (maximal administered activity 22.3 GBq 131 I). An ophthalmological investigation was performed 64±71 months (range 3-317 months) after initial radioiodine therapy by a single ophthalmologist. Lacrimal gland function was evaluated with three different function tests. External eye morphology was considered, and detailed ophthalmological history-taking was performed. Patients with factors known to affect lacrimal gland function (contact lenses, autoimmune disorders, history of additional radiation exposure) were excluded from the study. A total of 81 patients (92%) had at least one abnormal function test indicating impaired lacrimal gland function. Schirmer's tear test was decreased (<10 mm/5 min) in 47 of the 88 patients and definitely abnormal (<5 mm/5 min) in 35 patients. A tear film break-up time of <10 s was found in 78 patients, and 62 patients had a definitely abnormal break-up time of <5 s. The lacrimal lipid layer was impaired in 43 patients. The function tests were all significantly altered in the study group as compared with the controls (P<0.005, P<0.001, P<0.001, respectively). Both subjective symptoms of dry eye (P<0.01) and changes in the external eye morphology (P<0.001) were significantly more prevalent in the study group. Our findings suggest that in the majority of patients, lacrimal gland function may be permanently impaired after high-dose radioiodine therapy. All three layers of the

  3. A mathematical model of optimized radioiodine-131 therapy of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Doi, Suhail AR; Loutfi, Issa; Al-Shoumer, Kamal AS

    2001-01-01

    The current status of radioiodine-131 (RaI) dosimetry for Graves' hyperthyroidism is not clear. Recurrent hyperthyroidism and iatrogenic hypothyroidism are two problems which interact such that trying to solve one leads to exacerbation of the other. Optimized RaI therapy has therefore begun to be defined just in terms of early hypothyroidism (ablative therapy) as physicians have given up on reducing hypothyroidism. Optimized therapy is evaluated both in terms of the greatest separation of cure rate from hypothyroidism rate (non-ablative therapy) or in terms of early hypothyroidism (ablative therapy) by mathematical modeling of outcome after radioiodine and critically discussing the three common methods of RaI dosing for Graves' disease. Cure follows a logarithmic relationship to activity administered or absorbed dose, while hypothyroidism follows a linear relationship. The effect of including or omitting factors in the calculation of the administered I–131 activity such as the measured thyroid uptake and effective half-life of RaI or giving extra compensation for gland size is discussed. Very little benefit can be gained by employing complicated methods of RaI dose selection for non-ablative therapy since the standard activity model shows the best potential for cure and prolonged euthyroidism. For ablative therapy, a standard MBq/g dosing provides the best outcome in terms of cure and early hypothyroidism

  4. New Molecular Targeted Therapy and Redifferentiation Therapy for Radioiodine-Refractory Advanced Papillary Thyroid Carcinoma: Literature Review

    Directory of Open Access Journals (Sweden)

    Kai-Pun Wong

    2012-01-01

    Full Text Available Although the majority of papillary thyroid carcinoma could be successfully managed by complete surgical resection alone or resection followed by radioiodine ablation, a small proportion of patients may develop radioiodine-refractory progressive disease which is not amenable to surgery, local ablative treatment or other treatment modalities. The use of FDG-PET/CT scan for persistent/recurrent disease has improved the accuracy of restaging as well as cancer prognostication. Given that patients with RAI-refractory disease tend to do significantly worse than those with radioiodine-avid or non-progressive disease, an increasing number of phase I and II studies have been conducted to evaluate the efficacy of new molecular targeted drugs such as the tyrosine kinase inhibitors and redifferentiation drugs. The overall response rate of these drugs ranged between 0–53%, depending on whether the patients had been previously treated with these drugs, performance status and extent of disease. However, drug toxicity remains a major concern in administration of target therapies. Nevertheless, there are also ongoing phase III studies evaluating the efficacy of these new drugs. The aim of the review was to summarize and discuss the results of these targeted drugs and redifferentiation agents for patients with progressive, radioiodine-refractory papillary thyroid carcinoma.

  5. Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

    International Nuclear Information System (INIS)

    Koerber, C.; Schneider, P.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, C.

    2001-01-01

    There is controversy over the factors that may influence the outcome of radioiodine therapy for benign thyroid diseases. Antithyroid medication has been claimed to negatively influence the effectiveness of radioiodine therapy in Graves' disease. In a longitudinal study, we assessed the influence of sex, age, antithyroid drugs, target radiation dose, target mass, applied activity, delivered dose, interval between last meal and application, and TSH, FT 3 and FT 4 levels on the outcome of radioiodine therapy. One hundred and forty-four patients (111 female, 33 male) suffering from Graves' disease (GD) and 563 patients (434 female, 129 male) with toxic nodular goitre (TNG) were entered in the study and followed up until 8 months after therapy. Treatment was defined as successful when the TSH level was found to be normal or elevated. Ninety-eight GD patients and 418 TNG patients were successfully treated. Forward stepwise multiple regression analysis models retained only the target mass in GD and the applied activity in TNG as significantly associated with the outcome of therapy. The predictive value of all variables involved was extremely low in both disease groups. Whereas concomitant antithyroid medication had no influence in GD, it adversely influenced radioiodine therapy of TNG. This effect may be attributed to a radioiodine ''steal phenomenon'' induced by TSH-stimulated normal thyroid tissue, which causes overestimation of the uptake in toxic nodules. (orig.)

  6. Antithyroid drugs as a factor influencing the outcome of radioiodine therapy in Graves' disease and toxic nodular goitre?

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, C.; Schneider, P.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, C. [Wuerzburg Univ. (Germany). Abt. fuer Nuklearmedizin

    2001-09-01

    There is controversy over the factors that may influence the outcome of radioiodine therapy for benign thyroid diseases. Antithyroid medication has been claimed to negatively influence the effectiveness of radioiodine therapy in Graves' disease. In a longitudinal study, we assessed the influence of sex, age, antithyroid drugs, target radiation dose, target mass, applied activity, delivered dose, interval between last meal and application, and TSH, FT{sub 3} and FT{sub 4} levels on the outcome of radioiodine therapy. One hundred and forty-four patients (111 female, 33 male) suffering from Graves' disease (GD) and 563 patients (434 female, 129 male) with toxic nodular goitre (TNG) were entered in the study and followed up until 8 months after therapy. Treatment was defined as successful when the TSH level was found to be normal or elevated. Ninety-eight GD patients and 418 TNG patients were successfully treated. Forward stepwise multiple regression analysis models retained only the target mass in GD and the applied activity in TNG as significantly associated with the outcome of therapy. The predictive value of all variables involved was extremely low in both disease groups. Whereas concomitant antithyroid medication had no influence in GD, it adversely influenced radioiodine therapy of TNG. This effect may be attributed to a radioiodine ''steal phenomenon'' induced by TSH-stimulated normal thyroid tissue, which causes overestimation of the uptake in toxic nodules. (orig.)

  7. Pretreatment with betamethasone of patients with Graves' disease given radioiodine therapy: thyroid autoantibody responses and outcome of therapy

    International Nuclear Information System (INIS)

    Gamstedt, A.; Karlsson, A.

    1991-01-01

    The effects of betamethasone on thyroid autoantibody responses and outcome of radioiodine therapy were determined over a period of 1 yr in a prospective randomized study of 40 patients with Graves' disease. Twenty patients were given placebo tablets, and 20 patients were treated with betamethasone from 3 weeks before until 4 weeks after 131 I therapy. At the time of inclusion in the study, the mean serum concentrations of TSH receptor antibodies, thyroid peroxidase antibodies, and thyroglobulin antibodies (TgAb) were increased in both groups. Three weeks of treatment with betamethasone reduced the thyroid peroxidase antibody and TgAb titers as well as the serum concentrations of thyroid hormones. A decrease in the TSH receptor antibody level was not statistically significant. After radioiodine therapy, transient increases in thyroid autoantibody levels were observed. The titers of the different antibodies generally changed in parallel. In some patients a detectable level of a given antibody was found only after the radioiodine treatment, and in two cases, TgAb did not appear at all, although the two other antibodies increased temporarily. Betamethasone delayed, but did not abolish, the 131 I-induced antibody peaks. Betamethasone also caused a reduction in the total serum immunoglobulin G, a reduction which persisted throughout the study period. When the study ended, 17 patients given placebo and 9 patients given betamethasone were receiving replacement therapy due to the development of hypothyroidism. These patients at this point in time had lower antibody levels than those not requiring T4. The results of this study demonstrate that betamethasone reduces and modifies the thyroid autoantibody responses as well as the outcome of radioiodine therapy in patients with Graves' disease

  8. Routine sensor-augmented pump therapy in type 1 diabetes

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten; Scaramuzza, Andrea; Bratina, Natasa

    2013-01-01

    Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia.......Sensor-augmented pump (SAP) therapy can improve glycemic control, compared with multiple daily insulin injections or with insulin pump therapy alone, without increasing the risk of hypoglycemia....

  9. Sensor-augmented pump therapy at 36 months

    DEFF Research Database (Denmark)

    Schmidt, Signe; Nørgaard, Kirsten

    2012-01-01

    This follow-up study investigates the metabolic and psychosocial effects of sensor-augmented pump (SAP) therapy in adults with type 1 diabetes 36 months after therapy start.......This follow-up study investigates the metabolic and psychosocial effects of sensor-augmented pump (SAP) therapy in adults with type 1 diabetes 36 months after therapy start....

  10. Three-year follow-up of 500 patients with Graves' disease after radioiodine therapy

    International Nuclear Information System (INIS)

    Chen Yonghui; Jin Xiaona; Luo Yaping; Li Fang

    2012-01-01

    Objective: To investigate the incidence of early hypothyroidism and factors affecting the treatment effect of radioiodine therapy for Graves' disease (GD) at 3 years after treatment. Methods: Five hundred cases of GD were retrospectively studied. The mean age was (39.3±12.6) y, with a female to male ratio of 5 : 1. Data including symptoms, signs, blood tests, radioactive iodine uptake (RAIU), effective half-life, radioiodine doses, remission rates and hypothyroidism incidences were collected. Early hypothyroidism was also recorded. Student's t-test, χ 2 test and logistic regression were performed. Results: Three months after radioiodine therapy, the remission rate of GD was 63.8% (319/500). The hypothyroidism incidence was 36.6% (183/500). Six months after radioiodine therapy, the remission rate was 67.8% (339/500). The hypothyroidism incidence was 43.4% (217/500). Nine months after radioiodine therapy, the remission rate was 70.0% (350/500). The hypothyroidism incidence was 39.4% (197/500). One year after radioiodine therapy, the remission rate was 72.6% (363/500). The hypothyroidism incidence was 38.2% (191/500). Two years after radioiodine therapy, the remission rate was 79.6% (398/500). The hypothyroidism incidence was 40.8% (204/500). Three years after radioiodine therapy, the remission rate was 90.8% (454/500). The hypothyroidism incidence was 46.0% (230/500). Eighty-four cases were retreated (16.8%) due to treatment failure. Early hypothyroidism occurred in 260 cases. Among them, seventy cases were rendered euthyroid (26.9%). One hundred and seventy-eight cases still persisted in hypothyroidism while twelve cases relapsed during the second and third year. One hundred and ninety-two cases achieved euthyroidism and two hundred cases became hypothyroid three years after treatment. They were classified as a success group. The retreated eighty-four cases were classified as a failure group. ATD therapy (χ 2 =16.758, P<0.01), TRAb (t=-2.074, P=0

  11. Efficiency of radioiodine therapy in Graves disease and adenoma toxicum and incidence of hypothyroidism

    International Nuclear Information System (INIS)

    Petrovski, Z.P.

    2002-01-01

    The aim of the this study was to evaluate different states in hyperthyroid patients and incidence of hypothyroidism after I-131 therapy.We observed a total of 184 hyperthyroid pts, from which 108(58,7%)pts with Graves' disease,65(35,3%)pts with single toxicum nodule and 11(6%)pts with toxicum multinodular goitre,treated with radioiodine therapy during the period 1986-2001.Dose of I-131 orally administered ranged 150-1100MBq and was calculated according to the 'MBq/gram' method.The radioiodine-131 therapy was performed once in 69,5%(128/184)pts,twice in 21,2%(39/184)pts and in 9,3%(17/184)pts more than two doses. Completely cured of hyperthyroidism occurred in 61%(66/108)pts with Graves' disease,81,8%(9/11)pts with toxic multinodular goiter and 90,7%(59/65)pts with single toxic nodule. The patients in our study were evaluated 6 months to 15 years after received J-131 therapy. Incidence of early hypothyroidism within one year was 23,1%(25/108) in Graves' disease,9%(1/11) in toxic multinodular goiter and 4,6%(3/65) with single toxicum nodule.Overall incidence of hypothyroidism within one year was 17,6% and had cumulative increase of Graves' disease every following year approximately for 3%,while for adenoma toxicum there was no any significant changes. We concluded that radioiodine therapy is simple,comfortable radical method for medical treatment of hyperthyroidism and indicate higher incidence of hypothyroidism in patients treated with I-131 for Graves' disease than that of patients treated for toxicum multinodular goiters and single toxic nodule

  12. Synthetic prevention and treatment for hypothyroidism after radioiodine therapy hyperthyroidism

    International Nuclear Information System (INIS)

    Li Shiyun

    2004-01-01

    Hypothyroidism is main complication after 131 I therapy for hyperthyroidism in Graves' disease. The hypothyroidism restricts its popular application that 131 I treatment for Graves' disease. In clinic practice, different factors of every patient, involved case selection, sensitivity estimation, unite using medicine before 131 I therapy are analysed, and synthetic measures for posttreatment examination, transient hypothyroidism and permanent hypothyroidism after 131 I therapy are discussed

  13. Graves' disease and radioiodine therapy. Is success of ablation dependent on the choice of thyreostatic medication?

    International Nuclear Information System (INIS)

    Kobe, C.; Weber, I.; Eschner, W.; Sudbrock, F.; Schmidt, M.; Dietlein, M.; Schicha, H.

    2008-01-01

    Aim: this study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease. Patients, material, methods: a total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months offer RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved. Results: relief from hyperthyroidism was achieved in 96% of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p = 0.22). Conclusion: thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy. (orig.)

  14. Radioiodine therapy for hyperthyroidism - changing pattern of management over three decades at INMAS

    International Nuclear Information System (INIS)

    Ravi Shankar, L.; Prakash, R.; Sharma, S.K.; Khanna, C.M.

    1990-01-01

    Iodine-131 therapy is a relatively simple effective and economical method of treating hyperthyroidism. Even fifty years after the introduction of radioactive iodine, there is no concensus on the approach for selection of the dose for treatment of hyperthyroidism. Since the last three decades, the approach for radioiodine therapy at this Institute has been to treat with low, fractionated doses to produce partial destruction of the thyroid gland leaving the patient sufficient functioning gland for normal hormone production. New in vitro diagnostic techniques including free T 3 , T 4 and sensitive TSH assay have been introduced over the past decade for the diagnosis of hyperthyroidism. Changes in the thyroid radioactive iodine uptake in the population due to introduction of iodized salt, and the high incidence of persistent hyperthyroidism after low dose radioiodine therapy have prompted to go for a proportionate increase in the 131 I original dose schedules based on goitre grades. This has led to a nominal increase in the incidence of post therapy hypothyroidism. However the basic principle of low, fractionated dose therapy is still being followed at this Institute, which appears suitable for social and economic conditions in India. (author). 19 refs., 2 tabs

  15. Influencing factors of radioiodine therapy in hyperthyroidism in adults

    International Nuclear Information System (INIS)

    Xu Jiehua; Zhang Zikang; Cheng Muhua; Wu Chunxing; Wang Ping; Shan Hong

    2007-01-01

    The study was to evaluate factors affecting outcome of 131 I therapy in hyperthyroidism for optimizing the method. Data from 213 patients who received 131 I treatment from July 2003 to July 2005 in our department were retrospectively analyzed. Factors possibly contributing to the outcome of the 1311 therapy were analyzed, including gender, age, history of antithyroid drag, thyroid volume, duration of disease and radioactive iodine uptake rate. Multivariate analysis was done. The rates of euthyroidism and hypothyroidism were 69% and 8.5%, respectively, after one time 131 I therapy. Multivariate analysis of the patients showed no statistically significant factors affecting the outcome of 131 I therapy. The study showed that 131 I dose can be directly calculated, and this simplifies the dose-determined method and individualizes the therapy. (authors)

  16. A 30-year perspective on radioiodine therapy of benign nontoxic multinodular goiter

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Hegedüs, Laszlo

    2009-01-01

    rate of permanent hypothyroidism, whereas other side-effects are very modest when using a rhTSH dose of 0.1 mg or below. SUMMARY: RhTSH-stimulated radioiodine therapy of benign nontoxic multinodular goiter is still an off-label use but several trials have shown that this treatment is significantly more......PURPOSE OF REVIEW: There is no consensus on the ideal treatment of patients with a benign nontoxic multinodular goiter. In some European countries, (131)I therapy has replaced surgery as the treatment of choice in these patients. Recombinant human thyrotropin (rhTSH) is a very potent stimulator...... of the thyroid gland and this review focuses on rhTSH-stimulated (131)I therapy. RECENT FINDINGS: The concept of rhTSH-stimulated (131)I therapy has been tested in several trials during the last 8 years. With this treatment, the goiter reduction is improved by 35-55%, compared with (131)I therapy without rh...

  17. Effect of radioiodine therapy on thyroid nodule size in patients with toxic adenomas

    International Nuclear Information System (INIS)

    Rajkovaca, Z.; Mijatovic, J.; Skrobis, M.; Kovacevic, P.

    2005-01-01

    Full text: Autonomously functioning toxic adenomas are a common cause of hyperthyroidism. Surgery, radioiodine and percutaneous ethanol injection into the nodule are effective therapies. Radioiodine therapy is increasingly used as first line therapy especially in elderly patients. Radioactive iodine I-131 seems to be a good therapeutic option with low incidence of post-therapy hypothyroidism. The important therapeutic effect has also been the regression in nodule size. The aim of this study was to investigate the effect of radioiodine therapy on the size of toxic adenomas. Forty-six patients with age range of 37-76 years (Mean age=60.9 years) were followed up for a period of 12 months after I-131 therapy for toxic adenomas. Thyroid hormone levels (T3, T4 and TSH) were determined. Each patient was subjected to ultrasound and radionuclide scanning of thyroid gland at 3,6 and 12 months following I-131 therapy. Successful treatment was defined as control of hyperthyroidism and reappearance of extra-glandular thyroid tissue on Thyroid scan, which were suppressed by the hyperactive nodule prior to therapy. The volumes of the thyroid pre and post-therapy were estimated by US using the formula of ellipsoid model (δ/2π6 x length x width x depth). The therapeutic dose of I-131 was calculated for each patient by the following formula: 12 mCi x 100/24 hrs RAIU. Patients received a single dose of I-131 and the range of administered I-131 dose was 825 1221 MBq. Results revealed that 42 patients (91%) became euthyroid in three months after I-131. All patients became euthyroid in 6 months. The adenomas were reduced in size from a mean of 18.23+11.21 ml to 7.38+3.48 ml during the 12 months follow up. This was highly significant (p<0.05, t=3.408). The extra-nodular thyroid volume did not change following therapy (12.2+7.4 ml pre-therapy vs. 11.8+7.1 ml post therapy at 12 months). The results of our study showed that I-131 can successfully treat not only the functional state of

  18. The role of radioiodine therapy in benign nodular goitre

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Fast, Søren; Hegedüs, Laszlo

    2014-01-01

    For treatment of benign nodular goitre the choice usually stands between surgery and (131)I therapy. (131)I therapy, used for 30 years for this condition, leads to a goitre volume reduction of 35-50% within 1-2 years. However, this treatment has limited efficacy if the thyroid (131)I uptake is low...... for additional therapy due to insufficient goitre reduction, but the price is a higher rate of hypothyroidism. Another approach with rhTSH-stimulation is to reduce the administered (131)I activity by a factor that equals the increase in the thyroid (131)I uptake. Using this approach, radiation exposure...

  19. Radioiodine therapy of differentiated thyroid cancer: AIIMS experience

    International Nuclear Information System (INIS)

    Padhy, A.K.; Nair, P.G.G.; ); Bal, C.S.; Pant, G.S.; Basu, A.K.

    1999-01-01

    After a slow start in late sixties, the procedure of 131 I therapy for Differentiated Thyroid Cancer (DTC) has gained increasing popularity with every passing year at All India Institute of Medical Sciences. This has become an integral part of TC management at AIIMS like at most other centres all over the world. There is a general consensus that near total thyroidectomy along with 131 I therapy and suppressive doses of thyroid hormones provide the best mode of treatment for DTC

  20. Guide-line of the radio-iodine (131I) therapy in Graves' disease and thyroid cancer

    International Nuclear Information System (INIS)

    Mori, Yutaka; Ikekubo, Katsuji

    2005-01-01

    Radio-iodine ( 131 I) therapy has been using in Graves' disease and well differentiated thyroid cancer. The rules of control in the discharge from radio-isotope hospital were notified in 1999 in Japan. Guideline of the 131 I therapy in Graves' disease and thyroid cancer were prepared by sub-group of Japanese Society of Nuclear Medicine. (author)

  1. Radioiodine therapy induces dose-dependent in-vivo oxidation injury

    International Nuclear Information System (INIS)

    Sinzinger, H.; Resch, U.; Tatzber, F.; Weiss, K.

    2002-01-01

    Until now, radiation hazards as a consequence of radioiodine therapy are not examined in detail. Oxidation of lipoproteins may favour vasculopathy. We studied the influence of a single radioiodine therapy with 5 (n=8; 46-71a), 10 (n=6; 54-75a), 20 (n=11; 45-73a), 80 (n=6; 37-75a) or 200 (n=6; 43-67a) mCi on in-vivo oxidation injury in blood (plasma [P], serum [Se]), urine (U) and saliva (Sa) in patients suffering from hyperthyroidism opr thyroid cancer, respectively. The isoprostane 8-epi-prostaglandin (PG) F 2α as a marker of in-vivo oxidation injury (Sa, Se, P, U), oxidation of lipoproteins (LDL, HDL), thromboxane B2 (Sa, Se, P, U), PGE 2 , PGF 2α and circulating endothelial cells (CEC) were examined before therapy, daily for 7 days and weekly thereafter for 6 weeks. Blood was also analyzed for thiobarbituric acid reactive substances (TBARS), relative electrophoretic mobility (REM), baseline dienes (BD), endogenous peroxides (POX) and formation of conjugated dienes in copper-mediated oxidation (CD) expressed in lag-time and rate of propagation. There is a dose-dependent increase in 8-epi-PGF 2α being most pronounced in saliva (p 2 and HDL 3 subfractions 24 h after application, but 48 h and 72 h after application there was a significant increase in TBARS, REM, BD, POX and rate of propagation and a decrease in lag-time in HDL-subfractions independently from applied dose. Also HDL 2 showed more TBARS, REM, BD, POX and shorter lag-time than HDL 3 48 h after application, but this effect was reversed 72 h after application. HDL is the lipoprotein most prone to oxidation by radioiodine treatment. Apparently, when LDL becomes oxidized, it shifts metabolically its oxidation products to HDL. These findings show a significant temporary and dose-dependent endothelial desquamation, oxidation of lipoproteins and long-lasting in-vivo oxidation injury (saliva > urine > blood) as side effect of radioiodine therapy, altogether being potentially proatherogenic

  2. Radioiodine therapy effect on lacrimal gland function in patients with thyroid cancer

    International Nuclear Information System (INIS)

    Fard-Esfahani, A.; Mirshekarpour, H.; Fallahi, B.; Eftekhari, M.; Takavar, A.; Beiki, D.; Ansari-Gilani, K.; Saghari, M.

    2007-01-01

    Full text: Objectives: There is a limited number of case reports published in the past decade confirming the radioiodine presence in the tear. These observations as well as reported cases of salivary and lacrimal gland dysfunction after radioiodine therapy stimulated investigators to clarify whether lacrimal gland function can be affected postradioiodine therapy. Hence we planned a historical cohort study. Methods: We studied 100 eyes of 50 patients who had received high doses (accumulative dose: 100-450mCi) of I-131 (exposed group) for treatment of differentiated thyroid carcinoma with their latest admission at least 3 months ago. Dry eye symptoms (obtained via a standard questionnaire) and Schirmer I test results (mm/5 min) of this exposed group were compared with those of an unexposed group (100 eyes of 50 individuals) matched by sex and age. Cases with any other known cause(s) of dry eye were not included in either group. Results: The study demonstrated a significantly lower wetting amount of the Schirmer paper in exposed group compared to unexposed one. In the group of patients who have undergone radio-iodine therapy, results were 0-4 mm in 21%, 5-9 mm in 20% and 10 mm or more in 59%. These results were seen in the unexposed group in 6%, 17% and 77% respectively. In evaluating the symptoms, 51% of the exposed eyes and 50% of the unexposed ones revealed at least one of the mentioned dry eye symptoms in the questionnaire. Data analysis showed no significant difference between the number of symptoms of the two groups, but 2 symptoms (burning, unrelated to light and erythema) were significantly higher in the exposed eyes. From 9 exposed eyes complaining of erythema, Schirmer test result was abnormal only in 2 (one patient). Also among the 10 eyes with burning symptom (unrelated to light) one patient (2 eyes) revealed abnormal Schirmer test result. Conclusion: Long-term reduction in the tear secretion from major and/or minor lacrimal glands is seen after high

  3. Testicular effects of 131radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Ceccarelli, Claudia; Canale, Domenico; Carolina, Caglieresi; Moschini, Cecilia; Grasso, Lucia; Pinchera, Aldo; Vitti, Paolo

    2005-01-01

    Full text: Little data is available on possible untoward effects of 131 I therapy for hyperthyroidism on gonad male function. FSH, LH, Total Testosterone(T), Inhibin B and spermiogram were evaluated in 15 hyperthyroid males (mean age 38.5+/-6.7 years, m +/- SD) before, and at day 45, month 3, 6 and 12 after 131 I therapy. Mean basal FSH was 5.6 +/- 3.8 mU/ml. After 131 I, FSH remained unchanged in 13 patients. In two, one of whom with basal FSH in the upper normal limits (16.4 mU/ml), a mild increase was observed after therapy. Basal LH and T were in normal range and did not vary significantly after 131 I, but T/LH ratio significantly decreased at month 3 and 6 (basal: 1.34 +/- 0.6; month 3: 0.85 +/- 0.3, p=0.02, month 6: 0.8 +/- 0.1, p= 0.06). Basal Inhibin B values did not vary significantly after 131 I. Basal mean sperm concentration did not differ from that found in a control group of 20 normal men (51.0 +/- 6.9 x 106 E/ml, vs. 57.6 +/- 7.5 x 106 E/ml) and did not vary significantly after 131 I therapy. Sperm progressive motility (SPM) was 39.1+/-4.7 % in hyperthyroid patients and 54.4 +/- 1.8 % in the controls (p=0.02). Ten patients (67%) were asthenospermic (SPM 131 I treatment of hyperthyroidism may account for a marginal and transient damage of Leydig cells, as highlighted by T/LH ratio. The lower SPM and increased theratospermia observed in patients before treatment could be due to hyperthyroidism per se, as suggested by the normalization of SPM in 5/10 patients after therapy. (author)

  4. Treatment with antithyroid drugs or iodine following radioiodine therapy for Graves' disease

    International Nuclear Information System (INIS)

    Mazeto, Glaucia; Leal, B.M.B.; Souza, L.S.; Griva, B.L.; Moriguchi, S.M.; Moreira, C.C.; Lemos, A.C.; Kiy, Y.

    2005-01-01

    Full text: The effect of radioiodine ( 131 I) therapy in Graves' disease is gradual and the patients continue to be hyperthyroid for much time after this therapy. In a retrospective study, we compared the evolution of 196 patients in this situation treated with some therapeutic regimens. They received propylthiouracil or methimazole (ATD), one of them and potassium iodide (KI), KI only, or no drugs after 131 I therapy. ATD was started usually one day and KI two months after the radioiodine. The groups had similar age, pretreatment serum T 4 concentrations and 131 I treatment dose. Cure of the hyperthyroidism occurred in 83,9%, 75,5%, 75,0% and 70,6% in no-drugs, KI, ATD and KI-ATD groups, respectively. Hyperthyroidism was longer in KI and KI-ATD groups. Definitive hypothyroidism occurred in 39,2%, 47,2%, 52,9% and 66,1% in KI-ATD, KI, ATD and no-drugs groups, respectively. This condition appeared more quickly in no-drugs and ATD groups. Conclusion: We conclude that KI and ATD groups had similar evolutions as to cure of hyperthyroidism and occurrence of hypothyroidism. (author)

  5. Radiation safety procedures in radioiodine therapy for thyroid cancer

    International Nuclear Information System (INIS)

    Rajashekharrao, B.; Samuel, A.M.

    1999-01-01

    During any administration of radioactive materials, it is imperative to always be conversant with any forbidden radiation health safety practices. This need is amplified when dealing with therapeutic amount of radionuclides. Among all the procedures dealing with the use of radiopharmaceuticals, it is easiest to think of 131 I, since this is the most widely used unsealed source of a radiopharmaceutical for treatment of thyroid cancer and hyperthyroidism and carries with it most of the problems associated with therapy applications

  6. Patient management in radioiodine therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Dressler, J.

    1997-01-01

    Benign thyroid disease ranks by far as the most frequent therapy in nuclear medicine. In Germany approximately 25 000 cases of hyperthyreosis are being treated in association with autonomy or Graves' disease, but also for the reduction of goiters or the correction of latent functional disturbances. In such indications radiotherapy is virtually free of risk as opposed to surgery and ranks more favorable in regard to costs and curative effects versus pharmacological long term treatment. Still regional varying therapeutical concepts and intentions are being pursued and trials of improvements described. There is consent in therapy that quality of treatment is closely linked to a specialized out-door platient preparation, individual hospital activity dosage and lifelong follow up including continued evaluation of therapeutical results. In this paper minimal requirements of outpatient measures before and after therapy are summarized which in Germany is only permitted on an inhospital patient basis. Considering basics of radioactive preventive law, scientific evidence of available results of therapeutical studies and a survey of German therapeutic centers, suggestions for a quality maintaining management in view of the most effective utilization for the limited available number of beds is presented for discussion. (orig.) [de

  7. Radioiodine therapy in management of thyroid carcinoma - A review of 138 patients

    International Nuclear Information System (INIS)

    Hossain, A.S.; Hossain, S.; Hafiz, N.; Taslima, D.A.; Rashid, H.

    2001-01-01

    Differentiated thyroid carcinomas are being treated by using a widely accepted protocol of surgery and radioiodine therapy followed by supplementation of thyroid hormones in the Nuclear Medicine Centre (NMC), Dhaka Medical College Hospital (DMCH) since 1990. In the present study 138 patients(Male-54, Female-84) with differentiated thyroid cancers received radioiodine therapy for ablation of residual thyroid tissue with a dose of 2.77-3.7 GBq (75-100 mCi), for lymph node metastases 5.55-6.5 GBq(150-175mCi), for lung metastases 5.55 GBq(150 mCi) and for bony metastases 7.4 GBq (200 mCi). Among 138 patients papillary carcinoma was observed in 94 cases (68%; Male-42, Female-52), follicular type was found in 30 cases (22%; Male-8, Female-22) and mixed type in 14 patients (10%, Male-4, Female-10). Single dose of 2.77-3.7 GBq(75-100 mCi) of radioiodine was received by all 138 patients. Among the unablated patients 62 received double doses totalling 9.25 GBq (250 mCi), 44 received three doses 12.95 GBq (350 mCi) and one patient received 8 doses 33.3 GBq (900 mCi). Out of 138 patients single dose ablated 76 cases and 62 remain unablated. Multiple doses ablated 28 patients and 34 still remain unablated and is under follow up. The success and failure in management of patients with differentiated thyroid cancer over 8 years period have been discussed here revealing a satisfactory outcome. (author)

  8. In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

    Energy Technology Data Exchange (ETDEWEB)

    Spesshardt, K. (Sankt-Vincentius-Krankenhaeuser, Karlsruhe (Germany, F.R.). Radiologische Abt. mit Strahlentherapie und Nuklearmedizin)

    1980-10-15

    In-vivo diagnoses of thyroid diseases can be carried out using /sup 123/I, /sup 131/I, and /sup 99/sup(m)Tc-pertechnetate. For the thyroid scintiscan, /sup 99/sup(m)Tc-pertechnetate or /sup 123/I are used. Some functional parameters can be determined using /sup 99/sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with /sup 123/I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using /sup 131/I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited.

  9. In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Spesshardt, K.

    1980-01-01

    In-vivo diagnoses of thyroid diseases can be carried out using 123 I, 131 I, and 99 sup(m)Tc-pertechnetate. For the thyroid scintiscan, 99 sup(m)Tc-pertechnetate or 123 I are used. Some functional parameters can be determined using 99 sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with 123 I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using 131 I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited. (orig./MG) [de

  10. Administration of additional inactive iodide during radioiodine therapy for Graves' disease. Who might benefit?

    International Nuclear Information System (INIS)

    Dietlein, M.; Moka, D.; Reinholz, U.; Schmidt, M.; Schomaecker, K.; Schicha, H.; Wellner, U.

    2007-01-01

    Aim: Graves' hyperthyroidism and antithyroid drugs empty the intrathyroid stores of hormones and iodine. The consequence is rapid 131 I turnover and impending failure of radioiodine therapy. Can administration of additional inactive iodide improve 131I kinetics? Patients, methods: Fifteen consecutive patients, in whom the 48 h post-therapeutically calculated thyroid dose was between 150 and 249 Gy due to an unexpectedly short half-life, received 3 x 200 μg inactive potassium-iodide ( 127 I) daily for 3 days (Group A), while 17 consecutive patients with a thyroid dose of = 250 Gy (Group B) served as the non-iodide group. 48 hours after 131 I administration (M1) and 4 or 5 days later (M2) the following parameters were compared: effective 131 I half-life, thyroid dose, total T3, total T4, 131 I-activity in the T3- and T4-RIAs. Results: In Group A, the effective 131 I half-life M1 before iodine (3.81 ± 0.93 days) was significantly (p 131 I half-life M2 (4.65 ± 0.79 days). Effective 131 I half-life M1 correlated with the benefit from inactive 127 I (r = -0.79): Administration of 127 I was beneficial in patients with an effective 131 I half-life M1 of 131 I activity of T3 and T4 showed lower specific 131 I activity after addition of inactive iodine compared with patients from the same group with a lower initial specific 131 I activity of T3 and T4 and compared with the patient group B who was given no additional inactive iodide. This correlation was mathematically described and reflected in the flatter gradient in Group A (y = 0.5195x + 0.8727 for 131 I T3 and y = 1.0827x - 0.4444 for 131 I T4) and steeper gradient for Group B (y = 0.6998x + 0.5417 for 131 I T3 and y = 1.3191x - 0.2901 for 131 I T4). Radioiodine therapy was successful in all 15 patients from Group A. Conclusion: The administration of 600 μg inactive iodide for three days during radioiodine therapy in patients with Graves' hyperthyroidism and an unexpectedly short half-life of <3 or 4 days was a safe

  11. Radioiodine therapy of hyperfunctioning thyroid nodules: usefulness of an implemented dose calculation algorithm allowing reduction of radioiodine amount.

    Science.gov (United States)

    Schiavo, M; Bagnara, M C; Pomposelli, E; Altrinetti, V; Calamia, I; Camerieri, L; Giusti, M; Pesce, G; Reitano, C; Bagnasco, M; Caputo, M

    2013-09-01

    Radioiodine is a common option for treatment of hyperfunctioning thyroid nodules. Due to the expected selective radioiodine uptake by adenoma, relatively high "fixed" activities are often used. Alternatively, the activity is individually calculated upon the prescription of a fixed value of target absorbed dose. We evaluated the use of an algorithm for personalized radioiodine activity calculation, which allows as a rule the administration of lower radioiodine activities. Seventy-five patients with single hyperfunctioning thyroid nodule eligible for 131I treatment were studied. The activities of 131I to be administered were estimated by the method described by Traino et al. and developed for Graves'disease, assuming selective and homogeneous 131I uptake by adenoma. The method takes into account 131I uptake and its effective half-life, target (adenoma) volume and its expected volume reduction during treatment. A comparison with the activities calculated by other dosimetric protocols, and the "fixed" activity method was performed. 131I uptake was measured by external counting, thyroid nodule volume by ultrasonography, thyroid hormones and TSH by ELISA. Remission of hyperthyroidism was observed in all but one patient; volume reduction of adenoma was closely similar to that assumed by our model. Effective half-life was highly variable in different patients, and critically affected dose calculation. The administered activities were clearly lower with respect to "fixed" activities and other protocols' prescription. The proposed algorithm proved to be effective also for single hyperfunctioning thyroid nodule treatment and allowed a significant reduction of administered 131I activities, without loss of clinical efficacy.

  12. High-dose radioiodine therapy of Graves disease

    International Nuclear Information System (INIS)

    Solodky, V.; Fomin, D.; Pestritskaya, E.

    2015-01-01

    Full text of publication follows. Objectives: to estimate the effectiveness and safety of the disease treatment under different modes of applying RIT. Materials and methods: 67 patients with the thyrotoxicosis condition associated with Graves disease were researched. The patients were divided into 2 groups: a control group with 25 people (18 women and 7 men), who underwent a low-dose therapy of 150-500 MBq; and a main group of 42 people (32 women and 10 men), who underwent a high-dose therapy of 550 and 800 MBq. The volume of thyroid prior to the treatment made up 23.8 ± 20 ml in the main group and 30.2 ± 23 ml in the control one. The average age in the high-dose group was 44.6 ±23 years old and in the low-dose -47.2 ± 24 years old. In terms of the hormone level before the RIT, 52% of the main group patients experienced euthyroidism, while 48% - thyrotoxicosis. The corresponding indices in the control group were 42% and 58% respectively. The cessation of the thyreostatic therapy came on 5. to 21. day prior to the treatment, with the average of 14 ±7 days in both groups. The diagnosis of the disease was based on ultrasonography, planar scintigraphy, the hormone level and antibody titer. The performance was assessed through the attainment of hypo-thyrosis and the transition to a substitutive hormonal therapy with L-thyroxine in 6 months or more. The attainment of euthyroidism was seen as a partial effect due to a possibility of relapse. Results: in 6 months a positive result in the form of hypo-thyrosis was achieved for 39 patients in the main group, which accounted for 93%, and 3 patients (7%) experienced euthyroidism. No symptomatic thyrotoxicosis relapses were revealed. In the control group, hypo-thyrosis was achieved by 18 patients, which accounted for 72%; euthyroidism came up to 12%; 4 patients needed a refresher course of RIT, which made up 16% of the group. 93% of the main group patients tolerated the treatment favourably. 3 patients complained of the

  13. Influence of thyroid metabolism on radioiodine therapy in Graves` disease; Einfluss der Stoffwechsellage auf die Radioiodtherapie beim Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Boerner, A.R. [Forschungszentrum Juelich (Germany). Inst. fuer Medizin; Weckesser, M.; Boy, C.; Schmidt, D.; Langen, K.J.; Mueller-Gaertner, H.W. [Duesseldorf Univ. (Germany). Nuklearmedizinische Klinik]|[Forschungszentrum Juelich (Germany). Inst. fuer Medizin

    1997-12-01

    Radioiodine therapy is one of two definitive methods of treatment in Graves` disease beside near-total thyreoidectomy. Simple strategies like optimization of thyroid metabolism help to improve efficacy in radioiodine therapy thus lowering applied radioiodine doses, radiation exposure to the patient and to the environment and avoiding multiple vain therapeutic efforts. These strategies are likely to reduce costs at the same time. (orig.) [Deutsch] Die Radioiodtherapie ist eine der beiden definitiven Therapiemethoden bei Morbus Basedow neben der nahezu totalen Thyreoidektomie. Ziel ist es, mit einfachen Methoden wie der optimalen Einstellung der Stoffwechsellage die Effizienz der Radioiodtherapie zu optimieren im Hinblick auf eine Reduktion der einzusetzenden Aktivitaet, der Gesamtstrahlenexposition fuer Patient und Umwelt und durch Vermeidung mehrfacher, vergeblicher therapeutischer Ansaetze. Diese Optimierung traegt auch zur Reduktion der Gesamtkrankheitskosten bei. (orig.)

  14. Graves Disease Induced by Radioiodine Therapy for Toxic Nodular Goiter: A Case Report

    Directory of Open Access Journals (Sweden)

    Yakup Yürekli

    2015-10-01

    Full Text Available Graves’ disease (GD may be observed as an infrequent adverse effect after radioiodine therapy (RAIT for toxic thyroid adenoma (TA and toxic multi nodular goiter (MNG. We present a case of a 55-year-old male with a toxic nodule who was treated with RAI. After therapy, the patient’s serum free triiodothyronine (fT3 and free thyroxine (fT4 levels gradually increased. Antithyroid peroxidase (TPOAb, antithyroglobulin (TgAb and TSH-receptor antibodies (TRAb were also positive. Thyroid scintigraphy revealed diffuse intense uptake after four months of RAIT. Radiation-induced GD should be considered in patients with aggravated hyperthyroidism 3-4 months after therapy.

  15. A prospective study of the effects of radioiodine therapy for hyperthyroidism in patients with minimally active graves' ophthalmopathy.

    Science.gov (United States)

    Perros, Petros; Kendall-Taylor, Pat; Neoh, Chris; Frewin, Sarah; Dickinson, Jane

    2005-09-01

    Radioiodine is an effective and safe treatment for hyperthyroidism but has been implicated as a risk factor for deterioration or new presentation of Graves' ophthalmopathy (GO). Prophylactic glucocorticoids appear to prevent this effect. The objective of this study was to document the course of GO after radioiodine therapy. This was a prospective observational study. Patients were assessed at baseline and 2, 4, 6, and 12 months after radioiodine therapy. The study was conducted at a tertiary referral center. Seventy-two GO patients with minimally active eye disease participated in the study. A fixed dose of radioiodine was administered. T(4) was commenced 2 wk later to prevent hypothyroidism. Change in activity and severity of GO were analyzed. Exophthalmometer readings, the width of the palpebral aperture, diplopia scores, and the clinical activity score improved significantly. By clinically significant criteria, the eye disease improved in four patients (transiently in three of the four cases), most likely attributable to the natural course of the disease. No patient's eyes deteriorated. Radioiodine is not associated with deterioration of GO in patients with minimally active eye disease when postradioiodine hypothyroidism is prevented.

  16. Gastrointestinal Side Effects of the Radioiodine Therapy for the Patients with Differentiated Thyroid Carcinoma Two Days after Prescription

    International Nuclear Information System (INIS)

    Pashnehsaz, Mehran; Takavar, Abbas; Izadyar, Sina; Zakariaee, Seyed Salman; Mahmoudi, Mahmoud; Paydar, Reza; Geramifar, Parham

    2016-01-01

    Iodine-131 (I-131) therapy is one of the conventional approaches in the treatment of patients with differentiated thyroid carcinoma (DTC). The radioiodine agents also accumulate in the other organs that cause pain and damage to the patients. Radioiodine therapy is associated with various gastrointestinal (GI) toxicities. In this study, GI side effects of the radioiodine therapy were investigated. GI toxicities of the radioiodine therapy were studied in 137 patients with histologically proven DTC in Jun-Nov 2014. All the patients were treated by radioiodine agents in the research institute of Shariati Hospital, Tehran, Iran. The patients were examined 48 h after prescription (before discharge) and their GI side effects were registered. Correlation of the age, gender, administered dose, administered dose per body weight as the independent factors, and GI side effects were analyzed using the Pearson correlation test with Statistical Package for the Social Sciences (SPSS) version 20. Regression coefficients and linearity of the variable were investigated by MATLAB software. Line fitting was performed using MATLAB curve-fitting toolbox. From the subjects, 38 patients had GI complaints (30.4%). Significant factors influencing GI side effects were dose per body weight and administered doses. There was no significant correlation between age and gender as the independent parameters and GI complaints. The most prevalent GI side effect was nausea that occurs in 26.4% of the patients. From the results, it could be concluded that the GI side effects could be prevented by administering a safe radioiodine dose value less than 5,550 MBq

  17. Experimental peptide receptor radionuclide therapy in radioiodine negative somatostatin receptor positive thyroid cancer

    International Nuclear Information System (INIS)

    Nilica, B.; Kroiss, A.; Putzer, D.; Uprimmy, C.; Warwitz, B.; Kendler, D.; Waitz, D.; Virgolini, I.

    2015-01-01

    Full text of publication follows. Purpose: This retrospective analysis evaluated the time to progression (TTP), progression free survival (PFS) and overall survival (OS) in patients with radioiodine negative thyroid cancer who had undergone peptide receptor radionuclide therapy (PRRT) with 177 Lu-DOTA-TATE, 177 Lu-DOTA-LAN, 90 Y-DOTA-TOC or 90 Y-DOTA-LAN after tumor progression. Methods: Data derived from twenty patients with either differentiated (n=15), anaplastic (n=1) or medullary (n=4) somatostatin receptor positive thyroid cancer who had received treatment with PRRT after tumor progression. TTP, PFS and OS were defined according to the clinical trial endpoints suggested by the FDA (Food and Drug Administration). Progressive disease was defined by sonography, FDG-PET, Ga-DOTA-TOC-PET, or CT (RECIST Criteria). Results: In 17 patients the median overall survival time after the first PRRT was 17.3 (range: 0.1 - 109.7) months. Three patients still alive are actually showing stable disease. The median of PFS in 20 Patients (6 with more than one PRRT-cycle or PRRT-substance) has been 10.9 (range: 0.1 - 44.0) months. The median TTP was 15.6 (range 4.4 to 29.2) months. Conclusion: PRRT appears to be useful in patients with somatostatin receptor positive but radioiodine negative thyroid cancer as a complementary palliative cytotoxic therapy. (authors)

  18. Radioiodine therapy of Graves' disease - a dosimetric comparison of different strategies concerning antithyroid drugs

    International Nuclear Information System (INIS)

    Urbannek, V.; Voth, E.; Moka, D.; Schicha, H.

    2001-01-01

    Aim: Premedication with antithyroid drugs (ATD) compared to patients not pretreated with ATD causes a higher failure rate of radioiodine therapy (RITh) or demands higher therapeutical dosage of radioiodine (RI). For clinical reasons and because of accelerated iodine metabolism in hyperthyreosis a compensated thyroid metabolism is desirable. Aim of this study was to investigate the influence of ATD on the biokinetics of RI in case of Graves' disease in order to improve RITh of patients pre-treated with ATD. Methods: 385 consecutive patients who underwent RITh because of Graves' disease for the first time were included: Group A (n = 74): RITh under continuous medication with ATD; Group B (n = 111): Application of RI under continuous medication with ATD, in case of insufficient RI-uptake or shortened effective RI-half-life ATD were stopped 1-5 days after RITh; Group C (n = 200): ATD were stopped 2 days prior to RITh in all patients. We examined the influence of ATD on RI-uptake and effective RI-half-life as well as the absorbed dose achieved on the thyroid in dependence of thyroid volume and applied RI-dosage [TEQ - therapy efficiency quotient, (2)]. Results: In the RI-pretest (all patients under ATD) the RI-uptake was comparable in all three groups. During RITh-RI-uptake, effective RI-half-life and therefore the TEQ were significantly higher in Group C as compared to Groups A and B (p [de

  19. Influence of oral rinsing on the exposure of salivary glands during radioiodine therapy

    International Nuclear Information System (INIS)

    Luetzen, U.; Silvia, P.; Zhao, Y.; Marx, M.; Winkler, C.; Zuhayra, M.

    2015-01-01

    Full text of publication follows. Aim: the salivary glands (SG) constitute a risk organ during a radioiodine therapy of thyroid. A possible side effect is xerostomia. This study investigates whether repeated rinsing of the mouth with water during radioiodine therapy significantly extracts I-131 from the circuit between saliva and the gastrointestinal tract, and thus whether radiation exposure of the patient's SG is reduced. Methods: the control group consisted of 45 patients, ages 32 to 81 years, (mean 62 years, 8 male, 37 female), and received radioiodine therapy without rinsing their mouths. An intervention group of 42 patients, ages 36 to 88 years, (mean 61 years, 8 male, 34 female), with a benign or malignant thyroid disease, were asked 15-17 hours after capsule administration to rinse their mouths hourly with water for the next two days. The intervention group (n = 42) was divided into three groups. A low-risk group (n = 22) received between 0.4 and 1.0 GBq I-131 (mean 0.746), a medium risk group (n = 15) between 1.2 and 2.0 GBq (mean 1.783), and the high-risk group (n = 5) between 3.0 and 6.0 GBq (mean 3.600) respectively. To assess the function of the SG, scintigrams were performed prior to and 3 months after the radioiodine therapy. The estimation of the activity in the gastrointestinal tract was performed using whole-body scintigraphy on the day of release. Both, the SG and the whole body (WB) scintigraphies were evaluated using the region-of-interest technique. Furthermore, the activity of the collected saliva was quantified using a calibrated well-type detector. Results: the mean values of the activity extracted into the water-saliva mixture were 0.72% ± 0.3% and 0.14% ± 0.05% of the applied dose on the first and second day after capsule administration respectively. The analysis of the SG scintigrams of the low and medium risk groups showed no significant decrease in salivary gland function. Only in the high-risk group a significant loss of

  20. On the genetic risk after high dose radioiodine therapy with regard to the gonadal dose

    International Nuclear Information System (INIS)

    Ehrenheim, C.; Hauswirth, C.; Fitschen, J.; Martin, E.; Oetting, G.; Hundeshagen, H.

    1997-01-01

    Aim: The genetic risk for the offspring of patients treated with high doses of radioiodine was to be assessed with special regard to the gonadal dose caused by diagnostic and therapeutic procedures. Methods: 41 young females (aged between 19 and 39 years) and four young males (aged 26 to 36 years) treated with radioiodine because of a thyroid carcinoma were interviewed by use of a questionnaire. The course of pregnancy and birth history could be documented as well as the congenital and developmental conditions of 56 children. Results: The amount of radioactivity applied for therapy and whole body scans ranged over 4,144 and 35,15 GBq I-131; the individual gonadal dose was calculated based on the MIRD model and ranged over 0,2 and 2,2 Sv (0,51 Sv at a mean). The period of time between the last radioiodine application and confinement was at least 9 months, not exceeding 14 years. As to the course of pregnancy and birth two early abortions, one extrauterine gravidity and one premature birth due to an insufficiency of the placenta were stated. In one case a chromosomal translocation 7/14 occured as a genetic defect which lead to an interruption. The children's development was unconspicuous except of two cases of neurodermatitis as well as multiple allergies and an early closure of the anterior fontanelle in one child each. Conclusion: Although the genetic risk is supposed to increase with the gonadal dose achieved (doubling dose 1 Sv) and the increased risk of any congenital anomaly was calculated as about 13% at a mean in our patients, the rate of genetic determined diseases was not elevated (1,8% or 1/57). Thus, no increase of genetic defects or congenital malformations was reported in a total of 408 children described in the literature and in our group. (orig.) [de

  1. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: A quality improvement project

    OpenAIRE

    Mitra, Sujata; Muthu, Sonai G

    2012-01-01

    Introduction: Radioiodine (I-131) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after I-131 therapy. The present study was undertaken to reduce treatment failure rate of I-131 therapy in TMNG patients. Materials and Methods: Multiple causes may have lead to treatment failure of I-131 in TMNG patients making it difficult to establish a direct cause?effect relationship and take corrective action. Therefore, the JURAN methodology...

  2. The early development of transient and permanent hypothyroidism following radioiodine therapy for hyperthyroid Graves' disease

    International Nuclear Information System (INIS)

    Peden, N.R.; Hart, J.R.

    1984-01-01

    The outcome in 110 patients first treated with radioiodine (mean dose 6.56 mCi) for hyperthyroid Graves' disease in 1980 was reviewed. In 23 percent of the patients the disease had not been controlled by the initial dose after 3 months, and 17 percent were given one or two more doses. Within 2 years 65 percent of the patients required replacement thyroxine therapy. Although about half of the patients were biochemically hypothyroid 3 months after the last dose of iodine 131, this condition was transient in a third of them; five of these patients even became hyperthyroid again. Patients with transient, as opposed to permanent, hypothyroidism at 3 months tended to be clinically euthyroid but to have residual palpable thyroid tissue and only a modest reduction in the serum thyroxine level. It is therefore recommended that patients not overtly hypothyroid 3 months after treatment with 131 I be observed still longer before thyroxine replacement therapy is instituted

  3. Apoptosis: its pathophysiology and monitoring. The role of apoptosis in the radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Sopotyk, J.; Rogowski, F.; Parfienczyk, A.

    2004-01-01

    The review aims to give an up to date understanding of the mechanisms of apoptosis (programmed cell death), the methods of detecting apoptosis, in particular with regard to imaging such changes non-invasively. Radioiodine (I-131) is a gamma and beta emitting radionuclide and is commonplace in the treatment of hyperthyroidism. I-131 therapy relies on the destruction of thyroid tissue by beta radiation, and such destruction is proposed to be partly as a result of apoptosis. The review undertakes to explore and provoke research into the mechanisms of thyroid cell destruction by I-131, and whether such changes are able to be detected or monitored. Current knowledge concerning apoptosis in the thyroid gland in diseased states (including cancer) are described. The clinical significance of monitoring and modifying apoptosis are emphasized. Furthermore, overt and late destruction of thyroid tissue following I-131 therapy requires elaboration, and the relevance of detecting and modifying thyroid cell apoptosis following I-131 are questioned.(author)

  4. Caffeine Sodium Benzoate for Electroconvulsive Therapy Augmentation.

    Science.gov (United States)

    Bozymski, Kevin M; Potter, Teresa G; Venkatachalam, Vasu; Pandurangi, Ananda K; Crouse, Ericka L

    2018-05-15

    Because of an ongoing manufacturer shortage of injectable caffeine sodium benzoate (CSB), patients at our health system were given CSB compounded in-house to increase seizure response during electroconvulsive therapy (ECT). Therefore, we aimed to evaluate its effectiveness and safety as an ECT augmentation agent. Medical records of patients who received compounded CSB at Virginia Commonwealth University Health System were reviewed to identify adults receiving it as part of an index ECT treatment course between June 2012 and December 2016. The primary outcome was change in electroencephalogram seizure duration from pre-caffeine session to initial caffeine session. Data were also collected on demographics, motor seizure duration, maximum heart rate, mean arterial pressure, and concurrent medication use for these sessions and the last caffeine session. Seven-one patients were included in the study, predominantly white females with a mean age of 58.6 years. The most common indication for ECT was major depressive disorder resistant to pharmacotherapy (71.8%), followed by catatonia associated with another mental disorder (19.7%). Electroencephalogram seizure duration increased by 24.1 seconds on average with first CSB use (P < 0.0001), allowing 24 more patients overall to achieve goal of at least 30 seconds (P < 0.0001). No clinically significant changes in maximum heart rate or mean arterial pressure were observed, nor did any patients require an abortive agent for prolonged seizure. Five patients (7%) discontinued CSB prematurely: 4 related to adverse effects and 1 secondary to ineffectiveness. We confirm results of prior studies of the utility of CSB and add that compounded CSB is effective for ECT augmentation, maintaining effectiveness throughout the index course with minimal safety concerns.

  5. The influence of radioiodine therapy in 1470 patients with subclinical hyperthyroidism

    International Nuclear Information System (INIS)

    Abdelrazek, S.; Szumowski, P.; Mysliwiec, J.; Mojsak, M.; Kraszynska, A.; Amelian-Filonowicz, A.

    2015-01-01

    Full text of publication follows. The aim of our study was to assess the influence of radioiodine ( 131 I) therapy on the achievement of euthyroidism, prevention of adverse effects on the cardiovascular and prevent evolvement to overt hyperthyroidism. Material and methods: we treated 1470 patients sent to our department during the last 7 years, aged 24-76 years; 88% of them were female and 12% male; 490 patients with multi-nodular goitre (MNG), and 980 patients with autonomous nodule (ATN). Some of the patients were treated with antithyroid drugs for 1 to 3 months before 131 I therapy (140 patients). Malignant changes were excluded in all nodules by fine needle aspiration biopsy. All the patients had serum TSH levels <0.1 mU/l and effective T-half was more than 3 days at the time of treatment. The activity dose was calculated by the use of Marinelli's formula and ranged between 200 and 800 MBq. The absorbed dose (Gy) ranged between 180 and 300, and was proportional to thyroid volume. Follow up control was done every 6 weeks. Results: euthyroidism achieved in 99% of patient with ATN and 94% of MNG; 1% of patients with ATN and 5% of patients with MNG develop hypothyroidism. 1% of patients with MNG were in subclinical hyperthyroidism and received second dose of radioiodine therapy. In all of the patients, the symptoms and signs of subclinical hyperthyroidism disappeared (palpitation, tachycardia, atrial fibrillation, exercise tolerance improved, the blood pressure normalised and the quality of life improved). Conclusions: our result is good and is in the range of the existing literature. The achievement of euthyroidism and the remission of the symptoms and signs of subclinical hyperthyroidism, were due to good diagnosis, well preparation of the patients; accurate measurement of administered activity, effective half-life, and well-organised follow up. We recommend early treatment of subclinical hyperthyroidism, and long period of follow up visits in our department

  6. Graves' disease radioiodine-therapy: Choosing target absorbed doses for therapy planning

    Energy Technology Data Exchange (ETDEWEB)

    Willegaignon, J., E-mail: j.willegaignon@gmail.com; Sapienza, M. T.; Coura-Filho, G. B.; Buchpiguel, C. A. [Cancer Institute of São Paulo State (ICESP), Clinical Hospital, School of Medicine, University of São Paulo, São Paulo 01246-000 (Brazil); Nuclear Medicine Service, Department of Radiology, School of Medicine, University of São Paulo, Sao Paulo 01246-000 (Brazil); Watanabe, T. [Nuclear Medicine Service, Department of Radiology, School of Medicine, University of São Paulo, São Paulo 01246-000 (Brazil); Traino, A. C. [Unit of Medical Physics, Azienda Ospedaliero-Universitaria Pisana, Pisa 56126 (Italy)

    2014-01-15

    Purpose: The precise determination of organ mass (m{sub th}) and total number of disintegrations within the thyroid gland (A{sup ~}) are essential for thyroid absorbed-dose calculations for radioiodine therapy. Nevertheless, these parameters may vary according to the method employed for their estimation, thus introducing uncertainty in the estimated thyroid absorbed dose and in any dose–response relationship derived using such estimates. In consideration of these points, thyroid absorbed doses for Graves’ disease (GD) treatment planning were calculated using different approaches to estimating the m{sub th} and the A{sup ~}. Methods: Fifty patients were included in the study. Thyroid{sup 131}I uptake measurements were performed at 2, 6, 24, 48, 96, and 220 h postadministration of a tracer activity in order to estimate the effective half-time (T{sub eff}) of {sup 131}I in the thyroid; the thyroid cumulated activity was then estimated using the T{sub eff} thus determined or, alternatively, calculated by numeric integration of the measured time-activity data. Thyroid mass was estimated by ultrasonography (USG) and scintigraphy (SCTG). Absorbed doses were calculated with the OLINDA/EXM software. The relationships between thyroid absorbed dose and therapy response were evaluated at 3 months and 1 year after therapy. Results: The average ratio (±1 standard deviation) betweenm{sub th} estimated by SCTG and USG was 1.74 (±0.64) and that between A{sup ~} obtained by T{sub eff} and the integration of measured activity in the gland was 1.71 (±0.14). These differences affect the calculated absorbed dose. Overall, therapeutic success, corresponding to induction of durable hypothyroidism or euthyroidism, was achieved in 72% of all patients at 3 months and in 90% at 1 year. A therapeutic success rate of at least 95% was found in the group of patients receiving doses of 200 Gy (p = 0.0483) and 330 Gy (p = 0.0131) when m{sub th} was measured by either USG or SCTG and A

  7. Radioiodine therapy

    Science.gov (United States)

    ... FF ed. Ferri's Clinical Advisor 2017. Philadelphia, PA: Elsevier; 2017:644-645. Kaplan EL, Angelos P, James ... Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 96. Lai SY, Mandel SJ, ...

  8. Radioiodine therapy of autonomously functioning thyroid nodules and of Graves' disease

    International Nuclear Information System (INIS)

    Guhlmann, C.A.; Rendl, J.; Boerner, W.

    1995-01-01

    We studied the effects of radioiodine therapy (RIT) for autonomously functioning thyroid nodules (AFTNs) and Graves' disease on thyroid function and size up to one year after RIT. In 230 patients with AFTNs, a dose of 300 Gy was effective in about 90% of the cases 6 months after RIT. Out of 65 patients suffering from Graves' disease, 5 patients (8%) had persisting hyperthyroidism 6 months after RIT with a dose of 150 Gy. This group consisted exclusively of patients with manifest hyperthyroidism at the time of RIT. As determined by ultrasonography 6 months after RIT, a reduction of thyroid size by about 40% and 60% was observed in patients with AFTNs and Graves' disease, respectively. (orig.) [de

  9. Dose concepts and dosimetry for radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Bockisch, A.; Brandt-Mainz, K.; Goerges, R.

    1997-01-01

    Dose planning prior to radioiodine therapy of benign thyroidal disease is usually based on macrodosimetry. The paper shows that this assumption is acceptable. The common concepts for dose planning are given. The following target doses are nowadays widely accepted: 150 Gy for euthyroid goiter, 400 Gy for toxic adenoma, 150 Gy for disserminated autonomy, 200 Gy for hyperthyroid Grave's disease if posttherapeutic euthyroidism is intended, and 250 (to 300) Gy if the risk of recurrency is to be minimized ('ablative' concept). Finally, a surveyfis given concerning the precision in which the parameters relevant for the dose calcultion can be determined. For realistic favourable conditions, the dose can be determined with an accuracy of better than ±25%. (orig.) [de

  10. Effects of Radioiodine Therapy on the Natural History of Graves' Ophtalmopathy

    Directory of Open Access Journals (Sweden)

    A Dreval

    2007-09-01

    Full Text Available 21 patients with Graves’ disease and Graves’ ophthalmopathy (GO received radioiodine treatment (RIT. Before 131-I therapy in all patients GO were non-active and no severe. Six patients not received any treatment before RIT; four patients received orbital radiotherapy and 11 patients received intravenous glucocorticoids. Thyreotoxicosis compensation were achieved by antithyroid medication before RIT. Antithyroid medication was stopped 10 days before RIT. Worsening of GO was seen on 47.7% patients 3 months after RIT, but only 9.5% of patients needed additional treatment GO. GO exacerbation take place in 90% of hypothyroid patients and its compensation reduced the symptoms of activity of GO for 3 months. 42.8% was without any symptoms of activity of GO by 9—12 months after RIT. Treatment of GO before RIT were improved the course of GO after RIT.

  11. Treatment of hyperthyroidism with radioiodine: adjunctive therapy with antithyroid drugs reconsidered

    International Nuclear Information System (INIS)

    Velkeniers, B.; Vanhaelst, L.; Cytryn, R.; Jonckheer, M.H.

    1988-01-01

    To assess the value of antithyroid drugs as an adjunct to radioactive iodine for the treatment of hyperthyroidism the incidence of relapse or hypothyroidism after a mean follow-up of 51/2 years (range 2-7 years) was reviewed retrospectively for 206 patients, some treated with and others without antithyroid drugs after radioiodine therapy. Allocation to treatment group had been random, and both groups were similar in all respects except for the adjunctive treatment with antithyroid drugs. All doses of 131 I had been calculated by one physician. Compared with those who received 131 I alone, those starting on antithyroid drugs within 8 days after 131 I had a lower incidence of hypothyroidism but a higher incidence of early post-treatment recurrence or persistence of hyperthyroidism, and considerably lower incidence of remission. (author)

  12. Radiation exposure for 'caregivers' during high-dose outpatient radioiodine therapy

    International Nuclear Information System (INIS)

    Marriott, C. J.; Webber, C. E.; Gulenchyn, K. Y.

    2007-01-01

    On 27 occasions, radiation doses were measured for a family member designated as the 'caregiver' for a patient receiving high-dose radioiodine outpatient therapy for differentiated thyroid carcinoma. For 25 of the administrations, patients received 3.7 GBq of 131 I. Radiation doses for the designated caregivers were monitored on an hourly basis for 1 week using electronic personal dosemeters. The average penetrating dose was 98±64 μSv. The maximum penetrating dose was 283 μSv. Measured dose rate profiles showed that, on average, one-third of the caregiver dose was received during the journey home from hospital. The mean dose rate profile showed rapid clearance of 131 I with three distinct phases. The corresponding clearance half-times were 131 I contaminating the home. (authors)

  13. Intravenous alpha-1 antitrypsin augmentation therapy: systematic review

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C; Johansen, Helle Krogh

    2010-01-01

    We reviewed the benefits and harms of augmentation therapy with alpha-1 antitrypsin in patients with alpha-1 antitrypsin deficiency and lung disease. We searched for randomised trials comparing augmentation therapy with placebo or no treatment in PubMed and ClinicalTrials (7 January 2010). Two...... (difference 1.14 g/l; 95% confidence interval 0.14 to 2.14; p = 0.03) over the total course of the trials. Augmentation therapy with alpha-1 antitrypsin cannot be recommended in view of the lack of evidence of clinical benefit and the cost of treatment....

  14. Evaluation of radioiodinated vesamicol analogs for sigma receptor imaging in tumor and radionuclide receptor therapy.

    Science.gov (United States)

    Ogawa, Kazuma; Shiba, Kazuhiro; Akhter, Nasima; Yoshimoto, Mitsuyoshi; Washiyama, Kohshin; Kinuya, Seigo; Kawai, Keiichi; Mori, Hirofumi

    2009-11-01

    It has been reported that sigma receptors are highly expressed in a variety of human tumors. In this study, we selected (+)-2-[4-(4-iodophenyl)piperidino] cyclohexanol [(+)-pIV] as a sigma receptor ligand and evaluated the potential of radioiodinated (+)-pIV for tumor imaging and therapy. (+)-[(125/131)I]pIV was prepared by an iododestannylation reaction under no-carrier-added conditions with radiochemical purity over 99% after HPLC purification. Biodistribution experiments were performed by the intravenous injection of (+)-[(125)I]pIV into mice bearing human prostate tumors (DU-145). Blocking studies were performed by intravenous injection of (+)-[(125)I]pIV mixed with an excess amount of unlabeled sigma ligand into DU-145 tumor-bearing mice. For therapeutic study, (+)-[(131)I]pIV was injected at a dose of 7.4 MBq followed by measurement of the tumor size. In biodistribution experiments, (+)-[(125)I]pIV showed high uptake and long residence in the tumor. High tumor to blood and muscle ratios were achieved because the radioactivity levels of blood and muscle were low. However, the accumulations of radioactivity in non-target tissues, such as liver and kidney, were high. The radioactivity in the non-target tissues slowly decreased over time. Co-injection of (+)-[(125)I]pIV with an excess amount of unlabeled sigma ligand resulted in a significant decrease in the tumor/blood ratio, indicating sigma receptor-mediated tumor uptake. In therapeutic study, tumor growth in mice treated with (+)-[(131)I]pIV was significantly inhibited compared to that of an untreated group. These results indicate that radioiodinated (+)-pIV has a high potential for sigma receptor imaging in tumor and radionuclide receptor therapy.

  15. The relationship between 24 h/4 h radioiodine-131 uptake ratio and outcome after radioiodine therapy in 1402 patients with solitary autonomously functioning thyroid nodules

    International Nuclear Information System (INIS)

    Filesi, M.; Travascio, L.; Montesano, T.

    2009-01-01

    The objective of this study was to evaluate the role of 24 h/4 h uptake ratio (UR) in response to radioiodine-131 ( 131 I) therapy in patients with autonomously functioning thyroid nodules (AFTN). A total of 1402 consecutive hyperthyroid patients were treated with 131 I, between 1958 and 2005. Therapeutic doses (D) were calculated according to the formula: D=weight of nodule x dose per gram of nodular tissue (q)/24 h 131 I uptake. The ratios of the 24 and 4 h uptake were retrospectively calculated and the patients were grouped according to outcome and q into three groups of UR (≤1.25; 1.26-1.68; ≥1.69) by means of terziles. Of the 1402 patients, 95 did not respond to 131 I treatment while 93/1307 developed hypothyroidism. Most non-responders (55.8%) had UR ≤1.25, while many hypothyroid patients (66.7%) had UR ≥1.69 (χ 2 : P 131 I treatment, increasing to 13.9% at 5 years and 26.2% at 10 years. The 131 I UR can predict the outcome of 131 I treatment in AFTN and may have utility in modifying treatment in some patients to limit post-radioiodine induced hypothyroidism and treatment failures in order to achieve euthyroidism. (author)

  16. Administration of additional inactive iodide during radioiodine therapy for Graves' disease. Who might benefit?

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Moka, D.; Reinholz, U.; Schmidt, M.; Schomaecker, K.; Schicha, H.; Wellner, U. [Koeln Univ. (Germany). Dept. of Nuclear Medicine

    2007-07-01

    Aim: Graves' hyperthyroidism and antithyroid drugs empty the intrathyroid stores of hormones and iodine. The consequence is rapid {sup 131}I turnover and impending failure of radioiodine therapy. Can administration of additional inactive iodide improve 131I kinetics? Patients, methods: Fifteen consecutive patients, in whom the 48 h post-therapeutically calculated thyroid dose was between 150 and 249 Gy due to an unexpectedly short half-life, received 3 x 200 {mu}g inactive potassium-iodide ({sup 127}I) daily for 3 days (Group A), while 17 consecutive patients with a thyroid dose of = 250 Gy (Group B) served as the non-iodide group. 48 hours after {sup 131}I administration (M1) and 4 or 5 days later (M2) the following parameters were compared: effective {sup 131}I half-life, thyroid dose, total T3, total T4, {sup 131}I-activity in the T3- and T4-RIAs. Results: In Group A, the effective {sup 131}I half-life M1 before iodine (3.81 {+-} 0.93 days) was significantly (p <0.01) shorter than the effective {sup 131}I half-life M2 (4.65 {+-} 0.79 days). Effective {sup 131}I half-life M1 correlated with the benefit from inactive {sup 127}I (r = -0.79): Administration of {sup 127}I was beneficial in patients with an effective {sup 131}I half-life M1 of <3 or 4 days. Patients from Group A with high initial specific {sup 131}I activity of T3 and T4 showed lower specific {sup 131}I activity after addition of inactive iodine compared with patients from the same group with a lower initial specific {sup 131}I activity of T3 and T4 and compared with the patient group B who was given no additional inactive iodide. This correlation was mathematically described and reflected in the flatter gradient in Group A (y = 0.5195x + 0.8727 for {sup 131}I T3 and y = 1.0827x - 0.4444 for {sup 131}I T4) and steeper gradient for Group B (y = 0.6998x + 0.5417 for {sup 131}I T3 and y = 1.3191x - 0.2901 for {sup 131}I T4). Radioiodine therapy was successful in all 15 patients from Group A

  17. Whether antithyroid drugs influence on the outcome of radioiodine therapy of thyroid functional autonomy?

    International Nuclear Information System (INIS)

    Valuyevich, Viktar V.; Danilova, Larisa I.; Kaiser, Klaus P.; Ostwald-Lenz, Elisabeth; Wieler, Helmut

    2005-01-01

    Full text: The purpose of research was an estimation of the influence of antithyroid medication on efficiency of radioiodine therapy (RIT) in patients with thyroid functional autonomy (FA). 100 patients with various clinical variants of FA were included in research and received treatment with radioiodine. From them uni-focal autonomy (UFA) was diagnosed in 65 person, multifocal (MFA) in 14 and disseminated (DA) in 21. Among the patients included in research 8 had relapse of hyperthyroidism after initial operative treatment and 1 after RIT. The data in work are submitted as a median (1-st and 3-rd quartiles). The age of surveyed was 65.5 (54; 72.5), from them 63 persons were a female, 37 were a male. From surveyed 2 groups of patients were formed. The first group consisted from 50 person, initially accepting during 4 months (2.5; 6) antithyroid drugs (ATD) which cancellation had been made as a rule 2 day prior to RIT, and the second one included 50 person, not accepting ATD neither up to nor after RIT. 9 elderly and multi morbid patients from the first group continued to accept ATD within several months after RIT. Carbimazole (n=45) or methimazole (n=5) in a dose of 10 mg (5; 10) were used as ATD. Therapeutic activity of 131 I was calculated by means of Marinelli's formula. The target dose for UFA has made 400 Gy, for MFA and DA - 150 Gy. For calculation of thyroid uptake 24-hour radioiodine test was carried 2-3 day prior to RIT. Used activity of I-131 have made from 4.08 up to 58.89 mCi. Duration of inpatient stay has made 3 days (2; 5). In 4 months (4; 5) after RIT the successful result (euthyroidism or hypothyroidism) has been achieved in 48 (96 %) patients accepting ATD, and in 47 (94 %) patients who were not accepting last. Conclusion: The conclusion that antithyroid medication does not influence on the efficiency of RIT of FA was made. It was revealed that frequency of hypothyroidism after RIT in patients of the first group was higher (36 %) than in patients

  18. Efficiency of radioiodine therapy with a fix dose of I-131 in toxic thyroid adenoma

    International Nuclear Information System (INIS)

    Petrovski, Z

    2004-01-01

    Purpose: The aim of this study was to estimate the results obtained using a fix dose of I-131 in the treatment of the solitary toxic thyroid adenoma. Material and Methods: We have performed radioiodine therapy m 64 patients, 49 female (50+ 1 7 yrs) and 15 male (43+-15 yrs) with solitary toxic thyroid adenoma. 45 patients received fix dose I-131 of 850 MBq, while 19 patients were treated with calculated (MBq/gr) dose 555-1100 MBq Previously 39(64%) patients were clinically hyperthyreotic and received thyreostatic meditication which were interruptecf one week before the administration of I-131. Those patients who were euthyreotic, TSH was suppressed(<0.25 MU/m1). 61(95.3%) patients received a single dose, while 3(4, 7%) patients needed two doses. Resulting thyroid matabolism and volume of nodules were evaluated 6-48 months after treatment. Results: From 45 radioiodine treated patients with fix dose 6(9, 8%) became hypothyroidism, 36(85, 3%) euthyroidism and 3(4, 9%) recurrent hyperthyroidism, in comparison with 19 treated patients with calculated I-131 dose: 2(10, 5%) hypothyroidism, 16(84, 3%) euthyroidism and 1(5, 2%) recurrent hyperthyroidism. The size of the nodules became unpalpable m 17(26, 2%), decreased evidently in 33(52, 5%) and remained unchanged in 14(21, 3%) of the treated patients. Conclusion: A fix dose of I-131 is simple, safe and efficient in the treatment of solitary toxic thyroid adenoma. There was not significant different in incidence of late follow-up results of hypothyroidism and recurrent hyperthyroidism between fix dose and calculated MBq/gr dose. (authors)

  19. Results of a risk adapted and functional radioiodine therapy in Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Dunkelmann, S.; Neumann, V.; Staub, U.; Groth, P.; Kuenstner, H.; Schuemichen, C. [Klinik und Poliklinik fuer Nuklearmedizin, Zentrum fuer Radiologie, Univ. Rostock (Germany)

    2005-07-01

    Aim of this study was to find out, if results of a functional orientated radioiodine therapy in Graves' disease could be optimized using a risk adopted dose concept. Patients, method: 351 patients with Graves' disease were treated for the first time between 11/97 and 8/01. The basic dose was 125 Gy, which was increased up to 250 Gy in a cumulative manner depending on clinical parameters (initial thyroid metabolism, thyroid volume, immunoreactivity). Two different methods of dosimetry were used. Occasional thyreostasis was withdrawn two days before the radioiodine test was started. Follow up was done on overage 8 {+-} 2,4 (4-17,2) months. TSH {>=}0,27 {mu}IU/mL confirmed as a measure of the success. Results: With improved pretherapeutic dosimetry and a mean target dose of 178 {+-} 31 Gy (n = 72) therapeutic success occurred in 66,7%, in 51,4% euthyreosis was restalled and in 15,3% of patients hypothyroidism was seen (TSH >4,20 {mu}IU/mL). With simplified pretherapeutic dosimetry and a mean target dose of 172 {+-} 29 Gy (n = 279) results were moderately impaired (63,8%, 40,1% and 23,7%). With increasing target dose therapeutic failure increased, as unsufficiently adopted risk factors for therapeutic failure turned out the initial thyroid metabolism, the TcTU(s) as the (h)TRAb titer. Conclusion: Functional orientated RIT can be optimized by including illness specific characteristics, principal limitations are a high initial thyroid metabolism, a large thyroid volume and a high (h)TRAb-titer. (orig.)

  20. Radioiodine therapy of benign thyroid diseases: Graves' disease - current aspects; Radioiodtherapie gutartiger Schilddruesenerkrankungen: Morbus Basedow - aktuelle Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, M.J. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Bonn (Germany)

    2005-06-01

    Radioiodine therapy is a reliable and cost-effective alternative to medical treatment of Graves' hyperthyroidism. Current recommendations favour a risk-adapted therapeutic procedure. Medical treatment is preferred in patients with a low risk of relapse which are characterised by the combination of female gender, age of onset above 40 years, thyroid volume below 40 ml and TSH-receptor antibodies below 10 U/l. Because of the poor remission rate with medical treatment in patients at less than 40 years of age, male gender, thyroid volume above 40 ml and TSH receptor antibodies above 10 U/l, it is suggested that definitive treatment with radioiodine or surgery should be considered soon after disease presentation. Analysis of cost-effectiveness clearly favour ablative radioiodine treatment. Ablative treatment is even more favourable in terms of early resumption of a normal life style of the hyperthyroid patient. Recent publications suggest further an adaptation of the tissue-absorbed dose to the pre-treatment thyroid volume using Marinelli's formula to achieve thyroid ablation with a single radioiodine treatment. (orig.)

  1. Does an individual estimation of halflife improve the results of radioiodine therapy of Graves' disease?

    International Nuclear Information System (INIS)

    Schneider, P.; Koerber, C.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, Chr.

    2002-01-01

    Aim: The impact of our dosimetry concept on radioiodine therapy success in Graves' disease (GD) was analysed. Three questions arised: Did individual estimation of pretherapeutic halflife improve therapeutic success? Did individual dosimetry result in accurate dose calculation? Did antithyroid medication have a measurable influence on therapeutic success under the prevailing conditions? Methods: 126 consecutive patients were treated with 200 Gy I-131 in our therapy ward for GD and followed-up six to nine months after therapy. Success quote was assessed using a standardized protocol and treatment was classified as successful when the patients was eu- or hypothyroid, or unsuccessful when he or she presented with a suppressed TSH-level or in hyperthyroid condition after antithyroid medication withdrawal. Antithyroid medication, activity I-131, dose, concentration of fT 3 and fT 4 , specific delivered dose and halflife were put into a multiple regression model to assess their influence on therapeutic success. In order to assess possible factors disturbing the therapeutic outcome, relevant parameters were analyzed using Logit transformation. Results: Out of 126 patients 84 were classified as successfully treated and 42 (33,3%) as failures. A significant influence on the outcome only was found for thyroid mass. However, therapeutic success appeared to be more distinctly determined by the specific delivered dose using an estimated halflife of 5.5 days (Odds: 10.0, p [de

  2. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Eschner, W.; Luster, M.; Reiners, C.; Schober, O.; Muenster Univ.

    2007-01-01

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for 131 I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative 131 I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC ≤1 cm 131 I ablation may be helpful in an individual constellation. Preparation for 131 I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for 131 I-therapy in patients with metastases, higher sensitivity of 131 I whole-body scan) are discussed. In most centers standard activities are used for 131 I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of 131 I should not exceed 1-10MBq, alternative tracers are 123 I or 124 I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

  3. Radioiodine therapy in patients with Graves' disease; Radioiodoterapia em pacientes com doenca de Basedow-Graves

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Margarida Maria Galvao; Blum, Bernardo; Pellegrini, Paulo Martins [Instituto Brasileiro de Medicina Nuclear, Rio de Janeiro, RJ (Brazil); Corbo, Rossana [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Rebello, Ana Maria de Oliveira [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

    2000-04-01

    We studied retrospectively 104 patients with Graves' disease who underwent radioiodine therapy between 1983 and 1993. The administered dose varied from 2.0 to 9.0 mCi (74 to 333 MBq). In 1994 and 1998 the patients were asked to answer a questionnaire and were considered to have hypothyroidism when receiving T4 therapy. The importance of radioiodine therapy, its indications and the different methods of calculating the administered activity were studied. The results were compared with the literature. At the end of the evaluation, 62,4% of the patients presented hypothyroidism and 37,6% euthyroidism. There was no significant difference regarding the development of hypothyroidism when sex, number of doses, total activity (mCi), effective radiation ({mu}Ci per gram of tissue) and use of antithyroid drugs were considered. In conclusion, the period of time of post-radioiodine therapy is the most important factor in the analysis of the results, which may interfere with the development of hypothyroidism. (author)

  4. Benign thyroid disorders, radioiodine therapy and diagnosis related groups (DRGs): aspects of cost/benefit; Benigne Schilddruesenerkrankungen, Radioiodtherapie und Diagnosis Related Groups (DRGs): Kosten-Nutzen-Aspekte

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany)

    2005-06-01

    The increasing prevalence of goiter and thyroid nodules in older patients is accompanied by an increasing frequency of treatment and cost. Cost-effectiveness is given for programs of prophylaxis (primary prevention, e.g. alimentary iodine supplementation), for programs of screening (secondary prevention. e.g. TSH-screening), and for therapeutic strategies to avoid complications of thyroid dysfunction (atrial fibrillation, myocardial infarction, death for cardiac reasons) and to minimize iatrogenic complications (tertiary prevention). Examples of tertiary prevention are radioiodine-therapy of Graves' disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), radioiodine therapy of ouvert or subclinical hyperthyroidism, and radioiodine therapy of large goiters in older patients or in patients suffering from a relevant co-morbidity. A cost-effectiveness-analysis for different therapeutic strategies of Graves' disease has been published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%. Cost-minimization-analysis, comparing resection of goiter and radioiodine, has shown lower cost of radioiodine therapy for toxic multinodular goiter up to 100 ml and for Graves' disease up to 60 ml goiter volume. Medical aspects (volume of goiter, uptake of nodules, regressive goiter, suspicion on malignancy, patients' age, co-morbidity, patients' decision) remain decisive for the choice of treatment. (orig.)

  5. Radioiodine 131 therapy in hyperthyroidism evaluation of French nuclear medicine practices

    International Nuclear Information System (INIS)

    Bernard, D.; Boin, C.; Desruet, M.; Roux, J.; Wolf, M.; Fagret, D.; Allenet, B.; Foroni, L.

    2015-01-01

    Full text of publication follows. Aim Radioiodine 131 I (RAI) is currently used routinely in the treatment of hyperthyroidism including Graves disease (GD), toxic multi-nodular goitre (TMNG) and toxic solitary nodule (TSN). It has proved to be safe, efficient and relatively inexpensive therapy. But after more than 60 years, many protocols are coexisting and no consensus exists on the most appropriate way to prescribe RAI dose: fixed dose regime or calculated doses based on gland size or turnover of RAI. This is the first nationwide French survey assessing the current practices about radioiodine treatment in thyrotoxicosis. Methods: we sent a questionnaire to French nuclear medicine hospital units and cancer treatment centres (n=69) about their practices in 2012. Questions were asked about RAI treatment: objectives, way to prescribe the therapeutic dose and its factors, radioisotope use to explore thyroid function and method of gland size measurement. Results: we received 40 responses. Euthyroidism was a successful treatment outcome for 33% of French respondents whereas hypothyroidism was the aim for 26%. Antithyroid drugs were stopped 7 days on average (range 3-21 days) before therapy. 68% of physicians used ultrasound for thyroid volume measurement. Calculated doses were used by 40% of clinicians (Marinelli's formula: 80%). Factors influencing prescription were thyroid uptake (100%) based on radiotracer iodine-131 (33%) or iodine-123 (67%), thyroid volume (93%) and disease (80%). Fixed activities represented 60% of the prescribed doses (72,5% for TMNG and TSN). The administered dose was chosen between 1 to 3 levels of standard doses, according to the patient characteristics. Factors influencing this choice were disease, with respectively a median of 370 MBq (range:185-740), 555 MBq (185-740), 555 MBq (296-925) for GD, TSN and TMNG, thyroid volume (59%) and thyroid uptake (52%) with the radiotracer iodine-123 (30%) or technetium-99m (70%). Even physicians

  6. Clinical Utility of SPECT/CT Imaging Post-Radioiodine Therapy: Does It Enhance Patient Management in Thyroid Cancer?

    Science.gov (United States)

    Hassan, Fahim U; Mohan, Hosahalli K

    2015-12-01

    The aim of this study was to evaluate post-therapy iodine-131 single-photon emission computed tomography/computed tomography ((131)I-SPECT/CT) imaging in comparison to conventional planar (131)I whole-body imaging, and to assess its clinical impact on the management of patients. We retrospectively reviewed planar (131)I whole-body and (131)I-SPECT/CT imaging findings in 67 patients who underwent (131)I therapy for thyroid cancer. Two nuclear medicine physicians reviewed the scans independently. The foci of increased tracer uptake were identified in the neck, thorax and elsewhere. Within the neck, the foci of (131)I-increased uptake were graded qualitatively as probable or definite uptake in thyroid remnants and probable or definite uptake in the lymph nodes. Serum thyroglobulin level, histopathology and other imaging findings served as the reference standard. Of the 67 patients, 57 (85%) had radioiodine avid disease and 10 (15%) demonstrated non-radioiodine avid disease. Overall, post-therapy (131)I-SPECT/CT downstaged lymph node staging in 10 patients and upstaged it in 4 patients. This translated into a change of management for 9/57 (16%) patients with radioiodine avid disease. A change of management was observed in 5/10 patients with non-radioiodine avid disease confirmed in the post-(131)I-SPECT/CT study. Additionally, clinically significant findings such as incidental lung cancer, symptomatic pleural effusion and consolidation were also diagnosed in both groups of patients. In patients with thyroid cancer, (131)I-SPECT/CT is a valuable addition to standard post-therapy planar imaging. SPECT/CT also improved diagnostic confidence and provided crucial clinical information leading to change of management for a significant number of these patients.

  7. Guidelines on radioiodine therapy for differentiated thyroid carcinoma. Impact on clinical practice

    International Nuclear Information System (INIS)

    Biermann, M.; Pixberg, M.K.; Schober, O.; Doerr, U.; Dietlein, M.; Schlemmer, H.; Grimm, J.; Zajic, T.; Nestle, U.; Ladner, S.; Sepehr-Rezai, S.; Rosenbaum, S.; Puskas, C.; Fostitsch, P.; Heinecke, A.; Schuck, A.; Willich, N.; Schmid, K.W.; Dralle, H.

    2005-01-01

    Aim: For the examination of the impact on clinical practice of the guidelines for differentiated thyroid carcinoma (DTC), treatment data from the ongoing multicenter study differentiated thyroid carcinoma (MSDS) were analyzed. Patients, methods: patients were randomized to adjuvant external beam radiotherapy (RTx) or no RTx in addition to standard therapy in TNM stages pT4 pNO/1/x MO/x (UICC, 5 th ed. 1997). All patients were to receive the same treatment regimen consisting of thyroidectomy, ablative radioiodine therapy (RIT), and a diagnostic 131 I whole-body scintigraphy (WBS) 3-4 months after RIT. Results: Of 339 eligible patients enrolled between January 2000 and March 2004, 273 could be analyzed. Guideline recommendations by the German Society for Nuclear Medicine from 1999 and 1992 were complied with within 28% and 82% with regard to the interval between surgery and RIT (4 vs. 4-6 weeks), in 33% and 84% with regard to 131 I activity for RIT (1-3 vs. 1-4 GBq; ±10%), and in 16% and 60% with regard to 131 I activity for WBS (100-300 vs. 100-400 MBq; ±10%). Conclusions: the 1999 guideline revision appears to have had little impact on clinical practice. Further follow-up will reveal if guideline compliance had an effect on outcomes. (orig.)

  8. Preliminary study of attitude and knowledge of thyroid cancer patients to radioiodine therapy

    International Nuclear Information System (INIS)

    Thongpraparn, Thonnapong; Pusuwan, Pawana; Tocharoenchai, Chiraporn; Siriphitukyotin, Oratai; Wongsawat, Wanwimon; Chaudakshetrin, Pachee; Putrasreni, Nucharee

    2003-01-01

    The purpose of this preliminary study is to survey the attitude and knowledge of radiation and radioiodine treatment in thyroid cancer patients. Fifty-two thyroid cancer patients who were prepared for radioactive iodine treatment at Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital were requested to fill the questionaires before and after receiving the information about radioiodine treatment. The questionaires consisted of 12 questions of which the first five were about the attitude to radiation and radioiodine treatment. The rest was about an information on radioiodine treatment. For data analysis, firstly the percentage of correct answer of each question was calculated and compared between pre- and post-test. Secondly all patients were categorized into 2 groups according to their education: upto high school, and undergraduate or higher. The attitude and the understanding about radioiodine treatment were analyzed in each group. The results show that post-test gives higher percentages of correct answers for all questions with an average of 29% improvement. For upto high school group, the attitude improves from 69.4% to 97.2% and the understanding about radioiodine treatment improves from 88.9% to 100%. Similarly, for the undergraduate or higher group,the attitude improves from 93.3% to 100% and the understanding about radioiodine treatment improves from 73.3% to 100%. It may be concluded that our education intervention is informative and the well-educated patients have better attitude to radiation

  9. Results of a TcTUs-optimized radioiodine therapy of multifocal and disseminated functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.; Endlicher, D.; Prillwitz, A.; Rudolph, F.; Groth, P.; Schuemichen, C.

    1999-01-01

    Aim: The presented study prospectively evaluates the efficacy of optimized radioiodine therapy in patients (pts) with multifocal (MFA) and disseminated (DISA) autonomy. The target dose was related to the total thyroid volume and was increased in moderate and nonlinear increments for 150 to 300 Gy dependent on the pretherapeutic Tc-99m pertechnetate thyroid uptake under suppression (TcTUs). Patients with focal autonomy were treated with a target dose independent of TcTUs and were used as control group. Methods: The data of 641 pts (518 women, 123 men) were evaluated, 466 pts with MFA or DISA and 175 pts with focal autonomy. In pts with MFA and DISA the target dose was increased in four steps: TcTUs 3-6%: 200 Gy, >6-12%: 250 Gy and >12%: 300 Gy. In pts with focal autonomy a fixed target dose of 300 or 400 Gy was applied. The radioactivity to be administered was calculated using a modified Marinelli formula. The follow-up examination was performed at the earliest after four, on average after eight months. Normalization of TSH was the only criterion for successful therapy. Results: The success rate in pts with latent or manifest hyperthyroidism in focal autonomy was 91.5%, thereby was not successful in 5.1% and hypothyroidism occurred in 3.4%. The average success rate in pts with MFA and DISA was 91.5%, therapy failed in 7.5% and a very low rate of 1% with hypothyroidism was seen. Conclusion: The presented optimized therapy concept with calculated, nonlinear increase of the target dose according to the TcTUs-level guaranteed even in MFA and DISA a high success rate comparable to that in focal autonomy along with a very low rate of hypothyroidism. (orig.) [de

  10. Is administered radioiodine activity appropriate? The effects of pre- treatment antithyroid drugs on the therapy outcome

    International Nuclear Information System (INIS)

    Nanayakkara, D.; Udugama, C.; Perera, K.; Herath, S.

    2007-01-01

    Full text: Although radioiodine (RAI) therapy has been used in the treatment of thyrotoxicosis, there are both wide variations in current practice and deficiencies in outcome. There is concern as to decide the optimum activity to achieve better therapeutic outcome and uncertainty over the effects of pretreatment antithyroid drugs (ATD) on the post therapy outcome. Use of ATD (carbimazole) to control the severity of the disease prior to RAI therapy is a common accepted practice. The Royal college of Physicians (RCP) guideline on radioiodine therapy for thyrotoxicosis has recommended activity of 400mBq for Graves' disease (GD) and 15mCi for toxic multi nodular disease (TMND) to achieve euthyroidism with an incidence of hypothyroidism around 15-20% at 2 years. However, in the clinical setting, many patients have become hypothyroid very early than the expected time period. This study was carried out to see the fixed dose RAI therapy outcome of both GD and TMND. Another objective is to assess the effects of pre therapy ATD on the RAI therapy for both GD and TMND at 1 year. Post RAI therapy outcome was analyzed in thyrotoxic patients who received RAI at our institute from 2001-2005. Diagnosis of thyrotoxicosis was made on the basis of biochemical thyroid function tests and thyroid uptake scans. Both GD and TMND patients were selected. Patients who were treated with ATD were advised to stop drugs for at least 4 weeks before administration of RAI therapeutic dose. GD patients received 400mBq and TMND received 550mBq of RAI irrespective of the size of the thyroid gland. Both GD and TMND were further categorized into two groups on the basis of whether they have given ATD prior to RAI therapy. Patients with solitary toxic nodular disease were excluded from the study. Post therapy thyroid functions (free thyroxine and thyroid stimulating hormone) were done at 1, 2, 3, 6 and 12 months intervals. Therapy outcome over time was defined on the basis of thyroid function and

  11. Long-term carbimazole pretreatment reduces the efficacy of radioiodine therapy

    Directory of Open Access Journals (Sweden)

    C Shivaprasad

    2015-01-01

    Full Text Available Introduction: Data from several studies suggest that pretreatment with antithyroid drugs (ATD before 131 I increases the risk of treatment failure. This effect has been demonstrated more consistently with propylthiouracil than with carbimazole (CMZ or methimazole (MMI. Men with Graves′ disease (GD have a lower rate of remission with 131 I compared to women and the impact of long-term ATD pretreatment on the success of 131 I is unknown. The objective of our study was to compare the efficacy of fixed doses of radioiodine between patients with and without long-term CMZ pretreatment. Materials and Methods: We performed a retrospective study on 335 male patients with GD treated with 131 I from 1998 to 2008. 148 patients had been pretreated with CMZ, and the remaining 187 patients received 131 I without pretreatment. We compared the success rate of a single dose of 131 I, between patients with and without long-term CMZ pretreatment. Results: The success rate of a single dose of 131 I was significantly higher in patients without pretreatment than in patients who were pretreated with CMZ (91.4% vs. 82.3%, P = 0.01. The rate of hypothyroidism in the first 6 months after 131 I therapy was significantly higher in patients without pretreatment (55.1% vs. 44.6%, P = 0.05. There was also a trend for higher cumulative rate of hypothyroidism at last follow-up in nonpretreated patients (78.1% vs. 69.7%. Conclusion: Male patients with Graves′ hyperthyroidism pretreated with CMZ have lower efficacy with 131I therapy compared to nonpretreated patients. CMZ pretreatment given for a prolonged period reduces the efficacy of 131 I therapy.

  12. Cytogenetic biodosimetry and dose-rate effect after radioiodine therapy for thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Khvostunov, Igor K. [Russian Ministry of Health Care, A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Obninsk, Kaluga Region (Russian Federation); Nagasaki University, Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki (Japan); Saenko, Vladimir A.; Yamashita, Shunichi [Nagasaki University, Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki (Japan); Krylov, Valeri; Rodichev, Andrei [Russian Ministry of Health Care, A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Obninsk, Kaluga Region (Russian Federation)

    2017-08-15

    This study set out to investigate chromosomal damage in peripheral blood lymphocytes of thyroid cancer patients receiving {sup 131}I for thyroid remnant ablation or treatment of metastatic disease. The observed chromosomal damage was further converted to the estimates of whole-body dose to project the adverse side effects. Chromosomal aberration analysis was performed in 24 patients treated for the first time or after multiple courses. Blood samples were collected before treatment and 3 or 4 days after administration of 2-4 GBq of {sup 131}I. Both conventional cytogenetic and chromosome 2, 4 and 12 painting assays were used. To account for dose-rate effect, a dose-protraction factor was applied to calculate the whole-body dose. The mean dose was 0.62 Gy (95% CI: 0.44-0.77 Gy) in the subgroup of patients treated one time and 0.67 Gy (95% CI: 0.03-1.00 Gy) in re-treated patients. These dose estimates are about 1.7-fold higher than those disregarding the effect of exposure duration. In re-treated patients, the neglected dose-rate effect can result in underestimation of the cumulative whole-body dose by the factor ranging from 2.6 to 6.8. Elevated frequency of chromosomal aberrations observed in re-treated patients before radioiodine therapy allows estimation of a cumulative dose received from all previous treatments. (orig.)

  13. Radioiodine therapy in patients with Graves' disease: Comparison of outcome between Freiburg and Munich

    International Nuclear Information System (INIS)

    Moser, E.; Dagres, E.; Blattmann, H.; Kreisig, T.; Mann, K.

    1990-01-01

    The aim on this paper was to compare the results of radioiodine therapy (RIT) in patients with Graves' disease treated at two different nuclear medicine departments, Freiburg (FR); Munich (M). A low dose concept applying 60-80 Gy provides only a moderate rate of success: FR (80 Gy): 80%; M (60 Gy): 54%. A dose of 150 Gy, however, succeeds in 81% of the FR-cases and in 86% of the M-cases. As a consequence, this 150 Gy approach has a higher incidence of post-treatment hypothyroidism: FR: 49%; M: 62%. As the rate of post-treatment hypothyroidism seems to be independent of the dose concept these early post-treatment numbers will increase by about 4% per year in all patients. Nevertheless, the high dose concept is recommended, because the aim of RIT is to remove hyperthyroidism reliably, as the surgeons have told us. A hypothyroidism after RIT of Graves' disease, however, is the lesser evil compared to remaining or recurrent hyperthyroidism since these patients can be treated with thyroid hormones without problems. (orig.) [de

  14. Radioprotective action of carbimazole in radioiodine therapy for thyrotoxicosis - influence of the drug on iodine kinetics

    International Nuclear Information System (INIS)

    Connell, J.M.C.; Alexander, W.D.; Glasgow Univ.

    1987-01-01

    Pretreatment with carbimazole of patients given radioiodine ( 131 I) therapy for thyrotoxicosis reduces the incidence of early hypothyroidism. The possibility that this radioprotective effect might be a consequence of drug induced alteration in thyroidal iodide turnover, leading to a reduction in thyroid irradiation, was investigated in a prospective study of 24 thyrotoxic patients. Subjects were randomly assigned to receive 131 I alone or to be treated with carbimazole for a minimum of three months before 131 I. Thyroxine supplements were given in the latter group to prevent iatrogenic hypothyroidism. The effective half-life of therapeutic 131 I in the thyroid was measured using a gamma camera/computer system after oral administration of the dose, allowing the biological half life of the anion and estimated radiation dose to the thyroid to be derived. Effective half life of 131 I, biological half life of 131 I and estimated radiation dose to the thyroid were similar in the two groups of subjects. It is concluded that the radioprotective action of carbimazole is not a consequence of altered thyroidal iodide kinetics. (orig.)

  15. Cytogenetic effects of radioiodine therapy: a 20-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Livingston, Gordon K. [Oak Ridge Institute for Science and Education, Radiation Emergency Assistance Center/Training Site, Oak Ridge, TN (United States); Khvostunov, Igor K. [Medical Radiological Research Center, Obninsk, Kaluga Region (Russian Federation); Gregoire, Eric [Institut de Radioprotection et de Surete Nucleaire, PRP-HOM/SRBE/LDB, BP 17, Fontenay aux roses Cedex (France); Barquinero, Joan-Francesc [Universtitat Autonoma de Barcelona, Facultat de Biociencies, Cerdanyola del Valles (Spain); Shi, Lin; Tashiro, Satoshi [Hiroshima University, Department of Cellular Biology, Research Institute for Radiation Biology and Medicine, Hiroshima (Japan)

    2016-05-15

    The purpose of this study was to compare cytogenetic data in a patient before and after treatment with radioiodine to evaluate the assays in the context of biological dosimetry. We studied a 34-year-old male patient who underwent a total thyroidectomy followed by ablation therapy with {sup 131}I (19.28 GBq) for a papillary thyroid carcinoma. The patient provided blood samples before treatment and then serial samples at monthly intervals during the first year period and quarterly intervals for 5 years and finally 20 years after treatment. A micronucleus assay, dicentric assay, FISH method and G-banding were used to detect and measure DNA damage in circulating peripheral blood lymphocytes of the patient. The results showed that radiation-induced cytogenetic effects persisted for many years after treatment as shown by elevated micronuclei and chromosome aberrations as a result of exposure to {sup 131}I. At 5 years after treatment, the micronucleus count was tenfold higher than the pre-exposure frequency. Shortly after the treatment, micronucleus counts produced a dose estimate of 0.47 ± 0.09 Gy. The dose to the patient evaluated retrospectively using FISH-measured translocations was 0.70 ± 0.16 Gy. Overall, our results show that the micronucleus assay is a retrospective biomarker of low-dose radiation exposure. However, this method is not able to determine local dose to the target tissue which in this case was any residual thyroid cells plus metastases of thyroidal origin. (orig.)

  16. Radioprotective action of carbimazole in radioiodine therapy for thyrotoxicosis - influence of the drug on iodine kinetics

    Energy Technology Data Exchange (ETDEWEB)

    Connell, J.M.C.; Hilditch, T.E.; Robertson, J.; Alexander, W.D.

    1987-10-01

    Pretreatment with carbimazole of patients given radioiodine (/sup 131/I) therapy for thyrotoxicosis reduces the incidence of early hypothyroidism. The possibility that this radioprotective effect might be a consequence of drug induced alteration in thyroidal iodide turnover, leading to a reduction in thyroid irradiation, was investigated in a prospective study of 24 thyrotoxic patients. Subjects were randomly assigned to receive /sup 131/I alone or to be treated with carbimazole for a minimum of three months before /sup 131/I. Thyroxine supplements were given in the latter group to prevent iatrogenic hypothyroidism. The effective half-life of therapeutic /sup 131/I in the thyroid was measured using a gamma camera/computer system after oral administration of the dose, allowing the biological half life of the anion and estimated radiation dose to the thyroid to be derived. Effective half life of /sup 131/I, biological half life of /sup 131/I and estimated radiation dose to the thyroid were similar in the two groups of subjects. It is concluded that the radioprotective action of carbimazole is not a consequence of altered thyroidal iodide kinetics.

  17. The influence of antithyroid drugs on the results of radioiodine therapy of thyroid functional autonomy

    International Nuclear Information System (INIS)

    Valuevich, V.V.

    2005-01-01

    The purpose of the given research was the estimation of the influence of antithyroid medication on efficiency of radioiodine therapy (RIT) of nonimmune hyperthyroidism in patients with thyroid functional autonomy (FA). 100 patients with various clinical variants of thyroid FA were included in research and received treatment with radioactive iodine. From surveyed 2 groups of patients were formed. The first group consisted from 50 persons initially accepting during 4 months (2.5; 6) antithyroid drugs (ATD) which cancellation had been made, as a rule, 2 day prior to RIT, and the second included 50 persons not accepting ATD neither up to nor after RIT. 9 elderly and multimorbid patients from the first group continued to accept ATD within several months after RIT. Carbimazole (n=45) or methimazole (n=5) in a doze of 10 mg (5; 10) were used as antithyroid drugs. In 4 months (4; 5) after RIT the successful result (euthyrosis or hypothyroidism) was achieved in 48 (96%) patients accepting ATD, and in 47 (94%) patients who were not accepting last. The conclusion that antithyroid medication does not influence on efficiency of RIT of thyroid FA is made. It is revealed that frequency of hypothyroidism after RIT in patients of the first group was higher (36%), than in patients of the second group (20%). (authors)

  18. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    Energy Technology Data Exchange (ETDEWEB)

    Gotthardt, M. [Radboud Univ. Nijmegen Medical Center, Nijmegen (Netherlands). Dept. of Nuclear Medicine; Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Rubner, C. [Philipps Univ., Marburg (Germany). Dept. of Nuclear Medicine; Bauhofer, A. [Philipps Univ., Marburg (DE). Inst. of Theoretical Surgery] (and others)

    2006-07-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76{+-}80.6 Gy versus 125.6{+-}46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2{+-}101.7 Gy versus 125.6{+-}46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  19. Results of radioiodine therapy of manifest hyperthyroidism and autonomous euthyroid goiter

    International Nuclear Information System (INIS)

    Berding, G.; Schicha, H.

    1990-01-01

    In 200 patients follow-up examinations were performed up to one year after radioiodine therapy (RITh) with individual dose calculation. The mean applied dose was significantly lower in patients with immunogenic hyperhyroidism (Graves' disease) as compared to patients with non-immunogenic hyperthyroidism (disseminated/multifocal autonomy, HYDA). In Graves' disease the rate of recurrent hyperthyroidism was significantly higher and that of posttreatment hypothyroidism lower. Considering the high recurrence rate in Graves' disease a higher dose, e.g. 150 Gy, seems to be appropriate. In patients with HYDA who received antithyroid drugs during RITh, recurrence of hyperthyroidism appeared slightly more, and posttreatment hypothyroidism slightly less, frequent. The efficiency of RITh was not significantly reduced by additional treatment with antithyroid drugs. Posttreatment hypothyroidism in patients with euthyroid goiter and disseminated/multifocal autonomy (EUDA) occurred significnatly more frequent if the basal TSH level was ≥ 0.5 μIE/ml before therapy. The goiter size was reduced independent of the basal TSH level. In HYDA patients after thyroid surgery recurrence appeared less, and in those with EUDA posttreatment hypothyroidism significantly more, frequent. A lower dose seems to be suitable in patients who underwent thyroid surgery before. In patients with focal autonomy after RITh no recurrence of hyperthyroidism was observed. In 9% a suppressed basal TSH level indicating persistent autonomy was seen. Posttreatment hypothyroidism in focal autonomy appeared only in patients without manifest hyperthyroidism before RITh and was significantly more frequent in this group. In patients with focal autonomy who developed hypothyroidism the dose calculation was based on a significantly higher volume of the adenoma. (orig./MG) [de

  20. Radioiodine therapy for Plummer's disease based on the thyroid uptake of technetium-99m pertechnetate

    International Nuclear Information System (INIS)

    Meller, J.; Wisheu, S.; Behe, M.; Gratz, S.; Becker, W.

    2000-01-01

    The aim of this retrospective study was the evaluation of a TcTUs (global technetium-99m pertechnetate thyroid uptake under suppression)-based approach in 370 patients with thyroid autonomy (Plummer's disease) treated by radioiodine therapy (RIT) under standardised conditions. The analysis included 370 patients (309 females, 61 males; mean age 64±11.6 years) treated for thyroid autonomy [unifocal (UFA), 36.8%; multifocal (MFA), 55.7%; disseminated (DISA), 7.6%]. During RIT all patients were under thyroid suppression (TSH 0.5 μU/l and/or TcTUs 4 μU/ml). A dose of 350-450 Gy to the autonomous tissue resulted in a success rate of 97% in the UFA group and 81% in the MFA/DISA group. Decrease in total thyroid volume and TcTUs did not differ significantly between successfully treated patients and patients with persistent autonomy. Multivariate analysis of all 370 patients identified four independent factors that negatively influenced the therapeutic success: high pretherapeutic thyroid volume (P=0.0001; odds ratio: 1.017), high pretherapeutic TcTUs values (P=0.0001; odds ratio: 1.378), multifocal/disseminated autonomy (P=0.0056; odds ratio: 3.245) and low target dose (P=0.017; odds ratio: 0.997). It is concluded that the high success rate in the treatment of UFA indicates the concept of TcTUs-based RIT to be valid, but that in the therapy of MFA/DISA the target se has to be corrected if the total thyroid volume exceeds a critical threshold. (orig.)

  1. Influence of antithyroid medication on effective half-life and uptake of 131 I following radioiodine therapy

    International Nuclear Information System (INIS)

    Moka, D.; Voth, E.; Schicha, H.

    1997-01-01

    Aim: A radioiodine therapy (RIT) in thyrotoxic patients receiving antithyroid drugs (ATD) leads in comparison to nonpretreated patients either to higher therapeutic doses or to higher treatment failure rates. Aim of this study was to optimize the effect of RIT in patients pretreated with ATD. Methods: Therefore, the influence of ATD was assessed in 109 patients with shortened effective half-life of 131 I. RIT was performed under stationary conditions. Radioiodine activity of the thyroid gland was stopped three days after RIT. The patients antithyroid medication was stopped three days after RIT. The progress of the first RIT and of a second radioiodine application, which still was necessary in 29 patients, was compared to 32 patients receiving ATD, continuously. Results: Values of effective half-life for 131 I rose significantly from 3.2±0.2 to 5.7±0.2 days (Graves' disease: 3.4 to 5.7 days; toxic goiters' disease: Multifocal autonomy 3.2 to 6.2 days; unifocal autonomy 2.5 auf 5.0 days) 2-3 days after stopping ATD. There was an increase of the 131 I-uptake of a second RIT decreased significantly in patients receiving ATD, continuously. Conclusion: Effective half-life and uptake of 131 I was affected significantly by ATD. The stop taking of ATD after RIT is useful to improve an apparent insufficient RIT in thyrotoxic patients receiving ATD. (orig.) [de

  2. Graves' disease and radioiodine therapy. Is success of ablation dependent on the choice of thyreostatic medication?

    Energy Technology Data Exchange (ETDEWEB)

    Kobe, C.; Weber, I.; Eschner, W.; Sudbrock, F.; Schmidt, M.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2008-07-01

    Aim: this study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease. Patients, material, methods: a total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months offer RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved. Results: relief from hyperthyroidism was achieved in 96% of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p = 0.22). Conclusion: thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy. (orig.)

  3. Body weight gain after radioiodine therapy of hyperthyroidism; Koerpergewichtsentwicklung nach Radioiodtherapie einer Hyperthyreose

    Energy Technology Data Exchange (ETDEWEB)

    Scheidhauer, K.; Odatzidu, L.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Kiencke, P. [Koeln Univ. (DE). Inst. fuer Medizinische Statistik, Informatik und Epidemiologie (IMSIE)

    2002-02-01

    Aim: Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Methods: Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. Results: All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. Conclusions: An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas. (orig.) [German] Ziel: Untersuchung der Entwicklung des Koerpergewichtes nach {sup 131}I-Therapie einer Hyperthyreose, da der Radioiodtherapie (RITh) haeufig eine exzessive posttherapeutische Gewichtszunahme angelastet wird. Methoden: Retrospektiv wurden therapie- und koerpergewichtsbezogene Daten von 100 konsekutiven Patienten vor und bis drei Jahre nach RITh einer Hyperthyreose (Morbus Basedow oder funktionelle Autonomie) erfasst und mit denen einer euthyreoten Kontrollgruppe (n = 48) verglichen. Die

  4. The superiority and benefits of whole body imaging after radioiodine -131 therapy over radioiodine 131 diagnostic imaging in management of thyroid carcinomas.

    Energy Technology Data Exchange (ETDEWEB)

    Aleid, M A [Al-Mostansyria university, college of medicine P.O.Box 14132, Baghdad, (Iraq)

    1995-10-01

    A comparison between diagnostic and post therapeutic radioiodine imaging methods utilized in detection of thyroid metastases in 34 patients with well differentiated thyroid cancer was performed. The study revealed that the differences in detection on neck activity only between the two methods for papillary and follicular thyroid cancer were 35% and 27% respectively. While the overall detection percentages in both papillary and follicular thyroid cancers cases were 23% in diagnostic and 76% in post therapy scintigrams and the detection difference between the methods was 53% when all lesions throughout the body were seen on scintigram for only follicular thyroid cancer cases were counted, the detection percentage was increased up to 109%. It is clear that post therapeutic scans visualize an additional site activity not shown in diagnostic scans. There fore, post therapeutic imaging method is far superior to diagnostic imaging method and highly sensitive in visualization of thyroid metastases. On the other hand, this research also achieves many scientific and financial benefits. Therefore. This method should be adopted in management and follow up of well differentiated malignancies. 2 figs., 2 tabs.

  5. The superiority and benefits of whole body imaging after radioiodine -131 therapy over radioiodine 131 diagnostic imaging in management of thyroid carcinomas

    International Nuclear Information System (INIS)

    Aleid, M.A.

    1995-01-01

    A comparison between diagnostic and post therapeutic radioiodine imaging methods utilized in detection of thyroid metastases in 34 patients with well differentiated thyroid cancer was performed. The study revealed that the differences in detection on neck activity only between the two methods for papillary and follicular thyroid cancer were 35% and 27% respectively. While the overall detection percentages in both papillary and follicular thyroid cancers cases were 23% in diagnostic and 76% in post therapy scintigrams and the detection difference between the methods was 53% when all lesions throughout the body were seen on scintigram for only follicular thyroid cancer cases were counted, the detection percentage was increased up to 109%. It is clear that post therapeutic scans visualize an additional site activity not shown in diagnostic scans. There fore, post therapeutic imaging method is far superior to diagnostic imaging method and highly sensitive in visualization of thyroid metastases. On the other hand, this research also achieves many scientific and financial benefits. Therefore. This method should be adopted in management and follow up of well differentiated malignancies. 2 figs., 2 tabs

  6. Pre-therapeutic blood dosimetry in patients with differentiated thyroid carcinoma using 124-iodine. Predicted blood doses correlate with changes in blood cell counts after radioiodine therapy and depend on modes of TSH stimulation and number of preceding radioiodine therapies

    International Nuclear Information System (INIS)

    Hartung-Knemeyer, V.; Nagarajah, J.; Jentzen, W.; Ruhlmann, M.; Freudenberg, L.S.; Stahl, A.R.; Bockisch, A.; Rosenbaum-Krumme, S.J.

    2012-01-01

    Pre-therapeutic blood dosimetry prior to a high-dose radioiodine therapy (RAIT) is recommended and a blood dose of 2 Gy is considered to be safe. In this study, changes in the blood cell count after radioiodine therapy of high risk differentiated thyroid carcinoma (DTC) were analyzed and compared with the results of the pre-therapeutic blood dosimetry using 124 I. Moreover, the influence of different modes of TSH stimulation and the number of preceding radioiodine therapies on the blood dose were assessed. 198 patients with locally advanced or metastasized DTC received a pre-therapeutic blood dosimetry using 124 I. To analyze the influence of the modes of TSH stimulation and the number of preceding RAITs on blood dose subgroups were built as follows: patients with endogenous TSH stimulation versus patients with exogenous TSH stimulation and patients with no preceding RAIT versus patients with at least one preceding RAIT. In 124/198 patients subsequent RAIT was performed. In 73/124 patients, hemograms were performed from day 2 to 12 month after RAIT. There was no high-grade bone marrow toxicity (id est (i.e.) ≥grade 3) in patients receiving less than 2 Gy blood dose-independent of the therapeutic history. Within the first month after radioiodine therapy, there was an overall decrease in the white blood cell and platelet counts. The erythrocyte count was essentially stable. There was a correlation between cell count decrease and predicted blood doses (Spearman's correlation coefficient >-0.6 each) for the white cell line and the platelets. With regard to the subgroups, the blood dose per administered 131 I activity (BDpA) was significantly higher in patients with endogenous TSH stimulation (median 0.08 Gy/GBq) than in patients with exogenous TSH stimulation (0.06 Gy/GBq) and in patients with no previous RAIT (0.08 Gy/GBq) compared to patients who had previously undergone at least one RAIT (0.07 Gy/GBq). The range of BDpA among DTC patients is rather wide. Our

  7. Radioiodine Therapy of Hyperthyroidism. Simplified patient-specific absorbed dose planning

    Energy Technology Data Exchange (ETDEWEB)

    Joensson, Helene

    2003-10-01

    Radioiodine therapy of hyperthyroidism is the most frequently performed radiopharmaceutical therapy. To calculate the activity of {sup 131}I to be administered for giving a certain absorbed dose to the thyroid, the mass of the thyroid and the individual biokinetic data, normally in the form of uptake and biologic half-time, have to be determined. The biologic half-time is estimated from several uptake measurements and the first one is usually made 24 hours after the intake of the test activity. However, many hospitals consider it time-consuming since at least three visits of the patient to the hospital are required (administration of test activity, first uptake measurement, second uptake measurement plus treatment). Instead, many hospitals use a fixed effective half-time or even a fixed administered activity, only requiring two visits. However, none of these methods considers the absorbed dose to the thyroid of the individual patient. In this work a simplified patient-specific method for treating hyperthyroidism is proposed, based on one single uptake measurement, thus requiring only two visits to the hospital. The calculation is as accurate as using the individual biokinetic data. The simplified method is as patient-convenient and time effective as using a fixed effective half-time or a fixed administered activity. The simplified method is based upon a linear relation between the late uptake measurement 4-7 days after intake of the test activity and the product of the extrapolated initial uptake and the effective half-time. Treatments not considering individual biokinetics in the thyroid result in a distribution of administered absorbed dose to the thyroid, with a range of -50 % to +160 % compared to a protocol calculating the absorbed dose to the thyroid of the individual patient. Treatments with a fixed administered activity of 370 MBq will in general administer 250 % higher activity to the patient, with a range of -30 % to +770 %. The absorbed dose to other

  8. Predictors of treatment failure, incipient hypothyroidism, and weight gain following radioiodine therapy for Graves' thyrotoxicosis.

    Science.gov (United States)

    Gibb, F W; Zammitt, N N; Beckett, G J; Strachan, M W J

    2013-10-01

    Following radioiodine ((131)I) therapy, both late recognition of hypothyroidism and treatment failure may result in adverse outcomes. We sought to assess indicators of both incipient hypothyroidism and treatment failure following (131)I and determine factors predictive of weight gain. Retrospective study of 288 patients receiving (131)I for treatment of Graves' thyrotoxicosis. Primary outcome measures were thyroid status and weight change at 1 yr following (131)I. The treatment failure rate at 1 yr was 13.5%. Hypothyroidism developed in 80.9%, with 58.5% of patients having levels of free T4 (fT4) treatment failure (23.3%) than those with no thionamide exposure (6.3%, p=0.003), but also had more active Graves' disease. Following (131)I, development of a detectable TSH or low-normal fT4 levels was not associated with recurrent thyrotoxicosis. Median weight gain was 5.3 kg, although patients with nadir fT4 levels 6 pmol/l (p=0.05). The main predictor of weight gain was fT4 level immediately prior to treatment; those in the lowest tertile gained a median 3.1 kg whilst those in the highest tertile gained 7.4 kg (median difference 4.3 kg; 95% confidence interval: 2.5-6.2). Marked hypothyroidism following (131)I is common and often occurs early. Simple biochemical parameters may help identify incipient hypothyroidism and potentially limit excess weight gain. Treatment failure is common in patients with severe thyrotoxicosis and in such cases larger doses of (131)I may be warranted.

  9. Radioiodine therapy increases the risk of cerebrovascular events in hyperthyroid and euthyroid patients

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Jensen, Lars Thorbjoern; Vej-Hansen, Anders

    2015-01-01

    to radiation and is capable of inducing atherosclerosis. The objective of the study was to elucidate whether ionizing radiation from radioiodine might contribute to cerebrovascular morbidity. METHODS: In a retrospective register cohort study, 4000 hyperthyroid and 1022 euthyroid goitre patients treated...... with radioiodine between 1975 and 2008 were matched 1:4 on age and sex with random controls. The cohort was followed from the date of treatment until hospitalization due to cerebrovascular event, death, 20 years of follow-up or March 2013. Data were analyzed in competing risk models adjusting for age, sex...

  10. Influence of preceding diagnostic and therapeutic procedures on the radioiodine therapy of benign thyroid diseases. Einfluss vorangegangener diagnostischer und therapeutischer Massnahmen auf die Radiojodtherapie gutartiger Schilddruesenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Rendl, J.; Boerner, W. (Wuerzburg Univ. (Germany, F.R.). Klinik und Poliklinik fuer Nuklearmedizin)

    1991-02-01

    Before and until 3 weeks after application of nonionic CA iodine and the 20-min-technetium-thyroid-uptake was measured in serum and urine in 23 euthyroid patients, which were given intravenously nonionic CA during heart catheterization. Concerning the possible influence of iodine contamination on a subsequent radioiodine therapy the following aspects result from the study: the time interval between application of CA and therapy has to be at least 4-6 weeks to avoid dilution of the radioiodine by iodine being released from the contrast agents. The thyroid-uptake of Technetium or Iodine after administration of CA is not constant over time but reaches its original value only in a gradual way (60% of the initial value 3 weeks after the CA were given); that means, the iodine-uptake during, radioiodine therapy can be higher than it was at the time the dose was calculated. Concerning the possible influence of preceding therapeutic procedures on the therapy with radioiodine the pretreatment with antithyroid drugs plays the most important role. Antithyroid drugs of the thiourylene group have been shown by many study groups to have a radioprotective effect. Other large studies however could not demonstrate any effect of antithyroid medication on the results of radioiodine therapy. All studies so far existing have in common that they are not strongly randomized with regard to the patient groups, because generally only in severe cases of hyperthyroidism additional antithyroid drug treatment has been employed, therefore it might be the case that the radioprotective effect of antithyroid drugs may be caused only by selection artifacts. The contradictory results of the different studies justify the practical way in so far as there are no reasonable objections against the pretreatment with antithyroid drugs to restore euthyroidism before starting the therapy with radioiodine. (orig./MG).

  11. Effect of a Low Iodine Diet vs. Restricted Iodine Diet on Postsurgical Preparation for Radioiodine Ablation Therapy in Thyroid Carcinoma Patients.

    Science.gov (United States)

    Lim, Chi Young; Kim, Jung-Yeon; Yoon, Mi-Jin; Chang, Hang Seok; Park, Cheong Soo; Chung, Woong Youn

    2015-07-01

    The radioiodine ablation therapy is required for patients who underwent a total thyroidectomy. Through a comparative review of a low iodine diet (LID) and a restricted iodine diet (RID), the study aims to suggest guidelines that are suitable for the conditions of Korea. The study was conducted with 101 patients. With 24-hour urine samples from the patients after a 2-week restricted diet and after a 4-week restricted diet, the amount of iodine in the urine was estimated. The consumed radioiodine amounts for 2 hours and 24 hours were calculated. This study was conducted with 47 LID patients and 54 RID patients. The amounts of iodine in urine, the 2-week case and 4-week case for each group showed no significant differences. The amounts of iodine in urine between the two groups were both included in the range of the criteria for radioiodine ablation therapy. Also, 2 hours and 24 hours radioiodine consumption measured after 4-week restrictive diet did not show statistical differences between two groups. A 2-week RID can be considered as a type of radioiodine ablation therapy after patients undergo a total thyroidectomy.

  12. What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?

    International Nuclear Information System (INIS)

    Gotthardt, M.; Philipps Univ., Marburg; Rubner, C.; Bauhofer, A.

    2006-01-01

    Purpose: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. Patients, methods: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). Results: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n=143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n=44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p>0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76±80.6 Gy versus 125.6±46.3 Gy; p<0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2±101.7 Gy versus 125.6±46.3 Gy; p=0.0097). Conclusions: TcTUs-based determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. (orig.)

  13. The management of metastatic radioiodine-refractory differentiated thyroid cancer requires an integrated approach including both directed and systemic therapies.

    Science.gov (United States)

    Cooray, Shamil D; Topliss, Duncan J

    2017-01-01

    A 58-year-old man with metastatic radioiodine-refractory differentiated thyroid cancer (DTC) presented with left thigh and right flank numbness. He had known progressive and widespread bony metastases, for which he received palliative radiotherapy, and multiple bilateral asymptomatic pulmonary metastases. CT scan and MRI of the spine revealed metastases at right T10-L1 vertebrae with extension into the central canal and epidural disease at T10 and T11 causing cord displacement and canal stenosis but retention of spinal cord signal. Spinal surgery was followed by palliative radiotherapy resulting in symptom resolution. Two months later, sorafenib received approval for use in Australia and was commenced and up-titrated with symptomatic management of mild adverse effects. Follow-up CT scan three months after commencement of sorafenib revealed regression of pulmonary metastases but no evident change in most bone metastases except for an advancing lesion eroding into the right acetabulum. The patient underwent a right total hip replacement, intra-lesional curettage and cementing. After six months of sorafenib therapy, CT scanning showed enlarging liver lesions with marked elevation of serum thyroglobulin. Lenvatinib was commenced and sorafenib was ceased. He now has stable disease with a falling thyroglobulin more than 5 years after metastatic radioiodine-refractory DTC was diagnosed. In DTC, 5% of distant metastases become radioiodine-refractory, resulting in a median overall survival of 2.5-3.5 years. Tyrosine kinase inhibitor (TKI) therapy has recently been demonstrated to increase progression-free survival in these patients but poses some unique management issues and is best used as part of an integrated approach with directed therapy. Directed therapies may have greater potential to control localised disease and related symptoms when compared to systemic therapies.Consider TKI therapy in progressive disease where benefits outweigh risks.Active surveillance and

  14. Influence of smoking associated with stress on the outcome of radioiodine therapy in patients with Graves' disease

    International Nuclear Information System (INIS)

    Sekulic, V.; Rajic, M.; Vlajkovic, M.; Ilic, S.; Stevic, M.

    2015-01-01

    Full text of publication follows. Introduction: Graves' disease (GD) is characterized by activation of the immune system as a result of interactions between genetic predisposition and environmental factors such as iodine intake, stressful events or smoking. Currently, there are no sufficient data on influence of nicotine and other components of tobacco smoking on outcome of radioiodine therapy in GD. The aim of this study was to analyze a possible influence of cigarette smoking associated with stress on the outcome of radioiodine therapy (RIT) in the patients with Graves' disease. Patients and methods: the study included 29 patients (23 female) aged from 22 to 73 years, who were subjects of a follow-up within 12 months after RIT. The stressful events were presented in all patients prior to diagnosing the GD. Patients were divided into two groups: 1. smokers - 15 patients who smoked cigarettes before, at the moment and after RIT, and 2. non-smokers - 14 patients who were always non-smokers. Patients were treated using a sliding scale of fixed activity of radioiodine according to the goiter size. Antithyroid drugs were discontinued 7 days before radioiodine therapy. Therapy outcome was assessed by serum TSH and thyroid hormones levels, and clinical evaluation. A successful response (SR) to RIT was defined as euthyroidism and subclinical or clinical hypothyroidism, and unsuccessful response (UR) as persistent hyperthyroidism. Results: comparison of age (48.0±9.39 vs. 49.6±14.3 years, P=0.715), values of TRAb (2.25±0.91 vs. 2.75±1.32 U/l, P=0.560), administered activity of 131 I-NaI (365±75.8 vs. 360±44.4 MBq, P=0.832), and duration of ATDs therapy before RIT (3.34±3.41 vs. 5.06±5.81 years, P=0.397) between smokers and non-smokers showed no significant difference. There was no significant influence of smoking on UR at 3., 6., 9. and 12. month compared with UR in patients who did not smoke (P=0.597, P=0.837, P=0.876, P=0.812, χ 2 test). The cumulative

  15. Evaluation of radioiodine therapy with fixed doses of 10 and 15 mCi in patients with Graves disease

    International Nuclear Information System (INIS)

    Canadas, Viviane; Vilar, Lucio; Moura, Eliane; Brito, Ana; Castellar, Enio

    2007-01-01

    The treatment options for the hyperthyroidism of Graves' disease are antithyroid drugs, surgery and radioiodine, none of which is considered ideal, as they do not act directly on the etiopathogenesis of the disease. Radioiodine has been increasingly used as the treatment of choice because it is a safe and definitive therapy whose administration is very easy. Some authors prefer to administer higher doses in order to deliberately induce hypothyroidism, while others recommend lower doses that result in a lower incidence of hypothyroidism and a greater incidence of euthyroidism. There is no consensus for the optimal regimen of fixed doses to be used and this is the main focus of the present study, where doses of 10 and 15 mCi of 131 I were compared. Among the 164 patients analyzed, 61 (37.2%) were submitted to 10 mCi and 103 (62.8%) to 15 mCi. In the longitudinal analysis it was observed that remission of the hyperthyroidism was statistically different in the sixth month (p 131 I brought about a similar remission of the hyperthyroidism after 12 months of treatment. Moreover, the remission rate of the hyperthyroidism had no association with age, sex or previous therapy with antithyroid drugs. (author)

  16. [Incorporation monitoring of employees of a radioiodine therapy ward. Is incorporation monitoring required for routine?].

    Science.gov (United States)

    Happel, C; Kratzel, U; Selkinski, I; Bockisch, B; Etzel, M; Korkusuz, H; Sauter, B; Staudt, J; von Müller, F; Grünwald, F; Kranert, W T

    2013-01-01

    Aim of the study was to determine the annual incorporation of staff on a radioiodine therapy ward and the resulting annual effective dose (aed). Following the German incorporation guideline (gig), incorporation monitoring is not necessary for potential aed below 0.5 mSv/a. For aed > 0.5 mSv/a adherence to the 1 mSv dose limit must be verified. For doses > 1 mSv/a incorporation has to be monitored by the authority. Furthermore, the (131)I incorporation factor from the gig should be verified. To determine the actual work related incorporation, the (131)I activity concentration in urine samples (collection over 24 h) of 14 employees of different professions were examined over a period of 27 months. Measured activity concentrations were related to the individual time of exposure. A constant activity supply for at least three days was assumed. The mean annual effective doses were 2.4 · 10⁻¹ mSv/a (nursing staff; n = 3), 5.6 · 10⁻² mSv/a (cleaning staff; n = 2), 2.8 · 10⁻³ mSv/a (technical staff; n = 2) and 5.2 · 10⁻³ mSv/a (physicians; n = 7). All aed were below the dose limits of the gig. The calculated mean incorporation factors ranged from 3.0 · 10⁻⁸ for the nursing staff to 3.6 · 10⁻¹⁰ for the technical staff (cleaning staff: 7 · 10⁻⁹; physicians: 6.5 · 10⁻¹⁰) and were therefore well below the (131)I incorporation factor defined by the gig. To estimate the aed caused by incorporation of (131)I it has to be subdivided for the different requirements in the diverse fields of activity of the employees. Regarding those who spend most of their time nearby the patient an incorporation monitoring by the authority might be required. The (131)I incorporation factor from the guideline (10⁻⁶) can be reduced by a factor of 10. For (99m)Tc and (18)F an incorporation factor of 10⁻⁷ is accepted.

  17. Clinical Usefulness between High Dose Radioiodine Therapy and Helicobacter Pylori Infection after Total Thyroidectomy due to Well Differentiated Thyroid Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Kuk No; Lim, Seok Tae; Moon, Eun Ha; Kim, Jin Suk; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee [Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2009-12-15

    Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. One hundred ninety nine patients (M:F=33:166, age 46.7{+-}12.3 years) who had HD-RIT (dose 159.1{+-}25.9 mCi, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive ({>=}50 dpm) or negative (<50 dpm), and analyzed its values. Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were 62{+-}66.1 dpm in increased one of follow-up UBT, and 153.3{+-}157.1 dpm in decreased one of follow-up UBT. We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection.

  18. Clinical Usefulness between High Dose Radioiodine Therapy and Helicobacter Pylori Infection after Total Thyroidectomy due to Well Differentiated Thyroid Cancer

    International Nuclear Information System (INIS)

    Yun, Kuk No; Lim, Seok Tae; Moon, Eun Ha; Kim, Jin Suk; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Sohn, Myung Hee

    2009-01-01

    Helicobacter (H) pylori infection has been considered the most important cause of gastritis, dyspepsia, and gastroduodenal ulcer. Radioiodine can be accumulated in the remaining thyroid tissue, salivary gland, and stomach. We investigated if the high radiation induced by radioiodine in the stomach after high dose radioiodine therapy (HD-RIT) is effective in the eradication of H. pylori infection. One hundred ninety nine patients (M:F=33:166, age 46.7±12.3 years) who had HD-RIT (dose 159.1±25.9 mCi, range 120-250 mCi) after thyroidectomy due to well differentiated thyroid cancer were enrolled. To detect H. pylori infection, the urea breath tests (UBT) were performed at 1 hour before HD-RIT and at 4 weeks after HD-RIT. The results of UBT were classified as positive (≥50 dpm) or negative (<50 dpm), and analyzed its values. Of 199 patients, 103 (51.8%) patients had positive UBT before HD-RIT. Of these, 80 patients had follow-up UBT after HD-RIT. Among them, 76 (95.0%) patients had persistent positive UBT and only 4 (5.0%) patients were changed negative UBT. Among 76 patients with persistent positive UBT, 26 (34.2%) patients had increased the values of follow-up UBT, 49 (64.5%) had decreased them, and 1 (1.3%) had shown the same value. The different values of UBT between before and after HD-RIT were 62±66.1 dpm in increased one of follow-up UBT, and 153.3±157.1 dpm in decreased one of follow-up UBT. We conclude that the radiation induced by HD-RIT is ineffective in the eradication of H. pylori infection. However, it could be influential the degree or distribution of H. pylori infection

  19. Graves' disease and radioiodine therapy. Is success of ablation dependent on the achieved dose above 200 Gy?

    Energy Technology Data Exchange (ETDEWEB)

    Kobe, C.; Eschner, W.; Sudbrock, F.; Weber, I.; Marx, K.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2008-07-01

    Aim: this study was performed to determine the results of ablative radioiodine therapy (RIT) when the achieved dose in the thyroid was above 200 Gy and to characterize predictive factors for treatment outcome. Patients, methods: a total of 571 consecutive patients were observed for 12 months between July 2001 and June 2004. Inclusion criteria were a confirmed diagnosis Groves' disease, compensation of hyperthyroidism and withdrawal of antithyroid drugs two days before preliminary radioiodine-testing and RIT. The intended dose was 250 Gy and the therapeutically achieved dose was calculated from serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The relation between success rate and the achieved dose, thyroid volume, age and sex of patients, TSH- and TRAb-values and presence of ophthalmopathy was analysed. Results: relief from hyperthyroidism was achieved in 96% of patients who received more than 200 Gy, even for thyroid volumes >40 ml. The success of ablative RIT was not influenced by age or sex of patients, or by TSH- or TRAb values or concomitant ophthalmopathy. The mean achieved dose in the thyroid was 298 Gy with a standard deviation of 74.6 Gy. Conclusion: to achieve a dose of over 200 Gy with the above standard deviation, we recommend calculating on intended dose of 250 Gy and using a dosimetric approach with early and late uptake values in the radioiodine test, to allow early therapeutic intervention should the posttherapeutic thyroid dose fall unexpectedly below 200 Gy. (orig.)

  20. Potential of radioiodinated anti cancer compounds of natural origin for cancer therapy

    International Nuclear Information System (INIS)

    Pandey, U.; Bapat, K.; Samuel, G.; Venkatesh, M.; Sarma, H.D.

    2007-01-01

    Plumbagin and Quercetin are naturally occurring compounds which exhibit anti-cancerous activity. To evaluate the effect of radioiodination on cytotoxicity, both Plumbagin and Quercetin were radioiodinated with 125 I. 125 I-Plumbagin and 125 I-Quercetin could be prepared in moderate yields and good radiochemical purity and were characterized using reverse phase HPLC. In Swiss mice bearing fibrosarcoma, 125 I-Plumbagin showed a tumor uptake of ∼2.5%ID/g at 3 h p.i. and ∼0.5%ID/g at 24 h p.i on i.v. injection. When injected intratumorally, greater tumor uptake and retention was observed (∼20%ID/g at 3 h p.i. and ∼14%ID/g at 24 h p.i. respectively). (author)

  1. Supporting Treatment Decisions in Patients with Differentiated Thyroid Carcinoma (DTC) under Radioiodine-131 Therapy: Role of Biological Dosimetry Assessment

    International Nuclear Information System (INIS)

    Fadel, A.M.; Chebel, G.M.; Di Giorgio, M.; Vallerga, M.B.; Taja, M.R.; Radl, A.; Bubniak, R.V.; Oneto, A.

    2010-01-01

    Radioiodine-131 therapy is applied in patients with differentiated thyroid carcinoma (DTC), within the therapeutic scheme following thyroidectomy, for the ablation of thyroid remnants and treatment of metastatic disease. Several approaches for the selection of a therapeutic dose were applied. The aim of this therapy is to achieve a lethal dose in the tumor tissue, without exceeding the dose of tolerance in healthy tissues (doses greater than 2 Gy in bone marrow could lead to myelotoxicity). In this work, the treatment protocol used incorporates the assessment by biological dosimetry (BD) for estimating doses to whole body and bone marrow, to tailor patient's treatment. Biological Dosimetry prospective studies conducted on samples from patients with cumulative activities, before and after each therapeutic administration, allows to evaluate DNA damage and repair capacity in peripheral blood lymphocytes. (authors)

  2. Radioiodine therapy effects on offspring of patients with differentiated thyroid carcinoma; Efeitos da radioiodoterapia nas geracoes futuras de mulheres com carcinoma diferenciado de tireoide

    Energy Technology Data Exchange (ETDEWEB)

    Brandao, Carmen Dolores Goncalves [Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Endocrinologia]. E-mail: loloi@zaz.com.br; Antonucci, Jane [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil). Hospital das Clinicas. Servico de Medicina Nuclear; Correa, Nilson Duarte [Hospital dos Servidores do Estado, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear; Corbo, Rossana; Vaisman, Mario [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina

    2004-02-01

    Radioiodine therapy has attained a significant role in the treatment of differentiated thyroid cancer. The literature addressing possible secondary effects of {sup 131} I is limited, although there has been increasingly interest in this field. A more comprehensive understanding of the mutagenic effects of radiation on the offspring of women exposed to {sup 131} I is mandatory in view of the possibility of occurrence of miscarriages, congenital abnormalities and malignancies in these children. In this review, we found that many reports on safety of this type of treatment in female patients in reproductive age recommend that pregnancy should be avoided for at least one year after therapeutic administration of radioiodine. (author)

  3. Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report

    Directory of Open Access Journals (Sweden)

    Laura Pratchett

    2010-12-01

    Full Text Available Rationale: Prolonged exposure (PE therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD; however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring – the main mechanisms through which PE is hypothesized to work – are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening “new” learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD.

  4. Interest of a multidisciplinary and two-step consultation in radioiodine therapy to improve patient's support

    International Nuclear Information System (INIS)

    Guillaumon, C.; Eberle, M.; Deshayes, E.; Savry, B.; Vinson, B.; Kotzki, P.

    2015-01-01

    Full text of publication follows. Aim: the surgery of differentiated thyroid cancer may be followed by radioiodine therapy (I 131 ). This therapy requires a 3-day hospital stay in an isolation room without family visits, but also many precautions before, during and after the hospital stay. This clinical environment can give rise to increased anxiety for a number of patients. This is why we have set up a dedicated consultation, aimed at improving preparation of the hospital stay. The aim of our work was to assess the efficiency of such consultation for patient's understanding of their disease, related apprehensions, and coordination between the nuclear medicine (NM) unit and inpatient ward. Material and methods: we followed the recommendations of the first French Cancer Plan regarding the diagnosis or treatment announcement and the project was reviewed in the frame of Professional Practices Evaluation. Consultations were carried out according to a 2-step procedure in the NM unit. First, patients were informed by the NM physician about disease and treatment. Then, a technologist evaluated social and psychological conditions, and checked proper understanding of disease and treatment. He/she paid a special attention to radiation protection measures, especially for the discharge period. Patients received a guidance manual document, and when necessary were oriented towards the supportive care staff. A dedicated computerized form was used to share patient information between the NM unit and inpatient ward. These consultations ran every day (2 per day). To evaluate procedure efficiency, patients were asked to fulfill a satisfaction questionnaire. Inpatient ward nurses were also surveyed for patient's understanding of their disease, level of anxiety, and quality of care. Results: at Montpellier Cancer Institute, a total of 30 thyroid cancer patients and 15 nurses were surveyed about their perceptions about the consultation before radioiodine therapy from April to

  5. Radioiodine therapy for combined disseminated and nodular thyroid autonomy. Results after using a correction term for the disseminated part

    International Nuclear Information System (INIS)

    Vogt, H.; Dorn, R.; Otto, I.; Sciuk, J.; Wengenmair, H.; Kopp, J.

    2006-01-01

    Aim: in combined focal and disseminated thyroid autonomy a variety of concepts in the treatment with radioiodine are used. The difference lies mainly in the calculation of the autonomous volume. This retrospective study shows a new method of calculating the autonomous volume. Patients and methods: in 398 patients with combined thyroid autonomy and good correlation of scintigraphically hot nodules and lesions defined by ultrasound the volume of the nodules is ascertained from scintigraphic and ultrasound parameters and the volume of the disseminated autonomous tissue is assessed with a weighting factor (VF). This factor is the ratio of impulse density in a ROI over the disseminated volume divided by the corresponding impulse density over the nodular volume of the thyroid scintigraphy. The sum of nodular volume and weighted perinodular volume gives the total autonomous volume. A standard radioiodine test gives the maximum iodine-131-uptake and effective half-life to calculate the activity to obtain a treatment dose of 400 Gy. Results: the rate of success with and without thyrostatic medication was 97% with an 18.6% rate of hypothyroidism observed from 4 months post therapy onwards. Conclusion: the use of the weighting factor VF in the treatment of combined autonomy leads to an excellent rate of success in patients with good correlation of functional imaging and ultrasound findings. (orig.)

  6. Paradoxical effects of radioiodine therapy in functional thyroid autonomy and mild immunothyropathy; Paradoxe Effekte der Radiojodtherapie bei funktioneller Schilddruesenautonomie und milder Immunthyreopathie

    Energy Technology Data Exchange (ETDEWEB)

    Dunkelmann, S.; Rudolph, F.; Prillwitz, A.; Groth, P.; Schuemichen, C. [Rostock Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    1998-01-01

    Aim: To examine all cases with Graves` disease after radioiodine therapy of autonomously functioning thyroid tissue (AFFT) in order to find the cause. Methods: We retrospectively studied 1428 pts who were treated between 11/93 and 3/97 with radioiodine for AFTT and who underwent at least one control examination. Results: 15 (1.1%) of all pts developed Graves` disease 8.4 (4-13) months after radioiodine therapy. There was no direct suggestion of Graves` disease (TRAK negative, no endocrine ophthalmopathy) in any pt at the time of radioiodine therapy. More detailed analysis of anamnestic data, however, revealed evidence that immunothyropathy predated radioiodine therapy in 11 of the 15 pts. Paradoxical effects of radioiodine therapy manifested as an increase in immunothyropathy 14 pts, a deterioration in metabolism in 11 pts and a first occurrence of endocrine ophthalmopathy in 5 pts. Conclusion: Exacerbation of preexisting, functional primarily insignificant immunothyropathia is held responsible in most cases for the observed paradoxical effects after radioiodine therapy, resulting in radiation-induced manifest Graves` disease; however no therapeutical consequences are recommended. (orig.) [Deutsch] Ziel: Erfassung von Pat. mit einer nach Radiojodtherapie wegen einer funktionellen Autonomie aufgetretenen Immunhyperthyreose sowie deren Ursachen. Methoden: Wir untersuchten in einer retrospektiven Studie 1428 Pat., die im Zeitraum 11/93 bis 3/97 wegen einer funktionellen Autonomie mit Radiojod behandelt wurden und die sich mindestens einer Kontrolluntersuchung unterzogen hatten. Ergebnisse: 15 (1,1%) der Pat. entwickelten 8,4 (4-13) Monate nach Radiojodtherapie eine postradiogene Immunhyperthyreose. Bei allen 15 Pat. lag zum Zeitpunkt der Radiojodtherapie kein direkter Hinweis auf eine Immunhyperthyreose vor (TRAK neg., keine endokrine Orbitopathie). Bei einer genauen Analyse anamnestischer Daten fanden sich jedoch bei 11 der 15 Pat. erste Hinweise auf das Vorliegen

  7. Radioiodinated bleomycin

    International Nuclear Information System (INIS)

    Salmon, S.E.; Liu, R.H.

    1976-01-01

    Radioiodinated bleomycin is a useful imaging agent for body tissues. Its production by iodination of bleomycin with radioactive iodide ions in the presence of an oxidizing agent is described. 7 claims, no drawings

  8. Radioiodine dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, J R [Biomedical Research Branch, Health Sciences Div., Chalk River, Ontario (Canada). Chalk River Nuclear Lab.

    1981-01-01

    The estimation of individual doses for radiation protection and for risk assessment purposes from a radioiodine intake requires a knowledge of the distribution and retention of the radioiodine (primarily in the thyroid), and a knowledge of the average energy deposited in each organ of interest per radioactive decay (S-factors). This paper reviews a model for distribution and retention used previously for adults, and extends the model to include all ages. The extended model also includes the effects of stable iodine intakes on radioiodine uptakes explicitly. Included in the paper is a tabulation of existing adult S-factors for selected radioiodines and the extension of S-factors for the thyroid to all age groups. Finally, doses per unit intake are calculated and tabulated. A discussion and some calculations of the effects of stable iodine intake on committed doses are given.

  9. Radioiodine dosimetry

    International Nuclear Information System (INIS)

    Johnson, J.R.

    1981-01-01

    The estimation of individual doses for radiation protection and for risk assessment purposes from a radioiodine intake requires a knowledge of the distribution and retention of the radioiodine (primarily in the thyroid), and a knowledge of the average energy deposited in each organ of interest per radioactive decay (S-factors). This paper reviews a model for distribution and retention used previously for adults, and extends the model to include all ages. The extended model also includes the effects of stable iodine intakes on radioiodine uptakes explicitly. Included in the paper is a tabulation of existing adult S-factors for selected radioiodines and the extension of S-factors for the thyroid to all age groups. Finally, doses per unit intake are calculated and tabulated. A discussion and some calculations of the effects of stable iodine intake on committed doses are given. (author)

  10. Results of radioiodine therapy using different radiation doses in patients suffering from immunogenic and non-immunogenic hyperthyroidism

    International Nuclear Information System (INIS)

    Moser, E.

    1992-01-01

    During the past few years high rates of recidivation have increasingly been reported following drug treatment for hyperthyroidism. In view of these unsatisfactory results it is only natural that the use of surgery and ratioiodine treatment is now more often considered in order to achieve complete elimination of the metabolic disorders caused by hyperactivity of the thyroid gland. The aim of this study was to investigate into the effectiveness of radioiodine therapy in a large cohort of patients (n = 925). Particular attention was given to the influence of the dose applied to the thyroid tissue on the rates of success achieved in immunogenic hyperthyroidism (IH) and autonomous disorders (non-immunogenic hyperthyroidism = NIH). (orig./GDG) [de

  11. Outcome in hyperglycemic stroke with ultrasound-augmented thrombolytic therapy.

    Science.gov (United States)

    Martini, S R; Hill, M D; Alexandrov, A V; Molina, C A; Kent, T A

    2006-08-22

    Hyperglycemia independently predicts poor outcome after acute ischemic stroke. CLOTBUST (Combined Lysis Of Thrombus in Brain ischemia using transcranial Ultrasound and Systemic tPA) demonstrated that ultrasound-augmented thrombolysis improves recanalization and 24-hour outcome in patients with acute ischemic stroke. We hypothesized that ultrasound would preferentially benefit hyperglycemic patients, and reviewed CLOTBUST with respect to admission glucose and good outcome. We found that ultrasound's benefit on 90-day outcome was primarily apparent at higher glucose levels, suggesting that ultrasound therapy may improve outcome following hyperglycemic stroke.

  12. The effects of radioiodine therapy on peripheral blood lymphocyte subpopulations in patients with Graves' disease. Preliminary report

    International Nuclear Information System (INIS)

    Turowska, M.D.; Rogowski, F.; Turowski, D.; Wysocka, J.

    2002-01-01

    Treatment of Graves' disease patients with radioactive iodide ( 131 I) is becoming the standard therapy in an increasing group of cases but can induce alterations in immune response, like increasing levels of thyroid autoantibodies, and, in part, exacerbation of ophthalmopathy. The aim of this study was to assess the changes in peripheral blood (PB) lymphocyte subpopulations after 131 I treatment of patients with Graves' disease. The study was carried out in a group of 30 patients with Graves' disease (23 f; 7 m) 49.5±10.0 years of age, 26 with different subjective ocular signs like gritty sensation, increased lacrimation, orbital pain, and exophthalmos. PB lymphocyte subsets were analysed by cytofluorometry, serum concentration of TSH and fT4 were evaluated before and 6 weeks after radioiodine treatment. After 131 I treatment a significant increase in CD3+, CD4+, CD3+HLA-DR+ and a decrease in CD19+ percentages of lymphocyte subsets were found in comparison with the initial evaluation. No significant changes in percentage of CD8+ and NK (CD3-CD16+ CD56+) cells were observed during this study. A significant increase in TSH and a slight decrease in fT4 concentration concentration took place in the 6th week after 131 I application. The patients without subjective improvement of ocular signs during the therapy initially had a percentage of CD3+, CD8+ lymphocytes which was significantly lower compared with those with regression of ocular signs observed after 131 I treatment. The changes in PB lymphocyte subsets caused by 131 I treatment of Graves' disease confirm the involvement of acquired cellular immunity after radiation damage of the thyroid gland. The decreased initial percentage of CD8+ and CD3+ lymphocytes could help make a prediction of ocular symptoms persisting after radioiodine treatment in some patients with ophthalmopathy. (author)

  13. Radioiodine therapy of thyroid functional autonomies: Experience at a single university referral hospital centre in Czech Republic

    International Nuclear Information System (INIS)

    Kraft, O.

    2006-01-01

    This paper presents the results of I-131 therapy in patients suffering from various types of functional autonomies of the thyroid gland. The efficacy and adverse effects of radioiodine therapy are presented. Seven hundred ninety-nine patients (age range= 33 to 86 years; average age= 58.7 years; Male: Female = 7.4:1) with unifocal, multifocal and disseminated functional autonomies of thyroid gland were treated with at least one therapeutic dose of I-131. Baseline Tc-99m pertechnetate thyroid scans, radioactive iodine uptake studies and ultrasonography were performed in all cases prior to radio iodine therapy. Baseline serum total and free thyroxine (T-T4 and F-T4), total triiodothyronine (T-T3) and TSH levels were estimated in all cases. Effective half life of radio iodine in the thyroids was also determined in all patients prior to therapy and a few patients were subjected to TRH stimulation tests. Following treatment all patients were evaluated after a period of 4-6 months. Further follow up evaluations were done at one year in 545 patients and at two years in 254 patients. Complete elimination of functional autonomy was achieved in 733 (91.74%) patients with a single therapeutic dose of I-131, while 62 (7.76%) patients required two doses of I-131 and only 4 (0.5%) patients required three therapeutic doses of I-131. Following I-131 therapy, the suppression of TSH levels in serum disappeared in 607 (76%) of treated patients. An average volume reduction of 38% was noted in the thyroid gland following I-131. Side effects were minimal and only a few patients complained of transient neck pressure, pain and neck swelling. Postradiation hypothyroidism was diagnosed in 36 patients (4.5%). We conclude that radio iodine treatment is the most comfortable and economical approach to the treatment of the thyroid functional autonomies. The results of our approach show that the radioiodine therapy of the thyroid functional autonomies is safe, with low incidence of adverse effects

  14. Ablative therapy with radioiodine in the postoperative management of differentiated thyroid carcinoma, a retrospective observational study of the justified indication of the therapy

    International Nuclear Information System (INIS)

    Soto Herrera, Esteban

    2013-01-01

    The validity of the indication of treatment with I131 as part of the management of differentiated thyroid cancer, was analyzed in patients older than 16 years attended in Hospital San Juan de Dios and Hospital Mexico, who received this therapy, during the years 2006-2009. The medical records of the selected patients were reviewed and registered in the SPSS statistical program. The following variables were obtained: name, file number, age, gender, type of cancer, maximum diameter of the tumor, presence of one of 2 or more tumor foci in the surgical piece, hospital of origin, value of T, N and M according to the TNM staging, MACIS scale score and staging according to the MACIS score. The most common differentiated carcinoma in the studied population was papillary carcinoma. A little less than half of the patients, had the criteria to receive radioiodine therapy according to that established by the ATA, same result when said population was subjected to European criteria Criteria to receive radioiodine dictated by the American school as the European one were fulfilled in the majority of patients with stage 2. Compliance with indication or non-indication of treatment was maintained without significant difference between papillary and follicular carcinomas [es

  15. Correlation of stress with outcome of radioiodine therapy for Graves disease

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, T.; Rochon, J.; Lenfestey, R.; Wise, P.

    1985-06-01

    Between November 1965 and December 1983, 293 patients were treated for Graves disease using /sup 131/I. All patients were asked to identify a stressful event antedating the onset of overt clinical symptoms. Eighty-one patients were able to do this (27.6%). Two hundred forty-four patients received a single treatment, 49 required two or more treatments. Patients with stress initiating the symptoms of Graves disease became hypothyroid earlier, 50% at 12 mo compared with 36 mo for the nonstress group. At 10 yr 5% of the stress group remained euthyroid compared with 17% nonstress. The authors conclude that stress in the 12 mo or less before the onset of clinical symptoms potentiates the development of hypothyroidism induced by a standard dose of radioiodine.

  16. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3); Verfahrensanweisung zur Radioiodtherapie (RIT) beim differenzierten Schilddruesenkarzinom (Version 3)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Nuklearmedizinsiche Klinik der Henriettenstiftung, Hannover (Germany); Eschner, W. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Gruenwald, F. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Frankfurt Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Lassmann, M. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Allgemeines Krankenhaus St. Georg, Hamburg (Germany); Luster, M.; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Moser, E. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Radiologische Universitaetsklinik Freiburg (Germany); Schober, O. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for {sup 131}I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative {sup 131}I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC {<=}1 cm {sup 131}I ablation may be helpful in an individual constellation. Preparation for {sup 131}I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for {sup 131}I-therapy in patients with metastases, higher sensitivity of {sup 131}I whole-body scan) are discussed. In most centers standard activities are used for {sup 131}I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of {sup 131}I should not exceed 1-10MBq, alternative tracers are {sup 123}I or {sup 124}I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

  17. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: a quality improvement project

    International Nuclear Information System (INIS)

    Mitra, Sujata; Muthu, Sonai G.

    2012-01-01

    Radioiodine ( 131 I) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after 131 I therapy. The present study was undertaken to reduce treatment failure rate of 131 I therapy in TMNG patients. Multiple causes may have lead to treatment failure of 131 I in TMNG patients making it difficult to establish a direct cause-effect relationship and take corrective action. Therefore, the JURAN methodology of quality improvement was applied. The treatment failure rate in 80 TMNG patients treated with 131 I in the period 2003-06 was 29%. The root cause analysis identified delay in decision to radioablate and concomitant antithyroid drugs (ATD) with 131 I therapy as factors leading to relapse. In 2007, a change in management was introduced with decision to radioablate all TMNG patients not remitting at 1 year of ATD and to withdraw ATD for 2 weeks prior to 131 I therapy. A total of 63 patients of TMNG followed the changed protocol between 2007 and 2009. Further analysis showed that one of the factors identified in the initial brainstorming (high iodide pool in the patient) had not been addressed in the protocol currently followed. The protocol was modified to include patient preparation and implemented after standardization. The post- 131 I relapse rate in patients treated after implementation of the new protocol from 2007 to 2009 was 18% which further reduced to 16% in 2011 after modification of the protocol. The failure rate of 131 I therapy in TMNG reduced from 29% to 16% through standardization of the treatment procedure achieved by the use of Juran Methodology that helped to identify process-related defects. (author)

  18. Reduction in relapse rate of radioiodine therapy in patients of toxic multinodular goiter: a quality improvement project

    Energy Technology Data Exchange (ETDEWEB)

    Mitra, Sujata; Muthu, Sonai G., E-mail: sujatamitra@tatasteel.com [Department of Nuclear Medicine, Tata Main Hospital, Jamshedpur (India)

    2012-01-15

    Radioiodine ({sup 131}I) therapy is the definitive treatment of toxic multinodular goiter (TMNG). Treatment failure may result in relapse after {sup 131}I therapy. The present study was undertaken to reduce treatment failure rate of {sup 131}I therapy in TMNG patients. Multiple causes may have lead to treatment failure of {sup 131}I in TMNG patients making it difficult to establish a direct cause-effect relationship and take corrective action. Therefore, the JURAN methodology of quality improvement was applied. The treatment failure rate in 80 TMNG patients treated with {sup 131}I in the period 2003-06 was 29%. The root cause analysis identified delay in decision to radioablate and concomitant antithyroid drugs (ATD) with {sup 131}I therapy as factors leading to relapse. In 2007, a change in management was introduced with decision to radioablate all TMNG patients not remitting at 1 year of ATD and to withdraw ATD for 2 weeks prior to {sup 131}I therapy. A total of 63 patients of TMNG followed the changed protocol between 2007 and 2009. Further analysis showed that one of the factors identified in the initial brainstorming (high iodide pool in the patient) had not been addressed in the protocol currently followed. The protocol was modified to include patient preparation and implemented after standardization. The post-{sup 131}I relapse rate in patients treated after implementation of the new protocol from 2007 to 2009 was 18% which further reduced to 16% in 2011 after modification of the protocol. The failure rate of {sup 131}I therapy in TMNG reduced from 29% to 16% through standardization of the treatment procedure achieved by the use of Juran Methodology that helped to identify process-related defects. (author)

  19. Atypical antipsychotics as augmentation therapy in anorexia nervosa.

    Directory of Open Access Journals (Sweden)

    Enrica Marzola

    Full Text Available Anorexia nervosa (AN is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings.

  20. Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J; Joe, Alexius Y; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger [Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Brink, Ingo [Department of Nuclear Medicine, University Hospital of Freiburg (Germany); Krause, Thomas M [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

    2002-09-01

    This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15{+-}9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256{+-}80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses. (orig.)

  1. Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

    International Nuclear Information System (INIS)

    Reinhardt, Michael J.; Joe, Alexius Y.; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger; Brink, Ingo; Krause, Thomas M.

    2002-01-01

    This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15±9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256±80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses. (orig.)

  2. Effectiveness of radioiodine (131-I) as definitive therapy in patients with autoimmune and non-autoimmune hyperthyroidism.

    Science.gov (United States)

    Tarantini, B; Ciuoli, C; Di Cairano, G; Guarino, E; Mazzucato, P; Montanaro, A; Burroni, L; Vattimo, A G; Pacini, F

    2006-01-01

    We evaluated the outcome of radioiodine (RAI) therapy in 100 consecutive patients treated in the period 2000-2001 for hyperthyroidism due to Graves' disease (GD), toxic adenoma (TA) and toxic multinodular goiter (TMG). Thyroid function was measured before and after therapy every 3-6 months up to 3 yr. Three years after therapy, 75% of TA patients were euthyroid, 18.7% were hypothyroid and 6.3% hyperthyroid. Of the TMG patients, 62.2% were euthyroid, 18.9% were hypothyroid and 18.9% hyperthyroid. In GD patients euthyroidism was achieved in 12.9% of the patients, hypothyroidism in 74.2% and hyperthyroidism persisted in 12.9%. Definitive hypothyroidism was significantly higher in GD (p<0.0001) than in TA and TMG patients. Overall, positive effect of RAI (definitive hypothyroidism or euthyroidism) was very high: 93.7% in TA, 81.1% in TMG and 87.1% in GD patients. Thyroid volume reduction was observed in all patients, but was higher in GD patients (mean reduction of 76%) and in TA patients (mean nodule reduction of 69%). In TMG, mean reduction was of 32%. The median activity of RAI received by the 86 cured patients was 555 MBq (15 mCi) compared to 407 Mbq (11 mCi) received by the 14 patients who remained hyperthyroid. No influence was found between outcome and clinical parameters at the moment of 131-I therapy. In conclusion, our results indicate that RAI therapy is highly effective and safe for the control of hyperthyroidism.

  3. A theoretical model for prescription of the patient-specific therapeutic activity for radioiodine therapy of Graves' disease

    International Nuclear Information System (INIS)

    Di Martino, F.; Traino, A.C.; Lazzeri, M.; Brill, A.B.; Stabin, M.G.

    2002-01-01

    A fundamental function of the thyroid is to extract iodine from the blood, synthesize it into thyroid hormones, and release it into the circulation under feedback control by pituitary-secreted hormones. This capability of the thyroid, termed as functionality, can in principle be related to the severity of hyperthyroidism in individual patients. In this paper the uptake and release of 131 I by the thyroid following the administration of 131 I therapy for Graves' disease has been theoretically studied. The kinetics of iodine in the thyroid and blood have been evaluated using a two-compartment model. This simplified model appears to be adequate for dosimetry purposes and allows one to correlate levels of increased thyroid functionality (hyperthyroidism) with clinically measurable kinetic parameters. An expression has been derived for the rate of change of thyroid mass following therapy; this has the same form as an empirical relationship described in an earlier work. A method is presented for calculation of the amount of radioiodine activity to be administered to individual patients in order to achieve the desired final functionality of the gland. The activity to be administered is based on measurements of 131 I kinetics after the administration of a 'low-activity' (1850 kBq) tracer for treatment planning. (author)

  4. Radioiodine Therapy: Care of the Helpless Patient and Handling of the Radioactive Corpse

    International Nuclear Information System (INIS)

    Geaves, C. D.; Tendale, W. B.

    2016-01-01

    Nurses caring for a helpless patient following a nominal 800 MBq administration of radioiodine were concerned about their radiation dose. Using published data, a nurse could receive an estimated 650 micro Sv per shift. A regime to restrict their dose was planned using a 500 micro Sv dose constraint. Thermoluminescent dosimeters indicated a maximum whole body effective dose of 250 micro Sv. Three days post 131 I administration the patient died (estimated activity in the body 400 MBq). A minimum delay of two weeks was advised prior to a post-mortem. Special precautions were issued to minimise contamination. Dose rates (micro Sv h-1), measured one day after the patient died, at the level of the thyroid, chest and bladder at 0.01 m from the corpse were 1800, 290 and 73 respectively. At 1.0 m the dose rate was 26 micro Sv h-1 at all levels. The pathologist was estimated to have received a maximum whole-body dose of 400 micro Sv during the postmortem. Contamination measurements (Bq cm-2) made following the postmortem were as follows: pathologist's hands 5, clothes 0, towels 1.8, saw 5, instruments 0.5, plastic sheet 0.8, scales 0.4 and floors/walls 1.1. These data indicate that with appropriate radiation protection guidelines, staff can be reassured that their doses in these circumstances are very low. (author)

  5. Outcome of radioiodine-131 therapy in hyperfunctioning thyroid nodules: a 20 years' retrospective study.

    Science.gov (United States)

    Ceccarelli, Claudia; Bencivelli, Walter; Vitti, Paolo; Grasso, Lucia; Pinchera, Aldo

    2005-03-01

    To investigate the risk of hypothyroidism after radioiodine (131I) treatment for hyperfunctioning thyroid nodules. Retrospective analysis of patients treated with 131I for hyperfunctioning thyroid nodules and followed up for a maximum of 20 years. A total of 346 patients treated with 131I in the years 1975-95, for a single hyperfunctioning nodule. Hypothyroidism was defined as TSH levels > 3.7 mU/l. Kaplan-Meier survival analysis was used to analyse permanence of euthyroidism after 131I. A stepwise Cox proportional hazard model was used to identify factors influencing the progression to hypothyroidism. The cumulative incidence of hypothyroidism was 7.6% at 1 year, 28% at 5 years, 46% at 10 years and 60% at 20 years. Age (P thyroid and nodule size, thyroid status at diagnosis and degree of extranodular thyroid parenchymal suppression had no influence. In hyperthyroid patients with partial parenchymal suppression, however, previous MMI treatment was the most important prognostic factor (P hyperfunctioning nodule are hypothyroid. Factors increasing the risk of hypothyroidism are age, 131I uptake and MMI pretreatment. The prognostic value of this last factor, however, depends on the degree of suppression of the extranodular thyroid parenchyma at the scan.

  6. The influence of saliva flow stimulation on the absorbed radiation dose to the salivary glands during radioiodine therapy of thyroid cancer using 124I PET(/CT) imaging

    International Nuclear Information System (INIS)

    Jentzen, Walter; Schmitz, Jochen; Freudenberg, Lutz; Eising, Ernst; Bockisch, Andreas; Stahl, Alexander; Balschuweit, Dorothee; Hilbel, Thomas

    2010-01-01

    A serious side effect of high-activity radioiodine therapy in the treatment of differentiated thyroid cancer is radiogenic salivary gland damage. This damage may be diminished by lemon-juice-induced saliva flow immediately after 131 I administration. The aim of this study was to assess the effect of chewing lemon slices on the absorbed (radiation) doses to the salivary glands. Ten patients received (pretherapy) 124 I PET(/CT) dosimetry before their first radioiodine therapy. The patients underwent a series of six PET scans at 0.5, 1, 2, 4, 48 and ≥96 h and one PET/CT scan at 24 h after administration of 27 MBq 124 I. Blood samples were also collected at about 2, 4, 24, 48, and 96 h. Contrary to the standard radioiodine therapy protocol, the patients were not stimulated with lemon juice. Specifically, the patients chewed no lemon slices during the pretherapy procedure and neither ate food nor drank fluids until after completion of the last PET scan on the first day. Organ absorbed doses per administered 131 I activity (ODpAs) as well as gland and blood uptake curves were determined and compared with published data from a control patient group, i.e. stimulated per the standard radioiodine therapy protocol. The calculations for both groups used the same methodology. A within-group comparison showed that the mean ODpA for the submandibular glands was not significantly different from that for the parotid glands. An intergroup comparison showed that the mean ODpA in the nonstimulation group averaged over both gland types was reduced by 28% compared to the mean ODpA in the stimulation group (p=0.01). Within each gland type, the mean ODpA reductions in the nonstimulation group were statistically significant for the parotid glands (p=0.03) but not for the submandibular glands (p=0.23). The observed ODpAs were higher in the stimulation group because of increased initial gland uptake rather than group differences in blood kinetics. The 124 I PET(/CT) salivary gland

  7. First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

    International Nuclear Information System (INIS)

    Oexle, C.; Reinhardt, M.; Moser, E.

    1998-01-01

    Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99m Tc-pertechnetate thyroid uptake under suppression (TcTU s ) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTU s , which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTU s of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTU s >3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.) [de

  8. Estimation of radiation burden to relatives of patients treated with radioiodine for cancer therapy

    International Nuclear Information System (INIS)

    Tandon, Pankaj; Rohatgi, Rupali; Gaur, P.K.; Rao, B.S.; Gill, B.S.; Hari Babu, T.; Venkatesh, Meera

    2005-01-01

    Patients treated with radioiodine present a radiation hazard and precautions are necessary to limit the radiation dose to family members, nursing staff and members of the public. The precautions advised are usually based on the instantaneous dose rates or iodine retention and do not take into account the time spent in close proximity with a patient. The purpose of this study was to draw guidelines based on the actual measurements and confirm if the present guidelines for discharge of the 131 I-treated thyroid cancer patients are adequate or not. External exposure rates were measured on 37 patients using a calibrated ionization survey meter. The patients' exposure rates were measured at the time of the discharge from the hospital. The patient and their relatives were given lockets embedded with CaSO 4 :Dy dosimeters at the time of discharge from the hospital. These lockets were given with a chain to be worn in the neck for 15 days. These lockets were collected after a fortnight and read out in a conventional TLD reader. These dose estimates can be used to calculate the limits for the patient movements so as to limit doses received to less than 1 mSv for the family members. This study dealt only with the external exposure; the problem of internal contamination was not considered. In our study the doses to the patient have also been measured in order to estimate the percentage of dose received by their relatives. In our study, most of the cases the dose received by the relatives of the patients are more than 1 mSv, which is more than the limit prescribed by the International Commission of Radiological Protection (ICRP) for the general public. (author)

  9. The radio-iodine therapy of the functional autonomy. Indications, findings, risks

    International Nuclear Information System (INIS)

    Reiners, C.

    1990-01-01

    The functional autonomy of the thyroid is a disorder, which appears in connection with iodine deficit and befalls the complete organ. An absolute indication for a radio-iodine-therapy is given in case of hyperthyreoidism (these are 25 % of all at the functional autonomy). Contrary to the operation method the advantage of the I-131-therapy is, that all of the functional autonome-cells can be reached. The risk at the I-131-therapy is low. (Botek)

  10. A randomized clinical trial of alpha(1)-antitrypsin augmentation therapy.

    Science.gov (United States)

    Dirksen, A; Dijkman, J H; Madsen, F; Stoel, B; Hutchison, D C; Ulrik, C S; Skovgaard, L T; Kok-Jensen, A; Rudolphus, A; Seersholm, N; Vrooman, H A; Reiber, J H; Hansen, N C; Heckscher, T; Viskum, K; Stolk, J

    1999-11-01

    We have investigated whether restoration of the balance between neutrophil elastase and its inhibitor, alpha(1)-antitrypsin, can prevent the progression of pulmonary emphysema in patients with alpha(1)-antitrypsin deficiency. Twenty-six Danish and 30 Dutch ex-smokers with alpha(1)-antitrypsin deficiency of PI*ZZ phenotype and moderate emphysema (FEV(1) between 30% and 80% of predicted) participated in a double-blind trial of alpha(1)-antitrypsin augmentation therapy. The patients were randomized to either alpha(1)-antitrypsin (250 mg/kg) or albumin (625 mg/kg) infusions at 4-wk intervals for at least 3 yr. Self-administered spirometry performed every morning and evening at home showed no significant difference in decline of FEV(1) between treatment and placebo. Each year, the degree of emphysema was quantified by the 15th percentile point of the lung density histogram derived from computed tomography (CT). The loss of lung tissue measured by CT (mean +/- SEM) was 2.6 +/- 0.41 g/L/yr for placebo as compared with 1.5 +/- 0.41 g/L/yr for alpha(1)-antitrypsin infusion (p = 0.07). Power analysis showed that this protective effect would be significant in a similar trial with 130 patients. This is in contrast to calculations based on annual decline of FEV(1) showing that 550 patients would be needed to show a 50% reduction of annual decline. We conclude that lung density measurements by CT may facilitate future randomized clinical trials of investigational drugs for a disease in which little progress in therapy has been made in the past 30 yr.

  11. Prognostic Value of Tc99m-Pertechnetate Thyroid Scintigraphy in Radioiodine Therapy in a Cohort of Chinese Graves’ Disease Patients: A Pilot Clinical Study

    Directory of Open Access Journals (Sweden)

    Haifeng Hou

    2015-01-01

    Full Text Available Objectives. This study is to assess the prognostic value of Tc99m-pertechnetate thyroid scintigraphy for predicting the outcomes of fixed low dose of radioiodine therapy (RIT in a cohort of Chinese Graves’ disease (GD patients. Materials and Methods. This is a retrospective study of GD patients who received RIT with a single dose of radioiodine (5 mCi. All the patients received Tc99m-pertechnetate thyroid scintigraphy prior to RIT. Thyroid mass, Tc99m-pertechnetate uptake, gender, age at diagnosis, duration of the disease, ophthalmopathy, and serum levels of FT4, FT3, TT4, and TT3 prior to RIT were analyzed as potential interference factors for outcomes of RIT. Results. One hundred and eighteen GD patients who completed RIT were followed up for 12 months. The outcomes (euthyroidism, hypothyroidism, and hyperthyroidism were found to be significantly associated with thyroid mass and Tc99m-pertechnetate uptake. Patients with thyroid mass ≤ 40.1 g or Tc99m-pertechnetate uptake ≤ 15.2% had higher treatment success. Conclusions. A fixed low dose of 5 mCi radioiodine seems to be practical and effective for the treatment of Chinese GD patients with thyroid mass ≤ 40.1 g and Tc99m-pertechnetate uptake ≤ 15.2%. This study demonstrates Tc99m-pertechnetate thyroid scintigraphy is an important prognostic factor for predicting the outcomes of RIT.

  12. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism.

    Science.gov (United States)

    Hamada, Noboru; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Okamoto, Yasuyuki; Konishi, Toshiaki; Ito, Koichi; Ito, Kunihiko

    2011-01-01

    Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.

  13. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism

    International Nuclear Information System (INIS)

    Hamada, Noboru; Konishi, Toshiaki; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Ito, Koichi; Ito, Kunihiko; Okamoto, Yasuyuki

    2011-01-01

    Serum levels of thyroid stimulating hormone (TSH) receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism. (author)

  14. Results of radioiodine therapy of patients with immunogenic and non-immunogenic hyperthyroidism using different radiation doses

    International Nuclear Information System (INIS)

    Moser, E.; Pickardt, C.R.; Mann, K.; Engelhardt, D.; Kirsch, C.M.; Knesewitsch, P.; Tatsch, K.; Kreisig, T.; Kurz, C.; Saller, B.; Klinikum Grosshadern, Muenchen; Muenchen Univ.

    1988-01-01

    The aim of this study was to check the efficacy of radioiodine ( 131 I) therapy (RIT) in a large number of patients (n = 506) suffering from immunogenic or non-immunogenic hyperthyroidism (Graves' disease, Plummer's disease). Since there is no causal cure for immunogenic hyperthyroidism RIT provides, like all other modalities, only a moderate rate of success which is clearly dose-related. Applying 60 Gy, normal thyroid function can be achieved is only 54% of the cases. A dose of 150 Gy succeeds in 86% of the cases. The solitary decompensated autonomous adenoma (DAA) can be eliminated surgically as well as by RIT with a high degree of success (95%). Contrary to surgery, RIT does not have any noticeable early or late morbidity. The high rate of success of RIT in patients with DAA could be confirmed in two groups with different follow-up periods (16 and 65 months). As expected, the rate of hypothyroidism increased from 11% in the early group to 23% in the late group. Multinodular autonomous adenomas can be eliminated successfully using RIT as well. The concept to apply a dose of 400 Gy to the total functional autonomous tissue as determined by ultrasound yields better results (95%) than 150 Gy to the whole thyroid gland as measured by ultrasound (88%). The rate of hypothyroidism as shown by these results (up to a maximum of 62% after RIT of Graves' disease using 150 Gy) is the lesser evil compared to remaining or recurrent hyperthyroidism since these patients can be treated with thyroid hormones without problems. (orig.) [de

  15. The Sonographic Features of the Thyroid Gland After Treatment with Radioiodine Therapy in Patients with Graves' Disease.

    Science.gov (United States)

    English, Collette; Casey, Ruth; Bell, Marcia; Bergin, Diane; Murphy, Joseph

    2016-01-01

    The aim of the study was to describe the typical sonographic features of the thyroid gland in patients with Graves' hyperthyroidism after radioiodine therapy (RIT). Thirty patients (21 female and 9 male) with a mean age of 53 y (standard deviation [SD] ± 11.3) and with previous Graves' disease who had been successfully treated with RIT were enrolled in the study. All were hypothyroid or euthyroid after treatment. The thyroid ultrasound was carried out by a single experienced operator with an 8-MHz linear transducer. Volume, vascularity, echogenicity and echotexture of the glands were noted. The presence of nodules and lymph nodes was also documented. The mean volumes of the right lobe were 2.4 mL ± 2.9 SD (0.6-14) and the left lobe were 1.8 mL ± 1.9 SD (0.4-9.1), with a mean total volume of 4.2 mL ± 4.7 SD (1.3-19.1). Of those who had a pre-treatment ultrasound (23%), the percentage reduction in volume was 87% (p < 0.05); 93% of the glands were hypovascular, with the remaining 7% showing normal vascularity. The glands were hyperechoic and of coarse echotexture. Overall, the sonographic features of the post-RIT gland included a significantly reduced mean total volume of 4.2 mL, hypovascularity, coarse echotexture and hyperechogenicity. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  16. Relationship between serum TSH and the responsiveness of toxic solitary autonomous thyroid nodules to radioiodine therapy

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, U; Kirkegaard, B C

    1998-01-01

    hypothyroidism both had detectable serum TSH at the time of 131I treatment. No other clinical parameter seemed to influence the outcome. CONCLUSION: There is no clinically significant effect of circulating TSH on the response of toxic solitary autonomous thyroid nodules to 131I therapy. However, keeping...... the patients subclinically hyperthyroid when receiving 131I treatment may possibly result in a reduced frequency of hypothyroidism.......) were euthyroid, three (8%) had responded insufficiently and required further antithyroid therapy, and two (5%) had developed hypothyroidism. No significant difference in the response pattern between patients with suppressed or detectable serum TSH could be demonstrated. The two patients who developed...

  17. Follow-up on thyroidal uptake after radioiodine therapy. How robust is the peri-therapeutic dosimetry?

    International Nuclear Information System (INIS)

    Eschner, Wolfgang; Kobe, Carsten; Schicha, Harald

    2011-01-01

    Radioiodine therapy (RIT) for benign thyroid diseases in Germany requires the patient to stay in a nuclear medicine therapy ward for at least 48 hours and the dose to the thyroid to be computed from activity measurements performed during that stay. A major part of the total dose will be delivered after the patient's discharge from the hospital and thus has to be predicted through extrapolation with the effective half-life measured peri-therapeutically. We performed repeated thyroid uptake measurements on patients up to five months post therapy to investigate post-therapeutic changes in their effective half-lives and examine the dosimetric consequences. 12 patients (4 m, 8 f; age 36 - 76 y; 4 Graves' disease, 4 toxic adenoma, 3 toxic goitre, 1 non-toxic goitre) underwent late uptake measurements (1 - 7 meas., 13 - 154 d post administration, median 54 d, performed with thyroid probe resp. whole body counter at lower activities). Doses calculated from late measurements were compared to those predicted at discharge; half-lives calculated from the late measurement closest to the median delay (54 d) were compared to those determined at time of discharge. A cross-calibration between activity calibrator, thyroid probe, and whole body counter over an activity range from 52 MBq down to 45 Bq revealed linearity to within 6%, which was considered sufficient. In 9 out of 12 patients the achieved dose was within the range predicted at discharge. Averaged deviation between achieved and predicted dose was 3.1 ± 2.2% (median 2.5%, range 0.7% - 7.2%). Averaged deviation between post- and peri-therapeutic half-lives was 5.1 ± 3.9% (median 3.5%, range 1.3% - 12.5%). For n=5 patients discharged after 3 days, averaged deviations were greater (dose 4.0%, half-life 5.6%) than for those patients (n = 7) who stayed in the hospital for a minimum of 4 days (dose 2.5%, half-life 4.8%). Excretion of iodine from the thyroid remains practically unchanged for at least two months after RIT. The

  18. Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids

    Science.gov (United States)

    2008-08-01

    SUBJECT TERMS Cancer therapy by localized immune response, Magneto -rehological Fluids 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT...Metastasized Breast Cancer by Localized Therapy utilizing Biocompatible Magnetic Fluids PRINCIPAL INVESTIGATOR: Cahit Evrensel...2008 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy utilizing

  19. Radioiodine therapy in Graves' disease based on tissue-absorbed dose calculations: effect of pre-treatment thyroid volume on clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J.; Joe, Alexius Y.; Mallek, Dirk von; Ezziddin, Samer; Palmedo, Holger [Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn (Germany); Brink, Ingo [Department of Nuclear Medicine, University Hospital of Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

    2002-09-01

    This study was performed with three aims. The first was to analyse the effectiveness of radioiodine therapy in Graves' disease patients with and without goitres under conditions of mild iodine deficiency using several tissue-absorbed doses. The second aim was to detect further parameters which might be predictive for treatment outcome. Finally, we wished to determine the deviation of the therapeutically achieved dose from that intended. Activities of 185-2,220 MBq radioiodine were calculated by means of Marinelli's formula to deliver doses of 150, 200 or 300 Gy to the thyroids of 224 patients with Graves' disease and goitres up to 130 ml in volume. Control of hyperthyroidism, change in thyroid volume and thyrotropin-receptor antibodies were evaluated 15{+-}9 months after treatment for each dose. The results were further evaluated with respect to pre-treatment parameters which might be predictive for therapy outcome. Thyroidal radioiodine uptake was measured every day during therapy to determine the therapeutically achieved target dose and its coefficient of variation. There was a significant dose dependency in therapeutic outcome: frequency of hypothyroidism increased from 27.4% after 150 Gy to 67.7% after 300 Gy, while the frequency of persistent hyperthyroidism decreased from 27.4% after 150 Gy to 8.1% after 300 Gy. Patients who became hypothyroid had a maximum thyroid volume of 42 ml and received a target dose of 256{+-}80 Gy. The coefficient of variation for the achieved target dose ranged between 27.7% for 150 Gy and 17.8% for 300 Gy. When analysing further factors which might influence therapeutic outcome, only pre-treatment thyroid volume showed a significant relationship to the result of treatment. It is concluded that a target dose of 250 Gy is essential to achieve hypothyroidism within 1 year after radioiodine therapy in Graves' disease patients with goitres up to 40 ml in volume. Patients with larger goitres might need higher doses

  20. Greater Efficacy of Total Thyroidectomy versus Radioiodine Therapy on Hyperthyroidism and Thyroid-Stimulating Immunoglobulin Levels in Patients with Graves' Disease Previously Treated with Antithyroid Drugs

    Science.gov (United States)

    Kautbally, Shakeel; Alexopoulou, Orsalia; Daumerie, Chantal; Jamar, François; Mourad, Michel; Maiter, Dominique

    2012-01-01

    Aims We compared the effects of total thyroidectomy (TTx) and radioiodine (RAI) administration on the course of thyroid hormones and thyroid-stimulating immunoglobulins (TSI) in patients with Graves' disease. Methods We retrospectively studied 80 patients initially treated with antithyroid drugs and requiring either RAI (8.3 ± 1.7 mCi of 131I; n = 40) or TTx (n = 40) as second-line therapy. Results The TTx and RAI groups were not different, except for larger goiter, higher FT3 and more frequent Graves' orbitopathy at diagnosis in the surgery group (p antithyroid drugs. PMID:24783007

  1. Lithium as adjuvant to radioiodine therapy in differentiated thyroid carcinoma: clinical and in vitro studies

    NARCIS (Netherlands)

    Liu, Y. Y.; van der Pluijm, G.; Karperien, M.; Stokkel, M. P. M.; Pereira, A. M.; Morreau, J.; Kievit, J.; Romijn, J. A.; Smit, J. W. A.

    2006-01-01

    Lithium has been reported to increase radioactive iodine (RaI) doses in benign thyroid disease and in differentiated thyroid carcinoma (DTC). It is not known whether lithium influences the outcome of RaI therapy in DTC. We therefore studied the clinical effects of RaI without and with lithium

  2. Augmentation therapy with alpha1-antitrypsin: patterns of use and adverse events.

    Science.gov (United States)

    Stoller, James K; Fallat, Robert; Schluchter, Mark D; O'Brien, Ralph G; Connor, Jason T; Gross, Nicholas; O'Neil, Kevin; Sandhaus, Robert; Crystal, Ronald G

    2003-05-01

    To describe patterns of prescribing augmentation therapy, and types and rates of adverse events in the National Heart, Lung, and Blood Institute Registry for Individuals with Severe Deficiency of Alpha(1)-Antitrypsin. Observational cohort study with follow-up visits every 6 to 12 months for up to 7 years. The rate and dosing frequency with which Registry participants were prescribed to receive augmentation therapy by their managing physicians, and the type and frequency of adverse events, classified in two ways: severity of self-reported symptoms, and actions taken as a consequence of the symptom. Over the course of Registry follow-up, 66% (n = 747) of the participants received augmentation therapy at some time. In keeping with recommendations made in the 1989 American Thoracic Society (ATS) statement, 75% of participants with airflow obstruction at first visit (defined as FEV(1) or = 80% predicted (14%) also received augmentation therapy. Among those with COPD for whom augmentation therapy was not prescribed, financial constraints were the reported cause in 30%. Observed patterns also varied from approved practice, in that dosing frequencies other than the US Food and Drug Administration-approved, once-weekly regimen were frequently prescribed. The overall rate of reported adverse events was 0.02 per patient-month, with 83% of participants reporting no events. This overall rate was composed of 16% considered mild events, 76% moderate events, and 9% severe events. We conclude that augmentation therapy was generally well tolerated and, consistent with ATS guidelines, physicians generally did not prescribe augmentation therapy for subjects with FEV(1) > or = 80% predicted. However, the large percentage of subjects with FEV(1) <80% predicted not receiving augmentation therapy and the frequent use of 2- to 3-week or monthly dosing reflects variation of practice from suggested treatment guidelines.

  3. Prestimulation with Recombinant Human Thyrotropin (rhTSH) Improves the Long-Term Outcome of Radioiodine Therapy for Multinodular Nontoxic Goiter

    DEFF Research Database (Denmark)

    Fast, Søren; Nielsen, Viveque Egsgaard; Grupe, Peter

    2012-01-01

    goiter volume reduction with rhTSH-augmented (131)I therapy improves the long-term reduction in goiter-related symptoms and reduces the need for additional therapy compared with plain (131)I therapy. Overall patient satisfaction is benefited, despite a higher rate of permanent hypothyroidism....

  4. Moving from Virtual Reality Exposure-Based Therapy to Augmented Reality Exposure-Based Therapy: A Review

    OpenAIRE

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

    This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth centur...

  5. Sialadenitis after radioiodine therapy. Analysis of factors that influence the response to medical treatment.

    Science.gov (United States)

    Geres, Alejandra E; Mereshian, Paula Szafryk; Fernández, Silvia; Rey Caro, Daniel Gonzalo; Castro, Ricardo; Podio, Ricardo; Ojeda, Silvia

    2015-12-01

    To assess the incidence of 131I-induced sialadenitis (SD) in patients with differentiated thyroid cancer (DTC), to analyze clinical and other factors related to metabolic radiotherapy that may predict the lack of response to conventional medical therapy (CMT), and to determine the effectiveness of intraductal steroid instillation in patients failing CMT. Fifty-two patients with DTC, 45 females (86.5%) and 7 males (13.5%) with a mean age of 44.21±13.3 years (r=17-74) who received ablation therapy with 131I after total thyroidectomy. Patients with diseases and/or medication causing xerostomia were excluded. Patients underwent salivary gland scintigraphy with 99Tc (10mCi). Eighteen patients (34.62%) had SD and received antibiotics, antispasmodics, and oral steroids for 15 days. They were divided into two groups: responders to medical therapy (n=12, age 44.3±14.4 years, 2 men [17%], 10 women [83%], cumulative dose 225±167.1 mCi) and non-responders to medical treatment, who underwent steroid instillation into the Stensen's duct (n=6 [33%], 2 men [33%], 4 women [67%], age 50±13.8 years, cumulative dose 138.3±61.7 mCi). Scintigraphy showed damage to the parotid and submaxillary glands. Incidence of 131I-induced sialadenitis was similar to that reported by other authors. Age, mean cumulative dose of 131I, and involvement of parotid and submaxillary glands did not condition response to CMT; however, male sex was a conditioning factor. Symptom persistence for more than 15 days makes instillation into the Stensen's duct advisable. This is an effective and safe method to avoid surgical excision of salivary glands. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  6. Patient management in radioiodine therapy of benign thyroid disease; Radiojodtherapie gutartiger Schilddruesenerkrankungen: Ambulante Vorbereitung und Nachsorge

    Energy Technology Data Exchange (ETDEWEB)

    Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany)

    1997-08-01

    Benign thyroid disease ranks by far as the most frequent therapy in nuclear medicine. In Germany approximately 25 000 cases of hyperthyreosis are being treated in association with autonomy or Graves` disease, but also for the reduction of goiters or the correction of latent functional disturbances. In such indications radiotherapy is virtually free of risk as opposed to surgery and ranks more favorable in regard to costs and curative effects versus pharmacological long term treatment. Still regional varying therapeutical concepts and intentions are being pursued and trials of improvements described. There is consent in therapy that quality of treatment is closely linked to a specialized out-door platient preparation, individual hospital activity dosage and lifelong follow up including continued evaluation of therapeutical results. In this paper minimal requirements of outpatient measures before and after therapy are summarized which in Germany is only permitted on an inhospital patient basis. Considering basics of radioactive preventive law, scientific evidence of available results of therapeutical studies and a survey of German therapeutic centers, suggestions for a quality maintaining management in view of the most effective utilization for the limited available number of beds is presented for discussion. (orig.) [Deutsch] Die mit Abstand haeufigste nuklearmedizinische Therapie betrifft die gutartigen Schilddruesenerkrankungen. In Deutschland werden jaehrlich etwa 25 000 Hyperthyreosen bei Autonomie oder Morbus Basedow, aber auch Strumen zur Verkleinerung oder Beseitigung einer latenten Funktionsstoerung behandelt. Die Radiojodtherapie ist bei den genannten Indikationen gegenueber der Operation praktisch risikofrei, gegenueber einer medikamentoesen Langzeitbehandlung kurativ und kostenguenstiger. Nach wie vor werden regional variierende Behandlungskonzepte und -ziele verfolgt und Optimierungsversuche beschrieben. Einigkeit besteht bei den Therapeuten, dass die

  7. Role of antithyroid drug treatment prior to radioiodine therapy in hyperthyroidism

    International Nuclear Information System (INIS)

    Das, B.K.; Pradhan, P.K.; Senthilnathan, M.S.; Malhotra, G.

    2005-01-01

    Full text: Radio Iodine (RI) therapy is preceded by anti thyroid drug treatment in most centres. There is a general notion that this is a pre-requisite for RI therapy. There have been some sporadic reports in the past emphasizing that euthyroid state is not necessary in all cases before RI. However, no prospective randomized study has been reported in recent literature. The aim of this prospective study was to find out whether prior treatment with anti thyroid drugs showed any advantage in comparison to direct application of radio iodine in hyperthyroid patients. Seventy-two clinically and bio chemically proven cases of hyperthyroidism were randomized into two groups , each with 36 patients. They were matched by age, sex and size of goiter. After establishment of the diagnosis the patients were either subjected to anti thyroid drug treatment (Group A) or given calculated dose of radio iodine (Group B). After being euthyroid for at least 4 weeks the Group A patients were asked to stop the drugs (Neomercazole) for 3-5 days and radio iodine was administered. Patients in both groups were prescribed beta blockers for 4-6 weeks. Average radio iodine dose in both groups was 5 ± 0.92 mCi. All patients were evaluated both clinically and bio chemically 3, 6, 12 months after the radio iodine application. The duration to achieve euthyroid state, patient tolerance and side effects if any were meticulously recorded. In the pre treated group 72.1, 83.4 and 97.2% of the patients attained euthyroid state at 3, 6, 12 months respectively. Five patients needed a second dose after 3 months. No side effect or complications were observed. In group B 77.7, 88.8 and 94.4% of patients achieved euthyroid status at 3, 6 and 12 months respectively. There was no side effects or complications noted. However, 16.7 and 22.2% of the patients in group A and 27.7 and 36.1% of the group B became hypothyroid at 6 and 12 months respectively. They were treated with Thyroxine supplementation. Overall

  8. Fetus dose estimation in thyroid cancer post-surgical radioiodine therapy

    International Nuclear Information System (INIS)

    Mianji, Fereidoun A.; Karimi Diba, Jila; Babakhani, Asad

    2015-01-01

    Unrecognised pregnancy during radioisotope therapy of thyroid cancer results in hardly definable embryo/fetus exposures, particularly when the thyroid gland is already removed. Sources of such difficulty include uncertainty in data like pregnancy commencing time, amount and distribution of metastasized thyroid cells in body, effect of the thyroidectomy on the fetus dose coefficient etc. Despite all these uncertainties, estimation of the order of the fetus dose in most cases is enough for medical and legal decision-making purposes. A model for adapting the dose coefficients recommended by the well-known methods to the problem of fetus dose assessment in athyrotic patients is proposed. The model defines a correction factor for the problem and ensures that the fetus dose in athyrotic pregnant patients is less than the normal patients. A case of pregnant patient undergone post-surgical therapy by I-131 is then studied for quantitative comparison of the methods. The results draw a range for the fetus dose in athyrotic patients using the derived factor. This reduces the concerns on under- or over-estimation of the embryo/fetus dose and is helpful for personal and/or legal decision-making on abortion. (authors)

  9. TH-AB-206-01: Advances in Radionuclide Therapy - From Radioiodine to Nanoparticles

    International Nuclear Information System (INIS)

    Humm, J.

    2016-01-01

    In the past few decades, the field of nuclear medicine has made long strides with the continued advancement of related sciences and engineering and the availability of diagnostic and therapeutic radionuclides. Leveraging these advancements while combining the advantages of therapeutic and diagnostic radionuclides into one radiopharmaceutical has also created a new subfield “theranostics” in nuclear medicine that has the potential to further propel the field into the future. This session is composed of two talks; one focused on the physics principles of theranostics from properties of beta and alpha emitting radionuclides to dosimetric models and quantification; while the second describes preclinical and clinical applications of theranostics and discusses the challenges and opportunities of bringing them to the clinic. At the end of the session the listener should be able to identify: The different properties of beta and alpha emitting radionuclides Which radionuclides are selected for which nuclear medicine therapies and why How PET can be used to accurately quantify the uptake of tumor targeting molecules How individualized dosimetry can be performed from the management of thyroid cancer to novel radiolabeled antibody therapies Promising pre-clinical radiopharmaceutical pairs in prostate cancer and melanoma. Promising clinical Theranostics in neuroendocrine cancers. Challenges of bringing Theranostics to the clinic. E. Delpassand, RITA Foundation -Houston; SBIR Grant; CEO and share holder of RadioMedix.

  10. TH-AB-206-01: Advances in Radionuclide Therapy - From Radioiodine to Nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Humm, J. [Memorial Sloan-Kettering Cancer Center (United States)

    2016-06-15

    In the past few decades, the field of nuclear medicine has made long strides with the continued advancement of related sciences and engineering and the availability of diagnostic and therapeutic radionuclides. Leveraging these advancements while combining the advantages of therapeutic and diagnostic radionuclides into one radiopharmaceutical has also created a new subfield “theranostics” in nuclear medicine that has the potential to further propel the field into the future. This session is composed of two talks; one focused on the physics principles of theranostics from properties of beta and alpha emitting radionuclides to dosimetric models and quantification; while the second describes preclinical and clinical applications of theranostics and discusses the challenges and opportunities of bringing them to the clinic. At the end of the session the listener should be able to identify: The different properties of beta and alpha emitting radionuclides Which radionuclides are selected for which nuclear medicine therapies and why How PET can be used to accurately quantify the uptake of tumor targeting molecules How individualized dosimetry can be performed from the management of thyroid cancer to novel radiolabeled antibody therapies Promising pre-clinical radiopharmaceutical pairs in prostate cancer and melanoma. Promising clinical Theranostics in neuroendocrine cancers. Challenges of bringing Theranostics to the clinic. E. Delpassand, RITA Foundation -Houston; SBIR Grant; CEO and share holder of RadioMedix.

  11. Bilateral optic nerve swelling after thyroidectomy followed by a course of radioiodine therapy

    Directory of Open Access Journals (Sweden)

    Ioyleva E.E.

    2018-03-01

    Full Text Available The most common cancer of the endocrine system is thyroid cancer, representing 1.0–1.5 % all newly diagnosed cases of cancer. According to the cancer society of Russia, the thyroid cancer in children is much rarer than in adults. Thyroid cancer in children and adolescents is characterized by an adverse clinical course and a high risk of developing metastases in the lymph nodes. The main method of treatment for pediatric thyroid cancer is total thyroidectomy with central neck lymph node dissection followed by radioactive iodine therapy. In foreign and domestic literature, complications of the organ of vision, namely, changes of the optic disc, after surgical treatment for thyroid cancer are poorly understood. The risk of transient hypocalcemia and hypothyroidism increases after thyroidectomy. In the literature, there are two reported cases of the optic nerve swelling combined with hypoparathyroidism and hypocalcemia. While hypocalcemia intracranial hypertension and swelling of the optic nerves are often recorded. In this article, the authors present their own clinical observation of a 13-year-old patient after thyroidectomy and radioactive iodine therapy with detailed analysis of the clinical data and study results. According to the survey of the patient, bilateral swelling of the optic disc was revealed, which could occur due to hypothyroid state. Objective: to identify the cause of the development of bilateral optic nerve swelling in a patient after thyroidectomy and treatment course with radioactive iodine.

  12. Myopathy Associated with Acute Hypothyroidism following Radioiodine Therapy for Graves Disease in an Adolescent

    Directory of Open Access Journals (Sweden)

    Rivkees ScottA

    2010-08-01

    Full Text Available We describe acute myopathy following I-131 treatment for hyperthyroidism due to Graves Disease (GD in an adolescent. A 15 year-old diagnosed with GD required treatment with radioactive iodine (I-131 therapy. Six weeks post I-131, he developed generalized muscle cramps. The CK was 19.800 U/L, the total thyroxine was 2.3 mcg/dL (29.6 nmol/L SI and the estimated free thyroxine (EFT was 0.5 ng/dL (6.4 pmol/L SI. The ALT was 112 U/L and AST was 364 U/L (normal

  13. Radiation absorbed dose and expected risk in head and neck tissues after thyroid radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hamed, A [National Center for Nuclear and Radiation Control, AEA., Cairo (Egypt); Farag, H I [National Cancer instiute, Cairo University, Cairo (Egypt); Saleh, A [Al-hussien Hospital, Al-Azhar University, Cairo (Egypt)

    1997-12-31

    Measurement of absorbed dose in head and neck phantom after applying I-131 therapeutic dose for the treatment of thyroid malignancies was conducted. The measurement were carried out at several sites of phantom using TL dosimeters. The absorbed doses were also measured on the skin of four patients during their administration of I-131 therapeutic doses 1.332 GBq (36 mci) I-131. The measurements were taken over 69 hours exposure at different sites of phantom. The same measurements were carried out on the four patients. At five sites of the patients head and neck, the absorbed dose were measured and compared with that measured on the phantom. The values measured are discussed in the light of the published individual absorbed doses in the organs by ICRP tables. High absorbed doses were absorbed in the different sites of the head and neck during the I-131 therapy (0.14-9.68 mGy/mCi). 3 figs., 2 tabs.

  14. Gonadal radiation dose and its genetic significance in radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Robertson, J.S.; Gorman, C.A.

    1976-01-01

    Published estimates of radiation dose to the gonads from 131 I therapy of Graves' disease vary widely, largely because of differences in assumptions regarding the details of iodine kinetics. The calculations described in this paper show that hyperthyroid patients treated with 10 mCi of 131 I will usually receive a total radiation dose to the ovaries or testes of less than 3 rad. Several common roentgenographic diagnostic procedures may involve a greater radiation dose and a greater genetic hazard than does the usual 131 I treatment for hyperthyroidism. It is important to minimize total exposure to radiation, but it seems unreasonable to deny 131 I treatment for hyperthyroidism to young men and nonpregnant young women on the grounds of genetic hazard alone

  15. Long-term results of radioiodine (131I) therapy in 331 patients with Graves' disease

    International Nuclear Information System (INIS)

    Saito, Shintaro; Sakurada, Toshiro; Yamamoto, Makiko; Yoshida, Katsumi; Kaise, Kazuo

    1980-01-01

    To evaluate the long-term results of 131 I treatment for Graves' disease, the thyroid function was studied in 331 patients 5 - 17 years after this therapy. Twenty-five patients were hypothyroid and had already been on thyroid medication. Among the remaining 306 patients without any treatment for thyroid disorder, 188 patients (61.4%) had a normal thyroid-stimulating hormone (TSH) level (less than 10 μU/ml) of whom 151 were euthyroid with normal thyroxine (T 4 ) and triiodothyronine (T 3 ) level. 118 patients (38.6%) had a high TSH level, of whom 22 were hypothyroid with low T 4 and T 3 levels and 38 were with normal T 3 and low T 4 levels, and 14 patients out of this 38 were clinically hypothyroid. Although all of the patients with high TSH levels do not require the replacement therapy for hypothyroidism, the overt hypothyroidism seems to occur sooner or later in patients with a lower T 4 level. Among 331 patients studied, 61 (18.4%) were clinically hypothyroid. The incidence of hypothyroidism was 20.7% after 10 years of 131 I treatment and 33% after 15 - 17 years. The incidence of patients with high TSH levels was 50% after 10 years of 131 I treatment and 60% after 15 - 17 years. Both of cumulative incidence of hypothyroidism and patients with high TSH levels increased linearly with years after the treatment, which coincided with the linear decrease of mean T 4 and T 3 levels and linear increase of mean TSH level with years after the treatment. The difference of positive incidence of antithyroid antibodies between cases of normal TSH level and high TSH level was not significant. (author)

  16. Radioiodine therapy in skeletal metastases from well-differentiated thyroid cancer: a Johannesburg experience

    Directory of Open Access Journals (Sweden)

    Nalini Sindy Perumal

    2010-03-01

    Full Text Available Aim.The purpose of this study was to examine the outcome of patients with skeletal metastases from well-differentiated thyroid carcinoma and analyse the effect of variables that influence the prognosis of this disease. Method. We retrospectively reviewed 352 patients treated and followed-up at the Charlotte Maxeke Johannesburg Academic Hospital’s thyroid cancer clinic from 1982 - 1999. Findings. Skeletal metastases were diagnosed in 24 (6.8%, 17 at presentation to the thyroid clinic, and 7 at follow-up. Patients’ ages ranged from 30 - 77 years (mean 53.9 years and the female:male ratio was 3.8:1. Based on the original pathology reports from resected tumours, 9 were papillary and 15 were follicular cancers. Twenty-three of the 24 patients underwent thyroid surgery as the initial management – total thyroidectomy in 18, subtotal thyroidectomy in 3, and lobectomy plus neck dissection in one. The diagnosis of thyroid cancer was based on lobectomy in a single subject. Radioactive iodine (RAI was used as part of the original treatment; external radiation therapy (XRT was mainly used to alleviate severe symptoms. Twenty-one patients (87.5% were treated with RAI; 11 (45.8% received radiotherapy. Seven patients died – 4 from neurological disease directly associated with bone metastases. Of the 17 surviving patients, 2 appeared to be disease-free, 8 were asymptomatic despite overt bony disease, and 7 had persistent symptoms which much improved in 5. Bone metastases were uncommon, and follicular cancer predominated in this survey. Conclusion. RAI therapy improves quality of life in most patients. There is a place for XRT.

  17. Results of preventive radioiodine therapy in euthyroid patients with history of hyperthyroidism prior to administration of amiodarone with permanent atrial fibrillation--a preliminary study.

    Science.gov (United States)

    Czarnywojtek, Agata; Zgorzalewicz-Stachowiak, Małgorzata; Woliński, Kosma; Płazińska, Maria Teresa; Miechowicz, Izabela; Kwiecińska, Barbara; Czepczyński, Rafał; Królicki, Leszek; Ruchała, Marek

    2014-01-01

    Radioiodine (RAI) therapy is a standard procedure in the treatment of hyperthyroidism. However, the use of RAI in euthyroid patients requiring chronic administration of amiodarone (AM) where other antiarrhythmic drugs may lack efficacy is still controversial. The aim of this study was to assess the safety and efficacy of an AM therapy prior to treatment with radioiodine therapy in euthyroid patients with permanent atrial fibrillation (PAF), who had been treated for hyperthyroidism in the past. This was a retrospective observational study. Patients were assessed at baseline and two, six, eight, and 12 months after RAI therapy. 17 euthyroid patients with PAF were qualified to the RAI (female/male 3/14; age range 65 to 87, median 71). The patients required chronic administration of AM as a prophylaxis against sudden death. Each patient received an ablative dose of 800 MBq (22 mCi) of 131I. At baseline and during follow-up, no side effects of the therapy and no signs of drug intolerance were observed. Subclinical hyperthyroidism occurred in two (11.8%) cases after two months of RAI and five weeks of AM administration. In this situation, RAI therapy was repeated. Three patients (17.6%) after six months, and another two (11.8%) after eight months, required an additional dose of 131I due to amiodarone-induced thyrotoxicosis (AIT). Twelve patients (70.6%) returned to spontaneous sinus rhythm within two months. Fourteen patients (82.4%) had sinus rhythm during follow-up after six and 12 months of treatment. Preventive RAI in euthyroid (but previously hyperthyroid) patients with PAF before administration of AM may be the method of choice. This is particularly important for patients who will require permanent AM administration as a life-saving drug.

  18. Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Rosario, Pedro Weslley [Santa Casa de Belo Horizonte, MG (Brazil). Endocrinology Service

    2013-05-01

    Objective: To evaluate {sup 131}I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism. Subjects and methods: Thirty-six patients with TSH {<=} 0.1mIU/L and non-voluminous goiter (< 60 cm{sup 3} were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia. Results: Mean 24-h {sup 131}I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. Conclusions: In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia. (author)

  19. Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of 99mTc-pertechnetate: applicability to unifocal thyroid autonomy?

    International Nuclear Information System (INIS)

    Reinhardt, Michael J.; Joe, Alexius Y.; Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer; Wissmeyer, Michael; Juengling, Freimut D.; Krause, Thomas M.

    2006-01-01

    The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on 99m Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU s ) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1±10.3 years) with unifocal thyroid autonomy were treated at three different centres with 131 I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU s (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36±19% and 38±20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28±16%; p s can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

  20. Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism.

    Science.gov (United States)

    Rosario, Pedro Weslley

    2013-03-01

    To evaluate 131I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism. Thirty-six patients with TSH ≤ 0.1 mIU/L and non-voluminous goiter (< 60 cm³) were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia. Mean 24-h 131I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia.

  1. Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism

    International Nuclear Information System (INIS)

    Rosario, Pedro Weslley

    2013-01-01

    Objective: To evaluate 131 I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism. Subjects and methods: Thirty-six patients with TSH ≤ 0.1mIU/L and non-voluminous goiter ( 3 were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia. Results: Mean 24-h 131 I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. Conclusions: In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia. (author)

  2. Occupational exposure of nursing staff working with radioiodine therapy during 11 years

    International Nuclear Information System (INIS)

    Calegaro, Jose Ulisses Manzzini; Teixeira, Sandra Mara Pessano

    2007-01-01

    Objective: The present study was aimed at evaluating the occupational exposure of nursing staff in charge of inpatients undergoing 131 I therapy during 11 years. Materials and methods: The exposure situations were classified according to a questionnaire answered by three nursing attendants, correlating the procedures with activities, distances and amount of time in the iodotherapy room. Records of received doses by two types of dosimeters were evaluated over two subsequent periods. In both periods the nursing attendants received instructions about radiological protection. Results: In usual situations, their amount of time in the iodotherapy room was in compliance with the standard time established by the service. In unusual situations, where the patient needed assistance for mobility, the exposure period was above the standard. However, this exposure occurs casually (only one or two times a year). During the period between 1993 and 1999 (dosimetric films) there were ten dose records, all of them at record level. From 2000 to 2003 (thermoluminescent dosimeters) ten dose records were also obtained, with only one of them at the investigation level. During this study period, the mean 131 I activity was doubled. Conclusion: Despite the increased levels of activity there was no significant increase in dose to nursing attendants. (author)

  3. Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids. Addendum

    Science.gov (United States)

    2009-08-01

    Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids PRINCIPAL INVESTIGATOR: Cahit A. Evrensel...AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible... Magneto -rheological Fluid (MRF) iron nano-particles were synthesized using the reverse micelle technique and coated with poly(NIPAAm). The size

  4. New advances in amblyopia therapy I: binocular therapies and pharmacologic augmentation.

    Science.gov (United States)

    Kraus, Courtney L; Culican, Susan M

    2018-05-18

    Amblyopia therapy options have traditionally been limited to penalisation of the non-amblyopic eye with either patching or pharmaceutical penalisation. Solid evidence, mostly from the Pediatric Eye Disease Investigator Group, has validated both number of hours a day of patching and days per week of atropine use. The use of glasses alone has also been established as a good first-line therapy for both anisometropic and strabismic amblyopia. Unfortunately, visual acuity equalisation or even improvement is not always attainable with these methods. Additionally, non-compliance with prescribed therapies contributes to treatment failures, with data supporting difficulty adhering to full treatment sessions. Interest in alternative therapies for amblyopia treatment has long been a topic of interest among researchers and clinicians alike. Incorporating new technology with an understanding of the biological basis of amblyopia has led to enthusiasm for binocular treatment of amblyopia. Early work on perceptual learning as well as more recent enthusiasm for iPad-based dichoptic training have each generated interesting and promising data for vision improvement in amblyopes. Use of pharmaceutical augmentation of traditional therapies has also been investigated. Several different drugs with unique mechanisms of action are thought to be able to neurosensitise the brain and enhance responsiveness to amblyopia therapy. No new treatment has emerged from currently available evidence as superior to the traditional therapies in common practice today. But ongoing investigation into the use of both new technology and the understanding of the neural basis of amblyopia promises alternate or perhaps better cures in the future. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Use of recombinant human thyrotropin (rh TSH) as a method of preparation for radioiodine therapy in thyroid disorders; Utilisation de la thyreostimuline humaine recombinante dans la preparation au traitement par iode-131 des pathologies thyroidiennes

    Energy Technology Data Exchange (ETDEWEB)

    Taieb, D.; Guillet, B.A.; Tessonnier, L.; Mundler, O. [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, 13 - Marseille (France)

    2008-02-15

    The introduction of recombinant human TSH (rh TSH) as a method of preparation for radioiodine therapy of follicular-derived thyroid tumors (benign and malignant) is a significant medical advance. Rh TSH has been approved for use in remnants ablation after total thyroidectomy for carcinoma. There are other potential uses for rh TSH that have not yet been licensed. The use of rh TSH allows to reduce administrated doses in goiters through an increase of iodine uptake and a more homogeneous distribution of radioiodine in the gland. Rh TSH also improves thyroid cancer patients quality of life by avoiding hypothyroidism. (authors)

  6. Radioiodine therapy in veterinary medicine: treatment of hyperthyroidism in a cat; Die Radioiodtherapie in der Veterinaermedizin: Behandlung der Schilddruesenueberfunktion bei einer Katze

    Energy Technology Data Exchange (ETDEWEB)

    Reinartz, P.; Sabri, O.; Zimny, M.; Buell, U. [Technische Hochschule Aachen (Germany). Klinik fuer Nuklearmedizin; Kinzel, S.; Kuepper, W. [Technische Hochschule Aachen (Germany). Inst. fuer Versuchstierkunde; Bachmann, T. [Tierarztpraxis Dr. med. vet. Thomas Bachmann, Glashhuetten (Germany)

    1999-06-01

    A nine-year-old cat with symptoms of a distinct hyperthyroidism was presented at the University Hospital of the RWTH Aachen. The clinical symptoms as well as the diagnostic procedures performed at the hospital confirmed the diagnosis. After five weeks of thyreostatic medication a regular metabolism of the thyroid gland was established, followed by a radioiodine therapy with 70.3 MBq 131-iodine. Subsequently, the cat was hospitalized for two days before it could be released in good condition. Six weeks after treatment the former drastically reduced weight of the cat recovered to near normal. Even though the chemical analysis detected a discrete hyperthyroidism, clinical symptoms were no longer prominent. Three months after treatment, the final examination showed a regular metabolism of the thyroid gland without a specific thyroidal medication. The presented case illustrates that radioiodine therapy is a safe and efficient treatment of thyroidal dysfunctions in veterinary medicine. (orig.) [Deutsch] Eine neun Jahre alte, europaeische Langhaarkatze wurde mit Symptomen einer ausgepraegten Schilddruesenueberfunktion im Universitaetsklinikum der RWTH Aachen vorgestellt. Sowohl die klinische Symptomatik als auch die Labordiagnostik und die apparativ erhobenen Befunde belegten das Vorliegen einer Hyperthyreose. Im Anschluss an eine fuenfwoechige thyreostatische Therapie, mit der eine euthyreote Stoffwechsellage erreicht werden konnte, wurde eine Radioiodtherapie mit 70,3 MBq 131-Iod durchgefuehrt. Nach einer nur zweitaegigen komplikationslosen Hospitalisierung konnte die Katze in gutem Allgemeinzustand entlassen werden. Sechs Wochen nach der Therapie hatte sich das zuvor deutlich reduzierte Koerpergewicht auf nahezu normgerechte Werte erhoeht; klinische Symptome der Schilddruesenueberfunktion liessen sich trotz einer laborchemisch diagnostizierten diskreten Gesamtthyroxiderhoehung nicht mehr nachweisen. Bei einer abschliessenden Kontrolle drei Monate nach Entlassung wies

  7. Radioiodine treatment of Grave's disease

    International Nuclear Information System (INIS)

    Heidenreich, P.; Vogt, H.; Dorn, R.; Graf, G.; Kopp, J.

    2001-01-01

    In Germany radioiodine therapy of Grave's disease is performed in patients older than 20 years, after at least one year of unsuccessful antithyroid therapy, intolerance against antithyroid medication, recurrences after surgical interventions and small goiters. Hyperthyroidism is eliminated with an ablative dose concept (300 Gy) in more than 90% associated with rate of hypothyroidism in the outcome of also more than 90%. Adverse prognostic factors are an insufficient dose to the thyroid and/or concomitant antithyreoid medication. Radioiodine therapy in Germany must be an inpatient single time approach due to quality assurance and radiation protection reasons. The mean hospitalization is only 3-4 days with the patient being discharged at an annual dose of less than 1 mSv at 2 m distance (dose rate at discharge [de

  8. Radioiodine treatment for pediatric hyperthyroid Grave's disease.

    Science.gov (United States)

    Chao, Ma; Jiawei, Xie; Guoming, Wang; Jianbin, Liu; Wanxia, Liu; Driedger, Al; Shuyao, Zuo; Qin, Zhang

    2009-10-01

    Grave's disease (GD) is an autoimmune disease in which excessive amounts of thyroid hormones circulate in the blood. Treatment for pediatric GD includes (1) antithyroid drugs (ATD), (2) radioiodine, and (3) thyroidectomy. Yet, the optimal therapy remains controversial. We collected studies from all electronically available sources as well as from conferences held in China. All studies using radioiodine and/or ATD and/or thyroidectomy were included. Information was found on 1,874 pediatric GD patients treated with radioiodine, 1,279 patients treated with ATD and 1,362 patients treated surgically. The cure rate for radioiodine was 49.8%; the incidence of hypothyroidism, 37.8%; of relapse, 6.3%; of adverse effects, 1.55%; and of drop outs, 0.6%. These data show that radioiodine treatment is safe and effective in pediatric GD with significant lower incidence of relapse and adverse effects but significantly higher incidence of hypothyroidism as compared with both ATD and thyroidectomy. For the time being, radioiodine treatment for pediatric GD remains an excellent first-line therapy and a good second-line therapy for patients with ATD failure, severe complications, or poor compliance.

  9. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of {sup 99m}Tc-pertechnetate thyroid uptake

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger [Department of Nuclear Medicine, University Hospital Bonn (Germany); Joe, Alexius; Zimmerlin, Martina [Department of Nuclear Medicine, University Hospital Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

    2002-04-01

    The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}). The TcTU{sub s} value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70{+-}9 years, and the mean thyroid volume was 54{+-}26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTU{sub s}: 150 Gy for a TcTU{sub s} of 1.5%-2.49%, 200 Gy for a TcTU{sub s} of 2.5%-3.49%, 250 Gy for a TcTU{sub s} of 3.5%-4.49% and 300 Gy for a TcTU{sub s} of {>=}4.5%. Normalisation of TcTU{sub s} and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTU{sub s} in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54{+-}26 before treatment to 34{+-}20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTU{sub s} can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

  10. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake

    International Nuclear Information System (INIS)

    Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger; Joe, Alexius; Zimmerlin, Martina; Krause, Thomas M.

    2002-01-01

    The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTU s ). The TcTU s value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70±9 years, and the mean thyroid volume was 54±26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTU s : 150 Gy for a TcTU s of 1.5%-2.49%, 200 Gy for a TcTU s of 2.5%-3.49%, 250 Gy for a TcTU s of 3.5%-4.49% and 300 Gy for a TcTU s of ≥4.5%. Normalisation of TcTU s and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTU s in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54±26 before treatment to 34±20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTU s can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

  11. GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Hammes, Jochen; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Pietrzyk, Uwe [Forschungszentrum Juelich GmbH (Germany). Inst. fuer Neurowissenschaften und Medizin (INM-4); Wuppertal Univ. (Germany). Fachbereich C - Physik

    2011-07-01

    The recommended target dose in radioiodine therapy of solitary hyperfunctioning thyroid nodules is 300-400 Gy and therefore higher than in other radiotherapies. This is due to the fact that an unknown, yet significant portion of the activity is stored in extranodular areas but is neglected in the calculatory dosimetry. We investigate the feasibility of determining the ratio of nodular and extranodular activity concentrations (uptakes) from post-therapeutically acquired planar scintigrams with Monte Carlo simulations in GATE. The geometry of a gamma camera with a high energy collimator was emulated in GATE (Version 5). A geometrical thyroid-neck phantom (GP) and the ICRP reference voxel phantoms 'Adult Female' (AF, 16 ml thyroid) and 'Adult Male' (AM, 19 ml thyroid) were used as source regions. Nodules of 1 ml and 3 ml volume were placed in the phantoms. For each phantom and each nodule 200 scintigraphic acquisitions were simulated. Uptake ratios of nodule and rest of thyroid ranging from 1 to 20 could be created by summation. Quantitative image analysis was performed by investigating the number of simulated counts in regions of interest (ROIs). ROIs were created by perpendicular projection of the phantom onto the camera plane to avoid a user dependant bias. The ratio of count densities in ROIs over the nodule and over the contralateral lobe, which should be least affected by nodular activity, was taken to be the best available measure for the uptake ratios. However, the predefined uptake ratios are underestimated by these count density ratios: For an uptake ratio of 20 the count ratios range from 4.5 (AF, 1 ml nodule) to 15.3 (AM, 3 ml nodule). Furthermore, the contralateral ROI is more strongly affected by nodular activity than expected: For an uptake ratio of 20 between nodule and rest of thyroid up to 29% of total counts in the ROI over the contralateral lobe are caused by decays in the nodule (AF 3 ml). In the case of the 1 ml nodules this

  12. GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma.

    Science.gov (United States)

    Hammes, Jochen; Pietrzyk, Uwe; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang

    2011-12-01

    The recommended target dose in radioiodine therapy of solitary hyperfunctioning thyroid nodules is 300-400Gy and therefore higher than in other radiotherapies. This is due to the fact that an unknown, yet significant portion of the activity is stored in extranodular areas but is neglected in the calculatory dosimetry. We investigate the feasibility of determining the ratio of nodular and extranodular activity concentrations (uptakes) from post-therapeutically acquired planar scintigrams with Monte Carlo simulations in GATE. The geometry of a gamma camera with a high energy collimator was emulated in GATE (Version 5). A geometrical thyroid-neck phantom (GP) and the ICRP reference voxel phantoms "Adult Female" (AF, 16ml thyroid) and "Adult Male" (AM, 19ml thyroid) were used as source regions. Nodules of 1ml and 3ml volume were placed in the phantoms. For each phantom and each nodule 200 scintigraphic acquisitions were simulated. Uptake ratios of nodule and rest of thyroid ranging from 1 to 20 could be created by summation. Quantitative image analysis was performed by investigating the number of simulated counts in regions of interest (ROIs). ROIs were created by perpendicular projection of the phantom onto the camera plane to avoid a user dependant bias. The ratio of count densities in ROIs over the nodule and over the contralateral lobe, which should be least affected by nodular activity, was taken to be the best available measure for the uptake ratios. However, the predefined uptake ratios are underestimated by these count density ratios: For an uptake ratio of 20 the count ratios range from 4.5 (AF, 1ml nodule) to 15.3 (AM, 3ml nodule). Furthermore, the contralateral ROI is more strongly affected by nodular activity than expected: For an uptake ratio of 20 between nodule and rest of thyroid up to 29% of total counts in the ROI over the contralateral lobe are caused by decays in the nodule (AF 3 ml). In the case of the 1ml nodules this effect is smaller: 9-11% (AF

  13. GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma

    International Nuclear Information System (INIS)

    Hammes, Jochen; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang; Pietrzyk, Uwe; Wuppertal Univ.

    2011-01-01

    The recommended target dose in radioiodine therapy of solitary hyperfunctioning thyroid nodules is 300-400 Gy and therefore higher than in other radiotherapies. This is due to the fact that an unknown, yet significant portion of the activity is stored in extranodular areas but is neglected in the calculatory dosimetry. We investigate the feasibility of determining the ratio of nodular and extranodular activity concentrations (uptakes) from post-therapeutically acquired planar scintigrams with Monte Carlo simulations in GATE. The geometry of a gamma camera with a high energy collimator was emulated in GATE (Version 5). A geometrical thyroid-neck phantom (GP) and the ICRP reference voxel phantoms 'Adult Female' (AF, 16 ml thyroid) and 'Adult Male' (AM, 19 ml thyroid) were used as source regions. Nodules of 1 ml and 3 ml volume were placed in the phantoms. For each phantom and each nodule 200 scintigraphic acquisitions were simulated. Uptake ratios of nodule and rest of thyroid ranging from 1 to 20 could be created by summation. Quantitative image analysis was performed by investigating the number of simulated counts in regions of interest (ROIs). ROIs were created by perpendicular projection of the phantom onto the camera plane to avoid a user dependant bias. The ratio of count densities in ROIs over the nodule and over the contralateral lobe, which should be least affected by nodular activity, was taken to be the best available measure for the uptake ratios. However, the predefined uptake ratios are underestimated by these count density ratios: For an uptake ratio of 20 the count ratios range from 4.5 (AF, 1 ml nodule) to 15.3 (AM, 3 ml nodule). Furthermore, the contralateral ROI is more strongly affected by nodular activity than expected: For an uptake ratio of 20 between nodule and rest of thyroid up to 29% of total counts in the ROI over the contralateral lobe are caused by decays in the nodule (AF 3 ml). In the case of the 1 ml nodules this effect is smaller: 9

  14. Cost-effectiveness-analysis: radioiodine or antithyroid drugs as first-line therapy of hyperthyroidism due to Graves` disease; Kosten-Effektivitaets-Analyse: Radioiod oder thyreostatische Medikation bei der Primaerbehandlung der Immunhyperthyreose

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Moka, D.; Dederichs, B.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Hunsche, E.; Lauterbach, K.W. [Koeln Univ. (Germany). Inst. fuer Gesundheitsoekonomie, Medizin und Gesellschaft

    1999-06-01

    Aim: As first-line therapy of hyperthyroidism caused by Graves` disease antithyroid drugs are favoured in Europe, while radioiodine therapy is favoured in the USA. Radioiodine therapy has become more economic in Germany since the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines. Method: Sensitivity analyses took into account the long-term relapse rate of conservative or radioiodine therapy, use of diagnostic tests, level of health insurance, drops in productivity and a discount factor. Costing models included the costs of follow-up care over 30 years. The costs of the hospitalisation for radioiodine therapy were calculated for 300 patients, discharged with 250 MBq I-131 residual activity. Result: Antithyroid drugs were considered cost-effective when they achieved relapse rate of 50% or less, a cut in the number of tests needed and reduced working hours. Failure to meet any one of these conditions makes primary radioiodine therapy more cost-effective in 1593 of 1944 calculated costing models. Repeated conservative therapies will increase clearly the overall costs. Conclusion: Radioiodine is a cost-effective, first-line therapy in patients with a special risk of relapse after primary conservative therapy (goitre, younger patient, persistent elevated TSH-receptor-antibodies or Tc-uptake). (orig.) [Deutsch] Ziel: Die Erstmanifestation einer Immunhyperthyreose wird in Europa ueberwiegend thyreostatisch, in den USA mehrheitlich mit Radioiod definitiv behandelt. Diese beiden Alternativen wurden auf dem Hintergrund neuer nationaler Entlassungsrichtwerte nach einer Radioiodtherapie (RITh) verglichen. Methode: Aus Sicht der Gesellschaft entscheiden einerseits die langfristigen Rezidivraten, andererseits die Menge medizinischer Leistungen, der Versicherungsstatus und der Produktivitaetsausfall des Patienten (Fehlzeiten, Einkommen) sowie die zeitliche Verteilung der Kosten (Diskontierung) ueber die Kosten

  15. Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of {sup 99m}Tc-pertechnetate: applicability to unifocal thyroid autonomy?

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, Michael J.; Joe, Alexius Y. [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Wissmeyer, Michael [Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland); Juengling, Freimut D.; Krause, Thomas M. [University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland)

    2006-05-15

    The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on {sup 99m}Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1{+-}10.3 years) with unifocal thyroid autonomy were treated at three different centres with {sup 131}I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU{sub s} (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36{+-}19% and 38{+-}20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28{+-}16%; p<0.01). A dose strategy based on the TcTU{sub s} can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

  16. Current status of radioiodine (131I) treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Becker, D.V.; Hurley, J.R.

    1982-01-01

    Radioiodine appears to be increasingly selected as the primary form of therapy for most hyperthyroid adults. Some controversy exists concerning the use of I-131 in children and adolescents as well as in some patients with toxic nodular goiter. The technical aspects of radioiodine administration reviewed in this chapter include the biologic basis of I-131 use, dose strategies, measurement and evaluation of radioiodine parameters, and I-125 treatment of hyperthyroidism. The management of patients before and after I-131 treatment is discussed as well as posttreatment hypothyroidism and complications of radioiodine treatment

  17. Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression

    DEFF Research Database (Denmark)

    Straasø, Birgit; Lauritzen, Lise; Lunde, Marianne

    2014-01-01

    OBJECTIVE: To evaluate to what extent a twice daily dose of Transcranial Pulsating ElectroMagnetic Fields (T-PEMF) was superior to once daily in patients with treatment-resistant depression as to obtaining symptom remission after 8 weeks of augmentation therapy. METHODS: A self-treatment set...

  18. Guideline on radiation protection in medicine requires documentation of radioiodine therapy and follow-up. What are the benefits of an electronic database?

    International Nuclear Information System (INIS)

    Koch, W.; Rosa, F.; Knesewitsch, P.; Hahn, K.

    2005-01-01

    The lately updated German guideline on radiation protection in medicine (Richtlinie Strahlenschutz in der Medizin) requires the physician who administers radioactive substances for therapy, to perform and document follows-up. In order to decrease the administrative burden, an electronic database was developed that interfaces with a word processing software to generate written reports and statistic analysis. Methods: Based on Microsoft registered Access and Microsoft registered Visual Basic a database was created to monitor patients with benign and malignant thyroid disorders after radioiodine therapy. It permits automatic creation of therapy documents and necessary patient reports in Microsoft registered Word. Intuitive handling, third level of normalization in database architecture and automatic plausibility checks guarantee integrity of the data and the efficacy of the database. Results, conclusion: The new software has been a success in over 1500 patients and over 3800 in- and outpatient therapies and visits. The effort of data entry is easily offset by the automatic generation of the necessary patient reports. The required supervision of the follow-up appointments is now also user-friendly and efficient. (orig.)

  19. Comparative evaluation of the two fixed dose methods of radioiodine therapy (185 MBq and 370 MBq) for the treatment of Graves' disease

    International Nuclear Information System (INIS)

    Esfahani, A.F.; Fallahi, B.; Kakhki, V.R.D.; Eftekhari, M.; Beiki, D.; Saghari, M.

    2005-01-01

    Full text: Radioiodine therapy is the safest, simplest, least expensive and most effective method for treatment of Graves' disease. But optimal method for determining iodine-131 treatment doses for Graves' hyperthyroidism is unknown, and techniques have varied from a fixed dose to more elaborate calculations based upon gland size, iodine uptake, and iodine turnover. Due to difficulties in previous methods for dose determination, fixed dose method of I-131 is now considered the best practical method for I-131 therapy in Graves' disease, but there is no consensus on the dose. We compared two routinely recommended fixed doses of 185 and 370 MBq for this purpose. Methods and Materials: Patients with Graves' hyperthyroidism (n = 59) who had not been previously treated with radioactive iodine were randomized in two groups of 185 MBq (5 Ci) and 370 MBq (10 mCi). l patients were followed for two years, with 6-month intervals for following clinical outcomes: hyperthyroid requiring further radioiodine, and hypothyroid requiring life-long replacement therapy. Euthyroid and hypothyroid states were considered successful therapy (cure) and hyperthyroid state was considered failure (no response or relapse). Results: Totally, among 59 patients treated with I-131, 20 (33.9%) patients became euthyroid and 19(32.2%) became hypothyroid, while failed therapy was noticed in 20 patients (33.9%). In the group treated by 185 MBq (33 patients), 10(30.3%) were euthyroid, 6(18.2%) were hypothyroid (overall cure rate of 48.5%), while 17(51.5%) remained hyperthyroid by the end of the follow-up period. From the 26 patients treated with 370 MBq, the euthyroid and hypothyroid states were observed in 10(38.5%) and 13(50%) patients, respectively (overall cure rate of 88.5%), and hyperthyroid state in 3(11.5%). No relationship was noted between the outcome and age, sex, size of the thyroid gland and thyroid uptake, but the relationship between the disease outcome and the amount of administered

  20. The imunocytochemical advances in prognosis of metastasis radioiodine resistant of papillary thyroid carcinoma

    International Nuclear Information System (INIS)

    Zelyins'ka, G.V.

    2015-01-01

    The topical issues is the problem of prognosis of metastasis radioiodine resistant metastasis. We offered the methods of prognosis of metastasis radioiodine resistant of papillary thyroid carcinoma with the help of immunocytochemical detection of the cytokeratin 17 and thyroid peroxidase. With the purpose of prognosis of metastasis radioiodine resistibility the cytokeratin 17 is taped in punctates of primary papillary carcinomas. This approach allows predict response of metastases on radioiodine therapy to choose proper therapeutic approach

  1. Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

    Science.gov (United States)

    Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

    2017-07-01

    New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

  2. Clinical significance of thyroglobulin autoantibodies enhancement in patients with differentiated thyroid cancer after thyroidectomy and radioiodine therapy

    Directory of Open Access Journals (Sweden)

    N V Severskaya

    2013-09-01

    Full Text Available Purpose: to evaluate the clinical utility of antithyroglobulin antibodies (TgAb as a tumor marker in patients with differentiated thyroid cancer (DTC after thyroidectomy and radioiodine ablation. Patients and methods. From 345 consecutive DTC patients after thyroidectomy and radioiodine ablation we select ed 148 patients with elevated TgAb level (with distant metastasis n = 93, without distant metastasis n = 55. Serum TgAb concentration was measured before radioiodine ablation and then every time before 131I treatment (RIT or diagnostic 131I whole body scanning (WBS. Results were compared with serum thyroglobulin (Tg concentration, neck echography, lung and bone roentgenography and 131I WBS findings. Results. TgAb level was elevated in 21% DTC patients before 131I ablation. The other 22% with initially normal TgAb displayed their rising during followup. In absence of distant metastasis TgAb declined after 1 st–2 nd cycle of RIT (an average 8.9 months after 131I ablation. Persistance or rising of TgAb in the longer term was associated with detectable thyroid remnant, residual tumor or metastatic lymph nodes. In case of negative TgAb status after sugery an increase of TgAb during first 3–6 months after ablation indicated mostly a response to the rise of Tg antigen secondary to 131I ablation. A rise TgAb in the longer term (after 3rd–5th cycles of RIT indicated to residual or recurrent disease in 86% cases. In patients with distant metastasis there were no correlation between change in TgAb concentration and clinical sta tus, including the rate of regression of metastatic disease. But in case of low or undetectable Tg and permanent high TgAb level only TgAb indicated the presence of disease. Conclusion: persistence or rising TgAb in longer term after 131I ablation can serve as surrogate tumor marker of per sistent or recurrent disease. It is critical to measure TgAb concentration, especially in patients with low or unde tectable Tg, because

  3. Microsponges based novel drug delivery system for augmented arthritis therapy

    OpenAIRE

    Osmani, Riyaz Ali M.; Aloorkar, Nagesh H.; Ingale, Dipti J.; Kulkarni, Parthasarathi K.; Hani, Umme; Bhosale, Rohit R.; Jayachandra Dev, Dandasi

    2015-01-01

    The motive behind present work was to formulate and evaluate gel containing microsponges of diclofenac diethylamine to provide prolonged release for proficient arthritis therapy. Quasi-emulsion solvent diffusion method was implied using Eudragit RS-100 and microsponges with varied drug–polymer ratios were prepared. For the sake of optimization, diverse factors affecting microparticles physical properties were too investigated. Microsponges were characterized by SEM, DSC, FT-IR, XRPD and parti...

  4. Model-based sensor-augmented pump therapy.

    Science.gov (United States)

    Grosman, Benyamin; Voskanyan, Gayane; Loutseiko, Mikhail; Roy, Anirban; Mehta, Aloke; Kurtz, Natalie; Parikh, Neha; Kaufman, Francine R; Mastrototaro, John J; Keenan, Barry

    2013-03-01

    In insulin pump therapy, optimization of bolus and basal insulin dose settings is a challenge. We introduce a new algorithm that provides individualized basal rates and new carbohydrate ratio and correction factor recommendations. The algorithm utilizes a mathematical model of blood glucose (BG) as a function of carbohydrate intake and delivered insulin, which includes individualized parameters derived from sensor BG and insulin delivery data downloaded from a patient's pump. A mathematical model of BG as a function of carbohydrate intake and delivered insulin was developed. The model includes fixed parameters and several individualized parameters derived from the subject's BG measurements and pump data. Performance of the new algorithm was assessed using n = 4 diabetic canine experiments over a 32 h duration. In addition, 10 in silico adults from the University of Virginia/Padova type 1 diabetes mellitus metabolic simulator were tested. The percentage of time in glucose range 80-180 mg/dl was 86%, 85%, 61%, and 30% using model-based therapy and [78%, 100%] (brackets denote multiple experiments conducted under the same therapy and animal model), [75%, 67%], 47%, and 86% for the control experiments for dogs 1 to 4, respectively. The BG measurements obtained in the simulation using our individualized algorithm were in 61-231 mg/dl min-max envelope, whereas use of the simulator's default treatment resulted in BG measurements 90-210 mg/dl min-max envelope. The study results demonstrate the potential of this method, which could serve as a platform for improving, facilitating, and standardizing insulin pump therapy based on a single download of data. © 2013 Diabetes Technology Society.

  5. [Augmented antipsychotic therapy with pantogam active in patients with schizophrenia].

    Science.gov (United States)

    Medvedev, V E; Frolova, V I; Gushanskaya, E V; Ter-Israelyan, A U

    2015-01-01

    to study the efficacy of the GABA-ergic drug pantogam active (D-, L-gopantenic acid) in patients with schizophrenia treated with typical neuroleptics and to assess the rate of treatment response and tolerability of the drug. A sample consisted of 70 patients with schizophrenia stratified into main (n=35) and control (n=35) groups. All patients received one of typical antipsychotics (haloperidol, zuclopenthixol, promazine or perphenazine). Patients of the main group received in addition pantogam active in dose of 1200-1800 mg daily. The maximum allowed dose of 1800 mg daily was used in 62.9% of the patients. The long-term combined therapy with the addition of D-, L-gopantenic acid (pantogam activ) allowed to achieve clinical improvement earlier (on 8th week in the main group versus 16th week in the control group). The frequency and severity of secondary negative symptoms associated with antipsychotic therapy were decreased as well. The high efficacy and tolerability of the combined therapy allow to improve quality of life in patients with schizophrenia and their compliance to treatment as well as to reduce costs of medical care.

  6. Studies on the airborne radioiodine-contamination in thyroid therapy with /sup 131/I doses of approx 370 MBq

    Energy Technology Data Exchange (ETDEWEB)

    Krzesniak, J W; Czerminska, M [Centralne Lab. Ochrony Radiologicznej, Warsaw (Poland); Chomicki, O A [Centrum Medyczne Ksztalcenia Podyplomowego, Warsaw (Poland)

    1979-01-01

    The equipment and methods are described and the results presented of /sup 131/I levels in various physical and chemical forms measured at the Endocrinology Clinic of the Center for Postgraduate Medical Training in Warsaw. The analysis was made of the radiation hazards to the personnel and ''nonradioisotope'' patient from /sup 131/I inhaled. Even though the /sup 131/I levels in the air exceeded the permissible levels by a factor 2-5, when the time spent in corresponding areas was taken into consideration, the /sup 131/I uptake in the above persons constituted only between 1 and 10% of the maximum permissible level of the /sup 131/I inhaled. The dynamics of radioiodine exhalation in the euthyroid and hyperthyroid patients treated with /sup 131/I is discussed. No statistical difference was found between the exhalation curves when /sup 131/I was administered as a liquid or in the form of closed capsules.

  7. D-cycloserine augmentation in behavioral therapy for obsessive-compulsive disorder: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Xia J

    2015-04-01

    Full Text Available Jing Xia,1 Yanqiu Du,2 Jiyang Han,1 Guo Liu,1 Xumei Wang11Department of Psychiatry, Shengjing Hospital of China Medical University, Heping District Shenyang, Liaoning, People’s Republic of China; 2Department of Medicine, Shenyang Ninth People’s Hospital, Tiexi District, Shenyang, Liaoning, People’s Republic of ChinaObjective: To evaluate the overall effect of D-cycloserine (DCS augmentation on exposure and response prevention (ERP therapy for obsessive-compulsive disorder (OCD.Methods: Clinical studies on the effect of DCS augmentation on ERP therapy for OCD compared to placebo were included for meta analysis. The primary outcome was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS. Meta-analyses were performed with a random-effect model or a fixed-effect model using the Cochrane Review Manager (RevMan, version 5.2 to calculate the odds ratio and the mean difference, with their corresponding 95% confidence intervals.Results: A total of six studies was included in the current meta-analyses, and their data were extracted. Among them, four were for analyses of DCS and Y-BOCS at midtreatment, six for analysis at posttreatment, and four at 3-month follow-up. Besides, three of the six eligible studies were included in the meta-analysis of the DCS and Clinical Global Impression – Severity Scale at posttreatment, and three in the meta-analysis of DCS and proportions of treatment responders and of subjects attaining clinical remission status criteria at posttreatment. Our meta-analyses do not reveal a significant effect of DCS augmentation in ERP therapy for OCD patients, except when measured at midtreatment. Compared to the placebo group, DCS augmentation did show a trend toward significantly lower/decreased Y-BOCS; when measured at posttreatment and in the subpopulation of DCS taken before some of the ERP sessions, DCS augmentation showed a trend toward significantly lower/decreased Y-BOCS.Conclusion: Our result suggested that with the careful

  8. Microsponges based novel drug delivery system for augmented arthritis therapy.

    Science.gov (United States)

    Osmani, Riyaz Ali M; Aloorkar, Nagesh H; Ingale, Dipti J; Kulkarni, Parthasarathi K; Hani, Umme; Bhosale, Rohit R; Jayachandra Dev, Dandasi

    2015-10-01

    The motive behind present work was to formulate and evaluate gel containing microsponges of diclofenac diethylamine to provide prolonged release for proficient arthritis therapy. Quasi-emulsion solvent diffusion method was implied using Eudragit RS-100 and microsponges with varied drug-polymer ratios were prepared. For the sake of optimization, diverse factors affecting microparticles physical properties were too investigated. Microsponges were characterized by SEM, DSC, FT-IR, XRPD and particle size analysis, and evaluated for morphology, drug loading, in vitro drug release and ex vivo diffusion as well. There were no chemical interactions between drug and polymers used as revealed by compatibility studies outcomes. The drug polymer ratio reflected notable effect on drug content, encapsulation efficiency and particle size. SEM results revealed spherical microsponges with porous surface, and had 7.21 μm mean particle size. The microsponges were then incorporated in gel; which exhibited viscous modulus along with pseudoplastic behavior. In vitro drug release results depicted that microsponges with 1:2 drug-polymer ratio were more efficient to give extended drug release of 75.88% at the end of 8 h; while conventional formulation get exhausted incredibly earlier by releasing 81.11% drug at the end of 4 h only. Thus the formulated microsponge-based gel of diclofenac diethylamine would be a promising alternative to conventional therapy for safer and efficient treatment of arthritis and musculoskeletal disorders.

  9. Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease. A 3-month follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Korkusuz, H.; Happel, C.; Koch, D.A.; Gruenwald, F. [Frankfurt University Hospital (Germany). Dept. of Nuclear Medicine

    2016-01-15

    Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ± 7.9 ml (30.5 % ± 4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ± 4.8 % (p < 0.05) and hospitalization time by 30.9 % ± 19.9 % (p < 0.05). The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary.

  10. The effects of weekly augmentation therapy in patients with PiZZ α1-antitrypsin deficiency

    Directory of Open Access Journals (Sweden)

    Schmid ST

    2012-09-01

    Full Text Available ST Schmid,1 J Koepke,1 M Dresel,1 A Hattesohl,1 E Frenzel,2 J Perez,3 DA Lomas,4 E Miranda,5 T Greulich,1 S Noeske,1 M Wencker,6 H Teschler,6 C Vogelmeier,1 S Janciauskiene,2,* AR Koczulla1,*1Department of Internal Medicine, Division for Pulmonary Diseases, University Hospital Marburg, Marburg, Germany; 2Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany; 3Department of Cellular Biology, University of Malaga, Malaga, Spain; 4Department of Medicine, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom; 5Department of Biology and Biotechnology, Istituto Pasteur – Fondazione Cenci Bolognetti, Sapienza University of Rome, Rome, Italy; 6Department of Pneumology, West German Lung Clinic, Essen University Hospital, Essen, Germany*These authors contributed equally to this workBackground: The major concept behind augmentation therapy with human α1-antitrypsin (AAT is to raise the levels of AAT in patients with protease inhibitor phenotype ZZ (Glu342Lys-inherited AAT deficiency and to protect lung tissues from proteolysis and progression of emphysema.Objective: To evaluate the short-term effects of augmentation therapy (Prolastin® on plasma levels of AAT, C-reactive protein, and chemokines/cytokines.Materials and methods: Serum and exhaled breath condensate were collected from individuals with protease inhibitor phenotype ZZ AAT deficiency-related emphysema (n = 12 on the first, third, and seventh day after the infusion of intravenous Prolastin. Concentrations of total and polymeric AAT, interleukin-8 (IL-8, monocyte chemotactic protein-1, IL-6, tumor necrosis factor-α, vascular endothelial growth factor, and C-reactive protein were determined. Blood neutrophils and primary epithelial cells were also exposed to Prolastin (1 mg/mL.Results: There were significant fluctuations in serum (but not in exhaled breath condensate levels of AAT polymers, IL-8, monocyte chemotactic protein-1, IL

  11. Is electroconvulsive therapy effective as augmentation in clozapine-resistant schizophrenia?

    Science.gov (United States)

    Kittsteiner Manubens, Lucas; Lobos Urbina, Diego; Aceituno, David

    2016-10-14

    Clozapine is considered to be the most effective antipsychotic drug for patients with treatment resistant schizophrenia, but up to a third of the patients do not respond to this treatment. Various strategies have been tried to augment the effect of clozapine in non-responders, one of these strategies being electroconvulsive therapy. However, its efficacy and safety are not yet clear. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 55 studies, among them six randomized controlled trials addressing clozapine-resistant schizophrenia. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded electroconvulsive therapy probably augments response to clozapine in patients with treatment resistant schizophrenia, but it is not possible to determine if it leads to cognitive adverse effects because the certainty of the evidence is very low.

  12. Influence of radioiodine therapy on ocular changes and their relation to urine cotinine level in patients with Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Czarnywojtek, A.; Czepczynski, R.; Budny, B.; Ruchata, M.; Zgorzalewicz-Stachowiak, M.; Florek, E.; Komar-Rychlicka, K.

    2015-01-01

    Full text of publication follows. Radioiodine therapy (RIT) is frequently used as the definitive treatment in patients with Graves' hyperthyroidism when remission is not achieved with anti-thyroid drugs (ATDs). In this observational study, we intended to examine whether the use of high doses of radioiodine (RAI) [22 mCi (814 MBq)] with prophylaxis of oral glucocorticoids (oGCS) does not exacerbate Graves ophthalmopathy (GO) in smokers and non-smokers, especially with regard to cotinine concentrations and ocular changes before and after RIT. Material and methods: The studied group consisted of 26 smokers, aged 28-61 years and 25 non-smoker patients, aged 21-54 years, respectively. The patients were qualified to RAI after one-year of ineffective ATDs treatment. Criterion for acceptance in the study were patients with mild GO with hyperthyroidism at diagnosis based on the severity (NOSPECS) and activity (CAS) scale. All the patients were subjected to RIT with oGCS prophylaxis and evaluated prospectively during a one-year follow-up. The ophthalmological examination was performed at various stages of RIT: initial pre-radioiodine administration, at the time of treatment 6, and 12 months after RAI. Urine cotinine measurement was employed to detect nicotine exposure, also in regard to smoking intensity. Results: TSHR-Abs concentration was higher in smokers (P < 0.05), rising from (22.9 ± 1.2) IU/l before therapy to (29.6 ± 5.3) IU/l at 2 months, (32.6 ± 8.6) IU/l at 6 months, and (28.9 ± 10.6) IU/l at 12 months after RIT. These observed changes were statistically different between groups at baseline (P < 0.05) and after one-year follow-up (P < 0.005). Mean urine cotinine were considerably higher in smokers comparing to non smokers in each point of. CAS values in the smoking group before RIT increased statistically from 2.8 ± 0.2 points at baseline to 4.3 ± 0.3 after 6 months, and 4.0 ± 0.5 (12 months), while in the non-smoking patients it was 1.4 ± 0.2, 2.8

  13. Chemical forms of radioiodine

    International Nuclear Information System (INIS)

    Tachikawa, Enzo

    1979-01-01

    Release of radioiodine built-up during reactor operations presents a potential problem from the standpoint of environmental safety. Among the chemical forms of radioiodine, depending upon the circumstances, organic iodides cast a most serious problem because of its difficulties in the trapping and because of its stability compared to other chemical forms. Furthermore, pellet-cladding interaction (PCl) fuel failures in LWR fuel rods are believed to be stress corrosion cracks caused by embrittling fission product species, radioiodine. To deal with these problems, knowledge is required on the chemical behaviors of radioiodine in and out of fuels, as well as the release behaviors from fuels. Here a brief review is given of these respects, in aiming at clearing-up the questions still remaining unknown. The data seem to indicate that radioiodine exists as a combined form in fuels. upon heating slightly irradiated fuels, the iodine atoms are released in a chemical form associated with uranium atoms. Experiments, however, as needed with specimen of higher burnup, where the interactions of radioiodine with metallic fission products could be favored. The dominant release mechanism of radioiodine under normal operating temperatures will be diffusion to grain boundaries leading to open surfaces. Radiation-induced internal traps, however, after the rate of diffusion significantly. The carbon sources of organic iodides formed under various conditions and its formation mechanisms have also been considered. (author)

  14. The influence of saliva flow stimulation on the absorbed radiation dose to the salivary glands during radioiodine therapy of thyroid cancer using {sup 124}I PET(/CT) imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jentzen, Walter; Schmitz, Jochen; Freudenberg, Lutz; Eising, Ernst; Bockisch, Andreas; Stahl, Alexander [Universitaet Duisburg-Essen, Klinik fuer Nuklearmedizin, Essen (Germany); Balschuweit, Dorothee; Hilbel, Thomas [Fachhochschule Gelsenkirchen, Fachbereich Physikalische Technik, Gelsenkirchen (Germany)

    2010-12-15

    A serious side effect of high-activity radioiodine therapy in the treatment of differentiated thyroid cancer is radiogenic salivary gland damage. This damage may be diminished by lemon-juice-induced saliva flow immediately after {sup 131}I administration. The aim of this study was to assess the effect of chewing lemon slices on the absorbed (radiation) doses to the salivary glands. Ten patients received (pretherapy) {sup 124}I PET(/CT) dosimetry before their first radioiodine therapy. The patients underwent a series of six PET scans at 0.5, 1, 2, 4, 48 and {>=}96 h and one PET/CT scan at 24 h after administration of 27 MBq {sup 124}I. Blood samples were also collected at about 2, 4, 24, 48, and 96 h. Contrary to the standard radioiodine therapy protocol, the patients were not stimulated with lemon juice. Specifically, the patients chewed no lemon slices during the pretherapy procedure and neither ate food nor drank fluids until after completion of the last PET scan on the first day. Organ absorbed doses per administered {sup 131}I activity (ODpAs) as well as gland and blood uptake curves were determined and compared with published data from a control patient group, i.e. stimulated per the standard radioiodine therapy protocol. The calculations for both groups used the same methodology. A within-group comparison showed that the mean ODpA for the submandibular glands was not significantly different from that for the parotid glands. An intergroup comparison showed that the mean ODpA in the nonstimulation group averaged over both gland types was reduced by 28% compared to the mean ODpA in the stimulation group (p=0.01). Within each gland type, the mean ODpA reductions in the nonstimulation group were statistically significant for the parotid glands (p=0.03) but not for the submandibular glands (p=0.23). The observed ODpAs were higher in the stimulation group because of increased initial gland uptake rather than group differences in blood kinetics. The {sup 124}I PET

  15. Immunogenic hyperthyroidism following radioiodine ablation of focal autonomy

    International Nuclear Information System (INIS)

    Boddenberg, B.; Voth, E.; Schicha, H.

    1993-01-01

    Immunogenic hyperthyroidism rarely develops after radioiodine elimination of focal autonomous thyroid tissue. We observed this phenomenon in 8 patients between 1989 and 1992. The occurrence of immunogenic hyperthyroidism shortly after elimination of autonomous nodules has not been studied nor is it properly understood. Most studies known today describe the development of autonomous nodules in the course of immunogenic hyperthyroidism or ignore the chronologic order of occurrence. The possibility that immunogenic hyperthyroidism may occur after radioiodine therapy of autonomous nodules, makes a consequent follow-up within the first year following radioiodine therapy mandatory. (orig.) [de

  16. Clinical research of juvenile hyperthyroidism treatment with radioiodine

    International Nuclear Information System (INIS)

    Qiu Ling; Zhang Chunying; Chen Yue

    2001-01-01

    Objective: To evaluate the effects and side effects in the radioiodine management of juvenile hyperthyroidism. Methods: 80 patients with poor effects using anti-thyroid drug were assigned to receive 131 I therapy. The follows of therapy outcome were assessed 1, 3, 6 and 12 months after the start of treatment. One follows up per 1-3 years. Results: Among 80 patients followed by 6 months, clinical response was excellent in 65 patients (81%), good in 15 (19%). There were 12 patients with hypothyroidism followed 4 years, and with no other side effects. Conclusion: The good therapeutic effect was obtained in radioiodine treatment for juvenile hyperthyroidism. Radioiodine was effective to juvenile hyperthyroidism

  17. Male sex, African American race or ethnicity, and triiodothyronine levels at diagnosis predict weight gain after antithyroid medication and radioiodine therapy for hyperthyroidism.

    Science.gov (United States)

    Ariza, Miguel A; Loken, Won Mee J; Pearce, Elizabeth N; Safer, Joshua D

    2010-01-01

    To determine whether racial or ethnic differences affect weight gain after treatment of hyperthyroidism and to reassess established risk factors such as sex, age, and cause of hyperthyroidism. We conducted a retrospective review of medical records of 111 patients treated with radioiodine (RAI) for hyperthyroidism, with or without preceding antithyroid medication, during 2002 to 2005. We ascertained age, sex, race or ethnicity, insurance status, compliance with visits, serum triiodothyronine (T3) level at diagnosis, and cause of hyperthyroidism. Weights and serum thyroidstimulating hormone levels were obtained at diagnosis, at time of RAI therapy, and at 0 to 4 months, 4 to 8 months, 8 to 12 months, and 24 months after RAI treatment. There was a significant weight increase after treatment of hyperthyroidism. Levels of T3 at initial diagnosis of hyperthyroidism, male sex, and black or Hispanic ethnicity were found to be independent predictors of weight gain after RAI treatment. We found a significant interaction between race or ethnicity and sex in multivariate models. There was no difference in thyroid function across racial or ethnic groups or the sexes. Age, cause of hyperthyroidism, posttreatment thyroid-stimulating hormone level, compliance, and insurance status were not found to be significant predictors of weight gain. The T3 level at the time of diagnosis of hyperthyroidism is a strong predictor of weight gain after treatment of hyperthyroidism. Black race or ethnicity and male sex are also risk factors for weight gain.

  18. Comparative evaluation of the two methods of fixed dose radioiodine therapy (5 mCi and 10 mCi) for the treatment of Graves' disease

    International Nuclear Information System (INIS)

    Fard Esfehani, A.; Dabbagh Kakhki, V.R.; Eftekhari, M.; Zarpak, B.; Fallahi Seyjani, B.; Saghari, M.

    2002-01-01

    Radioiodine therapy is the safest, simplest, least expensive and most effective method for treatment in most patients with Graves' disease. Due to complexity of methods for dose determination, the tendency is toward using fixed doses of I-131 for this purpose. As there is conflict for the best fixed dose, regarding it's efficiency and complication of hypothyroidism, standardized dose selection is of particular importance in treatment of Grave' disease. 59 patients with grave' disease, referred to the nuclear medicine center of Shariati Hospital from 78.5.25 were studied. In this clinical trial, the patients were randomized into two groups, one were treated with 5 mCi of 1-131 and the other received 10 mCi of the same agent. All patients were followed for two years, with 6-month intervals. Among 65 patients treated with I-131, 20 (33 9%) patients became euthyroid and 19(32.2%) became hypothyroid while relapse was noticed in 20 patients (33.9%) In The group treated by 5 mCi I-131 (33 patients), 10(30%) were euthyroid, 6(18.2%) were hypothyroid (overall cure of 48.5% while 17(51.5%) remained hyperthyroid by the end of the follow -up period(two years). From the 26 patients who were treated with 10 mCi, the euthyroid, hypothyroid and hypothyroid states were observed in 10(38.5%), 13(50%), 13(50%) and 3(11.5%) patients respectively (with an overall cure rate of 88.5%). No relationship was noted between the outcome and age, sex, size of the thyroid gland and thyroid uptake, but the relationship between the disease outcome and the amount of administered radioiodine was statistically significant (P=0.003). For most of the patients, age, sex, iodine uptake and even thyroid size play minor roles in dose selection. Although the incidence-rate of early hypothyroidism (by the end of 2 years) in the cases related with 5 mCi is less than those treated with 10 mCi, the incidence of relapse is greatly higher in the former group. In addition, it was found that long

  19. The effect of short-term treatment with lithium carbonate on the outcome of radioiodine therapy in patients with long-lasting Graves' hyperthyroidism.

    Science.gov (United States)

    Sekulić, Vladan; Rajić, Milena; Vlajković, Marina; Ilić, Slobodan; Stević, Miloš; Kojić, Marko

    2017-12-01

    The outcome of radioiodine therapy (RIT) in Graves' hyperthyroidism (GH) mainly depends on radioiodine ( 131 I) uptake and the effective half-life of 131 I in the gland. Studies have shown that lithium carbonate (LiCO 3 ) enhances the 131 I half-life and increases the applied thyroid radiation dose without affecting the thyroid 131 I uptake. We investigated the effect of short-term treatment with LiCO 3 on the outcome of RIT in patients with long-lasting GH, its influence on the thyroid hormones levels 7 days after RIT, and possible side effects. Study prospectively included 30 patients treated with LiCO 3 and 131 I (RI-Li group) and 30 patients only with 131 I (RI group). Treatment with LiCO 3 (900 mg/day) started 1 day before RIT and continued 6 days after. Anti-thyroid drugs withdrawal was 7 days before RIT. Patients were followed up for 12 months. We defined a success of RIT as euthyroidism or hypothyroidism, and a failure as persistent hyperthyroidism. In RI-Li group, a serum level of Li was 0.571 ± 0.156 mmol/l before RIT. Serum levels of TT 4 and FT 4 increased while TSH decreased only in RI group 7 days after RIT. No toxic effects were noticed during LiCO 3 treatment. After 12 months, a success of RIT was 73.3% in RI and 90.0% in RI-Li group (P treatment with LiCO 3 as an adjunct to 131 I improves efficacy of RIT in patients with long-lasting GH. A success of RIT achieves faster in lithium-treated than in RI group. Treatment with LiCO 3 for 7 days prevents transient worsening of hyperthyroidism after RIT. Short-term use of LiCO 3 shows no toxic side effects.

  20. Use of physical therapy to augment dilator treatment for vaginal agenesis.

    Science.gov (United States)

    McVearry, Mary E; Warner, William B

    2011-05-01

    : Dilator therapy has been used successfully for many years to treat vaginal agenesis. Our objective was to show how established physical therapy techniques can be used to augment dilator therapy. : A 36-year-old woman desiring nonsurgical management of vaginal agenesis was instructed in the use of vaginal dilators by a pelvic-floor physical therapist. Manual stretching of the vaginal tissues was performed during office visits after application of heat and therapeutic ultrasound to the perineum. In addition, the patient's husband was taught how to perform the vaginal stretching at home in conjunction with dilator therapy. : The patient was able to attempt intercourse after 6 weeks of treatment and achieved full penetration by 9 weeks. At the completion of treatment, she scored 31.9 on the Female Sexual Function Index. The patient and her husband were very satisfied with the treatment approach, especially the encouragement and guidance received in physical therapy. : By using established physical therapy techniques in conjunction with dilator therapy, a faster time to intercourse may be achieved with high patient and spouse satisfaction. We recommend the involvement of a physical therapist specializing in the pelvic floor as an adjunct to standard dilator therapy in the treatment of vaginal agenesis.

  1. Radioiodine in soils

    International Nuclear Information System (INIS)

    Szabova, T.

    1981-01-01

    Behaviour was studied of radioiodine in different soil subtypes sampled in the vicinity of the A-1 nuclear power plant at Jaslovske Bohunice. Radioiodine sorption is mainly affected by the amount of humus and by the clay fraction of soil. The highest sorption was recorded for meadow chernozem and the lowest for rendzina soils. At the same pH, soils with a higher level of organic matter adsorb more radioiodine. Upon applying radioiodate in soil samples, reduction to iodide takes place. Under the action of anions, radioiodine sorption decreases, the effect decreasing as follows: H 2 PO 4 - >SO 2- >Cl - >NO 3 - . The highest desorption was caused by 0.1 N NaOH solution. (author)

  2. Radioiodine and radiotherapy in the management of thyroid cancers

    International Nuclear Information System (INIS)

    Simpson, W.J.

    1990-01-01

    Radioiodine is an important adjuvant treatment in the management of resectable papillary and follicular thyroid cancers in all patients except those with the best prognostic features. External radiation is also an important adjuvant therapy in these patients, especially those with tumors that extend beyond the thyroid gland and invade the trachea, esophagus, nerves, and blood vessels; it is especially important in treating patients whose tumors do not concentrate radioiodine. Radioiodine may be curative in patients with microscopic distant metastases demonstrated by radioiodine scanning. Even unresectable primary papillary and follicular cancers may be eradicated by combined therapy with radioiodine and radiotherapy. Radioiodine plays no significant role in the treatment of medullary or anaplastic thyroid cancers, but external radiation may eradicate microscopic thyroid bed or nodal disease when persistent disease is indicated by elevated calcitonin levels in medullary thyroid cancer patients. Anaplastic thyroid cancers are usually unresectable and are not eradicated by conventional radiotherapy or by any of the novel radiation techniques, with or without chemotherapy. In all types of thyroid cancer, external radiotherapy may produce beneficial palliative results in patients with distant metastases, but the use of radioiodine should always be explored in papillary and follicular thyroid cancer patients. 30 references

  3. Alpha-1 Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Clinical Practice Guideline

    Directory of Open Access Journals (Sweden)

    DD Marciniuk

    2012-01-01

    Full Text Available Alpha-1 antitrypsin (A1AT functions primarily to inhibit neutrophil elastase, and deficiency predisposes individuals to the development of chronic obstructive pulmonary disease (COPD. Severe A1AT deficiency occurs in one in 5000 to one in 5500 of the North American population. While the exact prevalence of A1AT deficiency in patients with diagnosed COPD is not known, results from small studies provide estimates of 1% to 5%. The present document updates a previous Canadian Thoracic Society position statement from 2001, and was initiated because of lack of consensus and understanding of appropriate patients suitable for targeted testing for A1AT deficiency, and for the use of A1AT augmentation therapy. Using revised guideline development methodology, the present clinical practice guideline document systematically reviews the published literature and provides an evidence-based update. The evidence supports the practice that targeted testing for A1AT deficiency be considered in individuals with COPD diagnosed before 65 years of age or with a smoking history of <20 pack years. The evidence also supports consideration of A1AT augmentation therapy in nonsmoking or exsmoking patients with COPD (forced expiratory volume in 1 s of 25% to 80% predicted attributable to emphysema and documented A1AT deficiency (level ≤11 μmol/L who are receiving optimal pharmacological and nonpharmacological therapies (including comprehensive case management and pulmonary rehabilitation because of benefits in computed tomography scan lung density and mortality.

  4. Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review.

    Science.gov (United States)

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

    This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed "safely" to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user's experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia.

  5. Moving from Virtual Reality Exposure-Based Therapy to Augmented Reality Exposure-Based Therapy: A Review

    Science.gov (United States)

    Baus, Oliver; Bouchard, Stéphane

    2014-01-01

    This paper reviews the move from virtual reality exposure-based therapy to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although, the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the twentieth century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed “safely” to the object(s) of their fear, without the costs associated with programing complete VEs. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper covers some less well-known aspects of the history of AR, raises some ARET related issues, and proposes potential avenues to be followed. These include the type of measures to be used to qualify the user’s experience in an augmented reality environment, the exclusion of certain AR-type functionalities from the definition of AR, as well as the potential use of ARET to treat non-small animal phobias, such as social phobia. PMID:24624073

  6. Moving from Virtual Reality Exposure-Based Therapy (VRET to Augmented Reality Exposure-Based Therapy (ARET: A review.

    Directory of Open Access Journals (Sweden)

    Oliver eBaus

    2014-03-01

    Full Text Available This paper reviews the move from virtual reality exposure-based therapy (VRET to augmented reality exposure-based therapy (ARET. Unlike virtual reality (VR, which entails a complete virtual environment (VE, augmented reality (AR limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the 20th century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed safely to the object(s of their fear, without the costs associated with programming complete virtual environments. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper also raises some ARET related issues, and proposes potential avenues to be followed. These include the definition of an AR related term, the type of measures to be used to qualify the user’s experience in an augmented reality environment (ARE, the development of alternative geospatial referencing systems, as well as the potential use of ARET to treat social phobia. Overall, it may be said that the use of ARET, although promising, is still in its infancy but that, given a continued cooperation between clinical and technical teams, ARET has the potential of going well beyond the treatment of small animal phobia.

  7. Extrathyroidal Radioiodine Accumulation in a Fibroadenoma of the Breast.

    Science.gov (United States)

    Kim, Myoung Hyoun; Kim, Hun Soo; Park, Soon-Ah

    2017-02-01

    A 45-year-old woman with a differentiated thyroid carcinoma received adjuvant radioiodine therapy following total thyroidectomy and left modified radical neck dissection. A posttherapy planar radioiodine scan showed multifocal uptake in the thyroid bed and left chest. SPECT/CT revealed a fibroadenoma in the left breast. Six months later, an I scan showed no iodine avidity in the breast fibroadenoma, whereas ultrasonography showed no significant change in the size of the fibroadenoma. Altered radioiodine uptake of a breast fibroadenoma can be observed on follow-up scans after cytotoxic radioiodide treatment in patients with differentiated thyroid carcinoma.

  8. Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder.

    Science.gov (United States)

    Key, Brenda L; Rowa, Karen; Bieling, Peter; McCabe, Randi; Pawluk, Elizabeth J

    2017-09-01

    A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms. Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from

  9. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Bin Long

    2015-01-01

    Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility.

  10. Thyrotropin receptor antibody activities significantly correlate with the outcome of radioiodine (131I) therapy for hyperthyroid Graves' disease

    International Nuclear Information System (INIS)

    Kaise, Kazuro; Kaise, Nobuko; Yoshida, Katsumi; Fukazawa, Hiroshi; Mori, Koki; Yamamoto, Makiko; Sakurada, Toshiro; Saito, Shintaro; Yoshinaga, Kaoru

    1991-01-01

    The outcome of 131 I therapy for 109 patients with Graves' disease was analysed according to pretreatment laboratory data including thyrotropin receptor antibody (TRAb) activities. Forty-five percent of patients became euthyroid, and 13% of patients became hypothyroid within one year after 131 I therapy. Forty-two percent of patients remained hyperthyroid one year after 131 I therapy. Pretreatment values for serum T 4 , T 3 , and the estimated weight of the thyroid were significantly higher in the hyperthyroid group. The mean for the TRAb index of the hyperthyroid group was significantly higher than that of the euthyroid group. Life table analysis revealed a significant effect of the TRAb index on the rate of hyperthyroidism after 3 months or later. These results appear to suggest that the TRAb index is one of the factors which influence the outcome of 131 I therapy for Graves' disease. (author)

  11. Use of recombinant, human TSH radioiodine therapy in patients with differentiated thyroid carcinoma; Radioiodtherapie des differenzierten Schilddruesenkarzinoms nach Vorbehandlung mit rekombinantem, humanem TSH

    Energy Technology Data Exchange (ETDEWEB)

    Luster, M. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2001-12-01

    We describe the use of recombinant human TSH (rhTSH) in conjunction with ablative radioiodine therapy (RIT) in 11 patients (16 total treatments) with advanced and/or recurrent DTC (5 papillary, 6 follicular) for whom withdrawal of thyroid hormone suppressive therapy (THST) to increase serum TSH was not an option. Indications for rhTSH use in these patients included inability to tolerate withdrawal of thyroid hormones due to poor physical condition or inability to achieve sufficient serum TSH levels after THST withdrawal. All patients had undergone thyroidectomy and most (9/11) had received prior radioablative therapy after THST withdrawal. In 7 cases (5 patients), post-therapy Tg levels assessed at a mean of 4.3 months (range 2-10 months) after I-131 therapy were decreased by at least 30% compared to pre-therapy levels. In an additional 3 patients, whole body scans performed at follow-up indicated decreased or stabilized tumor burden compared to pre-therapy scans or marked clinical improvement was found. Three patients died of progressive disease within 2 months of therapy before follow-up assessments occurred. No adverse events were reported among the 8 surviving patients. The results suggest that rhTSH offers a promising alternative to THST withdrawal to allow radioablative therapy under maximal TSH stimulation in patients with advanced recurrent DTC who would not otherwise be able to receive this treatment. This therapeutic indication extends the clinical potential of the new agent, already demonstrated to be effective for use with I-131 for diagnostic purposes. However in some patients suffering from highly aggressive tumors the poor prognosis will not be improved. (orig.) [German] An unserer Klinik liegen bislang Erfahrungen mit 16 Radioiodtherapien (RIT) (z.T. mehrfache Anwendung) unter rhTSH vor. Die ueberwiegende Mehrzahl der Patienten wurde wegen einer fortgeschrittenen Tumorerkrankung mit dem Risiko einer lebensbedrohlichen Verschlechterung in

  12. D-Cycloserine Augmentation of Cognitive-Behavioral Therapy: Directions for Pilot Research in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Storch, Eric A.; McKay, Dean; Reid, Jeannette M.; Geller, Daniel A.; Goodman, Wayne K.; Lewin, Adam B.; Murphy, Tanya K.

    2010-01-01

    This paper discusses a recent translational success in combining behavioral psychotherapy with a novel medication, d-cycloserine (DCS), to augment cognitive-behavioral therapy (CBT) for anxiety disorders. The literature on behavioral theory of exposure-based therapies is provided, followed by a discussion of the role of DCS in enhancing extinction…

  13. Alpha-1-antitrypsin augmentation therapy in deficient individuals enrolled in the Alpha-1 Foundation DNA and Tissue Bank

    Directory of Open Access Journals (Sweden)

    Adriano R Tonelli

    2009-12-01

    Full Text Available Adriano R Tonelli1, Farshid Rouhani1, Ning Li2, Pam Schreck1, Mark L Brantly11Alpha-1 Research Program, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, 2Department of Epidemiology and Biostatistics, University of Florida, Gainesville, Florida, USAIntroduction: Intravenous augmentation therapy with purified intravenous alpha-1 antitrypsin replaces the deficient protein and is the only currently approved treatment for alpha-1 antitrypsin deficiency (AATD related lung disease. While augmentation therapy has been available for more than 20 years, there are a limited number of studies evaluating the effect of augmentation on lung function.Material and methods: We examined the decline in forced expiratory volume in one second (FEV1 in patients enrolled in the Alpha-1 Foundation DNA and Tissue Bank in relation to the use or not of alpha-1 antitrypsin augmentation therapy. For the purpose of our analysis we included 164 patients with AATD and PI ZZ genotype.Results: Mean age of the patients was 60 years, 52% were females, 94% were white and 78% ex-smokers. The mean FEV1 at baseline was 1.7 L and the mean FEV1 % of predicted was 51.3%. The mean follow-up time was 41.7 months. A total of 124 (76% patients received augmentation therapy (augmented group while 40 patients (24% did not received it (non-augmented group. When adjusted by age at baseline, sex, smoking status, baseline FEV1 % of predicted, the mean overall change in FEV1 was 47.6 mL/year, favoring the augmented group (?FEV1 10.6 ± 21.4 mL/year in comparison with the non-augmented group (?FEV1 −36.96 ± 12.1 mL/year (P = 0.05. Beneficial ?FEV1 were observed in ex-smokers and the group with initial FEV1 % of predicted of <50%. No differences were observed in mortality.Conclusions: In conclusion, augmentation therapy improves lung function in subjects with AATD when adjusted by age, gender, smoking status and baseline FEV1 % of predicted. The beneficial

  14. Radioiodine-induced thyroid storm. Case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    McDermott, M.T.; Kidd, G.S.; Dodson, L.E. Jr.; Hofeldt, F.D.

    1983-08-01

    Thyroid storm developed following radioiodine therapy in a 43-year-old man with Graves' disease, weight loss, myopathy, severe thyrotoxic hypercalcemia, and a pituitary adenoma. The hypercalcemia may have been a significant, and previously unreported, predisposing factor for the radioiodine-associated thyroid storm. This case and 15 other well-documented cases of radioiodine-associated storm found in the literature are reviewed, as are several other cases of less severe exacerbations of thyrotoxicosis associated with radioiodine therapy. Although not often seen, these complications are often fatal. High-risk patients, such as the elderly, those with severe thyrotoxicosis, and those with significant underlying diseases, may benefit from preventive measures such as the judicious use of thyrostatic medications during the periods before and after isotope administration.

  15. Radioiodine-induced thyroid storm. Case report and literature review

    International Nuclear Information System (INIS)

    McDermott, M.T.; Kidd, G.S.; Dodson, L.E. Jr.; Hofeldt, F.D.

    1983-01-01

    Thyroid storm developed following radioiodine therapy in a 43-year-old man with Graves' disease, weight loss, myopathy, severe thyrotoxic hypercalcemia, and a pituitary adenoma. The hypercalcemia may have been a significant, and previously unreported, predisposing factor for the radioiodine-associated thyroid storm. This case and 15 other well-documented cases of radioiodine-associated storm found in the literature are reviewed, as are several other cases of less severe exacerbations of thyrotoxicosis associated with radioiodine therapy. Although not often seen, these complications are often fatal. High-risk patients, such as the elderly, those with severe thyrotoxicosis, and those with significant underlying diseases, may benefit from preventive measures such as the judicious use of thyrostatic medications during the periods before and after isotope administration

  16. Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study.

    Science.gov (United States)

    Taïeb, David; Bournaud, Claire; Eberle, Marie-Claude; Catargi, Bogdan; Schvartz, Claire; Cavarec, Marie-Béatrice; Faugeron, Isabelle; Toubert, Marie-Elisabeth; Benisvy, Danielle; Archange, Cendrine; Mundler, Olivier; Caron, Philippe; Abdullah, Ahmad Esmaeel; Baumstarck, Karine

    2016-04-01

    While radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT4) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon. A multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (n=46) (group A: early prophylactic LT4 treatment) or the control group (n=48) (group B: standard follow-up). The primary endpoint was the 6-month QoL. The secondary endpoints were other QoL scores such as Graves' ophthalmopathy (GO) outcomes, thyroid function tests and safety. The primary endpoint at 6 months was achieved: the mental composite score (MCS) of Short Form 36 (SF-36) was significantly higher in group A compared to group B (P=0.009). Four other dimension scores of the SF-36 and four dimension scores of the thyroid-specific patient-reported outcome (ThyPRO) significantly differed between the two groups, indicating better QoL in group A. After adjustment for variables, the early LT4 administration strategy was found as an independent factor for only two scores of SF-36: the MCS and the general health (GH) score. There were no differences in GO, final thyroid status and changes in the anti-TSH receptor antibodies (TRAbs) levels between the two groups. No adverse cardiovascular event was reported. Early LT4 administration post-radioactive iodine (RAI) could represent a safe potential benefit for patients with regard to QoL. The optimal strategy taking into account administered RAI activities and LT4 treatment dosage and timing remains to be determined. © 2016 European Society of Endocrinology.

  17. Efeitos agudos laringológicos e vocais da radioiodoterapia em pacientes com hipertireoidismo por doença de Basedow Graves Acute effects of radioiodine therapy on the voice and larynx of Basedow-Graves patients

    Directory of Open Access Journals (Sweden)

    Roberta Werlang Isolan-Cury

    2008-04-01

    Full Text Available A Doença de Graves constitui a forma mais comum de hipertireoidismo e três abordagens terapêuticas são atualmente utilizadas: uso de medicamentos antitireoideanos, cirurgia e iodo radioativo (I 131. Os efeitos do o I 131 e a indução precoce de hipotireoidismo são conseqüências da destruição induzida do I131 sobre o parênquima tireoideano. São poucos relatos encontrados na literatura acerca dos efeitos da radioioterapia sobre a laringe e conseqüentemente na produção vocal. OBJETIVO: Avaliar os efeitos agudos sobre a voz da radioiodoterapia em pacientes com hipertireoidismo por Doença de Basedow Graves. MATERIAL E MÉTODO: Estudo de corte contemporâneo longitudinal, prospectivo. Procedimentos: Investigação vocal, mensuração do tempo máximo fonatório de /a/ e relação s/z, análise freqüência fundamental (Software Praat, laringoscopia e análise perceptivo-auditiva em três momentos: pré-dose, 4 dias e 20 dias pós dose. Momentos baseados no perfil inflamatório do tecido tireoideano. RESULTADOS: Não houve mudanças estatisticamente significantes nos aspectos vocais e laringológicos nos três momentos avaliados. CONCLUSÃO: A radioiodoterapia não afeta a qualidade vocal.Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131. There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim and the AIM: os this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. MATERIAL AND METHOD: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/ and the s/z ratio, fundamental frequency analysis (Praat software, laringoscopy and (perceptive-auditory analysis in three different conditions: pre-treatment, 4 days, and

  18. Systemic oxidative stress to nucleic acids is unaltered following radioiodine therapy of patients with benign nodular goiter

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Stovgaard, Elisabeth S; Fast, Søren

    2015-01-01

    morning urine (normalized against the creatinine concentration) at baseline, and 7 and 21 days after rhTSH (not followed by (131)I), and 7 and 21 days after (131)I therapy, respectively. RESULTS: The baseline urinary excretions of 8-oxoGuo and 8-oxodG were 2.20 ± 0.84 and 1.63 ± 0.70 nmol/mmol creatinine......, respectively. We found no significant changes in the excretion of any of the metabolites, neither after rhTSH stimulation alone nor after (131)I therapy. Also, no significant differences were found between the rhTSH group (low dose, median (131)I: 152 MBq) and the non-rhTSH group (high dose, median (131)I: 419...

  19. DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality

    Science.gov (United States)

    Ben-Moussa, Maher; Rubo, Marius; Debracque, Coralie; Lange, Wolf-Gero

    2017-01-01

    The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. “DJINNI” is a conceptual design of an in vivo augmented reality (AR) exposure therapy mobile support system that exploits several capturing technologies and integrates the patient’s state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup. PMID:28503155

  20. DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality.

    Science.gov (United States)

    Ben-Moussa, Maher; Rubo, Marius; Debracque, Coralie; Lange, Wolf-Gero

    2017-01-01

    The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. "DJINNI" is a conceptual design of an in vivo augmented reality (AR) exposure therapy mobile support system that exploits several capturing technologies and integrates the patient's state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup.

  1. An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol.

    Science.gov (United States)

    Kootker, Joyce A; Rasquin, Sascha M C; Smits, Peter; Geurts, Alexander C; van Heugten, Caroline M; Fasotti, Luciano

    2015-09-01

    Currently, no evidence-based treatment is available for mood problems after stroke. We present a new psychological intervention designed to reduce depressive complaints after stroke. This intervention was based on cognitive behavioural therapy principles and was shown feasible in a pilot study. In order to meet the specific needs of stroke patients (concerning both sensori-motor, cognitive, and behavioural problems), we incorporated motivational interviewing, grief resolution, and psycho-education. We emphasised for each session to take into account the cognitive deficits of the patients (i.e. be concrete, accessible, structured, specific, and repeat information). Moreover, we augmented the psychologist-administered therapy with the contribution of an occupational or movement therapist aimed at facilitating patients' goal-setting and attainment. The intervention consisted of 12 one-hour sessions with a psychologist and three or four one-hour sessions with an occupational or movement therapist. Currently, the effectiveness of the intervention is evaluated in a randomised controlled trial. The proposed psychological treatment protocol is innovative, as it applies cognitive behavioural therapy in a stroke-specific manner; moreover, it supports goal attainment by incorporating occupational or movement therapy sessions. © The Author(s) 2014.

  2. DJINNI: A Novel Technology Supported Exposure Therapy Paradigm for SAD Combining Virtual Reality and Augmented Reality

    Directory of Open Access Journals (Sweden)

    Maher Ben-Moussa

    2017-04-01

    Full Text Available The present paper explores the benefits and the capabilities of various emerging state-of-the-art interactive 3D and Internet of Things technologies and investigates how these technologies can be exploited to develop a more effective technology supported exposure therapy solution for social anxiety disorder. “DJINNI” is a conceptual design of an in vivo augmented reality (AR exposure therapy mobile support system that exploits several capturing technologies and integrates the patient’s state and situation by vision-based, audio-based, and physiology-based analysis as well as by indoor/outdoor localization techniques. DJINNI also comprises an innovative virtual reality exposure therapy system that is adaptive and customizable to the demands of the in vivo experience and therapeutic progress. DJINNI follows a gamification approach where rewards and achievements are utilized to motivate the patient to progress in her/his treatment. The current paper reviews the state of the art of technologies needed for such a solution and recommends how these technologies could be integrated in the development of an individually tailored and yet feasible and effective AR/virtual reality-based exposure therapy. Finally, the paper outlines how DJINNI could be part of classical cognitive behavioral treatment and how to validate such a setup.

  3. Comparison of the Influence on the Liver Function Between Thyroid Hormone Withdrawal and rh-TSH Before High-Dose Radioiodine Therapy in Patients with Well-Differentiated Thyroid Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yeon-Hee; Lim, Seok Tae; Yun, Kuk-No; Yim, Sung Kyun; Kim, Dong Wook; Jeong, Hwan-Jeong; Sohn, Myung-Hee [Chonbuk National Univ. Medical School and Hospital, Jeonju (Korea, Republic of)

    2012-06-15

    An elevated thyroid stimulating hormone level (TSH) is essential to stimulate the uptake of radioiodine into thyroid remnants and metastases and metastases of thyroid cancer when a patient under-goes high-dose radioiodine therapy. Nowadays, recombinant human thyroid stimulating hormone (rh-TSH) is increasingly used instead of the classic method of thyroid hormone withdrawal (THW). However, beyond the therapeutic effects, clinical differences between the two methods have not yet been clearly demonstrated. The aim of this work was to investigate the effects of the two methods, especially on liver function. We identified 143 evaluable patients who were further divided into two groups: THW and rh-TSH. We first reviewed the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, which were measured during the admission period for total thyroidectomy. We called these liver enzyme levels 'base AST' and 'base ALT.' We also assessed other chemistry profiles, including AST, ALT, total cholesterol, LDL cholesterol, alkaline phosphatase (ALP), total bilirubin (TB), and triglyceride (TG), which were measured on admission day for high-dose radioiodine therapy. We called these liver enzyme levels 'follow-up AST'and 'follow-up ALT.' We compared the changes in base and follow-up liver enzyme levels and the other chemistry profiles between the two groups. The base AST and base ALT levels of the two groups were within normal range, and there was no significant difference between the two groups. In contrast to these base liver enzyme levels, follow-up AST and ALT levels than did the rh-TSH group. Patients in the THW group. Patients in the THW group also had higher levels of total cholesterol and LDL cholesterol than did the patients in the rh-TSH group. However there were no statistically significant differences in ALP, total bilirubin, and triglyceride levels between the two groups. In this retrospective analysis of liver

  4. Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Bonnema, Steen Joop

    2007-01-01

    at inclusion and at 1, 3 and 6 months after treatment. RESULTS: Normalization of serum TSH was achieved in 7 out of 14 patients in the ILP group and in all 15 patients in the (131)I group (P=0.0025). In the ILP group, mean thyroid nodule volume reduction was 44+/-5% (s.e.m.; P... 47+/-8% (Phypothyroidism but no major side...... hypothyroidism. Using the present design, ILP seems inferior to (131)I therapy in normalization of serum TSH. The potential value of ILP as a non-surgical alternative to (131)I needs further investigation...

  5. Noninferior response in BRAF{sup V600E} mutant nonmetastatic papillary thyroid carcinoma to radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Jiao; Zhao, Teng; Lin, Yansong [Peking Union Medical College Hospital, Department of Nuclear Medicine, Beijing (China); Liang, Jun [Peking University International Hospital, Department of Oncology, Beijing (China)

    2016-06-15

    As the most frequent and specific genetic alteration in papillary thyroid carcinoma (PTC), BRAF{sup V600E} has an intimate relationship with more invasive tumour and higher postoperative recurrence risk in PTC patients. We investigate the effect of radioactive iodine (RAI) therapy on the clinical outcome in PTC patients with the BRAF{sup V600E} mutation without distant metastases. This retrospective study included PTC 228 patients without distant metastases who underwent total or near-total thyroidectomy and RAI treatment in our hospital from January 2011 to July 2014. The BRAF{sup V600E} status of the primary lesions was determined and the patients were divided into two groups according to the presence of the mutation. Serological and imaging data were collected at a median follow-up of 2.34 years after RAI administration. Suppressed and stimulated thyroglobulin (Tg), Tg antibody, diagnostic whole-body scintigraphy, and other imaging examinations were used to assess clinical outcome, which was defined as excellent response, indeterminate response, biochemical incomplete response and structural incomplete response. The BRAF{sup V600E} mutation was observed in 153 of the 228 patients (67.1 %). The clinicopathological features did not differ between the BRAF{sup V600E} mutatation and wild-type groups except age at diagnosis (P = 0.000), tumour size (P = 0.023) and TNM stage (P = 0.003). Older age and more advanced TNM stage were prevalent in the BRAF{sup V600E} mutatation group, whereas tumours were slightly larger in the BRAF{sup V600E} wild-type group. The response to RAI therapy was evaluated in both the entire series and the patients with a high recurrence risk, and no significant difference in response was found between the BRAF{sup V600E} mutatation and the wild-type groups (P = 0.881 and P = 0.851, respectively). The clinical response to timely postsurgical RAI therapy is not inferior in BRAF{sup V600E} mutation PTC patients without distant metastases, which

  6. Exploring the role of CT densitometry: a randomised study of augmentation therapy in alpha1-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Dirksen, A; Piitulainen, E; Parr, D G

    2009-01-01

    for the assessment of the therapeutic effect of augmentation therapy in subjects with alpha(1)-antitrypsin (alpha(1)-AT) deficiency. In total, 77 subjects (protease inhibitor type Z) were randomised to weekly infusions of 60 mg x kg(-1) human alpha(1)-AT (Prolastin) or placebo for 2-2.5 yrs. The primary end...... was unaltered by treatment, but a reduction in exacerbation severity was observed. In patients with alpha(1)-AT deficiency, CT is a more sensitive outcome measure of emphysema-modifying therapy than physiology and health status, and demonstrates a trend of treatment benefit from alpha(1)-AT augmentation....

  7. Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms: A Randomized Controlled Trial.

    Science.gov (United States)

    Kootker, Joyce A; Rasquin, Sascha M C; Lem, Frederik C; van Heugten, Caroline M; Fasotti, Luciano; Geurts, Alexander C H

    2017-04-01

    To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety poststroke. Multicenter, assessor-blinded, randomized controlled trial. Ambulatory rehabilitation setting. Patients who had a Hospital Anxiety and Depression Scale-depression subscale (HADS-D) score >7 at least 3 months poststroke (N=61). Participants were randomly allocated to either augmented CBT or computerized cognitive training (CCT). The CBT intervention was based on the principles of recognizing, registering, and altering negative thoughts and cognitions. CBT was augmented with goal-directed real-life activity training given by an occupational or movement therapist. HADS-D was the primary outcome, and measures of participation and quality of life were secondary outcomes. Outcome measurements were performed at baseline, immediately posttreatment, and at 4- and 8-month follow-up. Analysis was performed with linear mixed models using group (CBT vs CCT) as the between-subjects factor and time (4 assessments) as the within-subjects factor. Mixed model analyses showed a significant and persistent time effect for HADS-D (mean difference, -4.6; 95% confidence interval, -5.7 to -3.6; P<.001) and for participation and quality of life in both groups. There was no significant group × time effect for any of the outcome measures. Our augmented CBT intervention was not superior to CCT for the treatment of mood disorders after stroke. Future studies should determine whether both interventions are better than natural history. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. An Explorative Study Examining Augmentative and Alternative Communication Training in the Field of Music Therapy.

    Science.gov (United States)

    Gadberry, Anita L; Sweeney, Alison

    2017-07-01

    Music therapists work with many people who require Augmentative and Alternative Communication (AAC). As communication goals are central to music therapy practice, many music therapists would benefit from training in AAC. The purpose of this survey study was to determine the state of AAC education for music therapists at the university level, how AAC is being used in music therapy sessions, and how practicing music therapists are trained in AAC. Music therapy faculty and credentialed music therapists in North America and Europe were invited to complete an online survey. Descriptive statistics were used to analyze survey data from each group of respondents. With regard to training in AAC at the university level, results indicate that almost half of music therapy faculty (44.66%) provided some training. The primary reason given for not providing training was a lack of educator knowledge in this area. Results indicate that a majority (81.77%) of music therapy clinicians are familiar with AAC and slightly over half (55.08%) reported that they work with clients who use AAC. Sixty-two percent of music therapists reported using AAC to promote expressive language, and 49% to increase receptive language. Over 80% of clinicians stated they would benefit from additional AAC training. Although a majority of music therapists are familiar with ACC, results indicate that ACC competency could be enhanced through university-level instruction and continuing professional development courses. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Low- and high-dose radioiodine therapy for low-/intermediate-risk differentiated thyroid cancer. A preliminary clinical trial

    International Nuclear Information System (INIS)

    Qu Yuan; Huang Rui; Li Lin

    2017-01-01

    To compare the ablation results, therapeutic responses and adverse reactions between a low dose (1.1 GBq) or high dose (3.7 GBq) of 131 I in low-/intermediate-risk differentiated thyroid cancer (DTC) patients. The factors influencing the ablation result and therapeutic response were also analyzed. The researchers used a random number table to randomly assign the enrolled patients to the low-dose group or high-dose group at a 1:1 ratio, and assessment of ablation result, therapeutic response, and adverse reactions evaluated 6 ± 3 months after therapy. A total of 140 patients were enrolled in the study through October 2014-June 2015. Until February 2016, 132 patients completed the trial. 99 patients were re-examined under thyroid-stimulating hormone (TSH) stimulation 3-9 months after 131 I therapy. For the low-dose and high-dose groups, the success rates of ablation were 52.7% (29/55) and 59.1% (26/44), respectively. The ablation results did not differ significantly between the two groups (P = 0.548). One hundred and thirty two patients were re-examined 2-9 months after 131 I therapy. The low-dose group had an excellent response rate of ∼80% (53/66), an indeterminate response rate of ∼ 20% (13/66), and no cases with a biochemical incomplete response. The high-dose group had an excellent response rate of ∼85% (36/66), an indeterminate response rate of ∼11% (7/66), and a biochemical incomplete response rate of ∼4% (3/66). No significant differences in the therapeutic response were observed between the two groups (P = 0.087). Patients in stage N1b had a significantly lower success rate of ablation than those in stage N0 (P = 0.000). The success rate of ablation increased significantly with lower thyroglobulin (Tg) levels (P = 0.000). A pre-treatment Tg level was significantly associated with a higher excellent response rate (P = 0.002). Pre-treatment-stimulated Tg of 0.47 and 3.09 μg/L were identified as cut-off values for predicting the ablation result and

  10. The incidence of ophthalmopathy after radioiodine therapy for Graves` disease: Prognostic factors and the role of methimazole

    Energy Technology Data Exchange (ETDEWEB)

    Kung, A.W.C. [Univ. of Hong Kong, Pokfulam (Hong Kong); Cheng, A. [Queen Mary Hospital, Pokfulam (Hong Kong)

    1994-08-01

    Radioactive iodine-131 (RAI) has been reported to be associated with a high incidence of development or exacerbation of Graves` ophthalmopathy (GO). This is thought to be associated with a surge of autoantibodies after RAI therapy. The role of methimazole (MMI), which possesses immunomodulatory action, in the prevention of GO was explored by studying 114 patients with Graves` disease. They were assigned randomly to receive either RAI alone or adjunctive antithyroid drugs, which consisted of MMI and L-T{sub 4} as a block-replacement therapy for 12 months and were followed for 2 yr. Thirty-five patients (30.7%) had GO at presentation. Twenty-one (18%) patients developed new GO, and six had worsening of preexisting GO. The development of hypothyroidism (P < 0.01) and an elevation of TSH (P < 0.05) were associated with increased risk of development or exacerbation of GO. The chance of development or exacerbation of GO is higher in those with no ophthalmopathy than in those with preexisting GO at presentation (P = 0.002). The incidence of development or exacerbation of GO was similar in the two treatment groups (RAI, 22.8%; adjunctive antithyroid drugs, 23.7%; P = NS). MMI was able to suppress the surge of TSH receptor antibody (TRAB) after RAI, but a surge in TRAB was not of prognostic significance for the development of GO after RAI. Patients who developed or had exacerbation of GO actually had lower TRAB at presentation (P = 0.02). The authors conclude that hypothyroidism with elevated TSH is an important adverse factor for the development or exacerbation of GO, and MMI was unable to prevent the development or exacerbation of GO after RAI. 35 refs., 4 tabs.

  11. The incidence of ophthalmopathy after radioiodine therapy for Graves' disease: Prognostic factors and the role of methimazole

    International Nuclear Information System (INIS)

    Kung, A.W.C.; Cheng, A.

    1994-01-01

    Radioactive iodine-131 (RAI) has been reported to be associated with a high incidence of development or exacerbation of Graves' ophthalmopathy (GO). This is thought to be associated with a surge of autoantibodies after RAI therapy. The role of methimazole (MMI), which possesses immunomodulatory action, in the prevention of GO was explored by studying 114 patients with Graves' disease. They were assigned randomly to receive either RAI alone or adjunctive antithyroid drugs, which consisted of MMI and L-T 4 as a block-replacement therapy for 12 months and were followed for 2 yr. Thirty-five patients (30.7%) had GO at presentation. Twenty-one (18%) patients developed new GO, and six had worsening of preexisting GO. The development of hypothyroidism (P < 0.01) and an elevation of TSH (P < 0.05) were associated with increased risk of development or exacerbation of GO. The chance of development or exacerbation of GO is higher in those with no ophthalmopathy than in those with preexisting GO at presentation (P = 0.002). The incidence of development or exacerbation of GO was similar in the two treatment groups (RAI, 22.8%; adjunctive antithyroid drugs, 23.7%; P = NS). MMI was able to suppress the surge of TSH receptor antibody (TRAB) after RAI, but a surge in TRAB was not of prognostic significance for the development of GO after RAI. Patients who developed or had exacerbation of GO actually had lower TRAB at presentation (P = 0.02). The authors conclude that hypothyroidism with elevated TSH is an important adverse factor for the development or exacerbation of GO, and MMI was unable to prevent the development or exacerbation of GO after RAI. 35 refs., 4 tabs

  12. Evaluation of radioiodine therapy with fixed doses of 10 and 15 mCi in patients with Graves disease; Avaliacao da radioiodoterapia com doses fixas de 10 e 15 mCi em pacientes com doenca de Graves

    Energy Technology Data Exchange (ETDEWEB)

    Canadas, Viviane; Vilar, Lucio; Moura, Eliane; Brito, Ana; Castellar, Enio [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Hospital das Clinicas. Servico de Endocrinologia]. E-mail: vivi2207@ig.com.br

    2007-10-15

    The treatment options for the hyperthyroidism of Graves' disease are antithyroid drugs, surgery and radioiodine, none of which is considered ideal, as they do not act directly on the etiopathogenesis of the disease. Radioiodine has been increasingly used as the treatment of choice because it is a safe and definitive therapy whose administration is very easy. Some authors prefer to administer higher doses in order to deliberately induce hypothyroidism, while others recommend lower doses that result in a lower incidence of hypothyroidism and a greater incidence of euthyroidism. There is no consensus for the optimal regimen of fixed doses to be used and this is the main focus of the present study, where doses of 10 and 15 mCi of {sup 131}I were compared. Among the 164 patients analyzed, 61 (37.2%) were submitted to 10 mCi and 103 (62.8%) to 15 mCi. In the longitudinal analysis it was observed that remission of the hyperthyroidism was statistically different in the sixth month (p < 0.001), being higher in the group that used the dose of 15 mCi, but similar in both groups at 12 and 24 months. It may be concluded that the administration of fixed doses of 10 and 15 mCi of {sup 131}I brought about a similar remission of the hyperthyroidism after 12 months of treatment. Moreover, the remission rate of the hyperthyroidism had no association with age, sex or previous therapy with antithyroid drugs. (author)

  13. Subjective perception of radioactivity. No change post successful treatment with radioiodine

    International Nuclear Information System (INIS)

    Freudenberg, L.S.; Mueller, S.P.; Beyer, T.; Bockisch, A.

    2009-01-01

    We assess the attitude of patients with thyroid disease towards radiation and radioactivity before and after radioiodine therapy by means of a cultural-anthropological approach. We evaluate in patient interviews how their subjective attitude towards radioactivity as an abstract term and towards radioactivity in the medical context on the basis of their personal experiences with radionuclide therapy. 29 patients with autonomously functioning thyroid lesions (17 women, 12 men, 35-79 years) were included in this study. All patients were interviewed prior to and 22-27 month post radioiodine therapy in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1: positive, 5: negative) to quantify their perception of radioactivity. The personal perception of radioactivity as an abstract term does not change significantly (p = 0.15) before and after radioiodine therapy. This perception is linked to mostly negative impressions of radiactivity. However, patients become more positive when assessing the value of radioactivity as part of their therapy regimen. Thus, we observe a significant increase in percepted value of radioactivity post radioiodine therapy (p = 0.03). Patients continue to view radioactivity as something negative despite treatment success following radioiodine therapy. Our results provide useful information for patient information by the nuclear medicine physician prior to a radioiodine therapy. (orig.)

  14. Tumour dosimetry and response in patients with metastatic differentiated thyroid cancer using recombinant human thyrotropin before radioiodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Keizer, Bart de; Hoekstra, Anne; Rijk, Peter P. van; Klerk, John M.H. de [Department of Nuclear Medicine, Room E02.222, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht (Netherlands); Brans, Boudewijn; Dierckx, Rudi A. [Department of Nuclear Medicine, Ghent University Hospital, Ghent (Belgium); Zelissen, Pierre M.J.; Koppeschaar, Hans P.F.; Lips, Cees J.M. [Department of Endocrinology, University Medical Center Utrecht (Netherlands)

    2003-03-01

    The development of recombinant human thyrotropin (rhTSH) has given clinicians new options for diagnostic follow-up and treatment of patients with differentiated thyroid cancer (DTC). This paper evaluates the tumour dosimetry and response following -iodine-131 treatment of metastatic thyroid cancer patients after rhTSH stimulation instead of classical hormone withdrawal-induced hypothyroidism. Nineteen consecutive {sup 131}I treatments in 16 patients were performed after rhTSH stimulation. All patients had undergone a near-total thyroidectomy followed by an ablative dosage of {sup 131}I. They all suffered from metastatic or recurrent disease showing tumoral {sup 131}I uptake on previous post-treatment scintigraphy. Dosimetric calculations were performed using {sup 131}I tumour uptake measurements from post-treatment {sup 131}I scintigrams and tumour volume estimations from radiological images. Response was assessed by comparing pre-treatment serum thyroglobulin (Tg) level with the Tg level 3 months post treatment. In 18 out of 19 treatments, uptake of {sup 131}I in metastatic or recurrent lesions was seen. The median tumour radiation dose was 26.3 Gy (range 1.3-368 Gy), and the median effective half-life was 2.7 days (range 0.5-6.5 days). Eleven of 19 treatments (10/16 patients) were evaluable for response after 3 months. {sup 131}I therapy with rhTSH resulted in a biochemical partial response in 3/11 or 27% of treatments (two patients), biochemical stable disease in 2/11 or 18% of treatments and biochemical progressive disease in 6/11 or 55% of treatments. Our study showed that although tumour doses in DTC patients treated with {sup 131}I after rhTSH were highly variable, 45% of treatments led to disease stabilisation or partial remission when using rhTSH in conjunction with {sup 131}I therapy, without serious side-effects and with minimal impact on quality of life. RhTSH is therefore adequately satisfactory as an adjuvant tool in therapeutic settings and is

  15. Local reactions to radioiodine in the treatment of thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Burmeister, L.A.; du Cret, R.P.; Mariash, C.N. (Univ. of Minnesota, Minneapolis (USA))

    1991-02-01

    The purpose of this study is to compare the rate of local complications resulting from radioiodine ablation of thyroid cancer in patients with a residual intact thyroid lobe to that in patients who had more extensive surgical treatment prior to radioiodine administration. We retrospectively studied 59 patients who had received 131I between 1979 and 1989. The patients were divided into two groups, depending on the extent of their previous surgical thyroid excision. Group 1 comprised 10 patients with a lobectomy or hemithyroidectomy before the ablative radioiodine dose, and Group 2 comprised 49 patients with more extensive thyroid excision (near-total or subtotal thyroidectomy) before the radioiodine treatment. Sixty percent of the 10 patients in Group 1 experienced some degree of neck pain or tenderness following radioiodine ablation of their residual thyroid. In one case, the local reaction was very severe and accompanied by the development of transient hyperthyroidism. There was only a 6% local complication rate in the patients who had undergone more extensive thyroid excision before ablative therapy (p less than 0.001), and none had a severe reaction. Patients with only unilateral surgical excision before radioiodine therapy have a higher rate of local complications than do patients treated with more extensive surgery prior to radioiodine ablation. If radioiodine is to be employed in such patients, they should be informed of this possible complication. Since evidence supports a dose effect in the pathogenesis of the complications, we recommend using a dose of less than 30 mCi for the initial ablation in these patients even though it may be necessary to repeat this dose to complete thyroid ablation.

  16. Local reactions to radioiodine in the treatment of thyroid cancer

    International Nuclear Information System (INIS)

    Burmeister, L.A.; du Cret, R.P.; Mariash, C.N.

    1991-01-01

    The purpose of this study is to compare the rate of local complications resulting from radioiodine ablation of thyroid cancer in patients with a residual intact thyroid lobe to that in patients who had more extensive surgical treatment prior to radioiodine administration. We retrospectively studied 59 patients who had received 131I between 1979 and 1989. The patients were divided into two groups, depending on the extent of their previous surgical thyroid excision. Group 1 comprised 10 patients with a lobectomy or hemithyroidectomy before the ablative radioiodine dose, and Group 2 comprised 49 patients with more extensive thyroid excision (near-total or subtotal thyroidectomy) before the radioiodine treatment. Sixty percent of the 10 patients in Group 1 experienced some degree of neck pain or tenderness following radioiodine ablation of their residual thyroid. In one case, the local reaction was very severe and accompanied by the development of transient hyperthyroidism. There was only a 6% local complication rate in the patients who had undergone more extensive thyroid excision before ablative therapy (p less than 0.001), and none had a severe reaction. Patients with only unilateral surgical excision before radioiodine therapy have a higher rate of local complications than do patients treated with more extensive surgery prior to radioiodine ablation. If radioiodine is to be employed in such patients, they should be informed of this possible complication. Since evidence supports a dose effect in the pathogenesis of the complications, we recommend using a dose of less than 30 mCi for the initial ablation in these patients even though it may be necessary to repeat this dose to complete thyroid ablation

  17. Thyroid volume reduction following radioiodine therapy in patients with autonomous goitre and Graves` disease; Volumenreduktion der Schilddruese nach Radiojodtherapie bei Patienten mit Schilddruesenautonomie und Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Dederichs, B. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Otte, R. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Klink, J.E. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany); Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Univ. Koeln (Germany)

    1996-10-01

    Aim: It is well known that radioiodine therapy (RITh) leads to a significant thyroid volume reduction (TVR). But until now only little data has been presented due to the course of time and the extent of TVR. Method: Therefore the data of 33 patients with Graves` disease (GD), 36 patients with multifocal (MAG) and 31 with solitary (SAG) autonomous goitre were analyzed retrospectively. Results: All the patients showed a highly significant (p<0.001) TVR, which continued up to 1 year after RITh. Receiving equal effective radiation doses, the extent of TVR was significantly greater for GD than for MAG. This difference developed within six weeks up to 3 months after RITh. Conclusion: This observation suggests that the underlying thyroid disease affects the therapeutic effect of RITh and may be partially explained by the total suppression of non-autonomous thyroid tissue in AG at the time of RITh. In patients with SAG with a 1.7 times higher effective radiation dose than in MAG relative TVR was about 1.6 times stronger in SAG than in MAG. This demonstrates a direct relation between the effective radiation dose and the extent of the TVR after RITh. (orig.) [Deutsch] Ziel: Es ist bekannt, dass die Radiojodtherapie (RJTh) zu einer relvanten Schilddruesenvolumenreduktion (SVR) fuehrt. Bisher wurden jedoch nur vereinzelt systematische Daten zum zeitlichen Verlauf und quantitativen Ausmass der SVR veroeffentlicht. Methode: Daher fuehrten wir eine retrospektive Auswertung der Daten von 33 Patienten mit Morbus Basedow (MB), 36 Patienten mit multifokaler (MFA) und 31 mit unifokaler (UFA) Autonomie der Schilddruese durch. Ergebnisse: Fuer alle Patientengruppen ergab sich eine hochsignifikante (p<0,001) SVR, welche sich bis ein Jahr nach RJTh signifikant fortsetzte. Obwohl die effektive Herddosis nicht signifikant verschieden war, war das Ausmass der SVR fuer Patienten mit MB signifikant groesser als fuer Patienten mit MFA. Dieser Unterschied war bereits innerhalb der ersten 6

  18. Radioiodine therapy of Graves' disease - a dosimetric comparison of different strategies concerning antithyroid drugs; Radioiodtherapie des Morbus Basedow - dosimetrischer Vergleich verschiedener Therapieregime bezueglich der Thyreostatikabgabe

    Energy Technology Data Exchange (ETDEWEB)

    Urbannek, V.; Voth, E.; Moka, D.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin, Medizinische Einrichtungen der Univ. zu Koeln (Germany)

    2001-08-01

    Aim: Premedication with antithyroid drugs (ATD) compared to patients not pretreated with ATD causes a higher failure rate of radioiodine therapy (RITh) or demands higher therapeutical dosage of radioiodine (RI). For clinical reasons and because of accelerated iodine metabolism in hyperthyreosis a compensated thyroid metabolism is desirable. Aim of this study was to investigate the influence of ATD on the biokinetics of RI in case of Graves' disease in order to improve RITh of patients pre-treated with ATD. Methods: 385 consecutive patients who underwent RITh because of Graves' disease for the first time were included: Group A (n = 74): RITh under continuous medication with ATD; Group B (n = 111): Application of RI under continuous medication with ATD, in case of insufficient RI-uptake or shortened effective RI-half-life ATD were stopped 1-5 days after RITh; Group C (n = 200): ATD were stopped 2 days prior to RITh in all patients. We examined the influence of ATD on RI-uptake and effective RI-half-life as well as the absorbed dose achieved on the thyroid in dependence of thyroid volume and applied RI-dosage [TEQ - therapy efficiency quotient, (2)]. Results: In the RI-pretest (all patients under ATD) the RI-uptake was comparable in all three groups. During RITh-RI-uptake, effective RI-half-life and therefore the TEQ were significantly higher in Group C as compared to Groups A and B (p<0,001, respectively). In Group B the medication with ATD was stopped in 61 of 111 cases 1-5 days after RITh. In this subgroup the effective RI-half-life increased from 4,4 {+-} 1,7 d to 5,1 {+-} 1,6 d after stopping of ATD (p = 0,001). Conclusion: Stopping of ATD 2 days prior to RITh leads to an increased efficiency of about 50% compared to RITh carried out under ATD and therefore to a clear reduction of radiation exposure to the rest of the body with equal absorbed doses of the thyroid. Stopping of ATD shortly after RITh increases efficiency in case of short effective RI

  19. Radioiodine therapy in non-toxic multinodular goitre. The possibility of effect-amplification with recombinant human TSH (rhTSH)

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, Steen J.; Nielsen, Viveque E.; Hegedues, Laszlo [Odense Univ. Hospital (Denmark). Dept. of Endocrinology and Metabolism

    2006-12-15

    There is no consensus regarding the optimum treatment of benign non-toxic goitre. L-thyroxine suppressive therapy is widely used, but there is poor evidence of its efficacy, and it may have serious adverse effects on health. Surgery is first choice in large goitres or if malignancy is suspected. {sup 131}I therapy results in a one-year goitre reduction of around 40% in multinodular goitres, usually with a high degree of patient satisfaction and improvement of the inspiratory capacity. The effect is attenuated with increasing goitre size. The risk of hypothyroidism is 22-58% within 5-8 years. A sufficient thyroid {sup 131}I uptake is mandatory for {sup 131}I therapy to be feasible and pre-stimulation with recombinant human TSH (rhTSH) increases this considerably. This leads to an increased absorbed thyroid dose by approx.75%, mainly in those patients with the lowest thyroid {sup 131}I uptake, and a more homogeneous intrathyroidal isotope distribution. Pre-stimulation with even a small dose of rhTSH seems to allow a reduction of the {sup 131}I activity while still achieving a mean goitre reduction of approximately 40% within a year. A significantly lower extrathyroidal radiation is achieved by this approach. With an unchanged {sup 131}I activity, rhTSH pre-stimulation improves the goitre reduction by 30-50%. However, this is at the expense of a higher rate of hypothyroidism, cervical pain and transient thyrotoxicosis. Of particular concern is the observation made in healthy persons, that rhTSH results in a transient average thyroid volume increase of 35%. A similar goitre swelling may cause problems in susceptible patients during rhTSH-augmented {sup 131}I therapy. Thus, this concept still needs a closer evaluation before routine use.

  20. Design and Implementation of Markerless Augmented Reality Application for Cockroach Phobia Therapy Using Adaptive Threshold

    Directory of Open Access Journals (Sweden)

    Fiandra Fatharany

    2017-01-01

    Full Text Available Augmented reality (AR technology is useful for treating several psychological problems, including phobias such as fear of flying, agoraphobia, claustrophobia, and phobia to insects and small animals. However, the currently existing applications for therapy of cockroach phobia that uses AR technology are still very dependent towards the presence of markers, which might lessen the feeling of being in an actual scenario from everyday lives. In this paper, we created a system that is able to use everyday things as a replacement for markers for phobia therapy for cockroach. There are five main processes: getting the live streaming feed from camera, preprocessing, extracting the center point of the objects, tracking the marker-substitute objects, and lastly, instantiating cockroaches randomly after user lifts the objects according to the number and mode of the cockroaches, whether it is moving or not, that are predetermined by the user. The evaluation in this paper includes eight participants that are carefully selected based on their Fear of Spiders Questionnaire (FSQ score that is translated into Indonesian and modified to accommodate cockroaches instead of spiders. The results is that the system can induce anxiety level on participants with the highest score of 10, which is the highest score in Standard Unit of Discomfort scale (SUDs. While the presence and reality judgment of this paper has the highest score of 7 which is also the highest score in Slater-Usoh-Steed Questionnaire (SUS.

  1. Synthesis of radioiodinated labeled peptides

    International Nuclear Information System (INIS)

    Matloobi, M.; Rafii, H.; Beigi, D.; Khalaj, A.; Kamali-Dehghan, M.

    2003-01-01

    Optimization of radioiodination of peptides is covered by both a direct method in which a constituent tyrosine residue is labeled and indirect method by using an iodinated derivative (SIB) of N succinimidyl 3-(tri-n-butylstannyl) benzoate (ATE) as the intermediate. Radioiodination of IgG and FMLF were performed by direct method using Chloramine-T as an oxidant but since Formyl-Methyl-Leucyl-Phenylalanine, FMLF, does not lend itself for direct radioiodination we performed labeling of FMLF by indirect method via radioiodined SIB at different pH. (author)

  2. Financial impact of outpatient clinic radioiodine therapy with sodium iodide I-131 for the treatment of patients with differentiated low-risk thyroid carcinoma in relation to hospital doses

    International Nuclear Information System (INIS)

    Berenguer, P.F.; Chang, T.M.C.; Silva, R.A.M.; Neto, A.H.D.; Belo, I.B.; Santos, M.A.P.

    2017-01-01

    Differential thyroid carcinoma (CDT) is the most prevalent endocrine malignancy in the world, with an excellent prognosis and a 10-year survival rate of over 95%. By 2013, the lowest activity of I-131 authorized by the Brazilian Unified Health System (SUS) in the therapy of patients with low-risk CDT was 3,700 MBq, requiring hospitalization. Recent studies have shown similar effectiveness between low and high doses of I-131 in the treatment of low-risk CDT. In 2014, the Ministry of Health included in the list of SUS procedures the use of lower activities (1,110 MBq and 1,850 MBq) for this purpose. The Brazilian National Nuclear Energy Commission (CNEN) also authorized the outpatient use of activity up to 1,850 MBq of I-131. Objective: To evaluate the financial impact of the adoption of ambulatory radioiodine therapy in patients with CDT of low-risk when compared to the hospital dose. Methods: Analysis of patients with CDT low-risk who were treated with an outpatient dose of I-131 from August / 2014 to January / 2017 at a nuclear medicine service in Recife, PE, Brazil. The cost of outpatient versus hospital doses was calculated. Results: A total of 289 patients underwent low doses of iodine therapy were evaluated, resulting in a savings of R$227,793.80. Conclusion: Outpatient radioiodine therapy in the treatment of patients with CDT of low-risk resulted in a 61.10% reduction in SUS expense, in addition to enabling faster care

  3. Radioiodine therapy for combined disseminated and nodular thyroid autonomy. Results after using a correction term for the disseminated part; Radioiodtherapie bei kombinierter Schilddruesenautonomie. Ergebnisse nach Korrektur fuer disseminierte Anteile

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, H.; Dorn, R.; Otto, I.; Sciuk, J. [Klinik fuer Nuklearmedizin, Klinikum Augsburg (Germany); Wengenmair, H.; Kopp, J. [Medizinische Physik und Strahlenschutz, Klinikum Augsburg (Germany)

    2006-07-01

    Aim: in combined focal and disseminated thyroid autonomy a variety of concepts in the treatment with radioiodine are used. The difference lies mainly in the calculation of the autonomous volume. This retrospective study shows a new method of calculating the autonomous volume. Patients and methods: in 398 patients with combined thyroid autonomy and good correlation of scintigraphically hot nodules and lesions defined by ultrasound the volume of the nodules is ascertained from scintigraphic and ultrasound parameters and the volume of the disseminated autonomous tissue is assessed with a weighting factor (VF). This factor is the ratio of impulse density in a ROI over the disseminated volume divided by the corresponding impulse density over the nodular volume of the thyroid scintigraphy. The sum of nodular volume and weighted perinodular volume gives the total autonomous volume. A standard radioiodine test gives the maximum iodine-131-uptake and effective half-life to calculate the activity to obtain a treatment dose of 400 Gy. Results: the rate of success with and without thyrostatic medication was 97% with an 18.6% rate of hypothyroidism observed from 4 months post therapy onwards. Conclusion: the use of the weighting factor VF in the treatment of combined autonomy leads to an excellent rate of success in patients with good correlation of functional imaging and ultrasound findings. (orig.)

  4. Metabolic control after years of completing a clinical trial on sensor-augmented pump therapy.

    Science.gov (United States)

    Quirós, Carmen; Giménez, Marga; Orois, Aida; Conget, Ignacio

    2015-11-01

    Sensor-augmented pump (SAP) therapy has been shown to be effective and safe for improving metabolic control in patients with type 1 diabetes mellitus (T1DM) in a number of trials. Our objective was to assess glycemic control in a group of T1DM patients on insulin pump or SAP therapy after years of participating in the SWITCH (Sensing With Insulin pump Therapy To Control HbA1c) trial and their return to routine medical monitoring. A retrospective, observational study of 20 patients who participated in the SWITCH trial at our hospital from 2008 to 2010. HbA1c values were compared at the start, during (at the end of the periods with/without SAP use - Sensor On/Sensor Off period respectively - of the cross-over design), and 3 years after study completion. HbA1c values of patients who continued SAP therapy (n=6) or only used insulin pump (n=14) were also compared. Twenty patients with T1DM (44.4±9.3 years, 60% women, baseline HbA1c level 8.43±0.55%) were enrolled into the SWITCH study). Three years after study completion, HbA1c level was 7.79±0.77 in patients on pump alone, with no significant change from the value at the end of the Off period of the study (7.85±0.57%; p=0.961). As compared to the end of the On period, HbA1c worsened less in patients who remained on SAP than in those on pump alone (0.18±0.42 vs. 0.55±0.71%; p=0.171), despite the fact that levels were similar at study start (8.41±0.60 vs. 8.47±0.45; p=0.831) and at the end of the On period (7.24±0.48 vs. 7.38±0.61; p=0.566). Frequency of CGM use in patients who continued SAP therapy was high (61.2% of the time in the last 3 months). Our study suggests that the additional benefit of SAP therapy achieved in a clinical trial may persist in the long term in routine clinical care of patients with T1DM. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  5. (Radioiodinated free fatty acids)

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, Jr., F. F.

    1987-12-11

    The traveler participated in the Second International Workshop on Radioiodinated Free Fatty Acids in Amsterdam, The Netherlands where he presented an invited paper describing the pioneering work at the Oak Ridge National Laboratory (ORNL) involving the design, development and testing of new radioiodinated methyl-branched fatty acids for evaluation of heart disease. He also chaired a technical session on the testing of new agents in various in vitro and in vivo systems. He also visited the Institute for Clinical and Experimental Nuclear Medicine in Bonn, West Germany, to review, discuss, plan and coordinate collaborative investigations with that institution. In addition, he visited the Cyclotron Research Center in Liege, Belgium, to discuss continuing collaborative studies with the Osmium-191/Iridium-191m radionuclide generator system, and to complete manuscripts and plan future studies.

  6. Investigation of early DNA damage after radioiodine therapy in patients with thyroid cancer using the gamma-H2AX focus assay

    International Nuclear Information System (INIS)

    Eberlein, U.; Lassmann, M.; Bluemel, C.; Buck, A.K.; Nowak, C.; Meineke, V.; Scherthan, H.

    2015-01-01

    Full text of publication follows. Objectives: the Aim of the study is to investigate the DNA damage formation in blood lymphocytes and the correlation to the absorbed dose to the blood in patients with differentiated thyroid carcinoma (DTC) after their first radionuclide therapy with I-131 as measured by the induction, persistence and decay behaviour of γ-H2AX and 53BP1 DNA damage-induced foci. Radiation-induced DNA double strand breaks (DSBs) cause in their vicinity the formation of microscopically visible foci of the phospho-histone H2AX (γ-H2AX) and the 53BP1 protein that binds to and signals damaged chromatin at the DSB site. Nuclear foci containing both markers thus represent radiation-induced DSBs. Methods: we investigated 19 patients with DTC during the first treatment with 3.5±0.3 GBq I-131. Between 7 and 10 sequential peripheral blood samples (at least four within the first 5 hours) were taken before and between 0.5 h and 144 h post administration. The physical dosimetry procedures were performed according to the EANM DTC SOP. White blood cells were recovered by density centrifugation in CPT tubes (BD Biosciences) and subjected to two-colour immunofluorescence staining. The average frequencies of the radiation-induced γ-H2AX foci/nucleus that co localized with 53BP1 foci were derived from immuno-stained mononuclear peripheral blood lymphocyte samples. The number of foci was counted manually using a red/green double band pass filter (Chroma) in a Zeiss microscope by an experienced observer. Results: The mean I-131 absorbed dose to the blood was (0.04±0.01) Gy at t=2 h, (0.07±0.02) Gy at t=4 h, and (0.21±0.05) Gy at t=24 h, respectively. The mean value of the total absorbed dose to the blood was (0.36±0.08) Gy. The highest number of radiation-induced foci per nucleus (RIF) and per absorbed dose (median: 8.8 RIF/Gy, range 3.1-10.9 RIF/Gy) was observed in the first three hours post administration. Four hours after radioiodine administration the number

  7. Augmenting Cognitive Behavior Therapy for School Refusal with Fluoxetine: A Randomized Controlled Trial.

    Science.gov (United States)

    Melvin, Glenn A; Dudley, Amanda L; Gordon, Michael S; Klimkeit, Ester; Gullone, Eleonora; Taffe, John; Tonge, Bruce J

    2017-06-01

    This study investigates whether the augmentation of cognitive behavior therapy (CBT) with fluoxetine improves outcomes in anxious school refusing adolescents (11-16.5 years). Sixty-two participants were randomly allocated to CBT alone, CBT + fluoxetine or CBT + placebo. All treatments were well tolerated; with one suicide-attempt in the CBT + placebo group. All groups improved significantly on primary (school attendance) and secondary outcome measures (anxiety, depression, self-efficacy and clinician-rated global functioning); with gains largely maintained at 6-months and 1-year. Few participants were anxiety disorder free after acute treatment. During the follow-up period anxiety and depressive disorders continued to decline whilst school attendance remained stable, at around 54 %. The only significant between-group difference was greater adolescent-reported treatment satisfaction in the CBT + fluoxetine group than the CBT alone group. These results indicate the chronicity of school refusal, and the need for future research into how to best improve school attendance rates.

  8. A retrospective study of predictive factors for effective aripiprazole augmentation of antidepressant therapy in treatment-resistant depression

    Directory of Open Access Journals (Sweden)

    Sugawara H

    2016-05-01

    Full Text Available Hiroko Sugawara,1,2 Kaoru Sakamoto,1 Tsuyoto Harada,3 Satoru Shimizu,4 Jun Ishigooka1 1Department of Psychiatry, Tokyo Women’s Medical University, 2Support Center for Women Health Care Professionals and Researchers, Tokyo Women’s Medical University, Shinjuku-ku, 3Department of Psychiatry, Tokyo Women’s Medical University Medical Center East, Arakawa-ku, 4Department of Research, Medical Research Institute, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan Background: Several studies have evaluated the efficacy and tolerability of aripiprazole for augmentation of antidepressant therapy for treatment-resistant depression (TRD. Here, we investigated the efficacy of aripiprazole augmentation for TRD including both major depressive disorder and bipolar disorder and the clinical predictors of treatment efficacy in a Japanese population.  Methods: Eighty-five depressed Japanese patients who underwent aripiprazole augmentation therapy after failing to respond satisfactorily to antidepressant monotherapy were included in the study. Treatment responses were evaluated based on Clinical Global Impression Improvement scores assessed 8 weeks after initiation of aripiprazole administration. We compared demographic and diagnostic variables, psychiatric medication variables, and clinical variables between remission and nonremission groups.  Results: The aripiprazole augmentation remission rate was 36.5%. Multiple logistic regression analysis indicated that aripiprazole augmentation was significantly more effective for bipolar depression than for major depressive disorder, and both absence of comorbid anxiety disorders and current episode duration >3 months were significantly associated with the efficacy of aripiprazole augmentation.  Conclusion: Polarity of depression, comorbidity of anxiety disorders, and current episode duration may predict the efficacy of aripiprazole augmentation for TRD including both major depressive disorder and

  9. A Preliminary Study of D-Cycloserine Augmentation of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

    Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.; Lewin, Adam B.; Henin, Aude; Micco, Jamie A.; Sprich, Susan; Wilhelm, Sabine; Bengtson, Michael; Geller, Daniel A.

    2010-01-01

    Background Research on the neural circuitry underlying fear extinction has led to the examination of d-cycloserine (DCS), a partial agonist at the NMDA receptor in the amygdala, as a method of enhancing exposure therapy outcome. Preliminary results have supported the use of DCS to augment exposure therapy in adult anxiety disorders; however, no data have been reported in any childhood anxiety disorder. Thus, we sought to preliminarily examine if weight-adjusted DCS doses (25 or 50mg) enhanced the overall efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). Method Participants were 30 youth (ages 8–17) with a primary diagnosis of OCD. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining CBT+DCS versus CBT+Placebo (15 youth per group). All patients received 7 E/RP sessions paired with DCS or placebo taken 1 hour prior to sessions. Results Although not significantly different, compared to the CBT+Placebo group, youth in the CBT+DCS arm showed small-to-moderate treatment effects (d=.31 to .47 on primary outcomes). No adverse events were recorded. Conclusions The present results complement findings in adult OCD and non-OCD anxiety disorders and provide initial support for a more extensive study of DCS augmentation of CBT among youth with OCD. PMID:20817153

  10. Airway complication occurring during radioiodine treatment for Graves' disease

    International Nuclear Information System (INIS)

    Kinuya, Seigo; Yoneyama, Tatsuya; Michigishi, Takatoshi

    2007-01-01

    Airway complications rarely occur in 131 I radioiodine therapy for Graves' disease. This study presents two cases in which 131 I therapy caused this acute complication. The patients complained of the symptom 6 h and 33 h after administration of 131 I. A histamine H1 receptor antagonist and hydrocortisone rapidly resolved symptoms in both cases. These two cases remind physicians that 131 I therapy for Graves' disease may cause potentially life-threatening complications. (author)

  11. Effects of augmented exercise therapy on outcome of gait and gait-related activities in the first 6 months after stroke: a meta-analysis.

    OpenAIRE

    Veerbeek, J.M.; Koolstra, M.; Ket, J.C.F.; Wegen, van, E.E.H.; Kwakkel, G.

    2011-01-01

    BACKGROUND AND PURPOSE-: The purpose of this study was to determine the effects of augmented exercise therapy on gait, gait-related activities, and (basic and extended) activities of daily living within the first 6 months poststroke. METHODS-: A systematic literature search in electronic databases from 1990 until October 2010 was performed. Randomized controlled trials were included in which the experimental group spent augmented time in lower-limb exercise therapy compared with the control g...

  12. Efeitos da radioiodoterapia nas gerações futuras de mulheres com carcinoma diferenciado de tireóide Radioiodine therapy effects on offspring of patients with differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Carmen Dolores Gonçalves Brandão

    2004-02-01

    Full Text Available A radioiodoterapia tem conseguido desempenhar um papel significante no tratamento do carcinoma diferenciado de tireóide. A literatura é limitada em relação a possíveis efeitos secundários do 131I, embora o interesse tenha aumentado nesse campo. A importância de se saber mais sobre os efeitos mutagênicos da radiação em filhos de mães expostas ao 131I para tratamento do carcinoma diferenciado de tireóide é devida à possibilidade de ocorrência de abortos, anormalidades genéticas e aparecimento de malignidades nas crianças. Nesta revisão da literatura vários estudos têm demonstrado a segurança desse tipo de tratamento em mulheres na idade fértil, sendo apenas aconselhadas a evitar gravidez pelo período de, pelo menos, um ano após a administração da radioiodoterapia.Radioiodine therapy has attained a significant role in the treatment of differentiated thyroid cancer. The literature addressing possible secondary effects of 131I is limited, although there has been increasingly interest in this field. A more comprehensive understanding of the mutagenic effects of radiation on the offspring of women exposed to 131I is mandatory in view of the possibility of occurrence of miscarriages, congenital abnormalities and malignancies in these children. In this review, we found that many reports on safety of this type of treatment in female patients in reproductive age recommend that pregnancy should be avoided for at least one year after therapeutic administration of radioiodine.

  13. 1,25-(OH)2-vitamin D3 enhances the cytotoxic effect of radioiodine therapy in prostate cancer cells expressing the sodium iodide symporter

    International Nuclear Information System (INIS)

    Spitzweg, Christine; Hirschmann, Martin; Unterholzner, Stefanie; Cengic, Neziha; Eckel, Petra; Sharif-Samani, Bibi-Rana; Willhauck, Michael J.; Goeke, Burkhard; Morris, John C.

    2005-01-01

    Full text: We reported recently the induction of androgen-dependent iodide uptake activity in human prostate cancer cells (LNCaP) utilizing a prostate-specific antigen (PSA)-promoter directed expression of the sodium iodide symporter (NIS) gene. This offers the potential to treat prostate cancer with radioiodine. In the current study we examined the regulation of PSA-promoter directed NIS expression and therapeutic effectiveness of 131 I in LNCaP cells by 1,25-(OH)2-Vitamin D3 (Vit D3). For this purpose, NIS mRNA and protein expression levels in the NIS-transfected LNCaP cell line NP-1 were examined by Northern and Western blot analysis following incubation with Vit D3 (10 -9 M - 10 -5 M) in the presence of mibolerone (10 -9 M). In addition, NIS functional activity was measured by iodide uptake assay, and in vitro cytotoxicity of 131 I was examined by in vitro clonogenic assay. Following incubation with Vit D3, NIS mRNA levels in NP-1 cells were stimulated 1.2-fold, whereas NIS protein levels increased 1.65-fold and iodide accumulation was stimulated 1.4-fold in a concentration-dependent manner. Further, the selective killing effect of 131 I in NP-1 cells was significantly increased from 55% in NP-1 cells incubated with mibolerone alone to 86 % in NP-1 cells treated with Vit D3 (10 -5 M) in the presence of mibolerone. In the absence of androgen, with or without Vit D3 no functional NIS expression was detected. Conclusion: Treatment with Vit D3 increases androgen-induced NIS expression levels and selective killing effect of 131 I in prostate cancer cells stably expressing NIS under the control of the PSA promoter. Vit D3 may therefore be used to enhance the therapeutic response to radioiodine in prostate cancer cells following PSA-promoter directed NIS gene delivery. (author)

  14. Multifactorial analysis on the short-term side effects occurring within 96 hours after radioiodine-131 therapy for differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Kita, Tamotsu; Yokoyama, Kunihiko; Kinuya, Seigo; Taki, Junichi; Nakajima, Kenichi; Michigishi, Takatoshi; Tonami, Norihisa; Higuchi, Takahiro

    2004-01-01

    This study was performed to clarify factors that might influence short-term side effects occurring within 96 hours after administration of 131 I for patients with thyroid carcinoma. In 71 patients with differentiated thyroid carcinoma, short-term side effects including gastrointestinal complaints, salivary gland swelling with pain, change in taste and headache were retrospectively analyzed. All patients were given domperidone for prevention of gastrointestinal complaints and advised to consume sour foods to promote discharge of radioiodine from the salivary glands. Selected factors possibly affecting the incidence of side effects were dose per body weight, thyroid stimulating hormone (TSH), effective half-life of 131 I, sex, age, 131 I accumulation into the stomach and salivary glands, and edema prior to radioiodine administration. The factors were evaluated by multivariate analyses. Incidence of gastrointestinal complaints, salivary gland swelling with pain, change in taste and headache was 65.2%, 50.0%, 9.8% and 4.4%, respectively. In gastrointestinal complaints, the incidence of appetite loss, nausea and vomiting was 60.9%, 40.2% and 7.6%, respectively. The gastrointestinal complaints increased significantly in the patients dosed above 55.5 MBq/kg and with TSH elevation. For salivary gland swelling with pain, female patients displayed a significantly higher incidence than males. No statistically significant factors were detected for change in taste or headache. Significant factors influencing short-term side effects were dose per body weight and TSH values for gastrointestinal complaints, and female sex for salivary gland swelling with pain. Our preliminary experience suggests that the most frequent gastrointestinal complaints can be prevented with ramosetron. (author)

  15. Radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Becker, D.V.; Hurley, J.R.

    1988-01-01

    Hyperthyroidism is a clinical symptom complex caused by elevated thyroid hormone levels. Of the disorders in which it appears, the most common is Graves' disease; toxic nodular goiter (Plummer's disease) is considerably less frequent. Recent studies suggest that Graves' disease is autoimmune in origin and is probably caused by a genetic defect in immunoserveillance in which thyroid-stimulating antibodies interact with thyroid-stimulating hormone (TSH) receptor sites on thyroid follicular cell membranes to increase synthesis and secretion of thyroid hormones. Toxic nodular goiter is characterized by the secretion of increased amounts of thyroid hormone by localized autonomous areas of increased function within the thyroid gland. Other forms of hyperthyroidism are discussed. Radioiodine treatment of hyperthyroidism is described

  16. Combination therapy with lercanidipine and enalapril reduced central blood pressure augmentation in hypertensive patients with metabolic syndrome.

    Science.gov (United States)

    Ghiadoni, Lorenzo; Bruno, Rosa Maria; Cartoni, Giulia; Stea, Francesco; Magagna, Armando; Virdis, Agostino; Grassi, Davide; Ferri, Claudio; Taddei, Stefano

    2017-05-01

    Arterial stiffness and blood pressure (BP) augmentation are independent predictors of cardiovascular events. In a randomized, open, parallel group study we compared the effect on these parameters of combination therapy with an ACE-inhibitor plus calcium channel blocker or thiazide diuretic in 76 hypertensive patients with metabolic syndrome uncontrolled by ACE-inhibitor monotherapy. After 4weeks run-in with enalapril (ENA, 20mg), patients were randomized to a combination therapy with lercanidipine (LER, 10-20mg) or hydrochlorothiazide (HCT, 12.5-25mg) for 24weeks. Aortic stiffness (carotid to femoral pulse wave velocity, PWV), central BP values and augmentation (augmentation index, AIx) were measured by applanation tonometry. The two groups showed similar office and central BP after run-in. Office (ENA/LER: from 149.1±4.9/94.5±1.5 to 131.7±8.1/82.2±5.3; ENA/HCT: from 150.3±4.7/94.7±2.1 to 133.1±7.1/82.8±5.3mmHg) and central BP (ENA/LER 127.4±17.1/85.2±12.1 to 120.5±13.5/80.0±9.5mmHg; ENA/HCT 121.6±13.4/79.3±9.5mmHg) were similarly reduced after 24weeks. PWV was comparable after run-in and not differently reduced by the two treatments (ENA/LER from 8.6±1.5 to 8.1±1.3m/s, pmetabolic syndrome not controlled by ENA alone. These results indicate a positive effect of the combination of ENA/LER on central BP augmentation, suggesting a potential additive role for cardiovascular protection. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Production of radioiodinated prosthetic group for indirect protein labeling

    International Nuclear Information System (INIS)

    Santos, Josefina da Silva

    2001-01-01

    Monoclonal antibodies and their fragments and, more recently, radiolabeled peptides have been extensively studied in order to develop radiopharmaceuticals for diagnostic and therapy in Nuclear Medicine. The radioiodination of proteins can be done by a direct method, with radioiodine being incorporated in to a tyrosine residue of the protein by electrophilic substitution. The main problem in the use of radioiodinated proteins, is that they are often dehalogenated in vivo by the action of specific enzymes, probably because of the structural similarity between iodophenyl groups and thyroid hormones. Several protein radioiodination methods have been developed in order to minimize this in vivo dehalogenation using prosthetic groups for indirect labeling. In this case, the radioiodine is first incorporated in to the prosthetic group that is subsequently attached to a terminal amino group or to a ε-amino group of lysine residue. The aim of this work is to obtain a radioiodinated prosthetic group for indirect labeling of proteins. The prosthetic group selected was the N-succinimidyl-4-radioiodine benzoate (SIB), obtained by the iodination of the p-bromobenzoic acid followed by the reaction with TSTU (0-(N-succinimidyl)-N,N,N',N'-tetramethyl uronium tetrafluoroborate) The results of these studies showed that the p-radio iodobenzoic acid was obtained with a radiochemical purity greater than 92% and a labeling yield of about 65%. Some reaction parameters were studied like temperature, time and Cu Cl mass (cataliser). The SIB was quantitatively obtained from p-radio iodobenzoic acid, using basic medium and after removing the water from the reaction using an nitrogen stream. The kinetic of this reaction is very fast with complete consumption of the p-radioiodebenzoic acid after 5 minutes. The coupling of the SIB prosthetic group to the protein was studied using Human Immunoglobulin (IgG) as a protein model. In a comparative way, the same protein was used on direct labeling

  18. Reduced radioiodine uptake at increased iodine intake and {sup 131}I-induced release of ''cold'' iodine stored in the thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Meller, B.; Haase, A.; Richter, E.; Baehre, M. [Dept. of Radiotherapy and Nuclear Medicine, Univ. of Luebeck (Germany); Seyfarth, M. [Inst. of Clinical Chemistry, Univ. of Luebeck (Germany); Wenzel, B.E. [Clinic of Internal Medicine I, Univ. of Luebeck (Germany)

    2005-07-01

    Aim: the extent of urinary iodine excretion (UIE) provides information about iodine supply and release. In the present study we investigated correlations between UIE and radioiodine uptake (RIU) as well as effects of radioiodine therapy on UIE in patients with autonomous goitre. Patients, methods: In 197 consecutive patients with thyroid autonomy, UIE was measured twice during radioiodine test (RITe) and correlated with RIU. In 98 of these patients, thyroglobulin and thyroid volume (V) were determined prior to therapy. Individual changes in urinary iodine excretion ({delta}UIE) and TG ({delta}TG) could be investigated four weeks (4W) and six months (6M) after radioiodine therapy. Additionally, {delta}V was determined 6M after therapy. {delta}UIE, {delta}TG and {delta}V were correlated with target dose and target volume. Results: patients with higher iodine excretion exhibited significantly lower thyroidal radioiodine uptake values. Twofold increased UIE prior to therapy decreased radioiodine uptake by 25%. Compared with pretherapeutic values, UIE and TG were significantly increased four weeks after radioiodine therapy (p < 0.001). Median values of both parameters were found to be doubled. The product of target dose and target volume was not only correlated with a decrease of thyroid volume 6M after therapy, but also with an increase of UIE and TG in the early phase after therapy. Conclusions: it was confirmed that UIE during RITe is a measure for iodine intake and can be used to investigate the competition between stable iodine and radioiodine. The increase of UIE and TG four weeks after therapeutic administration of radioiodine can be explained by disintegrated thyroid follicles. The therapy-induced iodine release may be one important cause for the development of hyperthyroidism in some patients during the first weeks after radioiodine therapy. It may contribute to the known decrease of radioiodine uptake after preapplications of {sup 131}I in various thyroid

  19. Psychometric analysis of the Melancholia Scale in trials with non-pharmacological augmentation of patients with therapy-resistant depression

    DEFF Research Database (Denmark)

    Bech, Per; Lauritzen, Lise; Lunde, Marianne

    2014-01-01

    . Patients resistant to anti-depressant medication (therapy-resistant depression) have participated in our trials with non-pharmacological augmentation. On the basis of these trials, we have evaluated to what extent the neuropsychiatric subscale of the MES (concentration difficulties, fatigability, emotional...... of transferability, we have tested item ranks across the rating weeks. RESULTS: In the Mokken analysis, the coefficient of homogeneity was above 0.40 for both the HAM-D subscale and the apathia subscale at week 4. The numerical transferability across the weeks was statistically significant (p

  20. Gluteal Augmentation With Intramuscular Implants in Patients With Human Immunodeficiency Virus With Lipoatrophy Related to the Use of Antiretroviral Therapy.

    Science.gov (United States)

    Andrade, Guilherme Augusto; Coltro, Pedro Soler; Barros, Mário Eduardo; Müller Neto, Bruno Francisco; Lima, Renan Victor; Farina, Jayme Adriano

    2017-11-01

    Lipodystrophy syndrome associated with highly active antiretroviral therapy (HAART) may lead to low self-esteem and poor compliance with the drug treatment on patients infected with human immunodeficiency virus (HIV), which is a matter of concern for the health system. The aim of this study was to evaluate patients with HIV submitted to gluteal augmentation with intramuscular silicone implants to correct gluteal lipoatrophy related to the use of HAART. This is a retrospective evaluation of 10 patients submitted to gluteal augmentation with intramuscular silicone implant for correction of gluteal lipoatrophy related to the use of HAART, operated between 2012 and 2015. Postoperative complications and the degree of patient's satisfaction were analyzed. There were 3 postoperative complications including 1 case of surgical wound dehiscence and 2 cases of seroma. Six months after surgery, 8 patients had an excellent degree of satisfaction, and 2 patients had a good degree of satisfaction related to the procedure. Although this intervention does not offer functional advantages, it improves the body contour, increases patients' self-esteem, and helps them to accept their body image. These advantages can lead to higher compliance with prolonged HAART. Gluteal augmentation with intramuscular silicone implant can be a viable option to treat patients with HIV with gluteal lipoatrophy related to the use of HAART. The patients were satisfied with the outcomes of the procedure, and there were only minor self-limited postoperative complications.

  1. Radioiodination of antibodies for tumor imaging

    International Nuclear Information System (INIS)

    Saha, G.B.

    1983-01-01

    In view of the great potential of radioiodinated antibody for the detection and treatment of cancer, the present article deals with the various techniques of radioiodination of antibody and their uses. Topics include methods of iodination of antibody, advantages and disadvantages of different methods, and effects of radioiodination on the antibody molecules with respect to their physiochemical and immunologic reactivity. In addition, the clinical usefulness of radioiodinated antibodies is discussed. (Auth.)

  2. Changing trends in the treatment of Graves' disease with radioiodine: a 12-year experience in a university hospital

    International Nuclear Information System (INIS)

    Souza, Marcus Vinicius Leitao de; Souza, Honomar Ferreira de; Buescu, Alexandru; Vaisman, Mario

    2009-01-01

    Objective: To evaluate the changes in clinical parameters and in the approach to patients submitted to radioiodine therapy for Graves' disease. Materials and methods: Dossiers of 226 patients submitted to radioiodine therapy for Graves' disease in the period between January 1990 and December 2001 were retrospectively evaluated. For the purposes of statistical analysis, the 12-year period was subdivided into three periods of 4 years, with a comparison of clinical and laboratory variables in these periods. Results: The authors have observed that the total number of patients referred for radioiodine therapy as well as the percentage of female patients presented a significant increase (from 62% to 86%; p = 0.005). The percentage of patients pretreated with methimazole before radioiodine therapy increased significantly (from 9.1% to 35.6%; p = 0.03). The mean radioiodine dose delivered has also presented a significant increase (from 7.6 mCi to 12.7 mCi; p = 0.000003) with a direct reflection on a higher percentage of patients cured one year after the radioiodine therapy (from 55.6% to 83.7%; p = 0.004). Conclusion: Radioiodine therapy has increasingly been accepted for treatment of patients with Graves' disease and the doses delivered have increased to achieve a permanent cure as well as a reduction of the chances of recurrence. (author)

  3. Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

    NARCIS (Netherlands)

    Hermanides, J.; Nørgaard, K.; Bruttomesso, D.; Mathieu, C.; Frid, A.; Dayan, C. M.; Diem, P.; Fermon, C.; Wentholt, I. M. E.; Hoekstra, J. B. L.; DeVries, J. H.

    2011-01-01

    To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with

  4. Radioiodination of humic substances

    Energy Technology Data Exchange (ETDEWEB)

    Franke, K.; Kupsch, H. [Inst. of Interdisciplinary Isotope Research, Leipzig (Germany)

    2010-07-01

    The known IODO-GEN trademark -method was adapted for radiolabeling of humic and fulvic acids with {sup 131}I. The water insoluble oxidizing agent 1,3,4,6tetrachloro-3{alpha},6{alpha}-diphenylglycoluril (IODO-GEN trademark) forms an iodous ion species (I{sup +}), which undergoes an electrophilic I/H-substitution on aromatic moieties of the humic and fulvic acids. This method offers mild conditions with a lesser extent of oxidative alterations of the target molecule, accompanied by an easy handling due to the virtual water-insolubility of the oxidizing agent. The method was optimized and different techniques were tested for the purification of the radioiodinated humic material. The yield of the labeling procedure varies between 45 and 75% depending on the provenance of the humic material and the applied purification method. A specific activity up to 40 MBq/mg was achieved. Furthermore, the known inherent photo-susceptibility of the iodinated humic substance and the influence of reducing agents were verified. An additional release of {sup 131}I up to 20% and up to 35%, respectively were observed. (orig.)

  5. Augmented therapy of extensive Hodgkin's disease: radiation to bulk disease or prolongation of induction chemotherapy did not improve survival

    International Nuclear Information System (INIS)

    Rafla, S.; Coleman, M.; Propert, K.; Glicksman, A.; Peterson, B.; Nissen, N.; Brunner, K.; Kaufmann, T.; Holland, J.; Anderson, J.; Gottlieb, A.

    1996-01-01

    Purpose: This prospective, randomized trial in extensive, untreated Hodgkin's disease was undertaken to assess the potential benefit of augmented therapy (12 months chemotherapy or radiation to 'bulk' disease) compared to standard, six months chemotherapy. Materials and Methods: Two-hundred fifty-eight patients, mostly stage IV, were randomized to four treatment regimens consisting of 6 cycles of CCNU, vinblastine, procarbazine, and prednisone (CVPP); 12 cycles of CVPP; 6 cycles of CVPP followed by 25 Gray (Gy) radiotherapy; or 3 cycles CVPP, 25 Gy radiotherapy, and 3 cycles CVPP. Results: Complete remissions were achieved in 65% of all patients. A 58% overall 5 year survival was obtained. Relapses in irradiated areas of bulk disease occurred in only 6% of responding patients. There was, however, no statistical difference in response frequency, disease free survival or overall survival amongst the four regimens. Elderly patients responded less frequently. Conclusion: While radiotherapy provided control of local (bulk) disease, no impact on overall survival was apparent. Likewise doubling the duration of chemotherapy did not improve response or survival. Augmentation of therapy with either radiotherapy or more chemotherapy in this study was of no benefit when compared to the standard six months of treatment

  6. Does an individual estimation of halflife improve the results of radioiodine therapy of Graves' disease?; Verbessert die individuelle Bestimmung der effektiven Halbwertszeit die Ergebnisse der Radioiodtherapie des Morbus Basedow?

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, P.; Koerber, C.; Koerber-Hafner, N.; Haenscheid, H.; Reiners, Chr. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany)

    2002-12-01

    Aim: The impact of our dosimetry concept on radioiodine therapy success in Graves' disease (GD) was analysed. Three questions arised: Did individual estimation of pretherapeutic halflife improve therapeutic success? Did individual dosimetry result in accurate dose calculation? Did antithyroid medication have a measurable influence on therapeutic success under the prevailing conditions? Methods: 126 consecutive patients were treated with 200 Gy I-131 in our therapy ward for GD and followed-up six to nine months after therapy. Success quote was assessed using a standardized protocol and treatment was classified as successful when the patients was eu- or hypothyroid, or unsuccessful when he or she presented with a suppressed TSH-level or in hyperthyroid condition after antithyroid medication withdrawal. Antithyroid medication, activity I-131, dose, concentration of fT{sub 3} and fT{sub 4}, specific delivered dose and halflife were put into a multiple regression model to assess their influence on therapeutic success. In order to assess possible factors disturbing the therapeutic outcome, relevant parameters were analyzed using Logit transformation. Results: Out of 126 patients 84 were classified as successfully treated and 42 (33,3%) as failures. A significant influence on the outcome only was found for thyroid mass. However, therapeutic success appeared to be more distinctly determined by the specific delivered dose using an estimated halflife of 5.5 days (Odds: 10.0, p <0.001). Accurate intratherapeutic dosimetry did not play a significant role to enhance therapeutic success. Neither did antihyroid medication during radioiodine therapy exert any significant impact. Conclusions: Measurement of individual intratherapeutic halflife as opposed to an estimate using a standard halflife did not provide improved results concerning the target dose. Retrospectively, the therapeutic outcome on the basis of a measured halflife as compared to a standard halflife did not

  7. Influence of antithyroid medication on effective half-life and uptake of {sup 131} I following radioiodine therapy; Einflussfon thyreostatischer Medikation auf die effektive Halbwertzeit und den Uptake von {sup 131}Iod waehrend einer Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Moka, D. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Voth, E. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    1997-04-01

    Aim: A radioiodine therapy (RIT) in thyrotoxic patients receiving antithyroid drugs (ATD) leads in comparison to nonpretreated patients either to higher therapeutic doses or to higher treatment failure rates. Aim of this study was to optimize the effect of RIT in patients pretreated with ATD. Methods: Therefore, the influence of ATD was assessed in 109 patients with shortened effective half-life of {sup 131}I. RIT was performed under stationary conditions. Radioiodine activity of the thyroid gland was stopped three days after RIT. The patients antithyroid medication was stopped three days after RIT. The progress of the first RIT and of a second radioiodine application, which still was necessary in 29 patients, was compared to 32 patients receiving ATD, continuously. Results: Values of effective half-life for {sup 131}I rose significantly from 3.2{+-}0.2 to 5.7{+-}0.2 days (Graves` disease: 3.4 to 5.7 days; toxic goiters` disease: Multifocal autonomy 3.2 to 6.2 days; unifocal autonomy 2.5 auf 5.0 days) 2-3 days after stopping ATD. There was an increase of the {sup 131}I-uptake of a second RIT decreased significantly in patients receiving ATD, continuously. Conclusion: Effective half-life and uptake of {sup 131}I was affected significantly by ATD. The stop taking of ATD after RIT is useful to improve an apparent insufficient RIT in thyrotoxic patients receiving ATD. (orig.) [Deutsch] Ziel: Eine Radioiodtherapie (RITh) unter laufender thyreostatischer Medikation bei hyperthyreoten Patienten fuehrt im Vergleich zu unbehandelten Patienten entweder zu hoeheren Therapiedosen oder zu einem hoeheren Prozentsatz von Therapieversagern. Ziel dieser Studie war es, die RITh unter thyreostatischer Medikation zu optimieren. Methoden: Der Einfluss der thyreostatischen Medikation wurde bei 109 Patienten mit verkuerzter thyreoidaler Halbwertzeit von {sup 131}I untersucht. Bei 77 Patienten wurde die thyreostatische Medikation am 3. Tag nach RITh abgesetzt. Der Verlauf der RITh bzw

  8. Radioiodine removal in nuclear facilities

    International Nuclear Information System (INIS)

    1980-01-01

    Technical means are reviewed available for the retention of radioiodine in nuclear power plants and fuel reprocessing plants, its immobilization, storage, and disposal. The removal of iodine species from gaseous effluents of nuclear power plants using impregnated activated charcoal is dealt with. Various scrubbing techniques for trapping iodine from the head-end and dissolver off-gases are discussed as well as solid adsorbents for iodine which may be used to clean up other gaseous streams. Current practices and activities for radioiodine treatment and management in Belgian, Dutch, Swedish, USSR and UK nuclear installations are presented

  9. Remission of classic rapid cycling bipolar disorder with levothyroxine augmentation therapy in a male patient having clinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Chen PH

    2015-02-01

    Full Text Available Pao-Huan Chen, Yu-Jui Huang Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan Abstract: The literature suggests that patients with bipolar disorder, particularly females, have greater vulnerability to rapid cycling features. Levothyroxine therapy might be potentially useful to attenuate mood instability in this patient group. In contrast, reports on male patients remain limited and controversial. Herein, we report a 32-year-old male patient who had bipolar 1 disorder for 12 years who developed a breakthrough rapid cycling course and first-onset clinical hypothyroidism at the age of 31 years during lithium therapy. After levothyroxine augmentation therapy was introduced, the patient had remission from the rapid cycling illness course along with normalization of serum levels of free T4 and thyroid stimulating hormone in the subsequent year. This observation suggested that investigation of both levothyroxine pharmacology and thyroid pathology in male patients with rapid cycling bipolar disorder might be of much value. Keywords: mood disorder, therapy, thyroid hormone

  10. Radioiodine in the environment

    International Nuclear Information System (INIS)

    Grauby, A.; Saas, A.

    1979-01-01

    An experimental procedure was developed in order to follow the pathways of radioiodine, 129 I especially, through the various compartments of nuclear plant environment: atmosphere, soil, plants, precipitations, ... A partial evaluation of the results is made. Data are supplied on iodine transfer into soil, iodine distribution one year later, release of iodine at the level of soil and plants. The intake of various forms of iodine in a soil and the evaluation of availability to plants by chemical tests showed that radioactive iodine ( 125 I) reached equilibrium with stable iodine after 120 - 140 days of incubation. During this time, there was a large amount of iodine exchangeable against a KI solution N/10. Equilibrium was reached progressively by iodine transfer on soil organic molecules. According to the origin of contamination, the transfer was more or less fast and differences were especially noticed in volatile iodine release and on chemical mobility. During intake, potential hazard of soil, groundwater, plant and atmospheric contaminations was greater. Iodine-129 is presently one of the chief contributors to air pollution around nuclear installations because of its radioactive half-life (1.72 x 10 7 yr) rather than on account of the amounts released. Just as with iodine-131, it is released into the atmosphere under many chemical forms. However, 129 I reaches man through several food chains and not only through the air-grass-cow-milk food chain. The values of its deposition rate on soil and plants are fairly dispersed because of its changing reactivity due to its chemical instability. On account of this chemical complexity, the transfer of iodine along the air-soil-plant system was studied using 125 I. (author)

  11. Efficacy of 131I SPECT/CT in the initial nodal staging in patients with differentiated thyroid carcinoma at the first ablative radioiodine therapy

    International Nuclear Information System (INIS)

    Kisiel, N.; Garcia-Burillo, A.; Barios, M.; Dellepiane, F.; Castell-Conesa, J.

    2015-01-01

    Full text of publication follows. Background: after the first radioiodine ablative dose, planar Whole-Body Scanning (WBS) offers the possibility for detecting thyroid remnant, loco-regional node involvement and distant metastases. Nevertheless, available anatomic information is scarce and the high activity of thyroid remnants can interfere with the detection of cervical lymphatic nodes. Objective: to determine the additional value of the SPECT-CT over planar WBS, performed seven days after ablative treatment with 131 I, in patients who were operated on for Differentiated Thyroid Cancer (DTC). Methods: from January 2009 to December 2012, 132 patients with DTC were admitted for radio-ablation with 131 I after thyroidectomy. All of them underwent WBS seven days after ablation, and 91 had an additional SPECT-CT, 71 women and 20 men, with ages ranged from 15 to 89 years (mean, age 54 years). All patients had histological confirmed DTC (73 papillary, 17 follicular -2 cases with double tumour, papillary and follicular-, and 1 insular type). In addition to the thyroidectomy, lymph node dissection was performed in 54 patients (59%): 20 patients were classified as N0 and 29 as N1. The remaining 42 patients were classified as Nx. Planar and tomographic images were independently evaluated by two experienced nuclear medicine physicians. Results: 195 cervical focal uptake were observed in the 91 planar WBSs. No additional foci were observed in SPECT-CT. Findings: Planar WBS........... SPECT-CT........... Number of Foci Thyroid remnant...... Thyroid remnant..........51........... LNM...........0 Indeterminate.......... Thyroid remnant..........84............. LNM............5 LNM............ Thyroid remnant.........12............ Indeterminate.............0............ LNM..........43. Total Number of Foci............. 195. Compared to the nodal staging prior to ablation based on the histopathological diagnosis, we had an upstaging from N0 to N1 in 4 of 20 patients and from Nx to

  12. Glucocorticoid administration for Graves' hyperthyroidism treated by radioiodine. A questionnaire survey among members of the European Thyroid Association

    NARCIS (Netherlands)

    Lazarus, J. H.; Bartalena, L.; Marcocci, C.; Kahaly, G. J.; Krassas, G.; Wiersinga, W. M.; Baldeschi, L.; Boboridis, K.; Boschi, A.; Currò, N.; Daumerie, C.; Dickinson, A. J.; Eckstein, A.; Kendall-Taylor, P.; Lane, C. M.; Ludgate, M. E.; Mann, K.; Marinò, M.; Mourits, M. P.; Nardi, M.; Neoh, C.; Orgiazzi, J.; Pearce, S.; Perros, P.; Pinchera, A.; Pitz, S.; Salvi, M.; Sivelli, P.; Stahl, M.; von Arx, G.

    2010-01-01

    Background: Glucocorticoid prophylaxis is required in some instances after radioiodine (RAI) treatment for Graves' hyperthyroidism to prevent progression of Graves' orbitopathy (GO). However, no randomized clinical trial has been performed to ascertain the optimum glucocorticoid therapy. Aim and

  13. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    International Nuclear Information System (INIS)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa

    1994-01-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after 131 I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after 131 I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after 131 I therapy.(author)

  14. Augmentation of exposure therapy with D-cycloserine for social anxiety disorder

    NARCIS (Netherlands)

    Hofmann, S.G.; Meuret, A.E.; Smits, J.A.J.; Simon, N.M.; Pollack, M.H.; Eisenmenger, K.; Shiekh, M.; Otto, M.W.

    2006-01-01

    Context: Social anxiety disorder ( SAD) is common and debilitating. Although exposure therapy is one of the most effective forms of psychotherapy for this disorder, many patients remain symptomatic. Fear reduction in exposure therapy is similar to extinction learning, and early clinical data with

  15. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    showed a higher sensitivity to radioiodine, with more cases of early hypothyroidism, than non-operated patients. However, after 50 months of follow-up the outcome was identical. The results indicate that frequent assessment is necessary after radioiodine treatment of previously operated patients, since......Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  16. Tissue engineering for lateral ridge augmentation with recombinant human bone morphogenetic protein 2 combination therapy: a case report.

    Science.gov (United States)

    Mandelaris, George A; Spagnoli, Daniel B; Rosenfeld, Alan L; McKee, James; Lu, Mei

    2015-01-01

    This case report describes a tissue-engineered reconstruction with recombinant human bone morphogenetic protein 2/acellular collagen sponge (rhBMP-2/ ACS) + cancellous allograft and space maintenance via Medpor Contain mesh in the treatment of a patient requiring maxillary and mandibular horizontal ridge augmentation to enable implant placement. The patient underwent a previously unsuccessful corticocancellous bone graft at these sites. Multiple and contiguous sites in the maxilla and in the mandibular anterior, demonstrating advanced lateral ridge deficiencies, were managed using a tissue engineering approach as an alternative to autogenous bone harvesting. Four maxillary and three mandibular implants were placed 9 and 10 months, respectively, after tissue engineering reconstruction, and all were functioning successfully after 24 months of follow-up. Histomorphometric analysis of a bone core obtained at the time of the maxillary implant placement demonstrated a mean of 76.1% new vital bone formation, 22.2% marrow/cells, and 1.7% residual graft tissue. Tissue engineering for lateral ridge augmentation with combination therapy requires further research to determine predictability and limitations.

  17. Effectiveness of Aerobic Exercise as an Augmentation Therapy for Inpatients with Major Depressive Disorder: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    Shachar-Malach, Tal; Cooper Kazaz, Rena; Constantini, Naama; Lifschytz, Tzuri; Lerer, Bernard

    2015-01-01

    Physical exercise has been shown to reduce depressive symptoms when used in combination with antidepressant medication. We report a randomized controlled trial of aerobic exercise compared to stretching as an augmentation strategy for hospitalized patients with major depression. Male or female patients, 18-80 years, diagnosed with a Major Depressive Episode, were randomly assigned to three weeks of augmentation therapy with aerobic (n=6) or stretching exercise (n=6). Depression was rated, at several time points using the 21-item Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI) and other scales. According to the HAM-D, there were four (out of six) responders in the aerobic group, two of whom achieved remission, and none in the stretching group. According to the BDI, there were two responders in the aerobic group who were also remitters and none in the stretching group. The results of this small study suggest that aerobic exercise significantly improves treatment outcome when added to antidepressant medication. However, due to the small sample size the results must be regarded as preliminary and further studies are needed to confirm the findings.

  18. Therapeutic outcome after radioiodine and surgery treatment of toxic thyroid adenoma

    International Nuclear Information System (INIS)

    Petrovski, Zlatko P.

    2005-01-01

    Full text: Purpose: The aim of the study was to evaluate late follow-up results in surgery and radioiodine treatment of toxic thyroid adenoma and compare incidence of hypothyroidism and recurrence hyperthyroidism in treated patients. Material and Methods: We observed 93 treated patients (77 female, 26 male, age range 18-76 years) with adenoma toxicum. 29 (32.2 %) patients underwent surgery (adenectomia), while 64 (67.8 %) patients received 131 I therapy (555-1100 MBq).The long term results of the treatment were followed 1-15 years after therapy (median 9,2 years). Results: Recurrent hyperthyroidism occurred in 4/29 (13.8%) patients after surgery adenectomia in comparison to 5/64 (7.8 %) patients after radioiodine therapy. The patients after enucleation of autonomous nodule of the thyroid show increase incidence of late recurrent hyperthyroidism. These results are likely to be due to persistent functional autonomy in the parenchyma surrounding the autonomous adenoma. Apparently this persistent autonomy could be successfully removed by radioiodine. Appear of hypothyroidism was observed in 6/64 (9.3 %) patients treated with 131 I, while after surgery had in 3/29 (10.3 %) patients. Incidence of hypothyroidism between operated patients and radioiodine treated patients was approximately the same. Conclusion: Radioiodine therapy is useful, economical and effective treatment of toxic thyroid adenoma that provides a safe protection in preventing late recurrent hyperthyroidism and is more successful therapy that surgery treatment. (author)

  19. Subjective perception of radioactivity. No change post successful treatment with radioiodine; Strahlen bleiben boese. Keine Aenderung der subjektiven Konzepte von Radioaktivitaet nach erfolgreicher Radioiodtherapie

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, L.S.; Mueller, S.P.; Beyer, T.; Bockisch, A. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin

    2009-07-01

    We assess the attitude of patients with thyroid disease towards radiation and radioactivity before and after radioiodine therapy by means of a cultural-anthropological approach. We evaluate in patient interviews how their subjective attitude towards radioactivity as an abstract term and towards radioactivity in the medical context on the basis of their personal experiences with radionuclide therapy. 29 patients with autonomously functioning thyroid lesions (17 women, 12 men, 35-79 years) were included in this study. All patients were interviewed prior to and 22-27 month post radioiodine therapy in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1: positive, 5: negative) to quantify their perception of radioactivity. The personal perception of radioactivity as an abstract term does not change significantly (p = 0.15) before and after radioiodine therapy. This perception is linked to mostly negative impressions of radiactivity. However, patients become more positive when assessing the value of radioactivity as part of their therapy regimen. Thus, we observe a significant increase in percepted value of radioactivity post radioiodine therapy (p = 0.03). Patients continue to view radioactivity as something negative despite treatment success following radioiodine therapy. Our results provide useful information for patient information by the nuclear medicine physician prior to a radioiodine therapy. (orig.)

  20. Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux - results and challenges.

    Science.gov (United States)

    Prakash, D; Campbell, B; Wajed, S

    2018-04-01

    Introduction Gastro-oesophageal reflux disease (GORD) is a common, chronic debilitating condition. Surgical management traditionally involves fundoplication. Magnetic sphincter augmentation (MSA) is a new definitive treatment. We describe our experience of introducing this innovative therapy into NHS practice and report the early clinical outcomes. Methods MSA was introduced into NHS practice following successful acceptance of a cost-effective business plan and close observation of National Institute for Health and Care Excellence (NICE) recommendations for new procedures, including a carefully planned prospective data collection over a two-year follow-up period. Results Forty-seven patients underwent MSA over the 40-month period. Reflux health-related quality of life (GERD-HRQL) was significantly improved after the procedure and maintained at one- and two-year (P business plan and compliance with NICE recommendations.

  1. Radioiodinated fatty acids for cardiological diagnosis

    International Nuclear Information System (INIS)

    Machulla, H.-J.; Knust, E.J.

    1986-01-01

    The development of fatty acids labelled with iodine-123 is reviewed. The variety of methods for producing 123 I and introducing radioiodine into the molecule is discussed and the important points of the biochemical background are recalled with the aim of finding a broad application for 123 I-labelled fatty acids. The results of the pharmacokinetic studies and biochemical analysis are presented as they prove that both 17- 123 I-heptadecanoic acid (IHA) and 15-(rho- 123 I-phenyl)pentadecanoic acid (IPPA) exhibit analogous behaviour to that of the naturally occurring fatty acids. Clinical applications demonstrated two fields of importance: (i) applications solely for imaging the heart and (ii) assessment of myocardial turnover rates of fatty acids for functional diagnosis. Moreover, very recent studies show that the provision of information about prognosis of myocardial diseases and the applied cardiological therapy appear to be possible. (author)

  2. Development of Graves' ophthalmopathy and uveitis after radioiodine therapy for Graves' disease in a patient with HTLA-I associated myelopathy (HAM)

    Energy Technology Data Exchange (ETDEWEB)

    Ozawa, Yasunori; Migita, Masayoshi; Watanabe, Tomoji; Okuda, Itsuko; Takeshita, Akira; Takagi, Akio; Shishiba, Yoshimasa (Toranomon Hospital, Tokyo (Japan))

    1994-09-01

    HTLV-I carriers or patients with HTLV-I associated myelopathy (HAM) are prone to immune-mediated inflammatory disorders. We present a 44-year-old female with HAM who developed Graves' disease. She developed severe Graves' ophthalmopathy shortly after [sup 131]I therapy, concurrently with a remarkable increase in TSH-receptor antibody titer. Ophthalmopathy was aggravated in spite of prednisolone therapy and euthyroidism being maintained by thyroxine replacement. Uveitis also developed after [sup 131]I therapy and iridocyclitis finally required trabeculotomy. This case suggests that HAM patients may have a higher risk of immune-mediated Graves' ophthalmopathy after [sup 131]I therapy.(author).

  3. Thyrotropin receptor antibody activities significantly correlate with the outcome of radioiodine ( sup 131 I) therapy for hyperthyroid Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Kaise, Kazuro; Kaise, Nobuko; Yoshida, Katsumi; Fukazawa, Hiroshi; Mori, Koki; Yamamoto, Makiko; Sakurada, Toshiro; Saito, Shintaro; Yoshinaga, Kaoru (Tohoku Univ., Sendai (Japan). School of Medicine)

    1991-08-01

    The outcome of {sup 131}I therapy for 109 patients with Graves' disease was analysed according to pretreatment laboratory data including thyrotropin receptor antibody (TRAb) activities. Forty-five percent of patients became euthyroid, and 13% of patients became hypothyroid within one year after {sup 131}I therapy. Forty-two percent of patients remained hyperthyroid one year after {sup 131}I therapy. Pretreatment values for serum T{sub 4}, T{sub 3}, and the estimated weight of the thyroid were significantly higher in the hyperthyroid group. The mean for the TRAb index of the hyperthyroid group was significantly higher than that of the euthyroid group. Life table analysis revealed a significant effect of the TRAb index on the rate of hyperthyroidism after 3 months or later. These results appear to suggest that the TRAb index is one of the factors which influence the outcome of {sup 131}I therapy for Graves' disease. (author).

  4. The use of virtual reality-based therapy to augment poststroke upper limb recovery

    Science.gov (United States)

    Samuel, Geoffrey S; Choo, Min; Chan, Wai Yin; Kok, Stanley; Ng, Yee Sien

    2015-01-01

    Stroke remains one of the major causes of disability worldwide. This case report illustrates the complementary use of biomechanical and kinematic in-game markers, in addition to standard clinical outcomes, to comprehensively assess and track a patient’s disabilities. A 65-year-old patient was admitted for right-sided weakness and clinically diagnosed with acute ischaemic stroke. She participated in a short trial of standard stroke occupational therapy and physiotherapy with additional daily virtual reality (VR)-based therapy. Outcomes were tracked using kinematic data and conventional clinical assessments. Her Functional Independence Measure score improved from 87 to 113 and Fugl-Meyer motor score improved from 56 to 62, denoting clinically significant improvement. Corresponding kinematic analysis revealed improved hand path ratios and a decrease in velocity peaks. Further research is being undertaken to elucidate the optimal type, timing, setting and duration of VR-based therapy, as well as the use of neuropharmacological adjuncts. PMID:26243983

  5. Augmenting breath regulation using a mobile driven virtual reality therapy framework.

    Science.gov (United States)

    Abushakra, Ahmad; Faezipour, Miad

    2014-05-01

    This paper presents a conceptual framework of a virtual reality therapy to assist individuals, especially lung cancer patients or those with breathing disorders to regulate their breath through real-time analysis of respiration movements using a smartphone. Virtual reality technology is an attractive means for medical simulations and treatment, particularly for patients with cancer. The theories, methodologies and approaches, and real-world dynamic contents for all the components of this virtual reality therapy (VRT) via a conceptual framework using the smartphone will be discussed. The architecture and technical aspects of the offshore platform of the virtual environment will also be presented.

  6. New prospects in radioiodine production technologies and radioiodination

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J [Magyar Tudomanyos Akademia, Budapest. Izotopintezete

    1984-01-01

    A new economical dry distillation procedure was developed to produce /sup 131/I or /sup 125/I from irradiated TeO/sub 2/ melt and xenon gas, respectively. The method can be applied to the thermodesorptive radioiodination of different types of water soluble or insoluble organic compounds: oleic acid, prostaglandin, insulin, ACTH, antipyrine. The labelling procedure is based on the thermolysis of the stable Pt(I) surface compound.

  7. "Combined Occlusion and Atropine Therapy" Versus "Augmented Part-Time Patching" in Children with Refractory/Residual Amblyopia: A Pilot Study.

    Science.gov (United States)

    Sachdeva, Virender; Mittal, Vaibhev; Gupta, Varun; Gunturu, Rekha; Kekunnaya, Ramesh; Chandrasekharan, Anjali; Chabblani, Preeti Patil; Rao, Harsha L

    2016-01-01

    To compare the efficacy of combined occlusion and atropine therapy (COAT) and augmented part-time patching for the treatment of unilateral refractory/residual amblyopia. This retrospective study evaluated children between 4 and 11 years with refractory/residual amblyopia who were treated with either additional atropine (COAT group) or increased hours of patching (augmented group). Data were collected on improvement in best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR] units) at each follow-up visit. There were 19 children in the COAT group and 17 children in the augmented group. The baseline BCVA of the amblyopic eye was 0.79 ± 0.36 logMAR in the COAT group and 0.72 ± 0.26 logMAR in augmented group. Children were statistically significantly younger in the COAT group (6.4 ± 2.2 years) compared to the augmented group (8.6 ± 3.3 years, P = 0.02). The mean duration of follow-up was statistically significantly longer in the augmented group (20.2 COAT group; 13.9 months augmented group) (P = 0.03). Compliance was similar in both groups. LogMAR BCVA (adjusted for difference in age and baseline BCVA) was statistically significantly better in the COAT group (0.56 ± 0.04) compared to the augmented group (0.80 ± 0.04) at 3 months (P = 0.000); 6 months (COAT group, 0.50 ± 0.04 vs. augmented group, 0.74 ± 0.04; P = 0.04) and at 1 year (COAT group, 0.42 ± 0.04 vs. augmented group, 0.67 ± 0.04, P = 0.000). There was statistically significantly greater improvement in logMAR BCVA at 6 months in COAT group (0.26 ± 0.15) compared to the augmented group (0.02 ± 0.14), (P = 0.0002). Age, gender, pretreatment BCVA, duration of follow-up, or compliance to patching did not affect improvement in BCVA. COAT may result in greater improvement in BCVA than augmented part-time patching in children with unilateral residual/refractory amblyopia.

  8. VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema

    Science.gov (United States)

    Yoon, Young-sup; Murayama, Toshinori; Gravereaux, Edwin; Tkebuchava, Tengiz; Silver, Marcy; Curry, Cynthia; Wecker, Andrea; Kirchmair, Rudolf; Hu, Chun Song; Kearney, Marianne; Ashare, Alan; Jackson, David G.; Kubo, Hajime; Isner, Jeffrey M.; Losordo, Douglas W.

    2003-01-01

    Although lymphedema is a common clinical condition, treatment for this disabling condition remains limited and largely ineffective. Recently, it has been reported that overexpression of VEGF-C correlates with increased lymphatic vessel growth (lymphangiogenesis). However, the effect of VEGF-C–induced lymphangiogenesis on lymphedema has yet to be demonstrated. Here we investigated the impact of local transfer of naked plasmid DNA encoding human VEGF-C (phVEGF-C) on two animal models of lymphedema: one in the rabbit ear and the other in the mouse tail. In a rabbit model, following local phVEGF-C gene transfer, VEGFR-3 expression was significantly increased. This gene transfer led to a decrease in thickness and volume of lymphedema, improvement of lymphatic function demonstrated by serial lymphoscintigraphy, and finally, attenuation of the fibrofatty changes of the skin, the final consequences of lymphedema. The favorable effect of phVEGF-C on lymphedema was reconfirmed in a mouse tail model. Immunohistochemical analysis using lymphatic-specific markers: VEGFR-3, lymphatic endothelial hyaluronan receptor-1, together with the proliferation marker Ki-67 Ab revealed that phVEGF-C transfection potently induced new lymphatic vessel growth. This study, we believe for the first time, documents that gene transfer of phVEGF-C resolves lymphedema through direct augmentation of lymphangiogenesis. This novel therapeutic strategy may merit clinical investigation in patients with lymphedema. PMID:12618526

  9. Periodontal Therapy in Dogs Using Bone Augmentation Products Marketed for Veterinary Use.

    Science.gov (United States)

    Angel, Molly

    Periodontal disease is extremely common in companion animal practice. Patients presenting for a routine oral examination and prophylaxis may be found to have extensive periodontal disease and attachment loss. Vertical bone loss is a known sequela to periodontal disease and commonly involves the distal root of the mandibular first molar. This case report outlines two dogs presenting for oral examination and prophylaxis with general anesthesia. Both patients did not have any clinical symptoms of periodontal disease other than halitosis. Both patients were diagnosed with three-walled vertical bone loss defects of one or both mandibular first molars utilizing dental radiography as well as periodontal probing, measuring, and direct visual inspection. These defects were consistent with periodontal disease index stage 4 (>50% attachment loss). The lesions were treated with appropriate root planing and debridement. Bone augmentation products readily available and marketed for veterinary use were then utilized to fill the defects to promote both the re-establishment of normal alveolar bone height and periodontal ligament reattachment to the treated surface. Follow-up assessment and owner dedication is critical to treatment outcome. Both patients' 6 mo follow-up examinations radiographically indicated bone repair and replacement with visible periodontal ligament space.

  10. Two-day thionamide withdrawal prior to radioiodine uptake sufficiently increases uptake and does not exacerbate hyperthyroidism compared to 7-day withdrawal in Graves' disease

    International Nuclear Information System (INIS)

    Kubota, Sumihisa; Ohye, Hidemi; Yano, Genichiro; Nishihara, Eijun; Kudo, Takumi; Ito, Mitsuru; Fukata, Shuji; Amino, Nobuyuki; Kuma, Kanji; Miyauchi, Akira

    2006-01-01

    The appropriate period of antithyroid drug (ATD) discontinuation before radioiodine therapy is the most critical problem in Graves' disease patients under going treatment with ATD. To determine the optimal period that does not alter the outcome of radioiodine therapy or exacerbate hyperthyroidism, we compared serum FT4 levels at radioiodine uptake (RAIU) and therapy outcomes between a 2-day withdrawal group and 7-day withdrawal group. We prospectively recruited 43 patients for the 2-day withdrawal protocol and retrospectively reviewed 49 patients treated with radioiodine following the protocol of 7-day withdrawal. There was no significant difference in RAIU between the 2 groups. The mean serum FT4 level measured on the first day of 24-h RAIU of the 7-day group was significantly higher than that in the 2-day group. There were no significant differences in the outcomes at each point (6 months, 1 year, and 2 years after therapy) between the 2 groups. Our results indicated that withdrawal of ATD for 2 days is superior to 7 days in that 2 days discontinuation did not exacerbate hyperthyroidism. In order to prevent serum thyroid hormone increase after ATD withdrawal and radioiodine therapy, a 2-day ATD withdrawal period before radioiodine therapy may be useful for high-risk patients such as the elderly and patients with cardiac complications. We believe that the 2-day ATD withdrawal method may be useful for patients undergoing treatment with ATD who are to undergo radioiodine therapy. (author)

  11. Induction of stimulating thyrotropin receptor antibodies after radioiodine therapy for toxic multinodular goitre and Graves' disease measured with a novel bioassay

    NARCIS (Netherlands)

    Hovens, Guido C.; Heemstra, Karen A.; Buiting, Antoinette M. J.; Stokkel, Marcel P.; Karperien, Marcel; Ballieux, Bart E.; Pereira, Alberto M.; Romijn, Johannes A.; Smit, Johannes W.

    2007-01-01

    Radioactive iodine therapy (RaI) in toxic multinodular goitre (TMNG) has been associated with the occurrence of Graves'-like hyperthyroidism. It has been postulated that pre-existing autoimmunity may contribute to this phenomenon. To study whether RaI induces thyrotropin receptor stimulating

  12. Biomechanical and histological effects of augmented soft tissue mobilization therapy on achilles tendinopathy in a rabbit model.

    Science.gov (United States)

    Imai, Kan; Ikoma, Kazuya; Chen, Qingshan; Zhao, Chunfeng; An, Kai-Nan; Gay, Ralph E

    2015-02-01

    Augmented soft tissue mobilization (ASTM) has been used to treat Achilles tendinopathy and is thought to promote collagen fiber realignment and hasten tendon regeneration. The objective of this study was to evaluate the biomechanical and histological effects of ASTM therapy on rabbit Achilles tendons after enzymatically induced injury. This study was a non-human bench controlled research study using a rabbit model. Both Achilles tendons of 12 rabbits were injected with collagenase to produce tendon injury simulating Achilles tendinopathy. One side was then randomly allocated to receive ASTM, while the other received no treatment (control). ASTM was performed on the Achilles tendon on postoperative days 21, 24, 28, 31, 35, and 38. Tendons were harvested 10 days after treatment and examined with dynamic viscoelasticity and light microscopy. Cross-sectional area in the treated tendons was significantly greater than in controls. Storage modulus tended to be lower in the treated tendons but elasticity was not significantly increased. Loss modulus was significantly lower in the treated tendons. There was no significant difference found in tangent delta (loss modulus/storage modulus). Microscopy of control tendons showed that the tendon fibers were wavy and type III collagen was well stained. The tendon fibers of the augmented soft tissue mobilization treated tendons were not wavy and type III collagen was not prevalent. Biomechanical and histological findings showed that the Achilles tendons treated with ASTM had better recovery of biomechanical function than did control tendons. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  13. Radioiodine-treatment (RIT) of functional thyroidal autonomy

    International Nuclear Information System (INIS)

    Meller, J.; Sahlmann, C.O.; Becker, W.

    2002-01-01

    Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

  14. Substrate reduction augments the efficacy of enzyme therapy in a mouse model of Fabry disease.

    Directory of Open Access Journals (Sweden)

    John Marshall

    Full Text Available Fabry disease is an X-linked glycosphingolipid storage disorder caused by a deficiency in the activity of the lysosomal hydrolase α-galactosidase A (α-gal. This deficiency results in accumulation of the glycosphingolipid globotriaosylceramide (GL-3 in lysosomes. Endothelial cell storage of GL-3 frequently leads to kidney dysfunction, cardiac and cerebrovascular disease. The current treatment for Fabry disease is through infusions of recombinant α-gal (enzyme-replacement therapy; ERT. Although ERT can markedly reduce the lysosomal burden of GL-3 in endothelial cells, variability is seen in the clearance from several other cell types. This suggests that alternative and adjuvant therapies may be desirable. Use of glucosylceramide synthase inhibitors to abate the biosynthesis of glycosphingolipids (substrate reduction therapy, SRT has been shown to be effective at reducing substrate levels in the related glycosphingolipidosis, Gaucher disease. Here, we show that such an inhibitor (eliglustat tartrate, Genz-112638 was effective at lowering GL-3 accumulation in a mouse model of Fabry disease. Relative efficacy of SRT and ERT at reducing GL-3 levels in Fabry mouse tissues differed with SRT being more effective in the kidney, and ERT more efficacious in the heart and liver. Combination therapy with ERT and SRT provided the most complete clearance of GL-3 from all the tissues. Furthermore, treatment normalized urine volume and uromodulin levels and significantly delayed the loss of a nociceptive response. The differential efficacies of SRT and ERT in the different tissues indicate that the combination approach is both additive and complementary suggesting the possibility of an improved therapeutic paradigm in the management of Fabry disease.

  15. Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: A randomized controlled trial.

    Science.gov (United States)

    Beidel, Deborah C; Frueh, B Christopher; Neer, Sandra M; Bowers, Clint A; Trachik, Benjamin; Uhde, Thomas W; Grubaugh, Anouk

    2017-08-23

    Virtual reality exposure therapy (VRET) realistically incorporates traumatic cues into exposure therapy and holds promise in the treatment of combat-related posttraumatic stress disorder (PTSD). In a randomized controlled trial of 92 Iraq and Afghanistan veterans and active duty military personnel with combat-related PTSD, we compared the efficacy of Trauma Management Therapy (TMT; VRET plus a group treatment for anger, depression, and social isolation) to VRET plus a psychoeducation control condition. Efficacy was evaluated at mid- and post-treatment, and at 3- and 6-month follow-up. Consistent with our hypothesis, VRET resulted in significant decreases on the Clinician Administered PTSD Scale and the PTSD Checklist-Military version for both groups. Also consistent with our hypothesis, significant decreases in social isolation occurred only for those participants who received the TMT group component. There were significant decreases for depression and anger for both groups, although these occurred after VRET and before group treatment. All treatment gains were maintained six-months later. Although not part of the original hypotheses, sleep was not improved by either intervention and remained problematic. The results support the use of VRET as an efficacious treatment for combat-related PTSD, but suggest that VRET alone does not result in optimal treatment outcomes across domains associated with PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Graves' disease in a 3 year-old patient with agranulocytosis due to anti-thyroid drugs: Radioiodine ablation therapy as an effective alternative.

    Science.gov (United States)

    Espinosa-Muñoz, E; Ramírez-Ocaña, D; Martín-García, A M; Ruiz-García, F J; Puentes-Zarzuela, C

    The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131 I ablation therapy. The relevance of the article is that Graves' disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131 I at this age, makes this case unique. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  17. Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression.

    Science.gov (United States)

    Abdollahi, Abbas; LeBouthillier, Daniel M; Najafi, Mahmoud; Asmundson, Gordon J G; Hosseinian, Simin; Shahidi, Shahriar; Carlbring, Per; Kalhori, Atefeh; Sadeghi, Hassan; Jalili, Marzieh

    2017-09-01

    Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals. In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment. Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group. No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear. The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Abnormal radioiodine uptake on post-therapy whole body scan and sodium/iodine symporter expression in a dermoid cyst of the ovary: report of a case and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Campenni, Alfredo; Baldari, Sergio, E-mail: acampenni@unime.ittalia [Dipartimento di Scienze Biomediche e delle Immagini Morfologiche e Funzionali, Unità di Medicina Nucleare, Università degli Studi di Messina, Messina (Italy); Giovinazzo, Salvatore; Ruggeri, Rosaria M. [Dipartimento di Medicina Clinica e Sperimentale, Unità di Endocrinologia, Università degli Studi di Messina (Italy); Tuccari, Giovanni [Dipartimento di Patologia Umana, Università degli Studi di Messina (Italy); Fogliani, Simone [Unità di Scienze Radiologiche, Ospedale di Milazzo, Messina (Italy)

    2015-08-15

    In patients affected by differentiated thyroid cancer, the whole-body scan (WBS) with 131-radioiodine, especially when performed after a therapeutic activity of {sup 131}I, represents a sensitive procedure for detecting thyroid remnant and/or metastatic disease. Nevertheless, a wide spectrum of potentially pitfalls has been reported. Herein we describe a 63-year-old woman affected by follicular thyroid cancer, who was accidentally found to have an abdominal mass at post-dose WBS (pWBS). pWBS showed abnormal radioiodine uptake in the upper mediastinum, consistent with lymph-node metastases, and a slight radioiodine uptake in an abdominal focal area. Computed tomography revealed an inhomogeneous mass in the pelvis, previously unrecognized. The lesion, surgically removed, was found to be a typical dermoid cyst of the ovary, without any evidence of thyroid tissue. By immunohistochemistry, a moderate expression of the sodium-iodine symporter (NIS) was demonstrated in the epithelial cells, suggesting a NIS-dependent uptake of radioiodine by the cyst. (author)

  19. Recombinant human thyrotropin prior to radioiodine therapy improves the size reduction of non-toxic nodular goiter: a prospective randomized double-blinded trial

    International Nuclear Information System (INIS)

    E Nielsen, Viveque; Bonnema, Steen; Hegedues, Laszlo; Grupe, Peter; Boel-Joergensen, Henrik

    2005-01-01

    Full text: Background: rh TSH increases the thyroid 131 I uptake (RAIU) and may have a role in the context of 131 I therapy of goiter. No placebo-controlled trial has yet been performed. Methods: In a double-blinded trial, 57 patients with nodular nontoxic goiter (51 F, 6 M) were randomized to receive either 0.3 mg rh TSH (n=28) or placebo (n=29) 24 h before 131 I. The thyroid dose was calculated based on thyroid size (measured by ultrasound) and RAUI at 24 h and 96 h. Thyroid size and function and patient satisfaction were monitored for 12 months. Results: At baseline the median goiter volume was 51 ml (range: 20-99 ml) in the placebo group and 59 ml (25-92 ml) in the rh TSH group (p=0.75). Three months after 131 I the goiter size was reduced to 38 ml (15-78 ml) and 43 ml (20-75 ml) in the two groups, respectively (p=0.001 within groups, p=0.96 between groups). At 12 months, the corresponding figures were 27 ml (15-82 ml) and 20 ml (6-59 ml); p=0.001 within groups compared with baseline, p=0.12 between groups. The relative goiter reduction at this time was 46 ± 22% in the placebo group, and 61 ± 15% in the rh TSH group (p=0.004). In addition to the influence of rh TSH, the magnitude of the goiter reduction correlated inversely with the initial goiter volume (p=0.019), whereas no significant correlation was found with the RAIU during therapy or with the absorbed thyroid dose. Discomfort during 131 I was reported by 10 patients in the placebo group and by 15 patients in the rh TSH group (p=0.12). Permanent hypothyroidism developed in 12% in the placebo group and in 52% in the rh TSH group (p=0.005). Patient satisfaction was generally very high without any major within group difference. Conclusion: In the first placebo-controlled double-blinded trial, we found that rh TSH prior to 131 I -therapy significantly improves thyroid size reduction by 33%, with a four-fold higher rate of hypothyroidism. These effects are, at least partially, mediated through other

  20. Thyroid remnant ablation using 1,110 MBq of I-131 after total thyroidectomy. Regulatory considerations on release of patients after unsealed radioiodine therapy

    International Nuclear Information System (INIS)

    Kusakabe, Kiyoko; Yokoyama, Kunihiko; Ito, Koichi

    2012-01-01

    This study was undertaken to measure the radiation exposure level of caregivers following outpatient NaI (I-131) 1,110 MBq therapy for remnant thyroid ablation after total thyroidectomy in patients with differentiated thyroid cancer, and to evaluate the influence of activities of daily living on radiation exposure level, with the goal of proposing an optimum method of I-131 therapy. The study included 37 patients with differentiated thyroid cancer, who had undergone total thyroidectomy and received outpatient based remnant thyroid ablation using NaI (I-131) 1,110 MBq, who were satisfying the following requirements: patients who have no evidence of distant metastases, whose living environments were appropriate for outpatient I-131 (1,110 MBq) therapy, and patients who gave written informed consent. The dose rate at a distance of 1 m from the body surface of the patient at the moment of release was measured using survey meters of the GM type or ionization chamber type. The dose level for the caregiver was measured with a personal dosimeter in all cases. The dose rate at a distance of 1 m from the patient's body surface 1 h after I-131 administration was in the range of 29-115 μSv/h (mean 63.8 μSv/h). The 7-day cumulative effective dose of caregivers was 0.11±0.08 mSv, on an average, in 34 dosimeters. In 31 of 34 dosimeters, cumulative effective dose of caregivers was below 0.2 mSv. Dose levels exceeding 0.2 mSv were recorded in 3 cases (0.21, 0.35 and 0.43 mSv in one case each). These results suggest that the exposure level of family members (caregiver and others) was minimal and is lower than the radiation levels affecting human environments. Outpatient-based remnant thyroid ablation with I-131 (1,110 MBq) performed after total thyroidectomy in patients with differentiated thyroid cancer is safe if applied in accordance with the appropriate supervision and guidance by experts with certain qualifications. (author)

  1. EFFECTS OF HOMEWORK COMPLIANCE ON COGNITIVE-BEHAVIORAL THERAPY WITH D-CYCLOSERINE AUGMENTATION FOR CHILDREN WITH OBSESSIVE COMPULSIVE DISORDER.

    Science.gov (United States)

    Olatunji, Bunmi O; Rosenfield, David; Monzani, Benedetta; Krebs, Georgina; Heyman, Isobel; Turner, Cynthia; Isomura, Kayoko; Mataix-Cols, David

    2015-12-01

    The present study examined the effects of homework compliance on outcome from cognitive behavioral therapy (CBT) for children with obsessive-compulsive disorder (OCD) and the extent to which these effects differ as a function of augmentation of CBT with D-cycloserine (DCS). Twenty-seven youth with OCD were randomized to either 50 mg DCS or placebo (PBO) administered immediately after each of 10 CBT sessions, primarily consisting of exposure and ritual prevention (ERP). Independent evaluators assessed OCD severity using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) at the start of each session. Compliance with between-session ERP assignments was also assessed at the start of each session using the Patient ERP Adherence Scale (PEAS). Greater homework compliance between the previous session and the current session was related to lower CY-BOCS at the current session. However, the relation between homework compliance and CY-BOCS varied by treatment condition. Higher homework compliance was related to lower CY-BOCS for participants in the DCS condition, but not for participants in the PBO condition. Furthermore, participants receiving DCS were estimated to have significantly lower CY-BOCS than those given PBO among those with the highest levels of homework compliance. DCS may more effectively facilitate the effects of CBT for youth with OCD when patients are compliant with prescribed homework. Theoretical and clinical implications are discussed. © 2015 Wiley Periodicals, Inc.

  2. Task-Based Mirror Therapy Augmenting Motor Recovery in Poststroke Hemiparesis: A Randomized Controlled Trial.

    Science.gov (United States)

    Arya, Kamal Narayan; Pandian, Shanta; Kumar, Dharmendra; Puri, Vinod

    2015-08-01

    To establish the effect of the task-based mirror therapy (TBMT) on the upper limb recovery in stroke. A pilot, randomized, controlled, assessor-blinded trial was conducted in a rehabilitation institute. A convenience sample of 33 poststroke (mean duration, 12.5 months) hemiparetic subjects was randomized into 2 groups (experimental, 17; control, 16). The subjects were allocated to receive either TBMT or standard motor rehabilitation-40 sessions (5/week) for a period of 8 weeks. The TBMT group received movements using various goal-directed tasks and a mirror box. The movements were performed by the less-affected side superimposed on the affected side. The main outcome measures were Brunnstrom recovery stage (BRS) and Fugl-Meyer assessment (FMA)-FMA of upper extremity (FMA-UE), including upper arm (FMA-UA) and wrist-hand (FMA-WH). The TBMT group exhibited highly significant improvement on mean scores of FMA-WH (P hemiparesis. MT using tasks may be used as an adjunct in stroke rehabilitation. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Can pill placebo augment cognitive-behavior therapy for panic disorder?

    Directory of Open Access Journals (Sweden)

    Churchill Rachel

    2007-12-01

    Full Text Available Abstract Background In a number of drug and psychotherapy comparative trials, psychotherapy-placebo combination has been assumed to represent psychotherapy. Whether psychotherapy plus pill placebo is the same as psychotherapy alone is an empirical question which however has to date never been examined systematically. Methods We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs that directly compared cognitive-behavior therapy (CBT alone against CBT plus pill placebo in the treatment of panic disorder. Results Extensive literature search was able to identify three relevant RCTs. At the end of the acute phase treatment, patients who received CBT plus placebo had 26% (95%CI: 2 to 55% increased chances of responding than those who received CBT alone. At follow-up the difference was no longer statistically significant (22%, 95%CI: -10% to 64%. Conclusion The act of taking a pill placebo may enhance the placebo effect already contained in the effective psychotherapeutic intervention during the acute phase treatment. Theoretically this is an argument against the recently claimed null hypothesis of placebo effect in general and clinically it may point to some further room for enhancing the psychotherapeutic approach for panic disorder.

  4. Augmented Feedback System to Support Physical Therapy of Non-specific Low Back Pain

    Science.gov (United States)

    Brodbeck, Dominique; Degen, Markus; Stanimirov, Michael; Kool, Jan; Scheermesser, Mandy; Oesch, Peter; Neuhaus, Cornelia

    Low back pain is an important problem in industrialized countries. Two key factors limit the effectiveness of physiotherapy: low compliance of patients with repetitive movement exercises, and inadequate awareness of patients of their own posture. The Backtrainer system addresses these problems by real-time monitoring of the spine position, by providing a framework for most common physiotherapy exercises for the low back, and by providing feedback to patients in a motivating way. A minimal sensor configuration was identified as two inertial sensors that measure the orientation of the lower back at two points with three degrees of freedom. The software was designed as a flexible platform to experiment with different hardware, and with various feedback modalities. Basic exercises for two types of movements are provided: mobilizing and stabilizing. We developed visual feedback - abstract as well as in the form of a virtual reality game - and complemented the on-screen graphics with an ambient feedback device. The system was evaluated during five weeks in a rehabilitation clinic with 26 patients and 15 physiotherapists. Subjective satisfaction of subjects was good, and we interpret the results as encouraging indication for the adoption of such a therapy support system by both patients and therapists.

  5. Exercise Therapy Augments the Ischemia-Induced Proangiogenic State and Results in Sustained Improvement after Stroke

    Directory of Open Access Journals (Sweden)

    Man He

    2013-04-01

    Full Text Available The induction of angiogenesis will stimulate endogenous recovery mechanisms, which are involved in the long-term repair and restoration process of the brain after an ischemic event. Here, we tested whether exercise influences the pro-angiogenic factors and outcomes after cerebral infarction in rats. Wistar rats were exposed to two hours of middle-cerebral artery occlusion and reperfusion. Different durations of treadmill training were performed on the rats. The expression of matrix metalloproteinase 2 (MMP2 and vascular endothelial growth factor (VEGF-related genes and proteins were higher over time post-ischemia, and exercise enhanced their expression. Sixteen days post-ischemia, the regional cerebral blood flow in the ischemic striatum was significantly increased in the running group over the sedentary. Although no difference was seen in infarct size between the running and sedentary groups, running evidently improved the neurobehavioral score. The effects of running on MMP2 expression, regional cerebral blood flow and outcome were abolished when animals were treated with bevacizumab (BEV, a VEGF-targeting antibody. Exercise therapy improves long-term stroke outcome by MMP2-VEGF-dependent mechanisms related to improved cerebral blood flow.

  6. Optimization of Inpatient Management of Radioiodine Treatment in Korea

    International Nuclear Information System (INIS)

    Park, Min Jae; Kim, Jung Hyun; Jeong, Jae Min; Lee, Dong Soo; Jang, Jung Chan; Kim, Chang Ho

    2008-01-01

    We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after long term retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer

  7. Dry Distillation of Radioiodine from TeO2 Targets

    Directory of Open Access Journals (Sweden)

    Jacek Koziorowski

    2013-10-01

    Full Text Available As medical cyclotrons are becoming more abundant, 123I and 124I are getting more attention as alternatives to 131I for diagnostics of thyroid disease. Both 123I and 124I provide better diagnostics, deliver less dose to patients and both reduce the risk of thyroid stunning, facilitating subsequent therapy. Dry distillation of radioiodine from tellurium dioxide targets has become the standard approach to producing these radioiodines. Setting up such a production of radioiodine is associated with a lengthy optimization of the process and for this purpose natural tellurium is often used for economical reasons. In this paper, the distillation parameters are scrutinized to ensure optimal distillation temperature, in order to minimize time spent and prevent loss of expensive target material. It is further demonstrated how the individual iodine isotopes, produced from proton bombardment of natTe, will diffuse out of the target in a time dependent ratio. We believe the effect is due to the isotopes having their maximum cross section at different energies. The individual isotopes produced will thus have their highest concentration at different depths in the target. This results in individual mean diffusion lengths and diffusion times for the different isotopes.

  8. Running for extinction? Aerobic exercise as an augmentation of exposure therapy in panic disorder with agoraphobia.

    Science.gov (United States)

    Bischoff, Sophie; Wieder, Gesine; Einsle, Franziska; Petzold, Moritz B; Janßen, Christiane; Mumm, Jennifer L M; Wittchen, Hans-Ulrich; Fydrich, Thomas; Plag, Jens; Ströhle, Andreas

    2018-06-01

    Exposure-based Cognitive Behavioral Therapy (eb-CBT) represents the most evidence-based psychotherapeutic approach in anxiety disorders. However, its efficacy may be limited by a delay in onset of action and a substantial number of patients does not respond sufficiently to treatment. In this context, aerobic exercise was found to be effective in reducing clinical anxiety as well as to improve (elements of) disorder-specific CBT in some mental disorders. We therefore investigated the effect of aerobic exercise supplementary to an eb-CBT in panic disorder and agoraphobia (PD/AG). 77 patients with PD/AG performed a 30 min treadmill task with moderate or low intensity (70% or 30% of the maximal oxygen uptake [VO 2max ]) prior to five exposure sessions within a standardized seven-week CBT. At baseline, after completing the treatment period (post) and six month after post (follow-up), several measures of (un)specific psychopathology (Hamilton Anxiety Rating Scale [Ham-A], Mobility Inventory [MI], Panic and Agoraphobia Scale [PAS], Agoraphobic Cognitions Questionnaire [ACQ], Body Sensations Questionnaire [BSQ]) were established to assess for clinical changes. All patients experienced a significant improvement of symptoms from baseline to post (for all measures p < .001) but repeated-measures analyses of variance found a trend towards a significant time × group interaction in the Ham-A in favor for the moderate intense exercise group (f[1, 74] = 4.15, p = .045, α=.025). This trend, however, disappeared at follow-up since the low-intense exercise group further improved significantly in Ham-A after post. Our findings therefore might point to an accelerating effect of moderate-intense exercise within an exposure-based CBT for AG/PD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Nicotinamide augments the survival and incidence of apoptosis in glioma cells following photodynamic therapy in vitro

    Science.gov (United States)

    Bisland, Stuart K.; Modi, Nayan; Wilson, Brian C.

    2004-10-01

    The ability to customize photodynamic therapy (PDT) parameters with regards to timing and dosing of administered drug and light can be beneficial in determining target specificity and mode of cell death. Sustained, low level PDT or metronomic PDT (mPDT) may afford enhanced apoptotic cell death. This is of particular importance when considering PDT for the treatment of brain tumors as unlike apoptosis, necrotic cell death often leads to inflammation with increased intracranial pressure. The ability, therefore, to 'fine tune' PDT in favour of apoptosis is paramount. We have studied both acute (one time treatment) PDT (aPDT) and mPDT delivery strategies in combination with nicotinamide (NA) in an attempt to maximize the number of tumor cells dieing by apoptosis. Using several different glioma cell lines (9L, U87-MG and CNS-1) we now confirm that NA provides a dose-dependent (0.1-0.5 mM) increase in apoptotic cells following d-aminolevulinic acid-mediated aPDT or mPDT. Furthermore, using the 9L cell line stably transfected with the luciferase gene, NA was shown to delay the depletion of bioluminscence signal in aPDT and mPDT treated cells, inferring that adenosine triphosphate levels are maintained for longer following NA treatment. NA has previously been reported as promoting neuronal and vascular cell survival in normal brain following a number of neurological insults in which reactive oxygen species are implicated including, stroke, Alzheimer's disease and toxin-induced lesions. It is likely that the effects of NA reflect its capacity as an antioxidant as well as its ability to inhibit poly (adenosine diphosphate-ribose) polymerase-mediated depletion of ATP. Our results indicate that NA may prove therapeutically advantageous when used in combination with PDT treatment of brain tumors.

  10. Cognitive Behavior Therapy as Augmentation for Sertraline in Treating Patients with Persistent Postural-Perceptual Dizziness.

    Science.gov (United States)

    Yu, Yi-Chuan; Xue, Hui; Zhang, Ying-Xin; Zhou, Jiying

    2018-01-01

    Persistent postural-perceptual dizziness (PPPD) is a common vestibular disorder. This study was conducted to assess whether the addition of cognitive behavior therapy (CBT) could significantly improve the efficacy and acceptability of sertraline in treating PPPD. PPPD patients were recruited and randomly assigned to control and experiment groups. Patients in both groups received sertraline 50-200 mg/day, and only patients in the experiment group received CBT (twice a week, one hour per time). The treatment was continued for eight weeks. At baseline, week 2, week 4, and week 8, the 25-item Dizziness Handicap Inventory (DHI), Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS) were used to assess the self-perceived handicapping effects caused by PPPD, anxiety, and depressive symptoms, respectively. The dose of sertraline used and the adverse events in both groups were recorded and analyzed. In total, 91 PPPD patients were randomly assigned to the control group ( n = 45) and experiment group ( n = 46). After eight weeks of treatment, the average DHI scores, HDRS scores, and HARS scores were significantly decreased in both groups. But compared to the control group, the experiment group had significantly lower average DHI score, HDRS score, and HARS score at weeks 4 and 8. Moreover, the dose of sertraline used in the experiment group was significantly lower than that in the control group, and adverse events occurred more frequently in the control group than in the experiment group (48.9% versus 26.1%, p = 0.025). These results demonstrated that the addition of CBT could significantly improve the efficacy and acceptability of sertraline in treating PPPD and reduce the dose of sertraline used.

  11. Cognitive Behavior Therapy as Augmentation for Sertraline in Treating Patients with Persistent Postural-Perceptual Dizziness

    Directory of Open Access Journals (Sweden)

    Yi-Chuan Yu

    2018-01-01

    Full Text Available Background. Persistent postural-perceptual dizziness (PPPD is a common vestibular disorder. This study was conducted to assess whether the addition of cognitive behavior therapy (CBT could significantly improve the efficacy and acceptability of sertraline in treating PPPD. Methods. PPPD patients were recruited and randomly assigned to control and experiment groups. Patients in both groups received sertraline 50–200 mg/day, and only patients in the experiment group received CBT (twice a week, one hour per time. The treatment was continued for eight weeks. At baseline, week 2, week 4, and week 8, the 25-item Dizziness Handicap Inventory (DHI, Hamilton Anxiety Rating Scale (HARS, and Hamilton Depression Rating Scale (HDRS were used to assess the self-perceived handicapping effects caused by PPPD, anxiety, and depressive symptoms, respectively. The dose of sertraline used and the adverse events in both groups were recorded and analyzed. Results. In total, 91 PPPD patients were randomly assigned to the control group n=45 and experiment group n=46. After eight weeks of treatment, the average DHI scores, HDRS scores, and HARS scores were significantly decreased in both groups. But compared to the control group, the experiment group had significantly lower average DHI score, HDRS score, and HARS score at weeks 4 and 8. Moreover, the dose of sertraline used in the experiment group was significantly lower than that in the control group, and adverse events occurred more frequently in the control group than in the experiment group (48.9% versus 26.1%, p=0.025. Conclusion. These results demonstrated that the addition of CBT could significantly improve the efficacy and acceptability of sertraline in treating PPPD and reduce the dose of sertraline used.

  12. Influence of antithyroid medication on effective half-life and uptake of {sup 131}I following radioiodine therapy; Einfluss thyreostatischer Medikation beim Morbus Basedow auf die Kinetik von 131-Iod waehrend einer Radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Moka, D.; Voth, E.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    1997-12-01

    Aim of this study was to assess the influence of antithyroid drugs (ADT) on the kinetics of {sup 131}I. Therefore, 56 patients with Graves` disease and with shortened effective half-life of {sup 131}I were examined under stationary conditionary conditions. In 38 patients ATD was stopped three days after radioiodine therapy (RIT). The progress of the first RIT and of a second RIT, which still was necessary in 12 patients, was compared to 18 patients receiving ATD continuously. Values of effective half-life for {sup 131}I rose significantly from 3.4 to 5.7 days 2-3 days after stopping ATD. There was an increase of the {sup 131}I-uptake of a second RIT after stopping ATD from 29.0 to 38.4%. In contrast, {sup 131}I-uptake of a second RIT decreased significantly in patients receiving ATD continuously. Effective half-life and uptake of {sup 131}I were affected significantly by ATD. Interrupting ATD after RIT is useful to improve an apparantly insufficient RIT in thyrotoxic patients receiving ATD. (orig.) [Deutsch] Ziel dieser Studie war es, beim M. Basedow die Kinetik von {sup 131}I unter dem Einfluss thyreostatischer Medikation (tM) zu untersuchen. Dazu wurden die 56 Patienten mit immunogener Hyperthyreose M. Basedow (MB) und mit einem erhoehten `turn over` von {sup 131}I unter tM untersucht. Bei 38 Patienten wurde die tM am 3. Tag nach RITh abgesetzt. Der Verlauf der 1. RITh bzw. einer Nachtherapie wurde mit 18 Patienten unter fortlaufender tM verglichen. 2-3 Tage nach Absetzen der tM stieg die effektive Halbwertzeit (HWZ{sub eff.}) von {sup 131}I signifikant von 3,4 auf 5,7 Tage und der {sup 131}I-Uptake bei der Nachtherapie von 29,0 auf 38,4% an, waehrend er unter fortlaufender tM signifikant abfiel. Beide Effekte zeigen, dass tM die {sup 131}I-Kinetik der Schilddruese sehr schnell beeinflussen kann. Gezieltes Absetzen der tM eignet sich deshalb, um bei ausgewaehlten Patienten eine primaer unzureichende RITh noch waehrend des stationaeren Aufenthaltes zu steuern und

  13. BRAF V600E mutation in papillary thyroid cancer and its effect on postoperative radioiodine (131I) therapy: Should we modify our therapeutic strategy?

    Science.gov (United States)

    Domínguez Ayala, Maite; Expósito Rodríguez, Amaia; Bilbao González, Amaia; Mínguez Gabiña, Pablo; Gutiérrez Rodríguez, Teresa; Rodeño Ortiz de Zarate, Emilia; García Carrillo, Maitane; Barrios Treviño, Borja

    2018-03-19

    The BRAF V600E mutation in papillary thyroid cancer (PTC) has been associated with resistance to 131 I. Our aim was to quantify the response to 131 I after surgery in patients who had the mutation (BRAF+) and those who did not have the mutated gene (BRAF-). A prospective cohort study was designed, from September 2015 to February 2016, which included patients with PTC receiving therapy after surgical treatment. Variables were described for age, gender, histology, tumor stage, thyroglobulin values before, 48h after and 6months after 131 I; absorbed dose and % activity on days 2 and 7 and elimination time. 41 patients giving in total 67 thyroid remnants were included. 61% were BRAF+. In stagesiii and iv, 80% were BRAF+. In lateral resection, 100% were BRAF+. The number of nodes was higher in BRAF+: 3.4 vs 1.2 (P=.01). The classic variant was predominant in BRAF+ (91.7% vs 8.3%, P=.03). 85.7% vs 14.3% of BRAF+ had desmoplastic reaction (P=.02). The BRAF+ had a lower absorbed dose than the administered activity (5.4Gy/MBq vs 20Gy/MBq, P=.02); lower% activity with respect to the unit of mass at 2 (0.046%/g vs 0.103%/g, P=.02) and at 7days (0.006%/gr vs 0.034%/gr, P=.04) CONCLUSIONS: The mutation of the BRAF V600E gene is related with greater resistance to postoperative treatment with 131 I since the onset of the disease. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Variants and pitfalls on radioiodine scans in pediatric patients with differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mostafa, Mohamed; Vali, Reza; Chan, Jeffrey; Omarkhail, Yusuaf; Shammas, Amer [University of Toronto, Nuclear Medicine Division, Department of Medical Imaging, The Hospital for Sick Children, Toronto, Ontario (Canada)

    2016-10-15

    Potentially false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma can mimic functioning thyroid tissue and functioning thyroid carcinomatous tissue. Such false-positive findings comprise variants and pitfalls that can vary slightly in children as compared with adults. To determine the patterns and frequency of these potential false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma. We reviewed a total of 223 radioiodine scans from 53 pediatric patients (mean age 13.3 years, 37 girls) with differentiated thyroid carcinoma. Focal or regional activity that likely did not represent functioning thyroid tissue or functioning thyroid carcinomatous tissue were categorized as variants or pitfalls. The final diagnosis was confirmed by reviewing the concurrent and follow-up clinical data, correlative ultrasonography, CT scanning, serum thyroglobulin and antithyroglobulin antibody levels. We calculated the frequency of these variants and pitfalls from diagnostic and post-therapy radioiodine scans. The most common variant on the radioiodine scans was the thymic activity (24/223, 10.8%) followed by the cardiac activity (8/223, 3.6%). Salivary contamination and star artifact, caused by prominent thyroid remnant, were the most important observed pitfalls. Variants and pitfalls that mimic functioning thyroid tissue or functioning thyroid carcinomatous tissue on radioiodine scan in children with differentiated thyroid carcinoma are not infrequent, but they decrease in frequency on successive radioiodine scans. Potential false-positive findings can be minimized with proper knowledge of the common variants and pitfalls in children and correlation with clinical, laboratory and imaging data. (orig.)

  15. Radioiodine uptake in inactive pulmonary tuberculosis

    International Nuclear Information System (INIS)

    Bakheet, S.M.; Powe, J.; Al Suhaibani, H.; Hammami, M.M.; Bazarbashi, M.

    1999-01-01

    Radioiodine may accumulate at sites of inflammation or infection. We have seen such accumulation in six thyroid cancer patients with a history of previously treated pulmonary tuberculosis. We also review the causes of false-positive radioiodine uptake in lung infection/inflammation. Eight foci of radioiodine uptake were seen on six iodine-123 diagnostic scans. In three foci, the uptake was focal and indistinguishable from thyroid cancer pulmonary metastases from thyroid cancer. In the remaining foci, the uptake appeared nonsegmental, linear or lobar, suggesting a false-positive finding. The uptake was unchanged, variable in appearance or non-persistent on follow-up scans and less extensive than the fibrocystic changes seen on chest radiographs. In the two patients studied, thyroid hormone level did not affect the radioiodine lung uptake and there was congruent gallium-67 uptake. None of the patients had any evidence of thyroid cancer recurrence or of reactivation of tuberculosis and only two patients had chronic intermittent chest symptoms. Severe bronchiectasis, active tuberculosis, acute bronchitis, respiratory bronchiolitis, rheumatoid arthritis-associated lung disease and fungal infection such as Allescheria boydii and aspergillosis can lead to different patterns of radioiodine chest uptake mimicking pulmonary metastases. Pulmonary scarring secondary to tuberculosis may predispose to localized radioiodine accumulation even in the absence of clinically evident active infection. False-positive radioiodine uptake due to pulmonary infection/inflammation should be considered in thyroid cancer patients prior to the diagnosis of pulmonary metastases. (orig.)

  16. Focal Bronchiectasis Causing Abnormal Pulmonary Radioiodine Uptake in a Patient with Well-Differentiated Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Ash Gargya

    2012-01-01

    Full Text Available Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions. Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an undetectable stimulated serum thyroglobulin in the absence of interfering thyroglobulin antibodies. Contrast-enhanced chest computed tomography has confirmed that the abnormal pulmonary radioiodine uptake correlates with focal bronchiectasis. Summary. Bronchiectasis can cause abnormal chest radioactive iodine uptake in the followup of differentiated thyroid carcinoma. Conclusions. Recognition of potential false-positive chest radioactive iodine uptake, simulating pulmonary metastases, is needed to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine.

  17. Radioiodine in the Savannah River Site environment

    Energy Technology Data Exchange (ETDEWEB)

    Kantelo, M.V.; Bauer, L.R.; Marter, W.L.; Murphy, C.E. Jr.; Zeigler, C.C.

    1993-01-15

    Radioiodine, which is the collective term for all radioactive isotopes of the element iodine, is formed at the Savannah River Site (SRS) principally as a by-product of nuclear reactor operations. Part of the radioiodine is released to the environment during reactor and reprocessing operations at the site. The purpose of this report is to provide an introduction to radioiodine production and disposition, its status in the environment, and the radiation dose and health risks as a consequence of its release to the environment around the Savannah River Plant. A rigorous dose reconstruction study is to be completed by thee Center for Disease Control during the 1990s.

  18. Radioiodine in the Savannah River Site environment

    International Nuclear Information System (INIS)

    Kantelo, M.V.; Bauer, L.R.; Marter, W.L.; Murphy, C.E. Jr.; Zeigler, C.C.

    1993-01-01

    Radioiodine, which is the collective term for all radioactive isotopes of the element iodine, is formed at the Savannah River Site (SRS) principally as a by-product of nuclear reactor operations. Part of the radioiodine is released to the environment during reactor and reprocessing operations at the site. The purpose of this report is to provide an introduction to radioiodine production and disposition, its status in the environment, and the radiation dose and health risks as a consequence of its release to the environment around the Savannah River Plant. A rigorous dose reconstruction study is to be completed by thee Center for Disease Control during the 1990s

  19. Radioiodine uptake by plants from soils

    International Nuclear Information System (INIS)

    Sabova, T.

    1976-01-01

    The uptake and accumulation of radioiodine by wheat, maize and peas from various types of soil have been studied. The uptake depends on the type of soil, on its content of organic matter and on the amount of fertilizer. Radioiodine is mainly accumulated in the roots. Accumulation in above-ground plant parts decreases in the following order: wheat, maize, peas. Uptake was highest from humus and clay soils and lowest from black and meadow soils. Application of chloride fertilizer or carrier iodine lead to an increase of radioiodine uptake in the whole plant. (author)

  20. Nationwide trends in surgery and radioiodine treatment for benign thyroid disease during iodization of salt

    DEFF Research Database (Denmark)

    Cerqueira, C.; Knudsen, N.; Ovesen, L.

    2010-01-01

    Objective: Iodization of salt was introduced in Denmark in 1998 because of mild-to-moderate iodine deficiency (ID). The aim of this study was to analyze the utilization rate of surgery and radioiodine therapy for benign thyroid disorders before and after the introduction of iodization, and to stu...

  1. Augmented postcard

    OpenAIRE

    Bernik , Aleš

    2012-01-01

    The aim of this thesis is the examination of augmented reality technology, which allows us mixing real and virtual elements. Augmented reality is a relatively new technology which is becoming more widespread, thanks to a fairly reasonable price of smart phones. Here we presents the types of augmented reality, the necessary technology and their advantages and disadvantages, its current use in applications, and software for building augmented reality applications. The thesis is mainly focuse...

  2. Detection of radioiodine-induced cytogenetic alterations in circulating lymphocytes of thyroid patients

    Energy Technology Data Exchange (ETDEWEB)

    Kasuba, V [Inst. for Medical Recearch and Occupational Health, Zagreb (Croatia). Laboratory for Mutagenesis; Konrady, A; Koeteles, G J [Frederic Joliot-Curie National Research Institute for Radiobiology and Radiohygiene, Budapest (Hungary); Kusic, Z [Clinical Hospital Sestre Milosrdnice, Zagreb (Croatia). Dept. of Oncology and Nuclear Medicine

    1994-10-01

    Radioiodines are often used for experimental purposes and for diagnosis and therapy in clinical practice. Human population might also be exposed to radioiodines in nuclear accidents. The ionizing energy of radioiodine affects not only the thyroid where it concentrates but also other tissues, especially the lymphocytes during their circulation through and around the gland containing the radioisotopes. Therefore, it seemed to be of interest to carry out investigations concerning the cytogenetic alterations in blood lymphocytes of patients treated with iodine-131. The method of choice was the relatively easily performable micronucleus assay in cytokinesis-blocked cultures of human peripheral lymphocytes. The test was performed on blood samples of 30 patients before the radioisotope treatment and one, two and four days after, one as well as 6 and - in a few cases - 12 weeks later. The amounts of iodine-131 injected were dependent on the clinical practices to reach the therapeutic radiation doses for hyperthyroidism and adenomas and were in the range of 220 and 5180 MBq. it was observed that the micronucleus frequency increased in the treated hyperthyroid patients while in patients with toxic adenomas the radioiodine did not result in an increase or even as compared to the pretreatment values in a few cases decreased values were seen. The results suggest individual differences in radiosensitivity as well as that the frequency of cytogenetic alterations depend on the physiological or pathological conditions of the thyroid. The significance of this observation will be discussed for dose assessments by cytogenetic techniques due to internal radioiodine. (author).

  3. Personalized Medicine Based on Theranostic Radioiodine Molecular Imaging for Differentiated Thyroid Cancer.

    Science.gov (United States)

    Ahn, Byeong-Cheol

    2016-01-01

    Molecular imaging based personalized therapy has been a fascinating concept for individualized therapeutic strategy, which is able to attain the highest efficacy and reduce adverse effects in certain patients. Theranostics, which integrates diagnostic testing to detect molecular targets for particular therapeutic modalities, is one of the key technologies that contribute to the success of personalized medicine. Although the term "theranostics" was used after the second millennium, its basic principle was applied more than 70 years ago in the field of thyroidology with radioiodine molecular imaging. Differentiated thyroid cancer, which arises from follicular cells in the thyroid, is the most common endocrine malignancy, and theranostic radioiodine has been successfully applied to diagnose and treat differentiated thyroid cancer, the applications of which were included in the guidelines published by various thyroid or nuclear medicine societies. Through better pathophysiologic understanding of thyroid cancer and advancements in nuclear technologies, theranostic radioiodine contributes more to modern tailored personalized management by providing high therapeutic effect and by avoiding significant adverse effects in differentiated thyroid cancer. This review details the inception of theranostic radioiodine and recent radioiodine applications for differentiated thyroid cancer management as a prototype of personalized medicine based on molecular imaging.

  4. Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Maria Eduarda; Flamini, Rodrigo C.; Corbo, Rossana; Mamede, Marcelo [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear], e-mail: mamede@inca.gov.br

    2009-10-15

    The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy. (author)

  5. A review of age dependent radioiodine dosimetry

    International Nuclear Information System (INIS)

    Johnson, J.R.

    1987-01-01

    Age dependent models of radioiodine metabolism in humans have been described. These models have been used to calculate age dependent committed doses to the thyroid from intakes of radioiodines. A model of fetal iodine metabolism is also described and used to calculate fetal thyroid doses from intakes of radioiodines by the mother. These doses are calculated using model parameter values thought to be representative of average for North American/European populations. Considerable variability from these results can be expected for individuals. In addition, population with significant differences in stable iodine intake, and in body parameters, will have model parameters somewhat different than the ones described in this paper. These different model parameters will result in different doses from intakes of radioiodines, but it is doubtful if the differences in population would be as large as the variation between individuals. 25 refs.; 11 figs.; 1 table

  6. Radioiodinated tracers for myocardial imaging

    International Nuclear Information System (INIS)

    Kulkarni, P.V.; Corbett, J.R.

    1990-01-01

    Recent advances in the efficient production of high purity radioiodine (123I) and new efficient radiolabeling techniques have allowed the development of new classes of cardiovascular radiopharmaceuticals. These include 123I-labeled fatty acids to assess myocardial metabolism, 123I-metaiodobenzylguanidine (MIBG) for myocardial neuronal activity, labeled monoclonal antibodies for myocardial necrosis, and labeled lipoproteins for receptor concentration. 123I-labeled fatty acids and MIBG are under clinical investigation with encouraging results. 123I- and 111In-labeled fragments of monoclonal antibodies to myosin have been used for imaging myocardial necrosis in humans. The development of radiotracers for imaging of cholinergic and adrenergic receptors is still in the experimental stage. Recent advances in imaging instrumentation and radiopharmaceuticals have resulted in cardiac imaging applications beyond blood pool ventriculography, perfusion, and infarct-avid imaging. Developments of radioiodine (123I)-labeled agents promise to play an important role in the assessment of myocardial metabolism, neuronal activity, and receptor concentration. The chemistry of iodine is well defined compared with that of 99mTc; therefore, iodine isotopes are well suited for labeling biologically important molecules. Among the iodine isotopes, 123I has nearly ideal nuclear properties for nuclear medical applications with a 13.3-hour half-life (T1/2) and 159 keV gamma emission (83%). Despite the nearly ideal chemical and nuclear properties of 123I, the widespread application of 123I-based radiopharmaceuticals in clinical practice has been limited by high production costs (123I is produced in a cyclotron), relatively limited availability, and the presence of undesirable radionuclidic impurities (124I, T1/2 = 4.2 days; 125I, T1/2 = 60 days; 126I, T1/2 = 13.1 days). 77 references

  7. Determination of Therapeutic Dose of I-131 for First High Dose Radioiodine Therapy in Patients with Differentiated Thyroid Cancer: Comparison of Usefulness between Pathological Staging, Serum Thyroglobulin Level and Finding of I-123 Whole Body Scan

    International Nuclear Information System (INIS)

    Jeong, Hwan Jeong; Lim, Seok Tae; Youn, Hyun Jo; Sohn, Myung-Hee

    2008-01-01

    Recently, a number of patients needed total thyroidectomy and high dose radioiodine therapy (HD-RAI) get increased more. The aim of this study is to evaluate whether pathological staging (PS) and serum thyroglobulin (sTG) level could replace the diagnostic I-123 scan for the determination of therapeutic dose of HD-RAI in patients with differentiated thyroid cancer. Fifty eight patients (M:F=13;45, age 44.5±11.5 yrs) who underwent total thyroidectomy and central or regional lymph node dissection due to differentiated thyroid cancer were enrolled. Diagnostic scan of I-123 and sTG assay were also performed on off state of thyroid hormone. The therapeutic doses of I-131 (TD) were determined by the extent of uptakes on diagnostic I-123 scan as a gold standard. PS was graded by the criteria recommended in 6th edition of AJCC cancer staging manual except consideration of age. For comparison of the determination of therapeutic doses, PS and sTG were compared with the results of I-123 scan. All patients were underwent HD-RAI. Among them, five patients (8.6%) were treated with 100 mCi of I-131, forty three (74.1%) with 150 mCi, six (10.3%) with 180 mCi, three (5.2%) with 200 mCi, and one (1.7%) with 250 mCi, respectively. On the assessment of PS, average TDs were 154±25 mCi in stage I (n=9), 175±50 mCi in stage II (n=4), 149±21 mCi in stage III (n=38), and 161±20 mCi in stage IV (n=7). The statistical significance was not shown between PS and TD (p=0.169). Among fifty two patients who had available sTG, 25 patients (48.1%) having below 2 ng/mL of sTG were treated with 149±26 mCi of I-131, 9 patients (17.3%) having 2≤ sTG <5 ng/mL with 156±17 mCi, 5 patients (9.6%) having 5≤ sTG <10 ng/mL with 156±13 mCi, 7 patients (13.5%) having 10≤ sTG <50 ng/mL with 147±24 mCi, and 6 patients (11.5%) having above 50 ng/mL with 175±42 mCi. The statistical significance between sTG level and TD (p=0.252) was not shown. In conclusion, PS and sTG could not replace the

  8. Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges.

    Science.gov (United States)

    Tsapkini, Kyrana; Frangakis, Constantine; Gomez, Yessenia; Davis, Cameron; Hillis, Argye E

    Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and family life call for the investigation of treatment alternatives. In this article, we present new data indicating that neuromodulatory treatment, using transcranial direct current stimulation (tDCS) combined with a spelling intervention, shows some promise for maintaining or even improving language, at least temporarily, in PPA. The main aim of the present article is to determine whether tDCS plus spelling intervention is more effective than spelling intervention alone in treating written language in PPA. We also asked whether the effects of tDCS are sustained longer than the effects of spelling intervention alone. We present data from six PPA participants who underwent anodal tDCS or sham plus spelling intervention in a within-subject crossover design. Each stimulation condition lasted 3 weeks or a total of 15 sessions with a 2-month interval in between. Participants were evaluated on treatment tasks as well as on other language and cognitive tasks at 2-week and 2-month follow-up intervals after each stimulation condition. All participants showed improvement in spelling (with sham or tDCS). There was no difference in the treated items between the two conditions. There was, however, consistent and significant improvement for untrained items only in the tDCS plus spelling intervention condition. Furthermore, the improvement lasted longer in the tDCS plus spelling intervention condition compared to sham plus spelling intervention condition. Neuromodulation with tDCS offers promise as a means of augmenting language therapy to improve written language function at least temporarily in PPA. The consistent finding of generalisation of treatment benefits to untreated items and the superior sustainability of treatment effects with tDCS justifies further investigations. However

  9. Application of lithium carbonate on radioiodine treatment of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Zha Jinshun; Huang Chunling; Jiang Tingyin; Jiang Yan

    2011-01-01

    Effectiveness of radioiodine for Graves' hyperthyroidism depends on retention time of 131 I in the thyroid, and may be effected by several factors, including previous treatment with antithyroid drugs,goiter volume, 24 h thyroidal radioactive iodine uptake and so on. A short course of therapy with low dose of lithium carbonate increased retention of 131 I in the thyroid and prolong the intrathyroidal effective half-life of 131 I before and after 131 I therapy in patients with Graves' disease, because of the actions that lithium blocks the release of organic iodine and thyroid hormone from the thyroid gland without affecting thyroidal radioactive iodine uptake. Therefore, using lithium as adjunct to radioiodine therapy increases the radiation dose delivered to the thyroid, to result in reduced the activity required and whole-body radiation dose in patients with very short effective half-life, and so improve the cure rate of hyperthyroidism. A short course of lithium carbonate therapy can be considered a useful adjunct to 131 I therapy for obtaining a more rapid control of thyrotoxicosis and avoiding its transient exacerbation because of methimazole withdrawal prior to 131 I administration or in patients who cannot tolerate or do not respond to antithyroid drugs, and for helping to prevent the radioiodine-associated increase in serum free thyroid hormone concentrations. In addition, lithium carbonate enhances the effectiveness of 131 I therapy, in terms of prompter control of hyperthyroidism in patients with small or large goiters. At the same time, lithium also may increases the rate of permanent control of hyperthyroidism in patients with large goiters. In summary, in the short-term lithium plays an important role as an adjunct to 131 I, since it helps to prevent the 131 I-associated increase in serum free thyroid hormone concentrations and allows a more prompt control of thyrotoxicosis. This is of particular importance in high risk patients, such as the elderly

  10. Radiostatine and radioiodine uptake characterization in sodium iodine symporter-expressing cell lines

    International Nuclear Information System (INIS)

    Petrich, T.; Helmeke, H.J.; Meyer, G.J.; Knapp, W.H.; Poetter, E.

    2002-01-01

    Full text: The sodium iodide symporter (NIS) has been recognized as an attractive target for cancer gene therapy. Here we investigated NIS-mediated transport of the high LET α-emitter astatine, 211 At, in comparison to radioiodine. A constitutive expression vector harbouring the human NIS cDNA was used in combination with reporter gene vectors for transient transfection of 13 different human cancer cell lines. Radioiodine uptake was measured as well as transfection efficiencies. Six stable NIS-expressing cell lines (3 derived from thyroid carcinomas, 2 colon carcinoma, 1 glioblastoma) were generated by antibiotic selection. NIS expression was monitored by immunohistochemistry and RT-PCR. Subsequently the radioastatine and radioiodine uptake characteristics of genetically modified cells were studied in comparison to the respective control cells. After xenotransplantation in nude mice in vivo tumor imaging by scintigraphy and biodistribution studies following organ removal were performed. Transient transfection of NIS cDNA led to high specific sodium perchlorate-sensitive radioiodine uptake in NIS-expressing cells that roughly correlates to transfection efficiencies. Similarly, stable NIS-expressing cell lines were able to concentrate high levels of radioiodine and in addition showed comparable transport capacity for radioastatine. Accumulation of 211 At was inhibited by sodium perchlorate like iodide uptake and displayed dependency an extracellular Na + - and I - -ions as well. Compared to wash-out experiments in cell culture the effective half life of radioiodine and radioastatine in vivo was significantly prolonged. Preliminary dose calculations by MIRD concepts indicated higher tumor radiation doses for 211 At compared to 131 I. Tumor cells of different origins transfected with the NIS-expression vector specifically and significantly take-up radioiodine and radioastatine in vitro and in vivo. The data provide direct evidence that the NIS efficiently transports

  11. Improving Care for Veterans with PTSD: Comparing Risks and Benefits of Antipsychotics Versus Other Medications to Augment First-Line Pharmacologic Therapy

    Science.gov (United States)

    2017-10-01

    Afghanistan Veterans  seen in VA care receiving this diagnosis. In addition to  counseling  therapies, several medications are effective in treating PTSD...disorder in Veterans, with nearly 1 in 3 returning Iraq and Afghanistan Veterans seen in VA care receiving this diagnosis. In addition to counseling ...than those prescribed non-antipsychotics. 4 Table 1: Characteristics by augmenting medication group Variable AAP (N=24,131) N (column %) NAP

  12. Exploring the optimum approach to the use of CT densitometry in a randomised placebo-controlled study of augmentation therapy in alpha 1-antitrypsin deficiency

    DEFF Research Database (Denmark)

    Parr, David G; Dirksen, Asger; Piitulainen, Eeva

    2009-01-01

    lung assessment. The EXAcerbations and CT scan as Lung Endpoints (EXACTLE) trial aimed to clarify the optimum approach to the use of CT densitometry data for the assessment of alpha 1-antitrypsin (AAT) augmentation therapy on the progression of emphysema in AAT deficiency (AATD). METHODS: Patients...... with AATD (n = 77) were randomised to weekly infusions of 60 mg/kg human AAT (Prolastin) or placebo over 2 to 2.5 years. Lung volume was included as a covariate in an endpoint analysis and a comparison was made of different CT densitometric indices (15th percentile lung density [PD15], mean lung density...

  13. Radioiodine Treatment of Well-Differentiated thyroid cancer in children

    International Nuclear Information System (INIS)

    Barrenechea, E.

    2007-01-01

    Full text: Well-differentiated thyroid cancer (DTCA) in children is quite different from the adult- onset disease in that they are more aggressive at the time of diagnosis and with metastases and has a higher risk for recurrence. Some studies claim it to be less lethal and hence treatment protocols may be different from that of the adult. This study was made to analyze the need for RAI therapy as one of the cornerstone of treatment aside from surgery and thyroid hormone suppression as well as to determine the behavior of WDTCA in children. Results: The incidence of DTCA is varied and ranges from 1-10% in several published series. In the Philippines where thyroid cancer in adults ranks 5th in mortality for both sexes, the incidence is likewise very low, around 0.5-1% for ages 18 years and below in a ten year study. It was predominantly a female population (74%) as compared to the males (26%). Fifteen cases were reviewed and included as most were given RAI (87%). Most presented as a solitary nodule and with lymph node metastases. Thirteen cases were papillary in nature and only two cases were follicular. The incidence of nodal metastases was 53% while lung metastases were seen in 20% of cases. Of the 13 cases that underwent RAI therapy, three cases of lung metastases needed repeat therapy. In the cases with lymph node metastases, 2 cases also had recurrence and which necessitated repeat RAI therapy. The two cases that did not get RAI therapy had progressive disease on follow- up after 5 and 7 years respectively from surgery. Discussion: Primary treatment for DTC should consist of surgery, radioiodine ablation and thyroid hormone suppression. We must rely on pediatric outcome studies and the high frequency of multifocal intrathyroidal disease, loco- regional spread and extra cervical metastases often seen as initial presentations of this particular group. The more advanced disease at diagnosis for children, propensity for recurrence as well as the greater radioiodine

  14. A pilot study for augmenting atomoxetine with methylphenidate: safety of concomitant therapy in children with attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Ball Susan

    2007-09-01

    Full Text Available Abstract Background This study examined augmenting atomoxetine with extended-release methylphenidate in children whose attention-deficit/hyperactivity disorder (ADHD previously failed to respond adequately to stimulant medication. Methods Children with ADHD and prior stimulant treatment (N = 25 received atomoxetine (1.2 mg/kg/day plus placebo. After 4 weeks, patients who were responders (n = 4 were continued on atomoxetine/placebo while remaining patients were randomly assigned to either methylphenidate (ATX/MPH (1.1 mg/kg/day or placebo augmentation (ATX/PB for another 6 weeks. Patients and sites were blind to timing of active augmentation. Safety measures included vital signs, weight, and adverse events. Efficacy was assessed by ADHD rating scales. Results Categorical increases in vital signs occurred for 5 patients (3 patients in ATX/MPH, 2 patients in ATX/PBO. Sixteen percent discontinued the study due to AE, but no difference between augmentation groups. Atomoxetine treatment was efficacious on outcome measures (P ≤ .001, but methylphenidate did not enhance response. Conclusion Methylphenidate appears to be safely combined with atomoxetine, but conclusions limited by small sample. With atomoxetine treatment, 43% of patients achieved normalization on ADHD ratings.

  15. Results of 52 cases with struma maligna treated with radio-iodine

    International Nuclear Information System (INIS)

    Grebe, S.F.; Huth, K.D.

    1982-01-01

    Results of 52 cases with struma maligna treated with radio-iodine. Between 1966 and 1977, 52 thyroid carcinoma patients received radio-iodine therapy. Their age ranged from 18 to 82 years. Out of 52 patients, 46 underwent surgery with 26 thyrodectomized subtotally and 20 totally so. No surgery was performed in 6 cases since this was refused in 2 cases and inoperable for clinical reasons in 4 cases. Radio-iodine treatment was performed 6 to 10 weeks after operation or 2 to 4 weeks after diagnosis. In 9 cases, additional irradiation therapy was performed on metastases (predominantly in skeleton) at total doses ranging between 2500-7500 R focal dose for palliative reasons. In terms of summary, the authors draw the conclusion that surgical ablation of thyroid tissue as total as possible combined with subsequent radio-iodine treatments till complete destruction of the iodine-storing tissue imposes as the optimum treatment of follicular and papillary thyroid carcinoma. (orig./MG) [de

  16. Peripheral blood T cell activation after radioiodine treatment for Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Wei-Ping Teng; Stark, R.; Borysiewicz, L.K.; Weetman, A.P. (Department of Medicine, University of Cambridge Clinical School, Level 5, Addenbrooke' s Hospital, Cambridge (UK)); Munro, A.J. (Department of Clinical Oncology, Hammersmith Hospital, London (UK)); McHardy Young, S. (Department of Medicine, Central Middlesex Hospital, London (UK))

    1990-01-01

    Radioiodine therapy for Graves' thyrotoxicosis produces a rise in thyroid autoantibodies in the first three months after treatment, but little is known of its effects on T cells. We have therefore followed the changes in T cell subsets in sequential samples from 23 patients with Graves' disease treated with radioiodine, using dualcolour flow cytometry. In the first month after treatment there was a significant rise in activated T cells, identified by the markers HLA-DR(la) and CDw26/Tal (p<0.025 in both cases). CD45RO-positive T cells, which are the primed population containing memory cells, also increased (p<0.025), but there was no change in CD45R-positive, resting T cells or in the CD4 to CD8 (helper to cytotoxic/suppressor) ratio. Vicia villosa-binding T cells, containing the contrasuppressor population, showed a more variable response, but the trend was to an overall increase from pre-treatment values (p<0.025). The changes did not appear to be related to antithyroid drug treatment, since they were seen irrespective of whether patients continued such therapy. These results suggest that T cell activation and enhanced contrasuppressor activity may in part be responsible for the rise in autoantibodies after radioiodine. The T cell changes could also contribute to the worsening of ophthalmopathy seen in some radioiodine-treated patients. (author).

  17. Changing trends in the treatment of Graves' disease with radioiodine: a 12-year experience in a university hospital; Mudancas evolutivas no tratamento da doenca de Graves com iodo radioativo: 12 anos de experiencia em um hospital universitario

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Marcus Vinicius Leitao de [Instituto Estadual de Diabetes e Endocrinologia (IEDE), Rio de Janeiro, RJ (Brazil)], e-mail: marcusleitao@gmail.com; Souza, Honomar Ferreira de [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Endocrinologia; Buescu, Alexandru; Vaisman, Mario [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Endocrinologia

    2009-03-15

    Objective: To evaluate the changes in clinical parameters and in the approach to patients submitted to radioiodine therapy for Graves' disease. Materials and methods: Dossiers of 226 patients submitted to radioiodine therapy for Graves' disease in the period between January 1990 and December 2001 were retrospectively evaluated. For the purposes of statistical analysis, the 12-year period was subdivided into three periods of 4 years, with a comparison of clinical and laboratory variables in these periods. Results: The authors have observed that the total number of patients referred for radioiodine therapy as well as the percentage of female patients presented a significant increase (from 62% to 86%; p = 0.005). The percentage of patients pretreated with methimazole before radioiodine therapy increased significantly (from 9.1% to 35.6%; p = 0.03). The mean radioiodine dose delivered has also presented a significant increase (from 7.6 mCi to 12.7 mCi; p = 0.000003) with a direct reflection on a higher percentage of patients cured one year after the radioiodine therapy (from 55.6% to 83.7%; p = 0.004). Conclusion: Radioiodine therapy has increasingly been accepted for treatment of patients with Graves' disease and the doses delivered have increased to achieve a permanent cure as well as a reduction of the chances of recurrence. (author)

  18. AUGMENTED REALITY

    DEFF Research Database (Denmark)

    Skov, Kirsten; Bahn, Anne Louise

    2017-01-01

    Projektets grundlæggende idé er udvikling af visuel, æstetisk læring med Augmented Reality, hvor intentionen er at bidrage med konkrete undersøgelser og udforskning af begrebet Augmented Reality – herunder koblingen mellem det analoge og digitale i forhold til læring, multimodalitet og it...

  19. Radioiodinated ligands for dopamine receptors

    International Nuclear Information System (INIS)

    Kung, H.F.

    1994-01-01

    The dopamine receptor system is important for normal brain function; it is also the apparent action site for various neuroleptic drugs for the treatment of schizophrenia and other metal disorders. In the past few years radioiodinated ligands for single photon emission tomography (SPECT) have been successfully developed and tested in humans: [ 123 I]TISCH for D1 dopamine receptors; [ 123 I]IBZM, epidepride, IBF and FIDA2, four iodobenzamide derivatives, for D2/D3 dopamine receptors. In addition, [ 123 I]β-CIT (RTI-55) and IPT, cocaine derivatives, for the dopamine reuptake site are potentially useful for diagnosis of loss of dopamine neurons. The first iodinated ligand, (R)trans-7-OH-PIPAT, for D3 dopamine receptors, was synthesized and characterized with cloned cell lines (Spodoptera frugiperda, Sf9) expressing the D2 and D3 dopamine receptors and with rat basal forebrain membrane preparations. Most of the known iodobenzamides displayed similar potency in binding to both D2 and D3 dopamine receptors expressed in the cell lines. Initial studies appear to suggest that by fine tuning the structures it may be possible to develop agents specific for D2 and D3 dopamine receptors. It is important to investigate D2/D3 selectivity for this series of potent ligands

  20. Current opinions on the radioiodine treatment of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Lee, Sang Woo; Lee, Jae Tae

    2003-01-01

    Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainty and debate. Early side effects are uncommon and readily manageable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies

  1. Procedure guideline for radioiodine test (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Eschner, W.; Deutsche Gesellschaft fuer Medizinische Physik; Koeln Univ.; Lassmann, M.; Deutsche Gesellschaft fuer Medizinische Physik; Wuerzburg Univ.; Leisner, B.; Allgemeines Krankenhaus St. Georg, Hamburg; Reiners, C.; Wuerzburg Univ.

    2007-01-01

    The version 3 of the procedure guideline for radioiodine test is an update of the guideline previously published in 2003. The procedure guideline discusses the pros and cons of a single measurement or of repeated measurements of the iodine-131 uptake and their optimal timing. Different formulas are described when one, two or three values of the radioiodine kinetic are available. The probe with a sodium-iodine crystal, alternatively or additionally the gamma camera using the ROI-technique are instrumentations for the measurement of iodine-131 uptake. A possible source of error is an inappropriate measurement (sonography) of the target volume. The patients' preparation includes the withdrawal of antithyroid drugs 2-3 days before radioiodine administration. The patient h