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  1. 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.)

  2. 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

  3. 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

  4. 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

  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. 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)

  7. 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

  8. 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)

  9. 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

  10. 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)

  11. Our experience with radioiodine therapy of thyroid functional autonomies

    International Nuclear Information System (INIS)

    Kraft, Otakar

    2005-01-01

    targeted radiation dose in autonomously functioning tissue. The radioiodine amount administered was based on the volume of thyroid or the nodule, 24-hours radioiodine accumulation, the effective half-life of radioiodine, the absorbed dose of 500 Gy per gram of the nodule (UFA) or 300 Gy per gram of the whole thyroid (in patients with MFA and DFA). Before radioiodine therapy an average serum levels of total thyroxine was 164.6 nmol/l, of free thyroxine 20.8 pmol/l and triiodothyronine 3.2 nmol/l, in all patients TSH was suppressed. Before therapy patient's complaints were cardiovascular in 88% of patients (tachycardia, irregular pulse, palpitation), neurological (nerves, agitation) in 72% of patients, hypermetabolic (loss of weight, intolerance of warm, perspiration) in 68% of patients and local (feeling of neck compression, swallow difficulties) in 30% of patients. After therapy the average serum levels of total thyroxine was 108.8 nmol/l, free thyroxine 12.5 pmol/l and triiodothyronine 2.0 nmol/l and improvement of symptoms in 91%, without improvement in 8.7% and worsening in 0.3% of patients. The suppression of TSH disappeared in 607 of treated patients (76%). A volume reduction of thyroid of 38% was achieved in any type of functional autonomy after radioiodine treatment. Side effects were minimal and in some patients presented as a transient neck pressure or pain and neck swelling as a manifestation of post radiation thyroiditis. Post radiation hypothyroidism was diagnosed in 36 patients (4.5%). The results of this study show that the radioiodine therapy of the thyroid functional autonomies is safe, with low incidence of adverse effects. It is effective and for patients non-demanding. (author)

  12. 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.)

  13. 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

    biochemical improvement within 6 months in which 15 were Graves' disease, 1 solitary toxic nodule and 2 toxic multinodular goiter. After becoming euthyroidism, hyperthyroidism recurs in 3 (1.58 %) cases within 1 year. Recurrence of hyperthyroidism was also seen in 2 cases after 1 year of radioiodine treatment. These patients (persistent and recur cases) were treated with second dose and if needed third and/or fourth dose of radioiodine. Second dose was given in 23 cases, third dose given in 7 cases and fourth dose given in 2 cases. We referred 1 case for surgical treatment not for responding even with fourth dose of radioiodine. During our follow up period, 6 patients became hypothyroid within 3 months, 14 patients became hypothyroid within 6 months, 7 patients became hypothyroid within 9 months and 5 patients became hypothyroid within 1 year. Thus hypothyroidism within 1 year was found to be 16.84% (32/190). Other side effects such as iododerma were observed in 5 (2.63%) cases, radiation thyroiditis developed in 17 (8.95%) cases, thyroid storm developed in 2 (1.05%) cases. Out of 43 with ophthalmopathy, 2 (4.44%) deteriorated, 1 (2.32%) unchanged and the rest (93.02%) improved. New ophthalmopathy developed in 3 cases (3/147 i.e., 2.04%). None developed any malignancy or leukemia during our follow up period. We conclude that our experience revealed similar outcomes as have been reported by other workers with the exception of iododerma, one of the early complications of radioiodine therapy that we noticed during our follow up period. (author)

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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)

  4. 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

  5. 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)

  6. 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)

  7. 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.)

  8. 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.)

  9. 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

  10. 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.)

  11. 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

  12. 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)

  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. 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

  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. 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.

  17. 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)

  18. 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.)

  19. 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

  20. 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

  1. 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.)

  2. 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)

  3. 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.)

  4. 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.)

  5. 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

  6. 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.)

  7. 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

  8. 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.)

  9. 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.)

  10. 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)

  11. 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)

  12. 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

  13. 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

  14. [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.

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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...

  1. 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.)

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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.)

  9. 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

  10. 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.)

  11. 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.)

  12. 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.

  13. 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...

  14. 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

  15. 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.)

  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. 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

  18. 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.

  19. 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.

  20. 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)

  1. 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

  2. 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.)

  3. 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

  4. 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

  5. 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...

  6. 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

  7. 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)

  8. 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.

  9. 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...

  10. 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

  11. 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.)

  12. 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

  13. 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

  14. 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...

  15. 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)

  16. 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)

  17. 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)

  18. 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

  19. 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

  20. 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

  1. 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)

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.)

  7. 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.)

  8. 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.)

  9. 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

  10. 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.

  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. 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)

  13. 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.

  14. 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

  15. 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)

  16. 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

  17. 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)

  18. 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)

  19. 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.)

  20. 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

  1. 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

  2. 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)

  3. 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)

  4. 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

  5. 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)

  6. 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

  7. 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.

  8. 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

  9. Recent advances in radioiodine use for the management of thyroid carcinoma

    International Nuclear Information System (INIS)

    Chung, J.K.

    2007-01-01

    Full text: It has been well accepted that radioiodine is useful in the management of patients with recurrent or metastatic differentiated thyroid cancer. Although radioiodine has been used for more than 60 years in diagnosis and treatment, some improvements still appear continuously. Serum Thyroglobulin (Tg) and radioiodine whole body scans (WBS) are used to detect recurrent thyroid caner. Tg has been known to be more sensitive than WBS, and false negative WBS with elevated Tg are frequently found. However, the clinical importance of Tg negative cases with positive WBS has not been clarified. We found that 34 among 960 patients who showed negative Tg with positive post-therapy I-131 WBS had functioning metastases to extrathyroidal organs. Complementary use of radioiodine WBS is recommended to exclude Tg false negative cases. The retinoic acid (RA) is well known to induce the cellular re-differentiation and increase the expression of sodium/iodide symporter (NIS) in de-differentiated tumor cell. We performed RA treatment with I-131 in 40 patients with elevated serum Tg level but no focal iodine uptake in WBS. In 14 patients (35%), improved I-131 uptake was seen. Focal iodine uptakes were seen in 4 patients, and diffuse hepatic visualization without localized lesions were found in 10 patients. Maximal safe dose (MSD) administration based on bone marrow radiation allows the delivery of a large amount of I-131 to thyroid cancer tissue within the safety margin. We performed MSD therapy in 46 patients with differentiated thyroid cancers, which had persisted even after conventional fixed dose therapy. MSD was calculated according to the Memorial Sloan Kettering Cancer Center protocol using blood samples. Mean calculated MSD was 12.5±2.1 GBq (337.3±37.5 mCi). Of the 46 patients, 6 (13.0%) showed complete remission, 15 (32.6%) partial response, 19 stable disease, and 6 disease progression. Twenty-nine patients (63%) had a transient cytopenia after therapy. MSD therapy of

  10. Improved radioiodination of 1,2-dipalmitoyl-3-IPPA via a tributyltin intermediate

    International Nuclear Information System (INIS)

    McPherson, D.W.; Luo, H.; Kropp, J.; Knapp, F.F.

    1999-01-01

    1,2-Palmitoyl-3-[15-(4-iodophenyl)pentadecan-3-oyl]-rac-glyceroI (MIPAG) is a new agent for the clinical evaluation of pancreatic lipase activity and has demonstrated promise in preliminary clinical studies with patients affected with pancreatic insufficiency. Iodine-131-MIPAG was initially prepared via thallium-iodide displacement. Because of the need for a simple method which is amendable for the routine clinical use of MIPAG we have investigated the preparation and radioiodination of MIPAG utilizing the tributyltin precursor, 1,2-palmitoyl-3-[15-(-4-tributylstannylphenyl)pentadecan-3-oyl] -rac-glyceroI (TBT-MIPAG, 2). Compound 2 was prepared via the condensation of 1,2-palmitoyl-rac-glycerol with 15-(4-tributylstannylphenyl)pentadecanoic acid (TBT-PPA) prepared from 4-bromophenylacetylene. Electrophilic radioiodination using peracetic acid with sodium iodide-125 in ethanol at 80 deg. C for 60 min afforded I-125-MIPAG in 65.9% (±11.5%) yield and radiochemical purity of 94% (±3.0%) after C-18 Sep-Pak purification (n=6). This improved method for radioiodination utilizing TBT-MIPAG now provides radioiodinated MIPAG for routine clinical evaluation

  11. Improved radioiodination of 1,2-dipalmitoyl-3-IPPA via a tributyltin intermediate

    Energy Technology Data Exchange (ETDEWEB)

    McPherson, D.W. E-mail: phm@oml.gov; Luo, H.; Kropp, J.; Knapp, F.F

    1999-10-01

    1,2-Palmitoyl-3-[15-(4-iodophenyl)pentadecan-3-oyl]-rac-glyceroI (MIPAG) is a new agent for the clinical evaluation of pancreatic lipase activity and has demonstrated promise in preliminary clinical studies with patients affected with pancreatic insufficiency. Iodine-131-MIPAG was initially prepared via thallium-iodide displacement. Because of the need for a simple method which is amendable for the routine clinical use of MIPAG we have investigated the preparation and radioiodination of MIPAG utilizing the tributyltin precursor, 1,2-palmitoyl-3-[15-(-4-tributylstannylphenyl)pentadecan-3-oyl] -rac-glyceroI (TBT-MIPAG, 2). Compound 2 was prepared via the condensation of 1,2-palmitoyl-rac-glycerol with 15-(4-tributylstannylphenyl)pentadecanoic acid (TBT-PPA) prepared from 4-bromophenylacetylene. Electrophilic radioiodination using peracetic acid with sodium iodide-125 in ethanol at 80 deg. C for 60 min afforded I-125-MIPAG in 65.9% ({+-}11.5%) yield and radiochemical purity of 94% ({+-}3.0%) after C-18 Sep-Pak purification (n=6). This improved method for radioiodination utilizing TBT-MIPAG now provides radioiodinated MIPAG for routine clinical evaluation.

  12. 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.

  13. 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

  14. 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

  15. [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.

  16. 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

  17. 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

  18. 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

  19. 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).

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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.)

  5. 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

  6. 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)

  7. 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....

  8. [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.

  9. 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)

  10. 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.)

  11. 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.

  12. 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

  13. 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

  14. 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)

  15. 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.)

  16. 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.)

  17. 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

  18. 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

  19. 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

  20. 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)

  1. 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

  2. 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.

  3. 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

  4. Design of Radioiodinated Pharmaceuticals: Structural Features Affecting Metabolic Stability towards in Vivo Deiodination

    Science.gov (United States)

    van der Born, Dion; Klaren, Peter H. M.; Boerman, Otto C.; Rutjes, Floris P. J. T.

    2017-01-01

    Radioiodinated pharmaceuticals are convenient tracers for clinical and research investigations because of the relatively long half‐lives of radioactive iodine isotopes (i.e., 123I, 124I, and 131I) and the ease of their chemical insertion. Their application in radionuclide imaging and therapy may, however, be hampered by poor in vivo stability of the C–I bond. After an overview of the use of iodine in biology and nuclear medicine, we present here a survey of the catabolic pathways for iodinated xenobiotics, including their biodistribution, accumulation, and biostability. We summarize successful rational improvements in the biostability and conclude with general guidelines for the design of stable radioiodinated pharmaceuticals. It appears to be necessary to consider the whole molecule, rather than the radioiodinated fragment alone. Iodine radionuclides are generally retained in vivo on sp2 carbon atoms in iodoarenes and iodovinyl moieties, but not in iodinated heterocycles or on sp3 carbon atoms. Iodoarene substituents also have an influence, with increased in vivo deiodination in the cases of iodophenols and iodoanilines, whereas methoxylation and difluorination improve biostability. PMID:28736501

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.)

  10. 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.

  11. 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)

  12. 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.)

  13. 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.)

  14. 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

  15. 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)

  16. Potential of the drug-regulation iodide uptake in patients for prevention of radioiodine-refractory papillary thyroid cancer

    Directory of Open Access Journals (Sweden)

    Dmitriy Kirillovich Fomin

    2014-11-01

    Full Text Available ObjectiveTo evaluate the efficacy and feasibility of retinoic acid derivatives and lithium salts for radioiodine-refractory prevention in patients with differentiated thyroid cancer during multistage radioiodine therapy.Materials and methodsThe retrospective analysis was performed using the diagnostic and treatment results of 40 patients with differentiated thyroid cancer that underwent 131I therapy, which on the basis of posttherapy whole-body scan had direct indications for subsequent course of radioiodine therapy. The patients were divided into two groups:the control group (20 patients, which conducted a second course of radioiodine therapy on the standard template and without special training$the main group (20 patients, who were administered Sedalia (900 mg per day for 8 days, p.o. and isotretinoin (1.2 mg/kg body weight for 60 days, p.o. to prevention of the 131I resistance.To evaluate the effectiveness of a repeated course of radioiodine therapy following parameters were used: the thyroglobulin (Tg and antibodies to thyroglobulin (Tg-Ab level in the serum, the posttherapy whole body scan in combination with SPECT-CT.ResultsWe have found, that radioactive iodine treatment was effective in 75% of the main group and 90% of patients in the control group. The remission was observed in 10% and 40% in the main and control group, respectively. The partial regression was considered as Tg and TG-Ab reduction, and was observed more in the study group. The resistance to 131I therapy was found in 20% and 10% in the main and control group, respectively, which was based on the fact of permanent Tg/Tg-Ab serum level and absence of the pathological foci iodine uptake on the whole-body scans. The disease progress was found in one patient in the main group.ConclusionThe use of retinoic acid derivatives and lithium salts, in an effort to prevent the resistance to 131I-theraphy pretend to be unjustified, because it does not lead to significant

  17. 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)

  18. Heath-related quality of life in thyroid cancer patients following radioiodine ablation

    Directory of Open Access Journals (Sweden)

    Henry Jean-françois

    2011-05-01

    Full Text Available Abstract Background There is limited information about the medium to long-term health-related quality of life (QOL in thyroid cancer patients after initial therapy and the existing studies suffer from limitations. The aim of the study was to assess the determinants of medium-term QOL after the initial therapy. Methods Following a total thyroidectomy, 88 thyroid cancer patients received either rhTSH or hypothyroid-assisted radioiodine ablation (RRA using 3.7 GBq (100 mCi of radioiodine. QOL evaluation of the patients using the validated Functional Assessment of Chronic Illness & Therapy (FACIT was performed at the time of inclusion (t0 and later at the 9-month post-RRA (t1. Results 83 patients were eligible for the final evaluation. Medium-term FACIT scores were not statistically different between t0 and t1 patients. All but one domain of the QOL score was similar between t0 and t1. Using a multivariate analysis, only age and immediate postoperative QOL scores were found to be determinants of the overall medium term 9-month QOL scores. Analysis showed that 'high QOL levels' (baseline and 9-month and 'no depression', 'low anxiety levels', were associated with ' Conclusions The use of radioiodine ablation does not seem to affect the medium term QOL scores of patients. Medium-term QOL is mainly determined by pre-ablation QOL. The assessment of baseline QOL might be interesting to evaluate in order to adapt the treatment protocols, the preventive strategies, and medical information to patients for potentially improving their outcomes.

  19. 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)

  20. 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

  1. 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

  2. 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)

  3. 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.

  4. 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)

  5. 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)

  6. 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.

  7. 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)

  8. 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

  9. 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

  10. 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)

  11. 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.)

  12. 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)

  13. 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....

  14. 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)

  15. 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

  16. 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

  17. Peripheral blood T cell activation after radioiodine treatment for graves' disease

    International Nuclear Information System (INIS)

    Teng Weiping; Weetman, A.P.

    1992-01-01

    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 cells subsets in sequential samples from 23 patients with Graves' disease treated with radioiodine, using dual-colour flow cytometry. In the first month after treatment there was a significant rise in activated T cells, identified by the markers HLA-DR (Ia) and CDW 26/Ta 1 (P<0.025 in both case). CD45RO-positive T cells, which are the prime population containing memory cells, also increased (P<0.025), but there was no change in CD45R-positive, resting cells or in the CD4/CD8 (helper to cytotoxic/suppressor) ratio. Vicia villosa-binding T cells, containing the contra-suppressor population, showed a more variable response, but the trend was to an overall increase from pre-treatment values (P<0.025). The change did not appear to be related to antithyroid drugs treatment, since they were seen irrespective of whether patients convinced such therapy. These results suggest that T cell activation and enhanced contra-suppressor activity may in part be responsible for the rise in autoantibodies after radioiodine therapy

  18. 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)

  19. 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)

  20. Dynamic changes and clinical significance of thyroid auto-antibodies before and after radioiodine treatment for Graves' disease

    International Nuclear Information System (INIS)

    Zhao Zhiying; Zhu Li; Wang Zhenghua

    2005-01-01

    To study the changes and their clinical effect of serum levels of thyroid globulin auto-antibodies (TGAb), thyroid peroxidase auto-antibodies (TPOAb) during radioiodine treatment of Graves' disease, and to investigate early therapeutic effect of radioiodine and influence factors for early hypothyroidism, 334 patients were divided into a positive group (TGAb>115IU/mL, TPOAb>34IU/mL) and a negative group (TGAb 131 I treatment. The levels of FT 3 , FT 4 , TSH, TGAb and TPOAb in serum were measured before 131 I therapy and at the 3rd, 6th, 9th, 12th month after the treatment respectively. Within one year after radioiodine treatment, 23.8% patients (48 out of 202) in the positive group and 11.4% (15 out of 132) in the negative group suffered from early hypothyroidism (P 131 I could reduce the level of thyroid auto-antibodies and promote the improvement and recovery of autoimmunity status. (authors)

  1. Change in the intrathyroidal kinetics of radioiodine under continued and discontinued antithyroid medication in Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Dunkelmann, Simone; Kuenstner, Hubertus; Nabavi, Elham; Rohde, Bettina; Groth, Peter; Schuemichen, Carl [University of Rostock, Clinic of Nuclear Medicine, Rostock (Germany)

    2007-02-15

    This study evaluated the thyroidal kinetics of radioiodine in Graves' disease under continued thiamazole medication and after discontinuation of thiamazole for 1-2 days, with a view to keeping the period of discontinuation as short as possible and to exploring the underlying mechanism of a postulated radioprotective effect of antithyroid drugs. In 316 patients, diagnostic and therapeutic radioiodine kinetics were followed up for 2 days by ten uptake measurements each and were defined mathematically by a two-compartment model. Without thiamazole or when thiamazole was discontinued for at least 2 days, all uptake curves could be fitted perfectly by a simple in- and output function; the mean square error (mse) was 0.38 (test) and 0.28 (therapy). Under continued thiamazole medication (11.0{+-}7.0 mg/day), the energy dose delivered to the thyroid was lowered by factor of 2.5. Uptake curves were deformed (mse: 1.06, test and 0.86, therapy) and appeared two peaked, suggesting coexistence of follicles with blocked and follicles with intact hormone synthesis and hence heterogeneous radioiodine uptake in the thyroid. In patients with maximally altered uptake curves, the success rate was as low as 31%. One day after discontinuation of thiamazole, mse was still increased (0.78, test), while 2 days afterwards it had normalised (0.36, test) and 3 days afterwards (mse: 0.24, therapy) the success rate was 87%. Efficacy of radioiodine therapy under continued thiamazole medication is reduced not only by a lower uptake and shorter half-life of radioiodine, but also by a heterogeneous energy dose distribution in the thyroid. Discontinuation of thiamazole (but probably not of propylthiouracil) for at least 2 days is required to restore the efficacy of radioiodine. (orig.)

  2. 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.

  3. 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)

  4. 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

  5. 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.

  6. 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

  7. 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).

  8. 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.

  9. 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

  10. 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...

  11. Radioiodine treatment of Grave's disease; Radiojodtherapie des Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Heidenreich, P.; Vogt, H.; Dorn, R.; Graf, G.; Kopp, J. [Klinik fuer Nuklearmedizin, Zentralklinikum Augsburg (Germany)

    2001-09-01

    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 < 3,5 {mu}Sv/h at 2 m). An adjuvant treatment with cortisone is recommended in a simultaneous endocrine ophthalmopathy to prevent from deterioration. Radioiodine therapy of Grave's disease is cost effective with a low probability of side-effects and is not associated with an increased genetic or somatic risk. Therapy control and life span follow up has to be carried out by the expert physician legally responsible for the radioiodine therapy. (orig.) [German] Die Radiojodtherapie des Morbus Basedow wird in Deutschland, bei Patienten aelter als 20 Jahre, erst nach mindestens einjaehriger, erfolgloser thyreostatischer Therapie, bei Thyreostatikaunvertraeglichkeit, Rezidiven nach Operation und kleinen Strumen durchgefuehrt. Die Beseitigung der Hyperthyreose wird mit einem ablativen Dosiskonzept (300 Gy) in > 90%, verbunden mit einer Hypothyreoserate von ebenfalls > 90% erreicht. Prognostisch unguenstige Einflussfaktoren sind eine zu niedrig gewaehlte Herddosis und/oder eine begleitende Thyreostase. Aus Gruenden der Qualitaetssicherung und des Strahlenschutzes muss in Deutschland die Radiojodtherapie stationaer als Einzeittherapie durchgefuehrt werden. Die

  12. 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)

  13. 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.)

  14. 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

  15. 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)

  16. 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...

  17. 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.)

  18. 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

  19. 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

  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. Labeling of the peptide DOTA-tyr3-octreotate with radioiodine and biodistribution and AR42J neuroendocrine tumor affinity study in mice

    International Nuclear Information System (INIS)

    Nagamati, Lucio Takeshi

    2006-01-01

    Neuroendocrine tumors are rare and affect mainly the gastrointestinal tract but other systems are also affected like the skin, lungs and the nervous system. They are rich in type 2 somatostatin (SM) receptors (SSTR2) and may secrete hormones in excess. Synthetic SM derivative peptides are of great utility because presented bigger half life when compared to SM and can be used to clinical improvement of these patients due to its tumoral inhibitory action. The labeling of these peptides with radioisotopes allowed the acquisition of images with favourable cost-efficiency relationship and use in therapy. The peptide, DOTATyr3- octreotate (DOTATATE), has much more affinity for the SSTR2 receptor than the peptide commercially used nowadays, is easily radioiodinated and has a favourable biodistribution for diagnosis and treatment due to the presence of the chelator DOTA. We have studied the influence of various factors on the radiochemical purity of the labeled compound as labeling stability, absorbed dose estimation and biodistribution in normal and AR42J cell tumor-bearing Swiss and Nude mice. We observed easy and stable peptide radioiodination at peptide/radioiodine ( 131 I) ratio of 2.73 that produced a radiochemical species with retention time of 22.7 minutes at high performance liquid chromatography and presented a favourable biodistribution and dosimetry for imaging and therapy of patients with neuroendocrine tumors, just the opposite result observed the radioiodinated compounds without a chelator as described in the literature. Other molar peptide/radioiodine ratios did not showed good results, with various radiochemical species and unfavourable biodistribution. A possible dosimetric study in patients with neuroendocrine tumors may be carried out in the near future. (author)

  2. 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.)

  3. Outpatient management of patients with large multinodular goitres treated with fractionated radioiodine

    International Nuclear Information System (INIS)

    Howarth, D.M.; Thomas, P.A.; Allen, L.W.; Akerman, R.; Lan, L.; Epstein, M.T.

    1997-01-01

    The efficacy of fractionated out-patient radioiodine therapy in 38 patients with compressive symptoms due to long-standing large multinodular goitres was assessed. The diagnosis was established by clinical assessment in addition to technetium-99m pertechnetate thyroid scan or computed tomography scan of the thyroid and mediastinum. Oral iodine-131 therapy was administered as a 2.22 GBq (60 mCi) cumulative dose over 4 months (555 MBq per month). All patients were monitored with serum thyroid-stimulating hormone and free thyroxine (± free tri-iodothyronine) assays before the treatment and after each dose fraction. Clinical and biochemical follow-up was performed on all patients and ranged from 6 to 45 months after therapy. The patients consisted of 35 female and three male patients with a median age of 59 years (range 37-87 years). Prior to treatment 20 patients were biochemically hyperthyroid and 18 were euthyroid. Overall, 71% of patients reported a subjective improvement in compressive symptoms and 29% reported no change. Clinically assessed reduction in goitre size occurred in 92% of patients while there was no change in 8%. At 3 months of follow-up, 31% of patients had become hypothyroid and at 18 months 66% were hypothyroid. Seven hyperthyroid patients (35%) became euthyroid and 13 hyperthyroid patients (65%) became hypothyroid. Three patients who became hypothyroid experienced neck soreness (transient in one patient, persistent in two patients). There were no differences in outcome between patients who were hyperthyroid and those who were euthyroid prior to treatment. Fractionated out-patient radioiodine therapy showed excellent short- and medium-term safety, was very well tolerated and offered a satisfactory alternative treatment to surgery. (orig.)

  4. 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.)

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. Graves' ophthalmopathy and 131I therapy

    International Nuclear Information System (INIS)

    Marcocci, C.; Bartalena, L.; Tanda, M.L.; Manetti, L.; Dell'Unto, E.; Mazzi, B.; Rocchi, R.; Barbesino, G.; Pinchera, A.

    1999-01-01

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; i i) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between progression of

  10. 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

  11. Radioiodine treatment effects of lacrimal glands function in patients with thyroid cancer

    International Nuclear Information System (INIS)

    Fard Esfahani, A.; Akhzari, F.; Mirshekarpour, H.; Saghari, M.; Izadyar, S.; Esmaili, J.; Fallahi, B.; Beiki, D.; Takavar, A.

    2005-01-01

    There is a limited number of case reports published in the past decade confirming the radio-iodine 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 post-radioiodine therapy. Hence we planned a historical cohort study to evaluate this effect. Methods: we studied 100 eyes of 50 patients who were referred to the nuclear medicine department of Dr. Shariati hospital from 01.1383 to 02.1384 and had received high doses (accumulative dose: 100-450mCi) of 1-131 treatment of differentiated thyroid carcinoma with their latest admission at least 3 months previously. Dry eye symptoms (obtained via a standard questionnaire) and Schirmer I test results (mm/5min) of this group were compared with those of an unexposed group (1 00 eyes of 50 individuals) matched by sex and age. Cases with another known cause(s) of dry eye were not included in either group. Results: 51% of the exposed eyes and 50% of the unexposed ones revealed at least one of the dry eye symptoms in the questionnaire. Data analysis showed no significant difference between the number of symptoms of two groups, but 2 symptoms (burning, unrelated to light and rythema) 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. The study also demonstrated a significantly lower wetting amount of the Schirmer paper in exposed group compared to others. In the patients 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. File review of the 21 exposed eyes with 0-4 mm Schirmer test results revealed presence of the

  12. 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)

  13. 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.

  14. 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

  15. 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

  16. 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

  17. 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.)

  18. Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium

    Energy Technology Data Exchange (ETDEWEB)

    Vannucchi, Guia; Mannavola, Deborah; Dazzi, Davide; Beck-Peccoz, Paolo; Fugazzola, Laura [Ospedale Maggiore IRCCS (Pad. Granelli), Institute of Endocrine Sciences, Milan (Italy); Chiti, Arturo; Rodari, Marcello; Tadayyon, Sara [Istituto Clinico Humanitas, Nuclear Medicine Unit, Milan (Italy)

    2005-09-01

    This study aimed to evaluate the effects of radioiodine ({sup 131}I), alone or in combination with lithium, on thyroid volume and the prevention of radioiodine-induced thyrotoxicosis. This is the first clinical trial including only patients with multinodular goitre, normal TSH values and negative anti-thyroid auto-antibodies at baseline. Eighty consecutive patients were randomised to receive {sup 131}I plus lithium (group I+L) or {sup 131}I alone (group I). Thyroid ultrasonography and biochemical analyses were performed at baseline and at 1, 3, 6, 12 and 24 months after treatment. At 1-4 weeks after treatment, {sup 131}I-induced hyperthyroidism was observed in 58.8% of patients and was prevented by lithium administration. A low incidence of hypothyroidism (19%) was recorded at 24 months, whereas up to 44% of patients developed anti-thyroid antibodies. A significant reduction in thyroid volume was observed after {sup 131}I, with a mean decrease of 47.2% (median 48.2%) at 24 months, without differences between the groups. Moreover, it was shown that the decrease in thyroid volume after {sup 131}I was also due to the significant shrinkage of thyroid nodules. This demonstrates that adjunctive lithium is able to reduce radioiodine-induced hyperthyroidism. Therefore, such treatment appears to be safe in older patients and those with underlying cardiovascular disease. In the present large series, {sup 131}I therapy was demonstrated to be highly effective in reducing thyroid and nodular volume even in patients treated with low {sup 131}I doses (2.5 MBq/ml of thyroid tissue), further supporting the view that radioiodine therapy represents a real alternative to surgery. (orig.)

  19. Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium

    International Nuclear Information System (INIS)

    Vannucchi, Guia; Mannavola, Deborah; Dazzi, Davide; Beck-Peccoz, Paolo; Fugazzola, Laura; Chiti, Arturo; Rodari, Marcello; Tadayyon, Sara

    2005-01-01

    This study aimed to evaluate the effects of radioiodine ( 131 I), alone or in combination with lithium, on thyroid volume and the prevention of radioiodine-induced thyrotoxicosis. This is the first clinical trial including only patients with multinodular goitre, normal TSH values and negative anti-thyroid auto-antibodies at baseline. Eighty consecutive patients were randomised to receive 131 I plus lithium (group I+L) or 131 I alone (group I). Thyroid ultrasonography and biochemical analyses were performed at baseline and at 1, 3, 6, 12 and 24 months after treatment. At 1-4 weeks after treatment, 131 I-induced hyperthyroidism was observed in 58.8% of patients and was prevented by lithium administration. A low incidence of hypothyroidism (19%) was recorded at 24 months, whereas up to 44% of patients developed anti-thyroid antibodies. A significant reduction in thyroid volume was observed after 131 I, with a mean decrease of 47.2% (median 48.2%) at 24 months, without differences between the groups. Moreover, it was shown that the decrease in thyroid volume after 131 I was also due to the significant shrinkage of thyroid nodules. This demonstrates that adjunctive lithium is able to reduce radioiodine-induced hyperthyroidism. Therefore, such treatment appears to be safe in older patients and those with underlying cardiovascular disease. In the present large series, 131 I therapy was demonstrated to be highly effective in reducing thyroid and nodular volume even in patients treated with low 131 I doses (2.5 MBq/ml of thyroid tissue), further supporting the view that radioiodine therapy represents a real alternative to surgery. (orig.)

  20. 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

  1. 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)

  2. 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.)

  3. Analysis on the childhood and adolescent differentiated thyroid cancer: clinical features and radioiodine treatment

    International Nuclear Information System (INIS)

    Chen Zequan; Luo Quanyong; Chen Libo; Ding Yin; Yu Yongli; Lu Hankui; Zhu Ruisen

    2009-01-01

    Objective: Children with differentiated thyroid cancer (DTC) frequently present with more extensive disease than adults. The aim of this study was to characterize the clinical features of child-hood and adolescent DTC and evaluate the outcome and safety of radioiodine treatment. Methods: The records of 38 childhood and adolescent DTC cases, with 28 females and 10 males (mean age: 16.4 years) were reviewed. At diagnosis, all had metastatic lesions with 38 at regional lymph nodes, 15 at lung, 2 at brain and bone. Twenty-three had a total thyroidectomy, 7 had subtotal thyroidectomy, 5 had lobectomy, and 3 had other treatment. All received post-operative radioiodine therapy. All had follow-up for at least one year. Results: At the time of follow-up, all were survive (with a median follow-up of 5.13 years). Four-teen patients had no evidence of disease, 16 had partial remission, and 8 were stable disease. Conclusions: DTC of the thyroid in childhood and adolescent has high risks of residual/recurrence and metastasis. Post-thyroidectomy oral administration of radioiodine was an effective and safety adjuvant therapy for outcomes. (authors)

  4. Outpatient management of patients with large multinodular goitres treated with fractionated radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, D.M.; Thomas, P.A.; Allen, L.W.; Akerman, R.; Lan, L. [Department of Nuclear Medicine, John Hunter Hospital, Newcastle, NSW (Australia); Epstein, M.T. [Department of Endocrinology, John Hunter Hospital, Newcastle, NSW (Australia)

    1997-12-01

    The efficacy of fractionated out-patient radioiodine therapy in 38 patients with compressive symptoms due to long-standing large multinodular goitres was assessed. The diagnosis was established by clinical assessment in addition to technetium-99m pertechnetate thyroid scan or computed tomography scan of the thyroid and mediastinum. Oral iodine-131 therapy was administered as a 2.22 GBq (60 mCi) cumulative dose over 4 months (555 MBq per month). All patients were monitored with serum thyroid-stimulating hormone and free thyroxine ({+-} free tri-iodothyronine) assays before the treatment and after each dose fraction. Clinical and biochemical follow-up was performed on all patients and ranged from 6 to 45 months after therapy. The patients consisted of 35 female and three male patients with a median age of 59 years (range 37-87 years). Prior to treatment 20 patients were biochemically hyperthyroid and 18 were euthyroid. Overall, 71% of patients reported a subjective improvement in compressive symptoms and 29% reported no change. Clinically assessed reduction in goitre size occurred in 92% of patients while there was no change in 8%. At 3 months of follow-up, 31% of patients had become hypothyroid and at 18 months 66% were hypothyroid. Seven hyperthyroid patients (35%) became euthyroid and 13 hyperthyroid patients (65%) became hypothyroid. Three patients who became hypothyroid experienced neck soreness (transient in one patient, persistent in two patients). There were no differences in outcome between patients who were hyperthyroid and those who were euthyroid prior to treatment. Fractionated out-patient radioiodine therapy showed excellent short- and medium-term safety, was very well tolerated and offered a satisfactory alternative treatment to surgery. (orig.) With 1 fig., 3 tabs., 23 refs.

  5. 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.

  6. 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.

  7. Radioiodine (I-131) application in the management of differentiated thyroid cancer (DTC) audit

    International Nuclear Information System (INIS)

    Nanayakkara, D.

    2005-01-01

    Full text: Differentiated thyroid cancer (DTC) remains one of the curable of all cancers. All literature reviews and clinical experiences regarding I 131 use in DTC conclude the beneficial effects, better prognosis, longer survival time and an assurance for cure. The Overall prognosis of patients with DTC is excellent if treat scientifically, adequately and timely. The management of thyroid cancer depends on the resources available in different institutions. Nuclear Medicine unit (NMU), Faculty of Medicine Peradeniya, Sri Lanka is in the process of uplifting the services for thyroid cancer management. Clinical audit was carried out in NMU on patients who utilized the Nuclear Medicine facilities in the management of DTC. It is important to identify deficiencies in current practice to improve our services. During January 2004 to March 2005, 126 DTC patients were referred for radioiodine Whole body scan (WBS) and therapy. Their age, sex, histology, extent of surgery, adequacy of thyroxine suppression treatment, monitoring with serum thyroglobulin levels (Tg), WBS results and radioiodine therapy were analyzed. There were 104(82.5%) females and 22(17.5%) males giving sex ratio of 4.7: 1. The Mean age was 35.5 years (range 9-58 years). The commonest histological types were papillary carcinoma 55.5% (n=70), follicular carcinoma 35% (n=44) and follicular variant of papillary carcinoma 9.5% (n=12). Seventy five percent (n=95) had total thyroidectomy (TT), 17 %(n=21) had near total thyroidectomy (NTT) and 8%(n=10) had subtotal thyroidectomy (STT). Sixty-nine patients (54.8%) were on thyroid suppression therapy. Thirty-six patients (28.6%) were referred to the WBS soon after surgery without initiation of thyroxine treatment. Another twenty-one patients (16.6%) were not on thyroxine therapy since surgery. Serum thyroglobulin was assessed on 20.6% (n=26). WBS done using 3-4 mCi liquid radioiodine showed residual functioning thyroid tissues in 41% (n=52). Lymph nodes or bone

  8. 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

  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. 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.)

  11. Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Ross, D.S.; Nussbaum, S.R.

    1989-01-01

    Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status

  12. Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ross, D.S.; Nussbaum, S.R.

    1989-06-01

    Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status.

  13. 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)

  14. 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.

  15. 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)

  16. 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).

  17. Comparison of Fixed versus Calculated Activity of Radioiodine for the Treatment of Graves Disease in Adults

    Directory of Open Access Journals (Sweden)

    Abigail U. Canto

    2016-03-01

    Full Text Available BackgroundRadioactive iodine as a treatment modality has been shown in several studies to be a safe and effective therapy for Graves disease. However, there is still no uniformity regarding optimal dosing method. The aim of this study is to compare the efficacy of calculated and fixed dosing of radioiodine for the treatment of Graves disease.MethodsA hundred twenty-two patients diagnosed with Graves disease were randomized to receive either fixed or calculated dose of radioiodine. Those randomized to fixed activity received either low fixed activity at 9.9 mCi for thyroid gland size <40 g or high fixed activity at 14.9 mCi for thyroid gland size 40 to 80 g, and those grouped to calculated activity received 160 µCi/g of thyroid tissue adjusted for 24 hours radioiodine uptake. Thyroid function tests (free thyroxine [T4] and thyroid stimulating hormone [TSH] were monitored at 10, 16, and 24 weeks after radioactive iodine therapy. The primary outcome, treatment failure was defined as persistently elevated free T4 and low TSH.ResultsOf the 122 patients randomized, 56 in the fixed dose group and 56 in the calculated dose group completed the follow-up. At the end of 6 months, the percentage of treatment failure was 37.50% in the calculated dose group versus 19.64% in the fixed dose group with a relative risk of 0.53 (95% confidence interval, 0.28 to 0.98 favoring the fixed dose group.ConclusionFixed dose radioiodine has a significantly lower incidence of persistent hyperthyroidism at 6 months post-radioactive therapy.

  18. 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)

  19. Internal contamination in nurses attending patients, that received therapeutic amounts of radioiodine-131

    International Nuclear Information System (INIS)

    Termorshuizen, W.; Gerritsen, A.J.M.

    1988-01-01

    The most frequent and often very successful used unsealed source in Nuclear Medicine and Radiotherapy is the radioiodine-131 for the treatment of thyroid carcinoma and hyperthyroidism. Always there is a great concern about the health physics of radioiodine and possible internal contamination involved in high level 131-I thyroid therapy cases, in particular to the thyroid as target and limiting organ. This report deals with 131-I air concentrations and internal contamination in nurses attending these patients under two different conditions. During the past three years a change took place from the old building, where we had an unventilated two-bed nursing room, to a new building were we have rooms with forced ventilation and air-conditioning (refreshment five times per hour). From both external exposure caused by radioiodine treated patients and internal contamination due to ingestion and inhalation of 131-I, we calculated the dose-equivalent to the thyroid and the effective dose-equivalent to our health care personnel

  20. 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.)

  1. 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

  2. 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.

  3. 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

  4. 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)

  5. 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

  6. 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

  7. 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....

  8. Effects of treatment with radioiodine (131 I) on the gonadal function of the hyperthyroid patients

    International Nuclear Information System (INIS)

    Eftekhari, M.; Takavar, A.; Nnsari-Gilani, K.; Akhzari, F.; Fard-Esfahani, A.; Beiki, D.

    2003-01-01

    Introduction: hyperthyroidism is a relatively common disorder caused by different etiologies, Graves' disease and toxic-nodular goiter(Plummer's disease) are among the most common causes. Treatment with radioiodine is considered to be the treatment of choices in many of the patients. Higher biological half-life of 13I in hyperthyroid patients as compared with patients with differentiated thyroid carcinoma who have undergone thyroidectomy, may lead to a higher frequency of complications with radioiodine at similar dosage. Therefore gonadal dysfunction in hyperthyroid patients treated with radioactive iodine is not likely. Materials and methods: hyperthyroid patients with the clinical diagnosis of Graves' disease , toxic multi nodular goiter and toxic adenoma were entered the study. Their age distribution was 16-40 years in women and 17-70 years in men (reproductive years). Patients were euthyroid at the time of radioiodine treatment. FSH, LH, testosterone and semen analysis in men; and FSH, LH, estrogen and progesterone in women were measured before and 3 months after radioiodine therapy. All patients with previous history of radioiodine treatment, those with known sexual hormone abnormalities, women with a history of tube ligation and men with a history of vasectomy, as well as those women who were receiving OCP contraception were excluded from the study. results: From 104 enrolled patients, 40(38.5%) were men and 64(61.5%) were women. The case of hyperthyroidism was Graves' disease in 66 cases(63.5%), toxic multi nodular goiter in 28 cases (26.9%), and toxic adenoma in 10 others (9.6%). Hormonal status was normal in all patients before therapy while this became abnormal in 20(19.2%) of patients after treatment. Semen analysis became abnormal in 8/20(40%) of the patients after treatment. Conclusion: among different variables which were analyzed during study, meaningful correlation was found in the following situations: FSH values in men and women were found to be

  9. Fibroelastic pseudotumor elastofibroma dorsi detected by 18F-FDG PET/CT scan and by postherapy radioiodine SPECT/CT.

    Science.gov (United States)

    Oporto, M; Cepa, F; Orta, N; Rubí, S; Navalón, H; Peña, C

    Radioiodine uptake in the thyroid tissue, metastasis of differentiated thyroid cancer (DTC), and in other tissues, depends on the expression of sodium-iodide symporter (NIS). Vascular permeability, effusions, inflammation, and other mechanisms may also play a role in the accumulation of radioactive iodine. A 63-year-old woman underwent radioiodine therapy, as well as a post-therapy whole-body scan, as she was suspected of having lung metastasis from thyroid carcinoma. The scan not only showed uptake at the lung metastasis but also a faint diffuse bilateral uptake in the posterior thorax. On SPECT/CT this uptake was located in a known Elastofibroma Dorsi (ED) previously diagnosed by contrast CT and viewed in a FDG PET/CT. The radioiodine uptake in ED, especially if typical, is not a diagnostic problem in SPECT/CT study, but can be misleading in a study limited to a few planar images, particularly if the uptake occurs asymmetrically, or ED is located in a unsuspected area. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  10. 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.)

  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. 131I therapy of thyroid cancer patients

    International Nuclear Information System (INIS)

    Reiners, C.; Farahati, J.

    1999-01-01

    Thyroid cancer is a rare malignancy with wide inter ethnic and geographic variations. In Germany thyroid carcinoma is the 13. most frequent malignancy (2.7 new cases yearly per 100,000 inhabitants). The overall temporal incidence is increasing slightly in recent years. The most common types of cancer are papillary (60-80%) and follicular cancers (10-20%). The relevant prognostic indicators are tumor stage and distant metastases. The mean survival rates in papillary thyroid cancer usually exceed 90%, whereas in follicular thyroid cancer they amount to approximately 80%. The standard treatment procedure in differentiated papillary and follicular thyroid cancer consists of total thyroidectomy followed by adjuvant ablative therapy with radioiodine. Only in papillary thyroid cancer stage pT 1 N 0 M 0 lobectomy alone is considered to be appropriate. In patients with locally invasive differentiated thyroid cancers stage pT 4 adjuvant percutaneous radiation therapy is a treatment option. Radioiodine therapy has to be performed under the stimulative influence of TSH. Usually TSH suppressive medication with Levothyroxine has to be withdrawn approximately 4 weeks prior to radioiodine therapy. In the future, exogenous stimulation by recombinant TSH may be used instead of thyroid hormone withdrawal. It has been proved by different studies that ablative radioiodine therapy reduces the frequency of recurrences and tumor spread in patients with thyroid cancer significantly. In patients with distant metastases, up to 50% of complete responses may be achieved with radioiodine treatment

  13. Mammary radioiodine accumulation due to functional sodium iodide symporter expression in a benign fibroadenoma

    International Nuclear Information System (INIS)

    Berger, F.; Unterholzner, S.; Diebold, J.; Knesewitsch, P.; Hahn, K.; Spitzweg, C.

    2006-01-01

    The sodium iodide symporter (NIS) has been characterized to mediate the active transport of iodide not only in the thyroid gland but also in various non-thyroidal tissues, including lactating mammary gland and the majority of breast cancers, thereby offering the possibility of diagnostic and therapeutic radioiodine application in breast cancer. In this report, we present a 57-year-old patient with multifocal papillary thyroid carcinoma, who showed focal radioiodine accumulation in a lesion in the right breast on a posttherapy 131 I scan following radioiodine therapy. CT and MR-mammography showed a focal solid lesion in the right breast suggestive of a fibroadenoma, which was confirmed by histological examination. Immunostaining of paraffin-embedded tumor tissue sections using a human NIS antibody demonstrated NIS-specific immunoreactivity confined to epithelial cells of mammary ducts. In conclusion, in a thyroid cancer patient we identified a benign fibroadenoma of the breast expressing high levels of functionally active NIS protein as underlying cause of focal mammary radioiodine accumulation on a posttherapy 131 I scan. These data show for the first time that functional NIS expression is not restricted to lactating mammary gland and malignant breast tissue, but can also be detected in benign breast lesions, such as fibroadenomata of the breast

  14. 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

  15. Graves' ophthalmopathy and {sup 1}31{sup I} therapy

    Energy Technology Data Exchange (ETDEWEB)

    Marcocci, C.; Bartalena, L.; Tanda, M.L.; Manetti, L.; Dell' Unto, E.; Mazzi, B.; Rocchi, R.; Barbesino, G.; Pinchera, A. [Pisa Univ. of Pisa, Pisa (Italy). Dept. of Endocrinology and Metabolism

    1999-12-01

    Graves' ophthalmopathy is an autoimmune process initiated and maintained by antigen(s) shared by the thyroid and the orbit. A matter of argument concerns the choice of the method of treatment for Graves' hyperthyroidism when clinically evident ophthalmopathy is present. Restoration of euthyroidism appears to be beneficial for ophthalmopathy. On the other hand the continuing disease activity associated with the recurrence of hyperthyroidism appears to adversely affect the course of ophthalmopathy. For these reasons it is our opinion that in patients with Graves' hyperthyroidism and ophthalmopathy the permanent control of thyroid hyper function by ablation of thyroid tissue should be obtained by radioiodine therapy or thyroidectomy. The rationale for an ablative strategy is the following: (i) permanent control of hyperthyroidism avoids exacerbations of eye disease associated with recurrence of hyperthyroidism; (ii) hypothyroidism, which follows thyroid tissue ablation, should be regarded as a therapeutic end point rather than as an undesirable result; (iii) ablation of thyroid tissue may result in the removal of both the thyroid-orbit cross-reacting antigen(s) and the major source of thyroid-auto reactive lymphocytes. The relationship between radioiodine therapy and the course of GO is a matter of controversy, and some authors have suggested that radioiodine administration ma be associated with a worsening of preexisting ophthalmopathy. This was not observed when radioiodine treatment was associated with a 3-month oral course of prednisone. The development or progression of GO after radioiodine therapy might be due to the release of thyroid antigens following radiation injury and to subsequent exacerbations of autoimmune reactions directed towards antigens shared by the thyroid and the orbit. The view that radioiodine therapy may be associated with a progression of ophthalmopathy is not shared by some authors who claim that the apparent link between

  16. 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.

  17. 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

  18. Guidelines for the use of radioiodine in the management of hyperthyroidism: a summary. Prepared by the Radioiodine Audit Subcommittee of the Royal College of Physicians Committee on Diabetes and Endocrinology, and the Research Unit of the Royal College of Physicians.

    Science.gov (United States)

    Lazarus, J H

    1995-01-01

    Radioiodine (131I) therapy is indicated in patients with nearly all causes of hyperthyroidism. It may safely be given to patients of all age groups but is less often given to children under 10 years old. It is completely contraindicated in pregnancy and while breast feeding, but there is no increased risk of thyroid cancer, leukaemia or solid tumours. Administration of radioiodine must conform to regulations and definitions laid down by ARSAC And POPUMET. Medical staff authorising therapy must hold an ARSAC licence. The recommended strategy is to give an activity sufficient to render the patient rapidly euthyroid and maintain that state or achieve no more than a low rate of hypothyroidism in subsequent years. A range of activity (300-800 MBq) is suggested depending on the clinical state. Antithyroid drugs may be given before or after (or both) radioiodine if necessary. Full written information should be given to the patient and written consent obtained. A structured follow-up should be used ensuring regular measurement of TSH or FT4. Close cooperation with the patient's general practitioner is recommended throughout the assessment, treatment and follow-up. Shared care with a computer based follow-up system is recommended.

  19. 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.)

  20. 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.)

  1. The principles of radioiodine dosimetry following a nuclear accident

    International Nuclear Information System (INIS)

    Zvonova, I.A.

    1996-01-01

    Based upon the experience of radioiodine dosimetry after the Chernobyl accident main principals of radioiodine measurements and dosimetry in thyroid glands of population in case of a radiation accident are discussed in the report. For the correct dose estimation following the radioiodine measurement in the thyroid one should know the ''history'' of radionuclide intake into the body of a contaminated person. So a measurement of radioiodine thyroid content should be accompanied by asking questions of investigated persons about, their life style and feeding after a nuclear incident. These data coincidently with data of radionuclides dynamic in the air and food (especially in milk products) are used for the development of radioiodine intake model and then for thyroid dose estimation. The influence of stable iodine prophylaxis and other countermeasures on values are discussed in dependence on the time of its using. Some methods of thyroid dose reconstruction used after the Chernobyl accident in Russia for a situation of thyroid radioiodine measurements lacking in a contaminated settlement are presented in the report. (author). 16 refs, 5 figs, 3 tabs

  2. The principles of radioiodine dosimetry following a nuclear accident

    Energy Technology Data Exchange (ETDEWEB)

    Zvonova, I A [Institute of Radiation Hygiene, St. Petersburg (Russian Federation)

    1996-08-01

    Based upon the experience of radioiodine dosimetry after the Chernobyl accident main principals of radioiodine measurements and dosimetry in thyroid glands of population in case of a radiation accident are discussed in the report. For the correct dose estimation following the radioiodine measurement in the thyroid one should know the ``history`` of radionuclide intake into the body of a contaminated person. So a measurement of radioiodine thyroid content should be accompanied by asking questions of investigated persons about, their life style and feeding after a nuclear incident. These data coincidently with data of radionuclides dynamic in the air and food (especially in milk products) are used for the development of radioiodine intake model and then for thyroid dose estimation. The influence of stable iodine prophylaxis and other countermeasures on values are discussed in dependence on the time of its using. Some methods of thyroid dose reconstruction used after the Chernobyl accident in Russia for a situation of thyroid radioiodine measurements lacking in a contaminated settlement are presented in the report. (author). 16 refs, 5 figs, 3 tabs.

  3. 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.)

  4. 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

  5. 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

  6. 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

  7. Radioiodine remnant ablation of differentiated thyroid cancer does not further increase oxidative damage to membrane lipids - early effect

    Directory of Open Access Journals (Sweden)

    Makarewicz Jacek

    2010-10-01

    Full Text Available Abstract Introduction Radioiodine (131I therapy is widely accepted as an essential part of therapeutic regimens in many cases of differentiated thyroid cancer. Radiation-induced oxidative damage to macromolecules is a well known phenomenon. Frequently examined process to evaluate oxidative damage to macromolecules is lipid peroxidation (LPO, resulting from oxidative damage to membrane lipids. The aim of the study was to examine serum LPO level in hypothyroid (after total thyroidectomy cancer patients subjected to ablative activities of 131I. Materials and methods The study was carried out in 21 patients (18 females and 3 males, average age 52.4 ± 16.5 years after total thyroidectomy for papillary (17 patients or follicular (4 patients thyroid carcinoma. Hypothyroidism was confirmed by increased TSH blood concentration (BRAHMS, Germany, measured before 131I therapy. Activity of 2.8 - 6.9 GBq of 131I was administered to the patients orally as sodium iodide (OBRI, Poland. Concentrations of malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA, as an index of LPO (LPO-586 kit, Calbiochem, USA, were measured in blood serum just before 131I administration (day "0" and on the days 1-4 after 131I therapy. Sera from 23 euthyroid patients served as controls. Correlations between LPO and TSH or 131I activity were calculated. Results Expectedly, serum LPO level, when measured before 131I therapy, was several times higher (p 131I therapy. LPO did not correlate with TSH concentration. In turn, negative correlation was found between 131I activity and LPO level on the day "2" after radioiodine treatment. Conclusions Radioiodine remnant ablation of differentiated thyroid cancer does not further increase oxidative damage to membrane lipids, at least early, after therapy.

  8. 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.)

  9. Reinvestigation of the radiopharmaceutical production of radioiodinated long-chain fatty acids. Vol. 3

    Energy Technology Data Exchange (ETDEWEB)

    El-Shaboury, G; El-Kolaly, M T; Raieh, M [Labelled Compounds Department, Hot Laboratories Center, Atomic Energy Authority, Cairo (Egypt)

    1996-03-01

    An improved and simple radiopharmaceutical production technique for radioiodination of {omega} - (Br) or (I) fatty acids ({omega}) - Br or I-(C H{sub 2}){sub n} Co{sub 2} H, where n = 16 to 17 with Na{sup 13I} for myocardial imaging study is described. The technique of production is reported here based on an isotope or non - isotopic exchange reaction between the inactive halogenated fatty acids and lyophilized ethanolic solution of Na{sup 131} I (previously dispensed in 0.02 M NaOH solution) at 80 Degree C within 30 min in absolute ethanol (dehydrated and redistill at 78.5 to 80 degree C over nitrobenzene b.p. 208 to 212 degree C). Although considerable radiochemical yields have been obtained using a wide variety of organic solvents as an isotropic or non-isotropic exchange media such as acetone, methyl ethyl ketone, benzene as well as di-n-propyl ketone; certain problems due to the evaporation of these solvents during the process of purification have been observed. These problems were completely avoided by the initial dissolution of the reactants in dehydrated ethyl alcohol which facilitate direct dispensing of the final radioiodinated acids in diluted human serum albumen without any decomposition. Basically, following the radioiodination process the radioiodinated fatty acids ethanolic solution is passed through out an AgCl-impregnated filter to remove the untreated inorganic radioiodine (2 to 5%). The final pure solution (containing over 99.o% radioiodinated pure fatty acids) is dispensed in human serum albumen (4%), and then sterilized by passing it through 0.22 mum milli pore bacterial filter. The technique is being applied for the radiopharmaceutical production of radioiodinated-phenyl long-chain fatty acids such as iodo phenoxy-, and iodobenzamido-heptadecanoic acids. 3 figs.

  10. Reinvestigation of the radiopharmaceutical production of radioiodinated long-chain fatty acids. Vol. 3

    International Nuclear Information System (INIS)

    El-Shaboury, G.; El-Kolaly, M.T.; Raieh, M.

    1996-01-01

    An improved and simple radiopharmaceutical production technique for radioiodination of ω - (Br) or (I) fatty acids (ω) - Br or I-(C H 2 ) n Co 2 H, where n = 16 to 17 with Na 13I for myocardial imaging study is described. The technique of production is reported here based on an isotope or non - isotopic exchange reaction between the inactive halogenated fatty acids and lyophilized ethanolic solution of Na 131 I (previously dispensed in 0.02 M NaOH solution) at 80 Degree C within 30 min in absolute ethanol (dehydrated and redistill at 78.5 to 80 degree C over nitrobenzene b.p. 208 to 212 degree C). Although considerable radiochemical yields have been obtained using a wide variety of organic solvents as an isotropic or non-isotropic exchange media such as acetone, methyl ethyl ketone, benzene as well as di-n-propyl ketone; certain problems due to the evaporation of these solvents during the process of purification have been observed. These problems were completely avoided by the initial dissolution of the reactants in dehydrated ethyl alcohol which facilitate direct dispensing of the final radioiodinated acids in diluted human serum albumen without any decomposition. Basically, following the radioiodination process the radioiodinated fatty acids ethanolic solution is passed through out an AgCl-impregnated filter to remove the untreated inorganic radioiodine (2 to 5%). The final pure solution (containing over 99.o% radioiodinated pure fatty acids) is dispensed in human serum albumen (4%), and then sterilized by passing it through 0.22 mum milli pore bacterial filter. The technique is being applied for the radiopharmaceutical production of radioiodinated-phenyl long-chain fatty acids such as iodo phenoxy-, and iodobenzamido-heptadecanoic acids. 3 figs

  11. Efficiency analysis of using tailored individual doses of radioiodine and fine tuning using a low-dose antithyroid drug in the treatment of Graves' disease.

    Science.gov (United States)

    Liu, Chang-Jiang; Dong, Yan-Yu; Wang, Yi-Wei; Wang, Kai-Hua; Zeng, Qun-Yan

    2011-03-01

    To evaluate the effect of using tailored individual doses of radioiodine (¹³¹I) and fine tuning using low-dose antithyroid drug (ATD) in the treatment of Graves' disease, and an attempt to establish a therapeutic strategy that can keep both high rate of euthyroidism and low incidence of hypothyroidism. The dose of radioiodine was calculated using the calculated dose formula, and low-dose ATD was used as a way of fine tuning during follow-up. The intended dose of radioiodine was modified according to the patient's age at radioiodine therapy, thyroid size, and duration of hyperthyroidism before radioiodine therapy in the study group; it was set as 2.96 MBq/g of thyroid in the control group. Twenty patients with Graves' disease were nonrandomly assigned to the control group and 98 patients with Graves' disease to the study group. The outcomes, which included euthyroidism, hypothyroidism, and persistent hyperthyroidism, were determined according to the patients' states at the end of follow-up. In the study group, 74 patients (75.5%) achieved the euthyroid state, six patients (6.1%) became hypothyroid, and 18 patients (18.4%) remained hyperthyroid. The rate of euthyroidism was statistically different between the study group and the control group (75.5 vs. 50%, P=0.03). Of 98 patients with Graves' disease in the study group, 19 patients were additionally treated with ATD during follow-up, and 12 patients achieved euthyroidism. In different age groups or duration of hyperthyroidism groups, the rate of euthyroidism was not statistically different among subgroups of goiter grade 1, grade 2, and grade 3 (P>0.05). Similarly, in different age groups or duration of hyperthyroidism groups, the incidence of hypothyroidism was not statistically different among subgroups of goiter grade 1, grade 2, and grade 3 (P>0.05). However, binary logistic regression analysis showed that thyroid size was associated with overtreatment and undertreatment in our study. Individual doses of

  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 (I-131) treatment for uncomplicated hyperthyroidism: An assessment of optimal dose and cost-effectiveness

    International Nuclear Information System (INIS)

    Paul, A.K.; Rahman, H.A.; Jahan, N.

    2002-01-01

    Aim: Radioiodine (I-131) is increasingly being considered for the treatment of hyperthyroidism but there is no general agreement for the initial dose. To determine the cost-effectiveness and optimal dose of I-131 to cure disease, we prospectively studied the outcome of radioiodine therapy of 423 patients. Material and Methods: Any of the fixed doses of 6, 8, 10, 12 or 15 mCi of I-131 was administered to the patients relating to thyroid gland size. The individual was excluded from this study who had multinodular goitre and autonomous toxic nodule. Patients were classified as cured if the clinical and biochemical status was either euthyroid or hypothyroid at one year without further treatment by antithyroid drugs or radioiodine. The costs were assessed by analyzing the total cost of care including office visit, laboratory testing, radioiodine treatment, average conveyance and income loss of patient and attendant and thyroxine replacement for a period of 2 years from the day of I-131 administration. Results: The results showed a progressive increase of cure rate from the doses of 6, 8 and 10 mCi by 67%, 76.5% and 85.7% respectively but the cure rate for the doses of 12 and 15 mCi was 87.9% and 88.8% respectively. Cure was directly related to the dose between 6 and 10 mCi but at higher doses the cure rate was increased marginally at the expense of increased total body radiation. There was little variation in total costs, but was higher for low dose-therapy and the cost proportion between the 6 mCi regimen and 10 mCi regimen was 1.04:1. Conclusion: We could conclude that an initial 10 mCi of I-131 may be the optimal dose for curing hyperthyroidism and will also limit the total costs

  14. Low dose iodine-131 therapy in solitary toxic thyroid nodules

    International Nuclear Information System (INIS)

    Prakash, Rajeev

    1999-01-01

    Forty patients with solitary hyperfunctioning thyroid nodules were treated with relatively low dose radioiodine therapy, 131 I doses were calculated taking into account thyroid mass and radioiodine kinetics to deliver 100 μCi/g of estimated nodule weight corrected for uptake. Patients remaining persistently hyperthyroid at four months after the initial therapy were retreated with a similarly calculated dose. Cure of the hyperthyroid state was achieved in all patients, total administered dose in individual cases ranging from 3-17 mCi. 28 of the 40 patients required a single therapy dose. 36 patients were euthyroid after a 4.5 year mean follow-up period. Four cases developed post therapy hypothyroidism requiring replacement therapy. Nodules regressed completely in nine cases following 131 I treatment, with partial regression in size in 19 patients. Control of hyperthyroid state in cases of solitary toxic thyroid nodules can be satisfactorily achieved using relatively low dose radioiodine therapy with low incidence of post therapy hypothyroidism. (author)

  15. 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...

  16. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Seo, Ye Young [Dept. of Nuclear Medicine, College of Medicine, The Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of); Ryu, Ji Young [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-12-15

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

  17. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    International Nuclear Information System (INIS)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo; Seo, Ye Young; Ryu, Ji Young

    2015-01-01

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients

  18. Treatment of hyperthyroidism with radioiodine targeted activity: A comparison between two dosimetric methods.

    Science.gov (United States)

    Amato, Ernesto; Campennì, Alfredo; Leotta, Salvatore; Ruggeri, Rosaria M; Baldari, Sergio

    2016-06-01

    Radioiodine therapy is an effective and safe treatment of hyperthyroidism due to Graves' disease, toxic adenoma, toxic multinodular goiter. We compared the outcomes of a traditional calculation method based on an analytical fit of the uptake curve and subsequent dose calculation with the MIRD approach, and an alternative computation approach based on a formulation implemented in a public-access website, searching for the best timing of radioiodine uptake measurements in pre-therapeutic dosimetry. We report about sixty-nine hyperthyroid patients that were treated after performing a pre-therapeutic dosimetry calculated by fitting a six-point uptake curve (3-168h). In order to evaluate the results of the radioiodine treatment, patients were followed up to sixty-four months after treatment (mean 47.4±16.9). Patient dosimetry was then retrospectively recalculated with the two above-mentioned methods. Several time schedules for uptake measurements were considered, with different timings and total number of points. Early time schedules, sampling uptake up to 48h, do not allow to set-up an accurate treatment plan, while schedules including the measurement at one week give significantly better results. The analytical fit procedure applied to the three-point time schedule 3(6)-24-168h gave results significantly more accurate than the website approach exploiting either the same schedule, or the single measurement at 168h. Consequently, the best strategy among the ones considered is to sample the uptake at 3(6)-24-168h, and carry out an analytical fit of the curve, while extra measurements at 48 and 72h lead only marginal improvements in the accuracy of therapeutic activity determination. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  19. Improved radioiodination of biomolecules using exhaustive Chloramine-T oxidation

    International Nuclear Information System (INIS)

    Robles, Ana M.; Balter, Henia S.; Oliver, Patricia; Welling, Mick M.; Pauwels, Ernest K.J.

    2001-01-01

    To improve standardization in analytical reagents we investigated Chloramine-T radioiodination ( 125 I) of several biomolecules based on the use of a single amount of the oxidizing agent Chloramine-T as the limiting reagent being exhausted during the course of the reaction. Whenever the labeling yield resulted in less than one atom 125 I/molecule, a second amount of the oxidizing agent was added. Thereafter, the integrity of the various biomolecules was assessed using radioimmunoassays, radioreceptor binding assays, or radioimmunometric assays. Purification yields were done by gel permeation (56%±19%, n=230) or by precipitation with trichloroacetic acid (59%±19%, n=230). Specific activity (117±61 MBq/nmol) and the degree of iodine incorporation (1.4±0.8 atoms of 125 I/molecule) were achieved after 300 sec of incubation. A second addition of Chloramine-T resulted in an increased labeling yield of all biomolecules tested by a mean factor of 1.8±0.9. After the second addition of Chloramine-T, we observed for some biomolecules a significant (p<0.001) decreased effect in biological performance. In conclusion, the use of Chloramine-T as a limiting reagent resulted in molecules with appropriate immunological and biological performance. In general, tracers were minimally damaged and assessment of the shelf life as well as storing conditions showed the usefulness of the standardization of biomolecule labeling

  20. A dose-effect correlation for radioiodine ablation in differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Flux, Glenn D; Chittenden, Sarah J; Buckley, Susan; Hindorf, Cecilia [Royal Marsden NHS Foundation Trust, Department of Physics, Sutton, Surrey (United Kingdom); Haq, Masud; Newbold, Kate; Harmer, Clive L [Royal Marsden NHS Foundation Trust, Thyroid Unit, Sutton, Surrey (United Kingdom)

    2010-02-15

    The aim of this study was to determine the range of absorbed doses delivered to thyroid remnants, blood, and red marrow from fixed administrations of radioiodine and to ascertain whether the success of ablation is more dependent on these absorbed doses than on the administered activity. Twenty-three patients received 3,000 MBq radioiodine following near-total thyroidectomy. The maximum absorbed dose to remnants was calculated from subsequent single photon emission tomography scans. Absorbed doses delivered to blood and red marrow were calculated from blood samples and from whole-body retention measurements. The protein bound iodine (PBI) was also calculated. Maximum absorbed doses to thyroid remnants ranged from 7 to 570 Gy. Eighteen of the 23 patients had a successful ablation. A significant difference was seen between the absorbed doses delivered to thyroid remnants, blood, and red marrow for those patients that had a successful ablation compared to those with a failed ablation (p = 0.030, p = 0.043 and p = 0.048, respectively). The difference between the PBI values acquired at day 1 and day 6 were also indicative of response (p = 0.074). A successful ablation is strongly dependent on the absorbed dose to the thyroid remnant. Dosimetry-based personalized treatment can prevent both sub-optimal administrations, which entails further radioiodine therapy, and excessive administration of radioactivity, which increases the potential for radiation toxicity. (orig.)

  1. 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.

  2. 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

  3. 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

  4. Influence of treatment with radioiodine and propylthiouracil on thyroid stimulating immunoglobulins in Graves' disease

    International Nuclear Information System (INIS)

    Bech, K.; Nistrup Madsen, S.

    1980-01-01

    Thyroid stimulating immunoglobulins (TSAb) were measured in fifty-four patients with Graves' disease before treatment with either radioiodine (seventeen patients) or propylthiouracil (PTU) (thirty-seven patients) and followed during treatment. After radioiodine TSAb increased to levels exceeding pretreatment values, and became detectable in three of six originally TSAb negative patients. In most patients TSAb decreased during treatment with PTU, and became undetectable after a mean of 12 months in patients above 40 years, and after a mean of 6 months in patients below 40 years. In order to eliminate the presumed causative agent in Graves' disease, antithyroid treatment should be at least 18 months in patients above 40 years, and at least 12 months in patients below 40 years of age. In twenty-nine patients TSAb were measured at cessation of 2 years antithyroid drug therapy. Ten patients were TSAb positive and all except one relapsed. Five of nineteen TSAb negative patients relapsed. Although TSAb positivity predicts relapse, it is not an ideal index of prognosis after antithyroid therapy. (author)

  5. Treatment of medulloblastoma using an oncolytic measles virus encoding the thyroidal sodium iodide symporter shows enhanced efficacy with radioiodine

    International Nuclear Information System (INIS)

    Hutzen, Brian; Pierson, Christopher R; Russell, Stephen J; Galanis, Evanthia; Raffel, Corey; Studebaker, Adam W

    2012-01-01

    Medulloblastoma is the most common malignant brain tumor of childhood. Although the clinical outcome for medulloblastoma patients has improved significantly, children afflicted with the disease frequently suffer from debilitating side effects related to the aggressive nature of currently available therapy. Alternative means for treating medulloblastoma are desperately needed. We have previously shown that oncolytic measles virus (MV) can selectively target and destroy medulloblastoma tumor cells in localized and disseminated models of the disease. MV-NIS, an oncolytic measles virus that encodes the human thyroidal sodium iodide symporter (NIS), has the potential to deliver targeted radiotherapy to the tumor site and promote a localized bystander effect above and beyond that achieved by MV alone. We evaluated the efficacy of MV-NIS against medulloblastoma cells in vitro and examined their ability to incorporate radioiodine at various timepoints, finding peak uptake at 48 hours post infection. The effects of MV-NIS were also evaluated in mouse xenograft models of localized and disseminated medulloblastoma. Athymic nude mice were injected with D283med-Luc medulloblastoma cells in the caudate putamen (localized disease) or right lateral ventricle (disseminated disease) and subsequently treated with MV-NIS. Subsets of these mice were given a dose of 131 I at 24, 48 or 72 hours later. MV-NIS treatment, both by itself and in combination with 131 I, elicited tumor stabilization and regression in the treated mice and significantly extended their survival times. Mice given 131 I were found to concentrate radioiodine at the site of their tumor implantations. In addition, mice with localized tumors that were given 131 I either 24 or 48 hours after MV-NIS treatment exhibited a significant survival advantage over mice given MV-NIS alone. These data suggest MV-NIS plus radioiodine may be a potentially useful therapy for the treatment of medulloblastoma

  6. Treatment of medulloblastoma using an oncolytic measles virus encoding the thyroidal sodium iodide symporter shows enhanced efficacy with radioiodine

    Directory of Open Access Journals (Sweden)

    Hutzen Brian

    2012-11-01

    Full Text Available Abstract Background Medulloblastoma is the most common malignant brain tumor of childhood. Although the clinical outcome for medulloblastoma patients has improved significantly, children afflicted with the disease frequently suffer from debilitating side effects related to the aggressive nature of currently available therapy. Alternative means for treating medulloblastoma are desperately needed. We have previously shown that oncolytic measles virus (MV can selectively target and destroy medulloblastoma tumor cells in localized and disseminated models of the disease. MV-NIS, an oncolytic measles virus that encodes the human thyroidal sodium iodide symporter (NIS, has the potential to deliver targeted radiotherapy to the tumor site and promote a localized bystander effect above and beyond that achieved by MV alone. Methods We evaluated the efficacy of MV-NIS against medulloblastoma cells in vitro and examined their ability to incorporate radioiodine at various timepoints, finding peak uptake at 48 hours post infection. The effects of MV-NIS were also evaluated in mouse xenograft models of localized and disseminated medulloblastoma. Athymic nude mice were injected with D283med-Luc medulloblastoma cells in the caudate putamen (localized disease or right lateral ventricle (disseminated disease and subsequently treated with MV-NIS. Subsets of these mice were given a dose of 131I at 24, 48 or 72 hours later. Results MV-NIS treatment, both by itself and in combination with 131I, elicited tumor stabilization and regression in the treated mice and significantly extended their survival times. Mice given 131I were found to concentrate radioiodine at the site of their tumor implantations. In addition, mice with localized tumors that were given 131I either 24 or 48 hours after MV-NIS treatment exhibited a significant survival advantage over mice given MV-NIS alone. Conclusions These data suggest MV-NIS plus radioiodine may be a potentially useful therapy for

  7. 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

  8. Comparison between thyroid hormone withdrawal and recombinant human TSH administration before radioiodine treatment for advanced thyroid cancer

    International Nuclear Information System (INIS)

    Coelho, Sabrina M.; Corbo, Rossana; Buescu, Alexandru; Carvalho, Denise P.; Vaisman, Mario

    2005-01-01

    Full text: Radioiodine treatment is traditionally performed after thyroid hormone withdrawal. However, induction of hypothyroidism is associated with physical and psychological symptoms and a possible induction of tumor growth. This is particularly harmful in patients with advanced thyroid cancer (ATC). The objective of this study was to compare the thyroxine withdrawal and the recombinant human TSH (rh TSH) administration in patients with non-radioiodine responsive ATC after retinoic acid (RA) therapy for induction of iodine uptake. Patients were treated with isotretinoin (1.0 to 1.5 mg/kg/d) for 5 weeks, then, thyroxine (LT 4 ) was discontinued 4 weeks before therapeutic dose (150 mCi). Based on the presence of a satisfactory response to RA (increased iodine uptake, reduction of serum thyroglobulin and tumor regression), another cycle of RA was offered, then rh TSH was used (0.9 mg in two consecutive days). A total of 8 patients (1 follicular, 1 poorly differentiated and 6 papillary carcinomas) were treated. In a patient with pituitary adenoma the endogenous TSH did not rise after T 4 withdrawal, and rh TSH was administered before radioiodine therapy. Although an increase in iodine uptake was observed after RA therapy in the patient with poorly differentiated cancer, the tumor continued to progress and patient died of respiratory insufficiency. Four out of 7 patients had at least a partial response and were selected for re-treatment. Post-therapeutic whole body scan was similar using both protocols, but patients had fewer side effects with rh TSH. One patient who had no compressive symptoms during LT 4 withdrawal did present dysphagia and dysphonia secondary to tumor swelling, 6 hours after the last rh TSH injection. Glucocorticoid was administered and symptoms were reversed after 10 days. Conclusion: Radioiodine uptake using rh TSH was comparable to T 4 withdrawal and is particularly useful when endogenous TSH cannot rise. However, the possibility of compressive

  9. 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

  10. 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)

  11. In contrast to matrix metalloproteinases, serum adiponectin concentrations increase after radioiodine treatment of thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Lewiński A

    2012-10-01

    Full Text Available Abstract Background Matrix metalloproteinases (MMPs, together with their tissue inhibitors (TIMPs, remodel extracellular matrix under physiological and pathological conditions and are implicated in pathogenesis of cardiovascular diseases, cancer and in chronic inflammation. We have endeavoured to assess whether concentrations of MMPs, TIMPs, and anti-inflammatory adiponectin are altered by pharmacological treatment of acute thyrotoxicosis or by radioiodine therapy (RIT. Material and methods We measured serum concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2, and adiponectin, TSH, free T4 (FT4 and free T3 (FT3 in 15 patients (4 males, age (years 51.8±15.3 (mean±SD with hyperthyroidism treated with thiamazole (Group 1 and in 20 subjects (2 males, treated for thyrotoxicosis with radioiodine, age 52.3±12.4 (Group 2, where blood samples were taken before RIT, visit 1 (V1, seven days post RIT, visit 2 (V2, and two to three months post RIT, visit 3 (V3. Results In Group 1 there was no significant change in concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2 or adiponectin, despite a fall in FT4 and FT3 (8.74±4.79 pg/ml vs 3.54±2.40 pg/ml, for FT3, and 4.48 ±2.21 ng/ml vs 1.02±1.07 ng/ml, for FT4, p4 and FT3 from 24.4±15.4 pmol/l (V1 to 14.7±10.6 pmol/l (V3, and from 10.0±5.65 (V1 to 6.1±4.8 pmol/l (V2, p4 and FT3, respectively. Conclusions Radioiodine therapy of thyrotoxicosis does not alter serum MMP-2, MMP-9 or TIMP-1 concentrations either acutely or after about three months of observation. An increase in serum adiponectin might reflect favourable effects of radioiodine administration on cardiovascular risk factors, while an increase in TIMP-2 (principal MMP-2 inhibitor might lead to a decrease in free MMP-2 concentrations.

  12. Inhibition of miR-146b expression increases radioiodine-sensitivity in poorly differential thyroid carcinoma via positively regulating NIS expression

    Energy Technology Data Exchange (ETDEWEB)

    Li, Luchuan; Lv, Bin; Chen, Bo [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Guan, Ming [Department of General Surgery, Qihe People' s Hospital, Qihe, Shandong 251100 (China); Sun, Yongfeng [Department of General Surgery, Licheng District People' s Hospital, Jinan, Shandong 250115 (China); Li, Haipeng [Department of General Surgery, Caoxian People' s Hospital, Caoxian, Shandong 274400 (China); Zhang, Binbin; Ding, Changyuan; He, Shan [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China); Zeng, Qingdong, E-mail: qingdz0201@163.com [Department of General Surgery, Shandong University Qilu Hospital, Jinan, Shandong 250012 (China)

    2015-07-10

    Dedifferentiated thyroid carcinoma (DTC) with the loss of radioiodine uptake (RAIU) is often observed in clinical practice under radioiodine therapy, indicating the challenge for poor prognosis. MicroRNA (miRNA) has emerged as a promising therapeutic target in many diseases; yet, the role of miRNAs in RAIU has not been generally investigated. Based on recent studies about miRNA expression in papillary or follicular thyroid carcinomas, the expression profiles of several thyroid relative miRNAs were investigated in one DTC cell line, derived from normal DTC cells by radioiodine treatment. The top candidate miR-146b, with the most significant overexpression profiles in dedifferentiated cells, was picked up. Further research found that miR-146b could be negatively regulated by histone deacetylase 3 (HDAC3) in normal cells, indicating the correlation between miR-146b and Na{sup +}/I{sup −} symporter (NIS)-mediated RAIU. Fortunately, it was confirmed that miR-146b could regulate NIS expression/activity; what is more important, miR-146b interference would contribute to the recovery of radioiodine-sensitivity in dedifferentiated cells via positively regulating NIS. In the present study, it was concluded that NIS-mediated RAIU could be modulated by miR-146b; accordingly, miR-146b might serve as one of targets to enhance efficacy of radioactive therapy against poorly differential thyroid carcinoma (PDTC). - Highlights: • Significant upregulated miR-146b was picked up from thyroid relative miRNAs in DTC. • MiR-146b was negatively regulated by HDAC3 in normal thyroid carcinoma cells. • NIS activity and expression could be regulated by miR-146b in thyroid carcinoma. • MiR-146b inhibition could recover the decreased radioiodine-sensitivity of DTC cells.

  13. Autonomous Functioning Thyroid Nodule in a 4-year-old Male Child Treated with Radioiodine (I-131)

    International Nuclear Information System (INIS)

    Khare, Abhishek; Bhutani, Puneet; Chauhan, Suneel

    2013-01-01

    Autonomous functioning thyroid nodules that cause toxic manifestations (toxic adenomas) are benign monoclonal tumors characterized by their capacity to grow and produce thyroxine (T4) and triiodothyronine (T3) autonomously, i.e. in the absence of thyrotropin thyroid stimulating hormone. Toxic adenomas are a rare presentation of hyperthyroidism in the pediatric population. Radioiodine (I-131) has been widely used for therapy of patients with toxic adenomas and is now accepted as a safe and effective treatment even in the pediatric age group. The authors here present a case of a 4-year-old boy with a solitary hyperfunctioning thyroid nodule, who was successfully treated with radioiodine (I-131) and is presently on follow-up

  14. Usefulness of recombinant human TSH aided radioiodine doses administered in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, Fabian; El Tamer, Elias; Schere, Daniel B.; Passerieu, Mariano; Bruno, Oscar D.; Niepominiszcze, Hugo

    2006-01-01

    The published studies confirming the safety and efficacy of rh TSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI) dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC). In order to establish the efficacy of RI therapy after rh TSH, we have reviewed 39 rh TSH-aided radioiodine treatments in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17), with previous thyroid bed uptake and undetectable thyroglobulin (Tg) levels under levothyroxine treatment and GII (n=11), with proven metastatic local or distant disease. Median follow-up after the first rh TSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months). Sixteen patients (94%) in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rh TSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer) and five out of the remaining patients have persistent disease. In conclusion, rh TSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94%) patients (GI). rh TSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rh TSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels. (author) [es

  15. Direct and indirect radioiodination of protein: comparative study of chemotactic peptide labeling

    International Nuclear Information System (INIS)

    Lavinas, Tatiana

    2004-01-01

    The development of simple methods for protein radioiodination have stimulated the use of radioiodinated peptides in vivo. There are two basic methods for labeling proteins with radioiodine: direct labeling, reaction of an electrophilic radioiodine with functional activated groups on protein, like the phenol ring in the tyrosine residue, and the conjugation of a previously radioiodinated molecule to the protein, referred as indirect method. The great problem related to the direct radioiodination of proteins is the in vivo dehalogenation. This problem can be minimized if a non-phenolic prosthetic group is used in the indirect radioiodination of the peptide. The ATE prosthetic group, N-succinimidyl 3-(tri-n-butylstannyl) benzoate, when radioiodinated by electrophilic iododestannilation produces N-succinimidyl 3-[ 123 l/ 131 l] iodine benzoate (SIB) that is subsequently conjugated to the protein by the acylation of the lysine group. There are many radiopharmaceuticals employed in scintigraphic images of infection and inflammation used with some limitations. These limitations stimulated the improvement of a new class of radiopharmaceuticals, the receptor-specific related labeled peptides, as the mediators of the inflammatory response, that presents high affinity by receptors expressed in the inflammation process, and fast clearance from blood and non-target tissues. One of these molecules is the synthetic chemotactic peptide fNleLFNIeYK that presents potent chemotaxis for leukocytes, with high affinity by the receptors presented in polymorphonuclear leukocytes and mononuclear phagocytes. The objective of this work included the synthesis of ATE prosthetic group and comparative radioiodination of the chemotactic peptide fNleLFNIeYK by direct and indirect methods, with radiochemical purity determination and evaluation of in vivo and in vitro stability of the compounds. This work presented an original contribution in the comparative biological distribution studies of the

  16. 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.)

  17. 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.

  18. Effective doses to family members of patients treated with radioiodine-131

    International Nuclear Information System (INIS)

    Kocovska, M Zdraveska; Vaskova, O; Majstorov, V; Kuzmanovska, S; Gjorceva, D Pop; Jokic, V Spasic

    2011-01-01

    The purpose of this study was to evaluate the effective dose to family members of thyroid cancer and hyperthyroid patients treated with radioiodine-131, and also to compare the results with dose constraints proposed by the International Commission of Radiological Protection (ICRP) and the Basic Safety Standards (BSS) of the International Atomic Energy Agency (IAEA). For the estimation of the effective doses, sixty family members of sixty patients, treated with radioiodine-131, and thermoluminiscent dosimeters (Model TLD 100) were used. Thyroid cancer patients were hospitalized for three days, while hyperthyroid patients were treated on out-patient basis. The family members wore TLD in front of the torso for seven days. The radiation doses to family members of thyroid cancer patients were well below the recommended dose constraint of 1 mSv. The mean value of effective dose was 0.21 mSv (min 0.02 - max 0.51 mSv). Effective doses, higher than 1 mSv, were detected for 11 family members of hyperthyroid patients. The mean value of effective dose of family members of hyperthyroid patients was 0.87 mSv (min 0.12 - max 6.79). The estimated effective doses to family members of hyperthyroid patients were higher than the effective doses to family members of thyroid carcinoma patients. These findings may be considered when establishing new national guidelines concerning radiation protection and release of patients after a treatment with radioiodine therapy.

  19. 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

  20. Sertraline can be useful pre radioiodine in patients with thyroid cancer

    International Nuclear Information System (INIS)

    Geber de Almeida, Mariana; Netto Campos Silva, Marcia

    2005-01-01

    Full text: Thyroid hormone withdrawal is a standard approach for increased TSH before radioiodine, in patients with thyroid cancer. However, some patients with hypothyroidism present clinical depression for long time, in spite of the euthyroid state. Sertraline is a selective serotonin reuptake inhibitor, which increases the neurotransmitter 5-hydroxytryptamine, and enhances the serum TSH level. Objectives: To analyze the efficacy of sertraline to increase TSH and improved symptoms of depression in these patients. Methods: In 12 patients with thyroid cancer without previous depression, we used 50 mg of sertraline one month before and after radioiodine and compare with group control. The serum TSH levels were performed ten days before radioiodine and the patients were evaluated 20, 40 and 60 days after started levothyroxine (The Montgomery -Asberg depression rating scale). Results: TSH levels were 85 ± 10 mU/L in the group that used sertraline vs 69 ± 8 mU/L in group control (p < 0,01). The patients who used sertraline reversed depression in (30 ± 5 days - median ± SD), significantly more rapidly if compared with the control group (50 ± 10 days - median ± SD). Three patients that received sertraline and five patients of the control group, severe depression persists, in spite of euthyroid state. Conclusion: This study suggests that sertraline can be useful pre radioiodine to increase TSH, and helps to restore the quality of life and mood, in a short period of time. (author)

  1. The influence of immunosuppressive treatment on the progression of Graves' disease after radioiodine

    International Nuclear Information System (INIS)

    Jurca, T.; Pirnat, E.; Hojker, S.; Avcin, J.

    1994-01-01

    Radioiodine therapy (RIT) for Graves' disease could produce a rise in autoimmune activity expressed as elevation of antibody against TSH receptors (TSI). In our retrospective study the influence of different immunosuppressive therapy on autoimmune activity was studied. Patients, treated with radioiodine or surgery for the first time, between January 1989 and March 1992 were included in the study, divided in the 5 groups (patients after thyroidectomy, and patients after RIT divided into groups according to treatment with different combinations of corticosteroids and cyclosporine A). Patients were examined and TT 4 , TT 3 TSH and TSI were collected before and 3, 6 and 9 months after treatment. There was no differences between groups before and according to the thyroid status the patients of all groups received antithyroid drugs or substitution therapy after the RIT or surgery. Immunosuppressive therapy was indicated because of Graves' ophthalmopathy. After surgery, the progressive fall of TSI and no relapses of the disease were stated. After first 3 months the situation was very similar in group of patients treated with cyclosporine A after RIT, later after the cessation of treatment, there were a slight elevation of TSI. In all other groups of patients after RIT there was a constant positive trend of TSI and the significant correlation was found between TSI before and after treatment. We conclude, that autoimmune response after RIT is a consequence of activity of T cells and therefore cyclosporine A could be taken in mind when we want to prevent it. Corticosteroids on the other hand had no such an effect. (author)

  2. 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.

  3. 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.

  4. A NTCP approach for estimating the outcome in radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Strigari, L.; Sciuto, R.; Benassi, M.; Bergomi, S.; Nocentini, S.; Maini, C. L.

    2008-01-01

    Radioiodine has been in use for over 60 years as a treatment for hyperthyroidism. Major changes in clinical practice have led to accurate dosimetry capable of avoiding the risks of adverse effects and the optimization of the treatment. The aim of this study was to test the capability of a radiobiological model, based on normal tissue complication probability (NTCP), to predict the outcome after oral therapeutic 131 I administration. Following dosimetric study, 79 patients underwent treatment for hyperthyroidism using radioiodine and then 67 had at least a one-year follow up. The delivered dose was calculated using the MIRD formula, taking into account the measured maximum uptake of administered iodine transferred to the thyroid, U0, and the effective clearance rate, T eff and target mass. The dose was converted to normalized total dose delivered at 2 Gy per fraction (NTD 2 ). Furthermore, the method to take into account the reduction of the mass of the gland during radioiodine therapy was also applied. The clinical outcome and dosimetric parameters were analyzed in order to study the dose-response relationship for hypothyroidism. The TD 50 and m parameters of the NTCP model approach were then estimated using the likelihood method. The TD 50 , expressed as NTD 2 , resulted in 60 Gy (95% C.I.: 45-75 Gy) and 96 Gy (95% C.I.: 86-109 Gy) for patients affected by Graves or autonomous/multinodular disease, respectively. This supports the clinical evidence that Graves' disease should be characterized by more radiosensitive cells compared to autonomous nodules. The m parameter for all patients was 0.27 (95% C.I.: 0.22-0.36). These parameters were compared with those reported in the literature for hypothyroidism induced after external beam radiotherapy. The NTCP model correctly predicted the clinical outcome after the therapeutic administration of radioiodine in our series

  5. Labelling of proteins with radioiodine and their application

    International Nuclear Information System (INIS)

    Franek, M.; Hampl, J.; Rodak, L.; Hruska, K.; Prochazka, Z.

    1975-01-01

    Various techniques of labelling proteins and peptides with radioactive iodine are reviewed. Particular attention is focused on the mechanism of iodination of tyrosine used as a model substance for radioiodination of proteins. Particular consideration is given to recent techniques attaining high specific radioactivity without side effects on the protein molecule and to factors affecting the rate of iodination and its character (buffers, polarity of the reaction environment, molecule type, etc.). The suitability is shown of radioiodinated proteins in the studies of protein metabolism and in the radioimmunoanalytical determination of substances of both the protein and non-protein nature. The possibility of further application of radioiodinated protein is discussed. (author)

  6. Late follow up results after J - 131 therapy of toxic multi-nodular goiter

    International Nuclear Information System (INIS)

    Petrovski, Z.

    2015-01-01

    Full text of publication follows. Objective: the aim of this study was to analyze success of radioiodine therapy in patients with toxic multi-nodular goiter (TMG). Methods: The group of 43 patients (36 females / 7 males, aged 47 ± 11 yrs, range 27 - 75 yrs) with TMG were treated with radioiodine. 28 patients were treated with one dose, 12 patients with two doses and 7 patients with three and more doses according to Marinelli's formula. The administered activity of J -131 was established basing on radioiodine uptake and goiter size ( median 555 MBq, range: 370 - 1100 MBq). Patients were evaluated by clinical and thyroid examination of TSH, FT4, FT3 after 1 - 3 months. Thyroid scintigraphy was performed 3 months after radioiodine therapy. Prior to treatment with J -131 all patients were treated with antithyroid medications, who were suspended 4 - 7 days and restarted one week after J - 131 therapy. Results: in 76,8% (33/43) patients there was control of disease after the first J -131 dose and in 95,2% (40/43) patients after the second and more doses. At 20 years of follow up, there were 84,4% (36/43) patients euthyroid, 13,9% (6/43) patients hypothyroid and 4,6% (2/43) patients hyperthyroid. Reduction of gland weight were in 74,4% (32/43) patients. During 20 years of follow up no adverse side effects were observed after J - 131 therapy. Conclusion: radioiodine therapy is the right choice of treatment for toxic multi-nodular goiter and single dose of J -131 is successful in most of the cases. A single higher radioiodine dose diminishes the need for additional J -131 therapy, without increasing of developing hypothyroidism. (authors)

  7. 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

  8. Optimized protocol for the radioiodination of hydrazone-type polymer drug delivery systems

    International Nuclear Information System (INIS)

    Sedláček, Ondřej; Kučka, Jan; Hrubý, Martin

    2015-01-01

    Hydrazone conjugates of polymers with doxorubicin represent a very promising tool for cancer chemotherapy. However, these conjugates are very difficult to radiolabel with iodine radionuclides, which possess otherwise very advantageous nuclear properties to, e.g., follow biodistribution. In this study, we developed a robust protocol for the high-yield radioiodination of hydrazone-type drug delivery systems with doxorubicin. In particular, it is crucial that the polymer radioiodination step be performed before the deprotection of the hydrazide and doxorubicin binding. - Highlights: • Hydrazone-type drug delivery systems with doxorubicin were radioiodinated. • Radioiodination was performed via polymer-bound phenolic moiety. • Radioiodination step must be performed before deprotection and drug binding

  9. 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

  10. Nucleophilic radioiodination of 6-bromocholesterol via non-isotopic exchange reaction in molten state

    International Nuclear Information System (INIS)

    El-Shaboury, G.; Farah, K.; El-Tawoosy, M.

    2001-01-01

    A synthetic method for preparing radioiodinated 6-[ 125 I]iodocholesterol [CL-6- 125 I] for adrenal evaluation is described. The radioiodine atom was incorporated onto the cholesterol molecule via non-isotopic exchange between 6-bromocholesterol [CL-6-Br] and radioiodine as iodide ion [ 125 I - ] in a molten state. The different parameters affecting the yield of exchange were investigated using 125 I (T 1/2 ≅ 60 d) to centralize the different physical and chemical reaction conditions and purification of the final product as pure as 6-[ 125 I]iodocholesterol. The method was suitable to either 131 I (T 1/2 ≅ 8 d) nucleophilic radioiodination which facilitates the scanning of the adrenal for a few days after administration or the use of 124 I (T 1/2 ≅ 4.16 d) nucleophilic radioiodination for PET evaluation of the adrenal. TLC as well as HPLC chromatographic analysis is used to determine the efficiency of the exchange reactions under different chemical reaction conditions and to monitor the stability of the final product as pure as CL-6- 125 I with radiochemical purity of ≅99%. This no-carrier-added method improved the speed of the reaction and affords high radiochemical yield of 90% and suitable specific activity due to the use of CL-6-Br rather than CL-6-I as substrate. Kinetic studies revealed second order iodine-bromine exchange reaction. The activation energy for the exchange reaction in ammonium acetate (m.p. 114 deg C) was calculated to be 4.576 kcal/mole. (author)

  11. Incidental findings of intense radioiodine uptake in struma ovarii and bilateral nonlactating breasts simultaneously on postablation {sup 131}I SPECT/CT for papillary thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Hye Kyung; Kim, Mi Ra [Haeundae Paik HospitalUniversity of Inje, College of Medicine, Busan (Korea, Republic of)

    2016-12-15

    A 52-year-old woman diagnosed with papillary thyroid carcinoma was referred for {sup 131}I therapy following total thyroidectomy. She was given 4,810 MBq (130 mCi) of {sup 131}I following 4 weeks of thyroid hormone withdrawal. A post therapy scan showed intense, focal activity in the pelvis and intense, diffuse activity on both sides of the chest, which was localized to the right ovary and both breasts on SPECT/CT examination. She had bilateral nipple pain and a history of antidopaminergic drugs as combination medication for her rheumatoid arthritis and prokinetics during radioiodine therapy. On a {sup 123}I whole-body scan 9 months later after stopping the drugs, bilateral breast uptake was not visible; however, right ovarian focal uptake was still visualized. Bilateral salpingo-oophorectomy was performed, and revealed struma ovarii with substantial internal necrosis due to radioiodine therapy. This case is interesting as two rare entities, {sup 131}I therapy-related struma ovarii and drug-related breast uptake, were simultaneously visualized.

  12. 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.)

  13. (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.

  14. Government-industry conference on airborne radioiodine

    International Nuclear Information System (INIS)

    Burchsted, C.A.

    1975-01-01

    The Working Group on Airborne Radioiodine met at AEC Headquarters on March 28, 1974. Dr. Alex Perge gave the introduction for the Division of Waste Management and Transportation, noting the Commission hopes that private industry will take a bigger share in the future in funding and initiating needed research; that there should be a greater effort in the direction of reducing the quantity of material that becomes contaminated as an avenue toward reducing the airborne radioiodine problem, and toward reducing the waste generated to a form suitable for direct storage; and that the Commission must ensure valid bases for future regulations governing airborne releases and contamination. Dr. First discussed the background of the review committee and its outgrowth from the earlier organization meeting. He noted that its function will be the coordination of efforts concerned with the radioiodine problem and the dissemination of information and research data. A major objective of this meeting was to identify subjects for discussion at the Government-Industry Conference of Adsorbers and Adsorbents which will be held in conjunction with the 13th AEC Air Cleaning Conference in August. Mr. Dempsey noted that the gaseous effluent program had been inherited by WMT from the Division of Operational Safety, and that an important function of these continuing meetings of the Working Group will be to guide WMT in the expenditure of funds and assignment of research related to the radioiodine problem. (U.S.)

  15. Obtention of a prosthetic group for labelling of radioiodinated proteins

    International Nuclear Information System (INIS)

    Santos, Josefina da S.; Colturato, Maria Tereza; Araujo, Elaine B. de

    2000-01-01

    Antibodies and peptides labeled with radionuclides has been extensively used in radioimmunotherapy and radioimmunodetection. The principal problem with the use of radioiodinated proteins is the in vivo dehalogenation. The use of prosthetic groups for indirect labeling of proteins with radioiodine has showed to be useful on labeling proteins with greater in vivo stability. A procedure is described for the preparation of an radioiodinated prosthetic group (N-succinimidyl 4-radioiodine-benzoate-SIB), using procedure described by Stocklin et al, with the iodination of p-bromo-benzoic acid and subsequent reaction with TSTU. Preliminary labeling results showed that the prosthetic group can be obtained in a good yield. The coupling of the SIB to the protein will be studied using human IgG as protein model. (author)

  16. 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 has to avoid iodine-containing medication and the possibility of additives of iodine in vitamin- and electrolyte-supplementation has to be considered. (orig.)

  17. 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

  18. Characterization and restoration of performance of 'aged' radioiodine removing activated carbons

    International Nuclear Information System (INIS)

    Freeman, W.P.

    1997-01-01

    The degradation of radioiodine removal performance for impregnated activated carbons because of ageing is well established. However, the causes for this degradation remain unclear. One theory is that this reduction in performance from the ageing process results from an oxidation of the surface of the carbon. Radioiodine removing activated carbons that failed radioiodine removal tests showed an oxidized surface that had become hydrophilic compared with new carbons. We attempted to restore the performance of these 'failed' carbons with a combination of thermal and chemical treatment. The results of these investigations are presented and discussed with the view of extending the life of radioiodine removing activated carbons. 4 refs., 2 tabs

  19. 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.)

  20. 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.)

  1. A dosimetric approach to patient-specific radioiodine treatment of Graves' disease with incorporation of treatment-induced changes in thyroid mass

    International Nuclear Information System (INIS)

    Traino, A. Claudio; Di Martino, Fabio; Lazzeri, Mauro

    2004-01-01

    The traditional algorithms (Marinelli-Quimby and MIRD) used for the absorbed dose calculation in radionuclide therapy generally assume that the mass of the target organs does not change with time. In radioiodine therapy for Graves' disease this approximation may not be valid. In this paper a mathematical model of thyroid mass reduction during the clearance phase (30-35 days) after 131 I administration to patients with Graves' disease is presented. A new algorithm for the absorbed dose calculation is derived, taking into account the reduction of the mass of the gland resulting from the 131 I therapy. It is demonstrated that thyroid mass reduction has a considerable effect on the calculated radiation dose. Either the model of the thyroid mass reduction or the new equation for the absorbed dose calculation depend on a parameter k for each patient. This parameter can be calculated after the administration of a diagnostic amount of radioiodine activity (0.37-1.85 MBq). Thus, thyroid absorbed dose and thyroid mass reduction during the first month after therapy can be predicted before therapy administration. The absorbed dose values calculated by the new algorithm are compared to those calculated by the traditional Marinelli-Quimby and MIRD algorithms

  2. Evaluation of methods for retention of radioiodine during processing of irradiated 237Np

    International Nuclear Information System (INIS)

    Thompson, G.H.; Kelley, J.A.

    1975-06-01

    Methods of removing radioiodine from 237 Np-- 238 Pu dissolver solution and process off-gas were investigated. This program is part of a continuing effort to reduce releases of radionuclides from plant operations. Experimental data show: Greater than 99.9 percent of the radioiodine in dissolver solution can be removed by precipitation, in situ, of manganese dioxide. Silver zeolite will sorb greater than 99.9 percent of radioiodine in process off-gas. Other solid sorbents and nitric acid-mercuric nitrate scrubber solutions do not remove appreciable amounts of radioiodine from process off-gas, because radioiodine is present principally as relatively unreactive organic iodine compounds. (U.S.)

  3. Cytogenetic in thyroid carcinoma and therapy with 131{sup I}; Citogenetica en cancer de tiroides y terapia con 131''I

    Energy Technology Data Exchange (ETDEWEB)

    Popova, L.; Hadjidekova, V.; Christova, R.; Agova, S.; Grudeva, V.; Hadjieva, T.; Dominguez, I.

    2007-07-01

    In order to assess the genotoxic risk of the therapy with radioiodine-131(''131I), the production of micronuclei (MN) and chromosome aberrations (CA) were analyzed in the peripheral blood lymphocytes of group of 26 patients undergoing therapy with this radionuclide for differentiated thyroid carcinoma (DTC). Blood samples were taken immediately before ''131 I administration and 1 month later. The patients underwent radioiodine ablation (RIA) or radioiodine therapy (RIT) after radical thyroidectomy. The amount of orally administered ''131I activity varied from 3330 to 4030 MBq according to the king of therapy (RIA or RIT). results show that after radioiodine therapy there is a significant increase in the frequency of MN and CA. The mean frequencies of MN {+-} Sd before and after the therapy were 10.72 % {+-} 5.84 % and 25.28 %{+-} 12.6% respectively. For CA, the mean frequencies obtained were 1.16% {+-} 0.36% before and 2.3% {+-} 0.87% after the therapy. These findings indicate a genotoxic activity of ''131I therapy estimated after a period of one month. (Author) 38 refs.

  4. 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.

  5. A New Technology Developed to Remove Aqueous Radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Yeop; Baik, Min Hoon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Radioiodine is considered as a critical radionuclide by the International Commission on Radiological Protection(ICRP) in terms of the radiation and radiotoxicity risks to nature and human health. In addition, there were reports about great increases of thyroid cancer in children in Belarus from 1990. In natural environments, there were several reports for the unusual increase of radioactive iodine ratios in most environmental samples (i.e. soils, vegetables, and seafoods). Iodine usually exists as iodide, iodate, and organic iodine in the environment. Iodide is considered as the most difficult form among the iodine species to treat by the conventional adsorption-based technology. This is why urgent new technology is needed to suppress such a progressive accumulation of radioiodine in natural environments. The conventional methods based on the anion-exchange and adsorption techniques have been difficult to manage the growing release of radioiodine for decades. Here we suggest a new solution that uses a biostimulant way to isolate radioiodine. We discovered that natural SRB can play an important intermediary role to get anionic iodide and cationic copper combined strongly as perfect counterions by enzymatic Cu-reduction.

  6. 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

  7. A survey of owners' perceptions and experiences of radioiodine treatment of feline hyperthyroidism in the UK.

    Science.gov (United States)

    Boland, Lara A; Murray, Jane K; Bovens, Catherine Pv; Hibbert, Angie

    2014-08-01

    The efficacy of radioiodine treatment of feline hyperthyroidism is well established; however, limited information is known about owners' perceptions or experiences of radioiodine. This study aimed to examine factors that influence owner treatment choices and their opinions following radioiodine. Surveys were sent to owners of cats referred for radioiodine treatment between 2002 and 2011 (radioiodine group; 264 cats) and owners of non-radioiodine-treated hyperthyroid cats seen at first-opinion practices (control group; 199 cats). The response rate was 67.0% (310 returned: 175 radioiodine, 135 control). Of 135 controls, 72 (53.3%) were unaware of radioiodine as a treatment option. Owners of cats ⩾15 years old and uninsured cats were less likely to pursue radioiodine. Cost of treatment, travel distance, potential human or animal health risks and waiting periods for radioiodine had a low impact on owners' treatment choice. Owners reported a moderate level of concern about treatment hospitalisation length, which included (158 respondents) the possibility of the cat being unhappy 130 (82.3%), owner missing the cat 102 (64.6%), inappetence 50 (31.6%), other pets missing the cat 32 (20.3%), development of co-morbid disease 28 (17.7%) and side effects 25 (15.8%). Owners assessed their cat's quality of life on a scale of 1 (very poor) to 10 (excellent), as 4 (4) (median [interquartile range]) pre-radioiodine (134 respondents) and 9 (2) post-radioiodine (131 respondents). Of 132 respondents, 121 (91.7%) were happy with their decision to choose radioiodine. The results of this questionnaire may assist veterinarians in addressing common owner concerns when discussing radioiodine as a treatment option for hyperthyroidism. © ISFM and AAFP 2014.

  8. Radioactive Iodine (I-131) Therapy for Hyperthyroidism

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Radioactive Iodine (I-131) Therapy Radioiodine therapy is a nuclear ... thyroid cancer. When a small dose of radioactive iodine I-131 (an isotope of iodine that emits ...

  9. Changes in conjunctival cytology and tear function tests with radioiodine treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Koca, Gökhan; Atilgan, Hasan Ikbal; Acar, Ugur

    2013-01-01

    Radioiodine (RAI) is used in the treatment of hyperthyroidism and differentiated thyroid cancer. Radioiodine therapy is associated with dry eyes and some side effects are seen especially due to beta rays. In this study, the functional and cytological status of lacrimal glands after RAI therapy was evaluated. Twenty-five patients with a mean age of 55.16 years with planned low-dose RAI therapy were evaluated. Just before and 6 months after the treatment, the lacrimal glands were evaluated with tear break-up time (BUT), Schirmer's test, impression cytology and ''Ocular Surface Disease Index (OSDI)'' questionnaire. The mean value of Schirmer's test was 16.20±3.61 pre-treatment and 11.28±4.39 post-treatment for the right eye, and 15.76±3.27 and 10.60±4.42 for the left eye, respectively. The mean value of Schirmer's test decreased significantly post-treatment in both eyes (p=0.0001). The BUT score also decreased significantly post-treatment (p=0.001). The mean value of OSDI score was 27.5±8.02 pre-treatment and 46.36±10.27 post-treatment. The mean value of OSDI score increased post-treatment (p=0.0001). The impression scores also increased post-treatment in both eyes (p=0.0001). Even low-dose (≤30 mci) RAI treatment affects lacrimal gland functions. Low-dose RAI causes a decrease in the value of Schirmer's test and the BUT test, and an increase in the value of OSDI score and impression scores. (author)

  10. Research on removal of radioiodine by charcoal

    International Nuclear Information System (INIS)

    Li Wangchang; Huang Yuying; Wu Yianwei; Jia Ming; Guo Liangtian

    1993-01-01

    The major R and D work carried out in the CIRP laboratory on removal of radioiodine is introduced, which involves the adsorption performances of various kinds of fruit shell base and coal base charcoal impregnated with chemicals, the influence of various parameters, the technique of non-destructive test for commercial scale iodine adsorber, and the iodine samplers for both gross iodine and iodine in different forms. The experimental results have been applied to the design and test of iodine adsorber and the monitoring of airborne radioiodine

  11. Synthesis, evaluation and application of radioiodine labeled compounds in nuclear medicine

    International Nuclear Information System (INIS)

    Ahmed, M. O. M.

    2006-01-01

    This study reviews synthesis, evaluation,diagnostic and therapeutic applications of iodine radiopharmaceutical especially with 13I I and 123 I in contemporary nuclear medicine. It is well Known that iodine is used in thyroid diagnostic and therapy with sodium iodide and played an important role in diagnostic procedures using single photon emission tomography (SPECT). The study covers the general chemistry of iodine, physical properties, biological role of iodine, general uses of iodine compounds , production and decay schemes of 131 I, 125 I and 123 I in the first chapter. Preparation of radioiodine labeled compounds, quality control of radiopharmaceuticals and safety of radioiodination are dealt with in detail in two chapters. These were followed by chapters dealing in length with the chemistry, preparation, quality control, pharmacokinetics and radiation dosimetry of some iodine radiopharmaceuticals, and then current trends in diagnostic and therapeutic applications of iodine radiopharmaceuticals particularly 131 / 123 I-MIBG and 123 I-IMP. We found that the iodine radiopharmaceuticals are considered amongst principal indicators in single photon emission tomography (SPECT), and 131 / 123 I-MIBG and 123 I-IMP appear to be appropriate diagnostic and therapeutic agents for variety of diseases.(Author)

  12. Therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Wildmeister, W.

    1982-01-01

    The etiology of hyperthyroidism is still largely unknown and therefore no causal therapy of this condition is possible. Antithyroid drug treatment is usually carried out with thiocarbamides. When an euthyroid state is achieved synthetic thyroid hormones are added. Pregnancy and iodine contamination (after exposure to contrast medium) require individual treatment. In this paper the advantages, indications and contraindications are discussed as well as supportive drug therapy necessary in specific cases. Radioiodine therapy is reserved for patients over 35 years of age; the individual dose is calculated according to the size of the thyroid gland and the iodine uptake. Disadvantageous is the late onset of therapeutic efficiency, the small effect on the size of goitre and the exposure to radiation. A patient should be operated upon in an euthyroid state, i.e. after preoperative drug therapy. Operations are normally performed on individuals with a coexistent goitre or where antithyroid drugs or radioiodine therapy are contraindicated. Paresis of the recurrent laryngeal nerve and hypoparathyroidism are rare complications. 3 to 4 g of thyroid tissues should remain. Of great importance in all cases are precise diagnostics both before and after commencing treatment and adequate follow up. (orig./MG) [de

  13. Current opinions on the radioiodine treatment of Graves' hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Woo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2003-12-01

    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.

  14. 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)

  15. Effective doses to family members of patients treated with radioiodine 131

    International Nuclear Information System (INIS)

    Kocovska, Marina Zdravevska; Ristevska, Svetlana Micevska; Nikolovski, Sasho; Jokic, Vesna Spasic

    2010-01-01

    The purpose of this study was to evaluate the effective dose to family members of thyroid cancer and hyperthyroid patients treated with radioiodine 131; also to compare the results with dose constraints proposed by International Commission of Radiological Protection (ICRP) and Basic Safety Standards (BSS) of the International Atomic Energy Agency (IAEA). Material and methods: for estimation of effective doses at sixty family members of thirty thyroid cancer and thirty hyperthyroid patients treated with radioiodine 131, the thermoluminescent dosimeters, Model TLD 100, were used. Thyroid cancer patients were hospitalized for three days, while hyperthyroid patients were treated on out-patient basis. The family members wore thermoluminescent dosimeter in front of the torso for seven days. Results: The radiation doses to family members of thyroid cancer patients were well below recommended dose constraint of 1 mSv. The mean value of effective dose was 0.21 mSv (min 0.02 - max 0.51 mSv). Effective doses, higher than 1 mSv, were detected at 11 family members of hyperthyroid patients.. The mean value of effective dose at family members of hyperthyroid patients was 0.87 mSv (min 0.12 - max 6.79) Conclusion: After three days of hospitalization and detailed given oral and written instruction, thyroid carcinoma patients maintain not to exceed the proposed dose limits. Hyperthyroid patients present a greater radiation hazard than thyroid carcinoma patients. The estimated effective doses were higher than the effective doses at family members of thyroid carcinoma patients. These findings may be considered when establishing new national guidelines concerning radiation protection and release of patients after a treatment with radioiodine therapy.(Author)

  16. Influence of dose, age at the onset of disease and ultrasonographic findings of the thyroid gland on the early outcome of the radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Ugrinska, A.; Pop Gjorceva, D.; Muratovska, L.; Crcareva, B.; Stojanovski, S.

    2007-01-01

    Full text: Aim of the study: Estimation of the early effects of the treatment of hyperthyroidism with radioactive iodine in correlation with the radioiodine dose, the age at the onset of disease and ultrasonographic (US) findings of the thyroid. Material and methods: Retrospective analysis of the files of 80 patients that underwent a radioactive iodine treatment from the period of 1987 till 2006 because of a diffuse hyperthyroid goiter was performed. The patients were divided in two groups. Group C consisted of patients who were treated with calculated doses from 60-100μC/ml gland volume and group NC who received higher, non-calculated doses. According to age at the onset of disease patients were divided in two groups- group A younger than 40 years and group B older than 40 years. According to the US findings of the thyroid prior to radioiodine therapy patients were divided in two groups group N with predominantly normal US findings and group H with predominantly hypoechoic structure. Results: One year after the application of radioactive iodine 58% of the patients from the group C still remained hyperthyroid, 29% became euthyroid and only 13% developed early hypothyroidism. In the NC group only 7% remained hyperthyroid, 40% were euthyroid, while 54% of the patients developed early hypothyroidism. The occurrence of early hypothyroidism was significantly more frequent in NC than in C group (58% vs. 32%, p<0.05). The age was predictor for the probability of development of early hypothyroidism in C group: only 13% younger in group A, but 46% older patients from group B developed an early hypothyroidism. In the NC group the age was not a predictive factor. In 44 patients there were available records on the US findings prior to radioiodine therapy. In the N group patients that received calculated dose of radioiodine therapy remained euthyroid in 86%, while the patients that received non-calculated dose achieved euthyroidism only in 30%.In the H group there was no

  17. Is it worth to calculate the dose of radioiodine?

    International Nuclear Information System (INIS)

    Mikalauskas, V.; Kuprionis, G.; Vajauskas, D.

    2005-01-01

    Full text: Administration of empirical doses of radioiodine (RAI) has been preferred to calculated doses in many hospitals, because the need to measure the size and the iodine uptake in the thyroid involves considerable inconvenience to the patient and additional costs. The preparation of RAI of varying activities also means extra work. Today there is no general consensus on whether radioiodine should be given as a fixed dose or should be calculated. There is also no consensus regarding the question of which radiation burden should be administered to a given volume of thyroid if the activity is calculated. However, while it is possible to deliver a relatively precise dose of radiation to the thyroid gland, maybe it is worth doing this?The aim of this study was to investigate the results of different uptake and volume dependent target doses on clinical outcome of patients with hyperthyroidism in Graves' disease, multi-nodular toxic goiter or toxic adenoma after radioiodine therapy. We reviewed the records of 428 patients (389 women and 39 men, mean age 56.8±12.9 years) who had received radioiodine treatment for Graves' disease and multinodular toxic goiter (n=312) or toxic adenoma (n=116) during the period of 2000-2004 in Kaunas Medical University Hospital. Most patients were given antithyroid drug therapy in order to achieve euthyroidism before treatment with RAI. Radioiodine uptake test with repeated measurements at 2, 6, 24, 48 and/or 72 and/or 96 hr to define the effective half-life was performed. In addition, all the patients underwent thyroid ultrasonography and scintigraphy to define the volume of the thyroid. The 131I activities were calculated according to the formula of Marinelli. In addition to the normal calculation individual target doses were adjusted to the thyroid volumes of each patient before therapy. For statistical evaluation, the patients were divided into four groups: group I included those with a thyroid volume 51 ml. Statistical analysis was

  18. Recombinant human thyrotropin stimulation prior to 131I therapy in toxic multinodular goitre with low radioactive iodine uptake.

    Science.gov (United States)

    Azorín Belda, M J; Martínez Caballero, A; Figueroa Ardila, G C; Martínez Ramírez, M; Gómez Jaramillo, C A; Dolado Ardit, J I; Verdú Rico, J

    Stimulation with recombinant human thyrotropin (rhTSH) increases thyroid radioiodine uptake, and is an aid to 131 I therapy in non-toxic multinodular goitre (MNG). However, there are not many studies using rhTSH prior to 131 I in toxic multinodular goitre to improve hyperthyroidism and compressive symptoms. A prospective study was conducted on patients with MNG and hyperthyroidism. Patients were recruited consecutively and divided into group I, stimulated with 0.3mg of rhTSH before radioiodine therapy, and a control group or group II, without stimulation. Thyroid function, radioiodine thyroid uptake, thyroid weight, and compressive symptoms were measured, and patients were followed-up for 9 months. Group I consisted of 16 patients (14 women), with a mean age 69.7 years, and group II with 16 patients (12 women), with a mean age 70.7 years. After stimulation with 0.3mg rhTSH in group I, 131 I uptake (RAIU) at 24h increased by 78.4%, and the estimated absorbed dose by 89.3%. In group II, the estimated absorbed dose was lower than group I after stimulation with rhTSH (29.8Gy vs. 56.4Gy; P=0.001). At 9 months of follow-up, hyperthyroidism was controlled in 87.5% of patients in group I, and 56.2% in group II (P=0.049). The mean reduction in thyroid weight was higher in group I than in group II (39.3% vs. 26.9%; P=0.017), with a tendency towards subjective improvement of compressive symptoms in group I, although non-significant. Only 2 patients described tachycardias after rhTSH administration, which were resolved with beta-blockers. Stimulation with 0.3mg of recombinant human thyrotropin prior to radioiodine therapy achieves a reduction in thyroid weight and functional improvement in patients with hyperthyroidism and multinodular goitre with low uptake, and with no need for hospital admission. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  19. Diet low in iodine as well as goitrogens (LILGD) enhanced radioiodine (I-131) uptake in treatment of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Aaro, Erik; Gebre-Medhin, Mehari; Lindahl, Sten-AAke

    2005-01-01

    Full text: Low iodine diet (LID) is accepted as an adjuvant to post-thyroidectomy radioiodine therapy of differentiated thyroid cancer since it is held to enhance radioiodine uptake in thyroid remnants and thyroid cancer tissue. However, in the few clinical investigations performed only an indirect and weak evidence of a positive effect of the LID has been demonstrated. Also we had discouraging experience in the application of a strict LID using the same design as in the present study. We therefore decided to investigate the effect of a diet low in iodine as well as in goitrogens (LILGD). Methods: Six patients with differentiated thyroid cancer entered the study and they were their own control. After thyroid hormone withdrawal (TSH > 30 m U/L) and on regular diet a diagnostic whole body scan was performed 24 h after administration of 50 MBq (1,4 mCi) 123 I. The day following diagnostic scan the patients were put on LILGD for 4 days prior and two days after radioiodine therapy. In LILGD beverages, fruits and vegetables containing flavonoids, glucosinolates, cyanides and thiocyanates were avoided and spices and smoking prohibited. Therapeutic radioiodine was administered one week after diagnostic procedures and in the morning after over-night fasting with an activity range of 3,7-5,4 GBq (100 -150 mCi) 131 I. A 24-h therapeutic whole body scan and calculations of percentage uptake U(24) were performed. Diagnostic (basal) D U(24)% and subsequent therapeutic T U(24)% uptake were compared and expressed as therapeutic/diagnostic uptake ratios T/D U(24). Results: A significant increase in therapeutic versus diagnostic uptake T/D U(24) was observed (mean 2,53, median 2,30, range 1,40 - 4,46, p 131 I uptake in radio-ablation of normal and thyroid cancer tissue. (author)

  20. The synthesis of radioiodinated carbohydrates and butyrothenones as potential imaging agents for computed tomography

    International Nuclear Information System (INIS)

    Waterhouse, R.N.

    1993-01-01

    Positron Emission tomography (PET) and Single Photon Emission Computed Tomography (SPECT) are two relatively new imaging techniques which allow for the non-invasive evaluation of biochemical processes in living subjects. Currently, SPECT is more widely accessible than PET, however, only a limited number of radiotracers have been successfully developed for imaging by SPECT. Two classes of radioiodinated compounds were developed as potential imaging agents for SPECT: (1) Radioiodinated carbohydrates for the assessment of glucose metabolism and (2) Radioiodinated butyrothienones for the evaluation of dopamine D 2 receptors in the brain. In both classes of compounds, the radioiodine was attached to an sp 2 hybridized carbon atom to provide radiotracers that were chemically and metabolically stable. Radioiodine incorporation was easily accomplished by radioiododestannylation of vinyl- and aryl-trialkylstannanes in the presence of an oxidizing agent. The incorporation of radioiodine into small molecules can have a significant effect on the biological activity of the resulting radiotracer because of the relatively large size and lipophilicity of the iodine atom. Preliminary evaluations of the effectiveness of the radioiodinated carbohydrates and butyrothienones as imaging agents are presented

  1. Incidental findings of intense radioiodine uptake in struma ovarii and bilateral nonlactating breasts simultaneously on postablation "1"3"1I SPECT/CT for papillary thyroid cancer

    International Nuclear Information System (INIS)

    Shim, Hye Kyung; Kim, Mi Ra

    2016-01-01

    A 52-year-old woman diagnosed with papillary thyroid carcinoma was referred for "1"3"1I therapy following total thyroidectomy. She was given 4,810 MBq (130 mCi) of "1"3"1I following 4 weeks of thyroid hormone withdrawal. A post therapy scan showed intense, focal activity in the pelvis and intense, diffuse activity on both sides of the chest, which was localized to the right ovary and both breasts on SPECT/CT examination. She had bilateral nipple pain and a history of antidopaminergic drugs as combination medication for her rheumatoid arthritis and prokinetics during radioiodine therapy. On a "1"2"3I whole-body scan 9 months later after stopping the drugs, bilateral breast uptake was not visible; however, right ovarian focal uptake was still visualized. Bilateral salpingo-oophorectomy was performed, and revealed struma ovarii with substantial internal necrosis due to radioiodine therapy. This case is interesting as two rare entities, "1"3"1I therapy-related struma ovarii and drug-related breast uptake, were simultaneously visualized

  2. Evaluation of radiation therapy for advanced well-differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Tatsuno, Ikuo; Tada, Akira; Choto, Shuichi; Takanaka, Tsuyoshi

    1987-01-01

    Eighty-two patients with advanced well-differentiated thyroid carcinoma were treated. Sixty-six patients survived for more than 10 years and 10-year-survival rate was 80.5 %. Multidisciplinary treatment, consisting of surgery, radioiodine, external irradiation and TSH suppression was studied. We emphasized that radioiodine treatment after thyroid-ectomy was unique and an ideal therapeutic model for locally advanced, distant metastatic and recurrent cases as far as radioiodine was accumulated on thyroid cancer tissue. External irradiation was sometimes effective for the remnant thyroid carcinoma and metastases. Occassionally, well-differentiated thyroid carcinoma showed good response to TSH suppression therapy using thyroid hormone. The significance of conversion of well-differentiated carcinoma of thyroid to anaplastic carcinoma was noticed. We recognized that radiation therapy was effective for advanced well-differentiated thyroid carcinoma in multidisciplinary treatment. (author)

  3. Evaluation of radiation therapy for advanced well-differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Tatsuno, Ikuo; Tada, Akira; Choto, Shuichi; Takanaka, Tsuyoshi

    1987-02-01

    Eighty-two patients with advanced well-differentiated thyroid carcinoma were treated. Sixty-six patients survived for more than 10 years and 10-year-survival rate was 80.5 %. Multidisciplinary treatment, consisting of surgery, radioiodine, external irradiation and TSH suppression was studied. We emphasized that radioiodine treatment after thyroid-ectomy was unique and an ideal therapeutic model for locally advanced, distant metastatic and recurrent cases as far as radioiodine was accumulated on thyroid cancer tissue. External irradiation was sometimes effective for the remnant thyroid carcinoma and metastases. Occassionally, well-differentiated thyroid carcinoma showed good response to TSH suppression therapy using thyroid hormone. The significance of conversion of well-differentiated carcinoma of thyroid to anaplastic carcinoma was noticed. We recognized that radiation therapy was effective for advanced well-differentiated thyroid carcinoma in multidisciplinary treatment.

  4. 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.)

  5. 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)

  6. Sorption of radioiodine in organo-clays and -soils

    International Nuclear Information System (INIS)

    Bors, J.

    1990-01-01

    In the framework of investigations on the sorption of radioiodine to natural and artificially altered soil components, a number of clay minerals and natural soils were treated with quaternary alkylammonium ions to replace the exchangeable metal cations. With help of batch experiments the resulting organo-clays were tested with respect to their sorption capability of radioiodine quantified by the distribution ratio (R D -value). Treatment of bentonite, vermiculite and cretaceous clay as well as of samples from natural horizons of chernozem soil with hexadecylpyridinium (HDPY + ) and benzethonium (BE + ) exhibited sorptions rates and amounts, which are several orders of magnitude higher than those of the respective untreated samples. Moderate increases of the R D -values were found after cation exchange with hexadecyltrimethylammonium (HDTMA + ), while the applications of trimethylphenylammonium (TMPA + ) and tetramethylammonium (TMA + ) were ineffective. Considerable sorption of radioiodine was observed with the commercially available Bentone. (orig.)

  7. Production of radioiodinated prosthetic group for indirect protein labeling; Obtencao de grupamento prostetico radioiodado para marcacao de proteinas por via indireta

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Josefina da Silva

    2001-07-01

    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 {epsilon}-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

  8. Sources of radioiodine at pressurized water reactors. Final report

    International Nuclear Information System (INIS)

    Pelletier, C.A.; Cline, J.E.; Barefoot, E.D.; Hemphill, R.T.; Voilleque, P.G.; Emel, W.A.

    1978-11-01

    The report determines specific components and operations at operating pressurized water reactors that have a potential for being significant emission sources of radioactive iodine. The relative magnitudes of these specific sources in terms of the chemical forms of the radioiodine and the resultant annual averages from major components are established. The data are generalized for broad industry use for predictive purposes. The conclusions of this study indicate that the majority of radioiodine emanating from the primary side of pressurized water reactors comes from a few major areas; in some cases these sources are locally treatable; the interaction of radioiodine with plant interior surfaces is an important phenomenon mediating the source and affecting its release to the atmosphere; the chemical form varies depending on the circumstances of the release

  9. Improvement of reproducibility and quality control of human growth hormone radioiodination

    International Nuclear Information System (INIS)

    Bartolini, P.; Ribela, M.T.C.P.; Camilo, M.A.

    1988-01-01

    The labelling reaction of human growth hormone (hGH) with 125 I and its chromatographic purification have been studied with emphasis on the reproducibility of the yields, quantitaTive recoveries and resulting activities. Through the accurate standardization of a monitoring technique, it is confirmed that there are no significant losses in radioactivity or protein during the labelling or purification process. By strict control of the reaction conditions a fairily good reproducibility is also obtained in the labelling of various hGH extracts with diferent 125 I shipments used after short or long storage. Finally, the specific activity (or absolute mass) of the radioiodinated protein is determined by this Analysis of the Reaction Mixture and compared to the widely used radioimmunological assay (Self-displacement). (M.A.C.) [pt

  10. Accuracy and optimal timing of activity measurements in estimating the absorbed dose of radioiodine in the treatment of Graves' disease

    Science.gov (United States)

    Merrill, S.; Horowitz, J.; Traino, A. C.; Chipkin, S. R.; Hollot, C. V.; Chait, Y.

    2011-02-01

    Calculation of the therapeutic activity of radioiodine 131I for individualized dosimetry in the treatment of Graves' disease requires an accurate estimate of the thyroid absorbed radiation dose based on a tracer activity administration of 131I. Common approaches (Marinelli-Quimby formula, MIRD algorithm) use, respectively, the effective half-life of radioiodine in the thyroid and the time-integrated activity. Many physicians perform one, two, or at most three tracer dose activity measurements at various times and calculate the required therapeutic activity by ad hoc methods. In this paper, we study the accuracy of estimates of four 'target variables': time-integrated activity coefficient, time of maximum activity, maximum activity, and effective half-life in the gland. Clinical data from 41 patients who underwent 131I therapy for Graves' disease at the University Hospital in Pisa, Italy, are used for analysis. The radioiodine kinetics are described using a nonlinear mixed-effects model. The distributions of the target variables in the patient population are characterized. Using minimum root mean squared error as the criterion, optimal 1-, 2-, and 3-point sampling schedules are determined for estimation of the target variables, and probabilistic bounds are given for the errors under the optimal times. An algorithm is developed for computing the optimal 1-, 2-, and 3-point sampling schedules for the target variables. This algorithm is implemented in a freely available software tool. Taking into consideration 131I effective half-life in the thyroid and measurement noise, the optimal 1-point time for time-integrated activity coefficient is a measurement 1 week following the tracer dose. Additional measurements give only a slight improvement in accuracy.

  11. Sorption of radioiodine in organo-clays and -soils

    Energy Technology Data Exchange (ETDEWEB)

    Bors, J. (Niedersaechsisches Inst. fuer Radiooekologie, Hannover (Germany, F.R.))

    1990-01-01

    In the framework of investigations on the sorption of radioiodine to natural and artificially altered soil components, a number of clay minerals and natural soils were treated with quaternary alkylammonium ions to replace the exchangeable metal cations. With help of batch experiments the resulting organo-clays were tested with respect to their sorption capability of radioiodine quantified by the distribution ratio (R{sub D}-value). Treatment of bentonite, vermiculite and cretaceous clay as well as of samples from natural horizons of chernozem soil with hexadecylpyridinium (HDPY{sup +}) and benzethonium (BE{sup +}) exhibited sorptions rates and amounts, which are several orders of magnitude higher than those of the respective untreated samples. Moderate increases of the R{sub D}-values were found after cation exchange with hexadecyltrimethylammonium (HDTMA{sup +}), while the applications of trimethylphenylammonium (TMPA{sup +}) and tetramethylammonium (TMA{sup +}) were ineffective. Considerable sorption of radioiodine was observed with the commercially available Bentone. (orig.).

  12. Graves' disease: cost-effectiveness of clinical and radioiodine treatments

    International Nuclear Information System (INIS)

    Cruz junior, Antonio F.; Takahashi, Miriam H.; Albino, Claudio C.

    2005-01-01

    Full text: In this study, we set out to evaluate the costs and effectiveness of the two most used therapies in Graves' disease: antithyroid drugs (ATD) and radioiodine (RAI). Twenty-tree patients, 7 men and 16 women, with a mean age of 35.4 years, treated with ATD and 35 patients, 5 men and 30 women, mean age of 39.4 years, treated with RAI were studied. After 2 years receiving ATD, 21 patients achieved euthyroidism and 2 remained hyperthyroid. In the RAI group, 21 patients presented hypothyroidism and 13 became euthyroid. To calculate the costs of each therapy, we analysed the number of visits during this period, the laboratory data and the drugs needed, such as tiamazol and/or thyroxine. The group treated only with ATD needed a higher number of visits and laboratory measurements, with the mean total cost of U$ 791.65, while the RAI group spent a mean amount of U$ 366.44. Therefore, the costs of the RAI treatment were 53,7 % lower than clinical therapy with ATD. Conclusion: The present study demonstrates that RAI treatment has a lower cost than ATD, being very effective in controlling the hyperthyroidism of Graves' disease. (author)

  13. Assessments of whole body scan images (PCI) obtained in patients undergoing treatment of radioiodine (pre and post-treatment)

    International Nuclear Information System (INIS)

    Costa, Fernanda Karolina Mendonca da; Lopes Filho, Ferdinand de Jesus; Vieira, Jose Wilson; Souza, Milena Thays Barbosa de

    2014-01-01

    Nuclear medicine is a medical specialty used for diagnosis and therapy of some diseases. For the treatment of differentiated thyroid carcinoma (papillary and follicular) Radioiodine therapy is employed, in order to eliminate the rest of thyroid tissue after removal of the thyroid (thyroidectomy). In radioiodine therapy is used radioisotope iodine-131 ( 131 I) as Sodium Iodide (NaI). The amount of the activity (dose) of 131 I administered is generally the responsibility of nuclear medicine, which is based on an image Research Length of the patient (pre-dose therapy PCI). PCI is also used after treatment (post-PCI therapeutic dose) to evaluate possible metastasis. The purpose of this study was to investigate the distribution of biokinetic 131 I at length and in some organs of the patient, in order to note any similarity. Exams PCI pre-dose and post-dose were analyzed, the anterior and posterior projections of ten patients. Contours in these images (ROI - Region Of Interest) were made in the whole body and in areas with high uptake of 131 I. The total score was used in the calculation to obtain the percentage distribution of 13I in the organs of the patient. The results showed that there similarity on the biodistribution of 131 I between pre-dose and post-dose PCI. Therefore, it was found that it is valuable images of PCI pre-dose therapy as a way to assist the nuclear medicine physician in choosing the best activity to be administered to the patient in order to minimize the dose to adjacent organs. (author)

  14. 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

  15. Production of non-stimulatory immunoglobulins that inhibit TSH binding in Graves' disease after radioiodine administration

    International Nuclear Information System (INIS)

    Bech, K.; Bliddal, H.; Siersbaek-Nielsen, K.; Friis, T.

    1982-01-01

    The effect of single dose of 131 I upon thyroid stimulating immunoglobulins has been studied in twenty-two patients with Graves' disease. The thyroid stimulating immunoglobulins were assessed by parallel measurements of thyrotrophin receptor binding inhibitory immunoglobulins (TBII) and of thyroid adenylate cyclase stimulating immunoglobulins (TACSI) in serum by radioreceptor assay and stimulation of adenylate cyclase respectively. The present study thus confirms that radioiodine therapy is followed by an increase of TBII and TACSI in most patients with Graves' disease. The level of TBII can probably provide a marker for development of hypothyroidism following 131 I therapy and might be involved in its pathogenesis. (author)

  16. Radioiodine uptake in young carp (Cyprinus carpio L.) retarded in growth

    International Nuclear Information System (INIS)

    Lysak, A.

    1978-01-01

    In the light of results obtained in recent years, radioiodine disposition in young carp (Cyprinus carpio L.), retarded in growth is described. The pharynx centre accumulates most of the administered radioiodine. Activation of renal centre takes place already after 10 days of intensive feeding. (author)

  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. Factors influencing the success of radio-iodine dose in the treatment of Graves disease: one year outcome

    International Nuclear Information System (INIS)

    Kamoun, T.; Sfar, R.; Regaieg, H.; Toumi, A.; Zanzouri, H.; Nouira, M.; Ben Fredj, M.; Ayachi, N.; Chatti, K.; Guezguez, M.; Essabbah, H.; Sakly, N.

    2015-01-01

    Full text of publication follows. Aim: radioiodine ( 131 I) is increasingly used as the definitive treatment of Graves disease (GD). Many factors influence the curative effects of the 131 I, thus there are some difficulties to define the optimal dose of 131 I for the treatment of GD. The purpose of our study is to evaluate the factors influencing the success rate in patients having GD and treated with radioiodine dose modulated by thyroid mass. Materials and methods: this is a prospective study of 86 patients (aged 43 ± 11, 58 women and 28 men) treated for Graves disease by radioiodine during the year 2011 in Nuclear Medicine department CHU Sahloul, Sousse. Radioiodine dose are modulated by thyroid mass: 370 MBq, 444 MBq and 555 MBq respectively for mass strictly less than 30 g, between 30 g and 40 g and greater than to 40 g. Some patients received more than 555 MBq for other causes to reach hypothyroidism precociously. The thyroid function outcome (hyperthyroidism or euthyroidism/hypothyroidism) was verified 6 months and 1 year after 131 I treatment. Patient gender, age, ophthalmopathy, thyroid size, antithyroid drugs used prior to 131 I treatment and anti-TSH receptor antibodies (TRAb), anti-thyroid peroxidase antibodies (ATPO) and anti-thyroglobulin antibodies (ATG) plasma concentrations before 131 I treatment were studied as potential interference factors for 131 I treatment success. Results: Thirty patients received 370 MBq, 29 received 444 MBq, 14 received 555 MBq and 13 more than 555 MBq. Outcome after treatment was determined in a total of 66 patients at 6 months and 63 at one year. Post-therapy follow-up revealed that treatment failed in 29% of the patients at 6 months and in 20% of patients at one year. No correlation was noted between the outcome of treatment and age, sex, ophthalmopathy, antithyroid drugs taking and ATG titer. A significant correlation was noted between the disease outcome at one year and TRAb titer: High TRAb levels are associated

  19. Behavior of gasketless deep bed charcoal filters for radioiodine removal in LWR power plants

    International Nuclear Information System (INIS)

    Wilhelm, J.G.; Deuber, H.; Furrer, J.; Gerlach, K.

    1981-01-01

    The removal efficiency of radioiodine filters can be affected by mechanical leakage, aging and poisoning, desorption of radioiodine originally removed by the activated carbon and also by the occurrence of penetrating iodine compounds. To provide high decontamination factors only the gasketless deep bed filter type seems to be appropriate. The experience gathered and the data given in this paper are based on the surveillance testing of radioiodine filters in all German nuclear power plants and on laboratory research work which has been done over years to evaluate the operating behavior of deep bed radioiodine filters and to prove their reliability

  20. Preparation and characterization of a radioiodinated bacterial lipopolysaccharide

    Energy Technology Data Exchange (ETDEWEB)

    Ulevitch, R J [Scripps Clinic and Research Foundation, La Jolla, Calif. (USA)

    1978-03-01

    Radioiodinated lipopolysaccharide (LPS) from E.coli 0111:B4 has been prepared by reacting p-OH methylbenzimidate with 0111:B4 LPS at alkaline pH. The resulting LPS derivative has been radiolabeled with Na/sup 125/I. Specific activities of up to 5..mu..Ci/..mu..g LPS may be obtained by this technique and significantly the preparation of the radioiodinated LPS does not alter the biophysical, immunologic or biologic properties of 0111:B4 LPS. The methods described here are applicable to any 'protein free' LPS preparation containing primary amino groups.

  1. Metastatic Follicular Thyroid Carcinoma Secreting Thyroid Hormone and Radioiodine Avid without Stimulation: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Syed A. Abid

    2014-01-01

    Full Text Available Introduction. This is an extremely rare case of a patient with metastatic follicular thyroid cancer who continued to produce thyroid hormone and was iodine scan positive without stimulation after thyroidectomy and radioiodine (I-131 therapy. Patient Findings. A 76-year-old Caucasian male was diagnosed with metastatic follicular thyroid carcinoma on lung nodule biopsy. Total thyroidectomy was performed and he was ablated with 160 mCi of I-131 after recombinant human thyrotropin (rhTSH stimulation. Whole body scan (WBS after treatment showed uptake in bilateral lungs, right sacrum, and pelvis. The thyroglobulin decreased from 2,063 to 965 four months after treatment but rapidly increased to 2,506 eleven months after I-131. Thyroid stimulating hormone (TSH remained suppressed and free T4 remained elevated after I-131 therapy without thyroid hormone supplementation. He was treated with an additional 209 mCi with WBS findings positive in lung and pelvis. Despite I-131, new metastatic lesions were noted in the left thyroid bed and large destructive lesion to the first cervical vertebrae four months after the second I-131 dose. Conclusions. This case is exceptional because of its rarity and also due to the dissociation between tumor differentiation and aggressiveness. The metastatic lesions continued to secrete thyroid hormone and remained radioiodine avid with rapid progression after I-131 therapy.

  2. Choice of therapy in young adults with hyperthyroidism of Graves' disease. A brief, case-directed poll of fifty-four thyroidologists

    International Nuclear Information System (INIS)

    Dunn, J.T.

    1984-01-01

    We asked 54 thyroidologists how they would treat each of four patients having moderate hyperthyroidism of Graves' disease and a thyroid gland weighing 70 g (three to four times normal). For a 19-year-old woman, 67% of thyroidologists recommended an initial course of therapy with antithyroid drugs, usually for 1 year; 24% favored radioiodine treatments; and 9%, surgery. Choices for treating a 19-year-old man were similar. For a 29-year-old man, 44% of thyroidologists preferred drug therapy; 50%, radioiodine; and 6%, surgery. For a 29-year-old woman, choices were similar to those for the 29-year-old man, except for a slight preference for drugs over radioiodine. If hyperthyroidism recurred after a first course of antithyroid drugs, the consultants favored radioiodine treatments and surgery about equally, except in the 29-year-old man, in whom radioiodine was preferred. This survey shows considerable variation among experts in treating hyperthyroidism in young adults

  3. Determination of the optimal minimum radioiodine dose in patients with Graves' disease: a clinical outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, D.; Tan, P.; Booker, J. [Pacific Medical Imaging, Newcastle, NSW (Australia); Epstein, M. [Dept. of Endocrinology, John Hunter Hospital, Newcastle, NSW (Australia); Lan, L. [High-Dependency Unit, St. George Hospital, Sydney, NSW (Australia)

    2001-10-01

    The study was performed under the auspices of the International Atomic Energy Commission, Vienna, Austria, with the aim of determining the optimal minimum therapeutic dose of iodine-131 for Graves' disease. The study was designed as a single-blinded randomised prospective outcome trial. Fifty-eight patients were enrolled, consisting of 50 females and 8 males aged from 17 to 75 years. Each patient was investigated by clinical assessment, biochemical and immunological assessment, thyroid ultrasound, technetium-99m thyroid scintigraphy and 24-h thyroid {sup 131}I uptake. Patients were then randomised into two treatment groups, one receiving 60 Gy and the other receiving 90 Gy thyroid tissue absorbed dose of radioiodine. The end-point markers were clinical and biochemical response to treatment. The median follow-up period was 37.5 months (range, 24-48 months). Among the 57 patients who completed final follow-up, a euthyroid state was achieved in 26 patients (46%), 27 patients (47%) were rendered hypothyroid and four patients (7%) remained hyperthyroid. Thirty-four patients (60%) remained hyperthyroid at 6 months after the initial radioiodine dose (median dose 126 MBq), and a total of 21 patients required additional radioiodine therapy (median total dose 640 MBq; range 370-1,485 MBq). At 6-month follow-up, of the 29 patients who received a thyroid tissue dose of 90 Gy, 17 (59%) remained hyperthyroid. By comparison, of the 28 patients who received a thyroid tissue dose of 60 Gy, 17 (61%) remained hyperthyroid. No significant difference in treatment response was found (P=0.881). At 6 months, five patients in the 90-Gy group were hypothyroid, compared to two patients in the 60-Gy group (P=0.246). Overall at 6 months, non-responders to low-dose therapy had a significantly larger thyroid gland mass (respective means: 35.9 ml vs 21.9 ml) and significantly higher levels of serum thyroglobulin (respective means: 597.6 {mu}g/l vs 96.9 {mu}g/l). Where low-dose radioiodine

  4. Transmission of radioiodine through sampling lines

    International Nuclear Information System (INIS)

    Unrein, P.J.; Pelletier, C.A.; Cline, J.E.; Voilleque, P.G.

    1985-01-01

    An experimental program to measure radioiodine transmission through sampling lines is described. The transmission depends upon both deposition on and resuspension from the walls of the line. The deposition and resuspension processes are themselves controlled by the length, diameter, and material of the line and the conditions under which it is operated. The operating conditions under study are sampling flow rate, temperature and relative humidity. Measurement results have been interpreted in terms of a four-compartment model of radioiodine deposition and resuspension. The model is applied to each of twenty or more segments of the line. Experimental measurements of short-term transmission fractions and the deposition velocities derived from them are presented for six lines. Data on resuspension rates for the same lines were obtained and are also discussed

  5. Synthesis, chemical and biological quality control of radioiodinated peptides

    International Nuclear Information System (INIS)

    Rafii, H.; Khalaj, A.; Beiki, D.; Motameidi, F.; Maloobi, M.; Karimian-dehghan, M.; Keshavarrzi, F.

    2002-01-01

    Iodinated compounds with I-131, 125 and 123 have been widely used for biochemical function studies. In conjunction with SPECT, [I-123] labelled proteins have various diagnostic and therapeutic applications in nuclear medicine. Preparation of some radioiodinated peptides with tyrosine and/or lysine groups on their main chain molecules can be carried out with both direct and indirect methods, but lack of these groups in molecule cause the molecule dose not lend itself for direct radioiodination. In this study, human IgG and Formyl-Methyl-Leucyl-Phenylalanine, FMLF, have been chosen as a model compounds for direct and indirect radioiodination respectively. Here, we will describe the labelling procedure of [I-125] IgG using chloramine-T as a suitable oxidant agent and [I-125 and I-131] FMLF by indirect method using ATE/SIB as a prosthetic group in multi-step reactions. The obtained results for chemical quality control of intermediate radioiodinated SIB by HPLC and two labelled IgG and FMLF will be also discussed. Biological results, biodistribution studies and SPECT scans on mice per-injected labelled FMLF show a low uptake of thyroid but a high at urine and bladder, perhaps because of low molecular weight of FMLF. In this case, it seems to be better to separate the reaction mixture of labelled FMLF by BPLC than Sephadex-G50 gel filtration. (Author)

  6. 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...

  7. Effect of temperature on the radioiodination of human growth hormone

    International Nuclear Information System (INIS)

    Mohammed-Ali, S.A.; Salacinski, P.R.; Landon, J.

    1981-01-01

    Studies have been undertaken to assess the effect of altering the temperature at which human growth hormone is radioiodinated on the incorporation of 125 I and the immunoreactivity and stability of the labelled hormone. Employing highly purified monomeric hormone it proved possible, by the iodogen procedure, to prepare a labelled product of high specific activity irrespective of temperature. However, in radioiodinations performed at ambient temperature (20 to 25 degrees) significant amounts of the labelled hormone were in an aggregated form which was less immunoreactive than the 125 I-labelled monomeric hormone. Such aggregation was largely prevented by radioiodinating at low temperature (0 to 4 degrees) and even the large monomeric peak was more immunoreactive (about 95% bound in antibody excess) than the monomeric peak from iodinations performed at room temperature

  8. An engagement factor for caregiver radiation dose assessment with radioiodine treatment

    International Nuclear Information System (INIS)

    Lee, Hyun Kuk; Hong, Seong Jong; Jeong, Kyu Hwan; Jung, Jae Won; Kim, Seong Min; Kang, Yun-Hee; Han, Man Seok

    2015-01-01

    This study aims to suggest ways to better manage thyroid cancer patients treated with high- and low-activity radioiodine ( 131 I) by assessing external radiation doses to family members and caregivers and the level of radiation in the surrounding environment. The radiation doses to caregivers of 33 inpatients (who were quarantined in the hospital for 2-3 d after treatment) and 31 outpatients who received radioiodine treatment after thyroidectomy were measured using passive thermoluminescence dosemeters. In this study, 33 inpatients were administered high-activity (100-200 mCi) 131 I, and 31 outpatients were administered low-activity (30 mCi) 131 I. The average doses to caregivers were measured at 0.61 mSv for outpatients and 0.16 mSv for inpatients. The total integrated dose of the recovery (recuperation) rooms where the patients stayed after release from hospital was measured to be 0.83 mSv for outpatients and 0.23 mSv for inpatients. To reflect the degree of engagement between the caregiver and the patient, considering the duration and distance between two during exposure, the authors used the engagement factor introduced by Jeong et al. (Estimation of external radiation dose to caregivers of patients treated with radioiodine after thyroidectomy. Health Phys 2014;106:466-474.). This study presents a new engagement factor (K-value) of 0.82 obtained from the radiation doses to caregivers of both in- and out-patients treated with high- and low-activity radioiodine, and based on this new value, this study presented a new predicted dose for caregivers. A patient treated with high-activity radioiodine can be released after 24 h of isolation, whereas outpatients treated with low-activity radioiodine should be isolated for at least 12 h. (authors)

  9. Analysis of influence of dosimetric factors on the outcome of I-131 therapy in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Knapska-Kucharska, M.; Oszukowska, L.; Makarewicz, J.; Lewinski, A.

    2012-01-01

    The influence of dosimetric factors on the outcome of 131 I therapy has been examined in hyperthyroid patients submitted to 131 I treatment. The following factors - which could have influence on the effects of therapy with radioiodine - were analysed: the goitre volume, the thyroid radioiodine uptake after 24 h, and the effective half-life time of 131 I (EHL). Five hundred (500) randomly selected patients with hyperthyroidism, treated with 131 I, were studied. They were divided into three groups (based on clinical examination, hormonal and immunological tests, thyroid scintigraphy and ultrasound imaging). The study shows that the effectiveness of 131 I therapy depends on the thyroid volume and absorbed dose in all the groups of patients and on the thyroid radioiodine uptake and EHL in patients with a single autonomously functioning thyroid nodule. We have failed to determine the borderline D, distinguishing between effective and ineffective therapy. The treatment outcome can be predicted with approximately 70% accuracy, based on minimal absorbed dose

  10. Analysis of influence of dosimetric factors on the outcome of I-131 therapy in patients with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Knapska-Kucharska, M.; Oszukowska, L.; Makarewicz, J. [Department of Nuclear Medecine and Oncological Endocrinology, Province Hospital, Zgierz (Poland); Lewinski, A. [Chair and Department of Endocrinology and Metabolic Diseases, Medical University, Lodz (Poland)

    2012-07-01

    The influence of dosimetric factors on the outcome of {sup 131}I therapy has been examined in hyperthyroid patients submitted to {sup 131}I treatment. The following factors - which could have influence on the effects of therapy with radioiodine - were analysed: the goitre volume, the thyroid radioiodine uptake after 24 h, and the effective half-life time of {sup 131}I (EHL). Five hundred (500) randomly selected patients with hyperthyroidism, treated with {sup 131}I, were studied. They were divided into three groups (based on clinical examination, hormonal and immunological tests, thyroid scintigraphy and ultrasound imaging). The study shows that the effectiveness of {sup 131}I therapy depends on the thyroid volume and absorbed dose in all the groups of patients and on the thyroid radioiodine uptake and EHL in patients with a single autonomously functioning thyroid nodule. We have failed to determine the borderline D, distinguishing between effective and ineffective therapy. The treatment outcome can be predicted with approximately 70% accuracy, based on minimal absorbed dose

  11. Fast radioiodination of rose bengal at room temperature

    International Nuclear Information System (INIS)

    Verbruggen, R.F.

    1987-01-01

    Polyhalogenated dyes based on aromatic ring systems such as fluorosceins have been used for the evaluation of hepatobiliary function since 1909. In 1955 rose bengal was radioiodinated and a radiocontrastdye become a radiopharmaceutical. In the present study an improved method, based on the chloramine-T method, has been developed for labelling rose bengal. This method was chosen for its short reaction time, its mild conditions and its high yield. The optimum values of the reaction parameters have been determined, and resulted in a slightly higher yield, within a shorter time and without breakdown products being present

  12. The Chernobyl accident: Thyroid exposure among the population due to radioiodine

    Energy Technology Data Exchange (ETDEWEB)

    Gavrilin, Yu I; Shinkarev, S M [Biophysics Inst., Russian Federation State Science Centre, Moscow (Russian Federation); Stepanenko, V F [Medical Radiological Research Centre, Academy of Medical Sciences, Obninsk (Russian Federation); Domaratskij, V P; Moroz, G L [Scientific Research Inst. for Industrial and Marine Medicine, St. Petersburg (Russian Federation); Hrushtch, V T [State Scientific Centre, Moscow (Russian Federation)

    1997-09-01

    Different aspects of internal and external exposure to thyroid of inhabitants from the contaminated areas of Belarus, Russia, and Ukraine are discussed in the paper. In the case of consumption of contaminated foods contribution to total absorbed dose from internal radioiodine exposure was more than 90%, otherwise (in the case of only inhalation radioiodine intake), not lesser than 85%. {sup 131}I exposure to thyroid was the main contribution to internal exposure, and exposure to thyroid from short-lived radioiodines was significant only for the inhabitants who did not consume contaminated foods. Peculiarities of formation of ``measured`` doses are considered. Semiempirical model of relationships between the average internal thyroid dose received by people in the rural settlements and the ground-deposition density of radionuclides in these settlements is presented. It has been indicated the necessity of intensification of {sup 129}I measurements in soil. Practical efficiency of used countermeasures for majority people to reduce radioiodine intake is estimated as high as approximately 2 times and caused mainly by removing people from contaminated areas. 11 refs, 1 fig., 5 tabs.

  13. The disease related deaths due to differentiated thyroid carcinomas treated multidisciplinary, including radioiodine

    International Nuclear Information System (INIS)

    Stefanovic, Lj.; Kermeci, K.; Malesevic, M.; Mihailovic, J.; Srbovan, D.; Popadic, S.

    2002-01-01

    Aim: To analyse the disease related deaths of differentiated thyroid carcinoma (DTC) patients treated multidisciplinary, including radioiodine. Patients and Methods: 364 DTC patients were treated from 1977 to the end of 2000. All patients were operated, treated by radioiodine and by hormonal therapy, external radiotherapy was applied in 22 and chemotherapy in 6 of them. 54 treated patients were lost from the follow-up. The course of disease and outcomes are known in 310 patients, among them 53 patients died. The disease related deaths occurred in 33 (10.6%) patients. Results: Between 33 patients whose deaths were in relation with DTC the disease progression was the cause of deaths in 30 (9.7% of treated) patients (the locoregional disease in 10, distant metastases /M1/ in 17, locoregional disease + M1 in 3 patients). From the late complications of treatment died 3 (1%) patients (all of them were in complete remission to the deaths). The mean survival of these 33 patients from the diagnosis to the end of the life was 6.9 years, median 5.1 years, range 2 months to 23.9 years. The five years survived 54.6% of them, 10 years 21.2% and more than 20 years 3%. M1 had 72.7% of patients (lung and/or bone M1 were present in 91.7% of them), N1 had 69.7% and in 30.3% local tumor was T4. In relation to all treated patients died 14.6% men compared to 9% women (p<0.05), 15.7% of patients 45 years old or older compared to 4.4% of younger then 45 years (p<0.001) and 21.3% of patients with follicular type of DTC compared to 7.3% with papillary type (p<0.001). From all patients without radioiodine accumulation in tumor tissue died 60%. Conclusion: The DTC related deaths were the consequence of M1 and less frequently the result of locoregional disease (T4 and/or N1) in about 1/10 of all treated patients. The deaths as result of the late complications of treatment were exceptional. The deaths were significantly more frequent between males, patients 45 years old or older and patients

  14. Metal organic framework MIL-101 for radioiodine capture and storage

    Science.gov (United States)

    Assaad, Thaer; Assfour, Bassem

    2017-09-01

    we report on the use of metal organic frameworks(MOFs) for radioiodine recovery and storage. One MOF (namely MIL-101) was prepared and investigated in detail to demonstrate the iodine removal efficiency and capacity of MOFs. The typical sorption kinetics and uptake isotherms were measured using radioactive iodine (123 I) for the first time. Our measurements indicate that MOFs can capture and store radioiodine in very high efficiency and fast kinetics.

  15. 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

  16. Turbulent transfer characteristics of radioiodine effluents from air to grass

    Energy Technology Data Exchange (ETDEWEB)

    Markee, E. H. [ARFRO, Environmental Science Services Administration, Idaho Falls, Idaho (United States)

    1967-07-01

    A total of 20 controlled field releases of radioiodine have been performed at the National Reactor Testing Station in Idaho as a portion of a program to study the transmission of gaseous radioiodine through the air-vegetation-cow-milk-human chain. Most of the releases were conducted over typical pasture grasses during different wind and stability conditions. Radioiodine adherence to grass and carbon plates was measured during most of the tests. Vertical air concentration profiles and turbulence parameters were measured to determine flux characteristics. Analysis of the data reveals the complex interdisciplinary nature of transfer of radioiodine from air to a natural surface. The data are in reasonable agreement with the deposition models of Sheppard and Chamberlain when corrections for the physical and biological receptiveness of the grass and grass density are made. The average ratios of momentum to mass flux were found to be 0.9 in stable conditions and 1.4 in unstable conditions. These ratios demonstrate the effect on mass flux in the lowest 4m by a surface that acts as a partial sink for gaseous effluents. This series of releases indicates the need for further research on the biological receptiveness of grass and turbulent transfer within a grass canopy. (author)

  17. Selective mono-radioiodination and characterization of a cell-penetrating peptide. L-Tyr-maurocalcine

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadi, Mitra; Bacot, Sandrine; Perret, Pascale; Riou, Laurent; Ghezzi, Catherine [Universite Joseph Fourier, Grenoble (France); INSERM U1039, Grenoble (France). Radiopharmaceutiques Biocliniques; Poillot, Cathy; Cestele, Sandrine [INSERM U836, Grenoble (France). Grenoble Inst. of Neuroscience; Universite Joseph Fourier, Grenoble (France); Desruet, Marie-Dominique [INSERM U1039, Grenoble (France). Radiopharmaceutiques Biocliniques; Couvet, Morgane; Bourgoin, Sandrine; Seve, Michel [CRI-INSERM U823, Grenoble (France). Inst. of Albert Bonniot; Universite Joseph Fourier, Grenoble (France); Waard, Michel de [INSERM U836, Grenoble (France). Grenoble Inst. of Neuroscience; Universite Joseph Fourier, Grenoble (France); Smartox Biotechnologies, Grenoble (France)

    2014-07-01

    Mono-and poly-iodinated peptides form frequently during radioiodination procedures. However, the formation of a single species in its mono-iodinated form is essential for quantitative studies such as determination of tissue concentration or image quantification. Therefore, the aim of the present study was to define the optimal experimental conditions in order to exclusively obtain the mono-iodinated form of L-maurocalcine (L-MCa). L-MCa is an animal venom toxin which was shown to act as a cell-penetrating peptide. In order to apply the current direct radioiodination technique using oxidative agents including chloramine T, Iodo-Gen {sup registered} or lactoperoxidase, an analogue of this peptide containing a tyrosine residue (Tyr-L-MCa) was synthesized and was shown to fold/oxidize properly. The enzymatic approach using lactoperoxidase/H{sub 2}O{sub 2} was found to be the best method for radioiodination of Tyr-L-MCa. MALDI-TOF mass spectrometry analyses were then used for identification of the chromatographic eluting components of the reaction mixtures. We observed that the production of different radioiodinated species depended upon the reaction conditions. Our results successfully described the experimental conditions of peptide radioiodination allowing the exclusive production of the mono-iodinated form with high radiochemical purity and without the need for a purification step. Mono-radioiodination of L-Tyr-MCa will be crucial for future quantitative studies, investigating the mechanism of cell penetration and in vivo biodistribution.

  18. Iodine-131 therapy for parotid oncocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Kosuda, S.; Ishikawa, M.; Tamura, K.; Mukai, M.; Kubo, A.; Hashimoto, S.

    1988-06-01

    We present a rare case of a patient with coexisting parotid oncocytoma and chronic thyroiditis who received two therapeutic doses of (/sup 131/I)iodide for a recurrent oncocytoma (oxyphilic granular cell adenoma), resulting in a definite reduction in tumor volume. We suggest that radioiodine therapy for a recurrent oncocytoma is an effective form of tumor therapy.

  19. Recommendation for KIT-formulation of radioiodinated [*I] meta-iodo benzyl guanidine (M*IBG). Vol. 3

    International Nuclear Information System (INIS)

    El-shaboury, G.; El-Kolaly, M.T.; Raieh, M.; El-Bayoumy, S.; Zakareia, N.

    1996-01-01

    A recommended simple technique for preparation of radioiodinated [ * I - ] meta - iodobenzylguanidine (M * IBG) is presented. The technique is based on a schematic procedure for the synthesis of inactive M IBG using meta -iodo benzoic as substrate, results into a chemical yield of 80% as pure as M IBG 0.5 substrate, then recrystallized from water - ethyl alcohol as crystalline powder of M.P. 165 Degree C - 167 degree C. The radioiodination process is performed through an isotropic exchange reaction between the inactive M IBG and radioiodine as iodine ion ( * I - ) in 0.2 M acetate buffer pH 4.2 - 4.25 at 100 degree C within 30 min in the presence of metal as exchange catalyst. Following these processes, the reaction solution is allowed for purification by passing it through an AgCl - impregnated filter to remove the unreacted radioiodine as Ag * I (5%). According of these results and reaction conditions it was possible to develop a technology for the radiopharmaceutical production of radioiodinated M * IBG using the currently used short - lived radioiodine nuclides by a simple kit like - type technique, where the radiochemical yield % is 95 - 99% as pure as M * IBG. 5 figs., 3 tabs

  20. 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)

  1. Radioiodine treatment in children with thyroid cancer from Belarus

    International Nuclear Information System (INIS)

    Reiners, C.; Biko, J.; Geworski, L.; Olthoff, M.; Demidchik, E.P.; Streffer, C.; Paretzke, H.; Voigt, G.; Kenigsberg, Y.; Bauer, W.; Heinemann, G.; Pfob, H.

    1996-01-01

    Between 1st of April 1993 and 15th of November 1995, 95 children from Belarus with most advanced stages of thyroid cancer have been treated totally 305 times with radioiodine in Germany. In spite of a high frequency of advanced tumor stages pT4 (82%), lymph node metastases (95%) and distant metastases (55%) in those selected children, the preliminary results of radioiodine treatment are promising. In 55% of the children complete remission and in 44% partial remission of thyroid cancer could be achieved. In no case progressive disease under treatment has been observed

  2. Absorption of radioiodine in silver nitrate molecular sieve

    International Nuclear Information System (INIS)

    Delfino, C.A.; Molinari, M.A.

    1983-01-01

    Obtainment method and control techniques of materials for the retention of radioiodine in gaseous effluents of nuclear installations. The experimental section is referred to the following processes: preparation of absorbents using, as basis, a molecular sieve and zeolite; impregnation with AgNO 3 ; efficiency determination; efficiency study as a function of the specific charge and bed length; optimization of Ag-consumption; resistance to the gas flux, bed temperature, specific surface, and nitrogen oxides effects. With the described impregnation method, materials, whose properties made them suitable for use in filters for the radioiodine retention and comparable to the imported manufactured materials, may be obtained. (R.J.S.) [es

  3. Immobilization of radioiodine in synthetic boracite

    Science.gov (United States)

    Babad, H.; Strachan, D.M.

    1982-09-23

    A nuclear waste storage product is disclosed in which radioiodine is incorporated in a synthetic boracite. The boracite may be prepared by reacting a transition metal iodide with an alkali horate under mild hydrothermal conditions, drying the reaction product, and then hot pressing.

  4. 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.

  5. Radioiodination of proteins by reductive alkylation

    International Nuclear Information System (INIS)

    Panuska, J.R.; Parker, C.W.

    1987-01-01

    The use of the aliphatic aldehyde, para-hydroxyphenylacetaldehyde as the reactive moiety in the radioiodination of proteins by reductive alkylation is described. The para-hydroxyphenyl group is radiolabeled with 125 I, reacted through its aliphatic aldehyde group with primary amino groups on proteins to form a reversible Schiff base linkage which can then be stabilized with the mild reducing agent NaCNBH 3 . The introduction of the methylene group between the benzene ring and the aldehyde group increases its reactivity with protein amino groups permitting efficient labeling at low aldehyde concentrations. Using this method, radioiodinated proteins with high specific activity can be produced. The reductive alkylation procedure is advantageous in that the labeling conditions are mild, the reaction is specific for lysyl residues, and the modification of the epsilon-ammonium group of lysine results in ionizable secondary amino groups avoiding major changes in protein charge

  6. I-131 Therapy in patients with hyperthyroidism 11- year follow-up

    International Nuclear Information System (INIS)

    Radeva, M.

    2007-01-01

    Full text: Radioiodine therapy is a well-established method for the treatment of patients with various forms of hyperthyroidism and is preferred in many countries as the first line therapy. Traditionally, it has been applied in Bulgaria in low doses, mainly in elderly patients with contraindications for surgery or after long-term antithyroid drug therapy. No systematic follow up of these patients has ever been done in the country. Materials and Methods: 571 subjects aged 34 to 79 years (mean 64, 7), 108 males with mean age of 68.61 years (54 to 76 yrs) and 463 females with mean age of 68.89 years (34 to 84 yrs). Mean disease duration was 73±5 months. The study included 296 patients with toxic nodular goiter, 220 patients with Graves- Basedow disease and Hashitoxicosis and 55 patients with adenoma toxicum. 256 females and 40 males with toxic nodular goiter, 158 females and 62 males with Graves- Basedow disease and Hashitoxicosis, 49 females and 6 males with adenoma toxicum. The disease duration is 48.19 months in females and 22.5 months in males. Methods: 131-iodine scan and uptake before the treatment and on follow-up visits at months 6,12,18 and 24 with a dose of 1.48 MBq 131-I for the both tests, given orally as a water solution. Uptake was measured at hours 2, 4 and 24; thyroid scan -at hour 24, thyroid ultrasound, FNB cytology if suspicious of malignancy, thyroid hormones -TSH (normal range 0.3-4.0 mU/l), FT4 (normal range 8-17 pmol/l) Results: 131-iodine therapy was administered to subjects with 131-I uptake over 25% at hour 24. Doses between 148- 370MBq were given depending on diagnosis and thyroid volume. A single radioiodine dose, mean value 189.07 MBq is applied in 246 (87, 85%) patients, second dose, mean value 183, 5 MBq is required in 30 (10, 72%) and third dose, mean value 148 MBq received 4 (1, 43%) patients. Effect of 131-iodine therapy-the change in radioiodine uptake is a marker for complex assessment of the result of the 131-iodine therapy. In

  7. 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.)

  8. Therapy with radionuclides. Radionuklid-Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Biersack, H.J.; Hotze, A.L. (Bonn Univ. (Germany). Klinik fuer Nuklearmedizin)

    1992-12-01

    Radioiodine therapy of benign and malignant thyroid diseases is a well-established procedure in Nuclear Medicine. However, the therapeutic use of radioisotopes in other diseases is relatively unknown among our refering physicians. The therapeutic effects of intraarticular (rheumatoid arthritis) and intracavitary (pleural and peritoneal carcinosis) applications yields good results. The radiophosphorus therapy in polycythemia vera rubra has always to be considered as an alternative to chemotherapy. The use of analgetics may be reduced by pain therapy of bone metastasis by injection of bone-seeking beta emitters like Rh-186 HEDP. Other procedures like therapeutic application of meta-iodo-benzylguanidine in neuroblastoma and malignant pheochromocytoma resulted in at least remissions of the disease. Radioimmunotherapy needs further evaluation before it can be recommended as a routine procedure. (orig.).

  9. Characterization and restoration of performance of {open_quotes}aged{close_quotes} radioiodine removing activated carbons

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, W.P. [NUCON International, Inc., Columbus, OH (United States)

    1997-08-01

    The degradation of radioiodine removal performance for impregnated activated carbons because of ageing is well established. However, the causes for this degradation remain unclear. One theory is that this reduction in performance from the ageing process results from an oxidation of the surface of the carbon. Radioiodine removing activated carbons that failed radioiodine removal tests showed an oxidized surface that had become hydrophilic compared with new carbons. We attempted to restore the performance of these {open_quotes}failed{close_quotes} carbons with a combination of thermal and chemical treatment. The results of these investigations are presented and discussed with the view of extending the life of radioiodine removing activated carbons. 4 refs., 2 tabs.

  10. Radiation exposure and familial aggregation of cancers as risk factors for colorectal cancer after radioiodine treatment for thyroid carcinoma

    International Nuclear Information System (INIS)

    Rubino, Carole; Adjadj, Elisabeth; Doyon, Francoise; Shamsaldin, Akhtar; Abbas, Tahaa Moncef; Caillou, Bernard; Colonna, Marc; Cecarreli, Claudia; Schvartz, Claire; Bardet, Stephane; Langlois, Christiane B.Sc.; Ricard, Marcel; Schlumberger, Martin; Vathaire, Florent de

    2005-01-01

    Purpose: In thyroid cancer patients, radioiodine treatment has been shown to be associated with an increased risk of colon carcinoma. The aim of this study in thyroid cancer patients was to evaluate the role of familial factors in the risk of colorectal cancer and their potential interaction with radioiodine exposure. Methods and Materials: We performed a case-control study on 15 colorectal cancer patients and 76 matched control subjects, nested in a cohort of 3708 thyroid cancer patients treated between 1933 and 1998. For each patient, the radiation dose delivered to the colon by radioiodine was estimated by use of standard tables. In those who received external radiation therapy, the average radiation doses delivered to the colon and rectum were estimated by use of DOS E g software. A complete familial history was obtained by face-to-face interviews, and a familial index was defined to evaluate the degree of familial aggregation. Results: The risk of colorectal cancer increased with familial aggregation of colorectal cancer (p = 0.02). After adjustment for the radiation dose delivered to the colon and rectum, the risk of colorectal cancer was 2.8-fold higher (95% CI, 1.0-8.0) for patients with at least one relative affected by colorectal cancer than for patients without such a family history (p = 0.05). The radiation dose delivered to the colon and rectum by 131 I and external radiation therapy was associated with an increase of risk near the significance threshold (p = 0.1). No significant interaction was found between radiation dose and having an affected relative (p = 0.9). Conclusions: The role of familial background in the risk of colorectal cancer following a differentiated thyroid carcinoma appears to increase with the radiation dose delivered to the colon and rectum. However, the study population was small and no interaction was found between these two factors

  11. 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

  12. Radioiodine treatment for malignant thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

    2006-12-15

    Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

  13. Enhancement of radioiodine uptake in hyperthyroidism with hydrochlorothiazide: a prospective randomised control study

    Energy Technology Data Exchange (ETDEWEB)

    Tepmongkol, Supatporn [Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330 (Thailand)

    2002-10-01

    The aim of this study was to determine whether hydrochlorothiazide (HCTZ) could improve radioiodine uptake in low-uptake hyperthyroid patients. Eighteen hyperthyroid patients with low 3-h and 24-h iodine-131 uptake were recruited to the study. Eleven patients were assigned to the HCTZ group, and seven to the control group. Two weeks after the first, baseline uptake study, a second uptake study was performed. Patients in both groups had a low-iodine diet after the first uptake study. In the HCTZ group, 50 mg of HCTZ was administered twice a day for 5 days prior to the second uptake study. Improvement in uptake at 3 and 24 h in the second uptake study, as compared with the baseline study, was assessed within and between groups. In the control group, compared with the baseline study there was a significant improvement in uptake at 3 h (P=0.03) but a non-significant improvement at 24 h (P=0.07). In the HCTZ group, significant improvements were observed at both 3 h (P=0.0005) and 24 h (P=2.28 x 10{sup -5}). Patients in the HCTZ group had statistically greater improvement in uptake at both 3 h and 24 h compared with the control group (P=0.003 and 0.0008, respectively). There was a 7.18-fold average improvement in uptake in the HCTZ group at 24 h, compared with only a 1.33-fold improvement in the control group. Administration of HCTZ significantly improves 24-h radioiodine uptake in high-iodide pool, low-uptake hyperthyroid patients compared with patients who have received a low-iodine diet alone. (orig.)

  14. Radioiodinated methylene blue for melanoma targeting: Chemical characterisation and tumour selectivity of labelled components

    International Nuclear Information System (INIS)

    Blower, Philip J.; Clark, Katherine; Link, Eva M.

    1997-01-01

    Radioiodinated methylene blue contains a mixture of components showing selective uptake in human pigmented melanoma, and it has potential for imaging and therapy. Nuclear magnetic resonance and mass spectroscopic studies show that the majority of the radioactivity (85%) is in the form of monoiodinated methylene blue, 4-iodo-3-methylamino-7-dimethylaminophenaza thionium chloride. The amino group ortho-to iodine has become demethylated to a mono-methylamino group. The remainder (15%) of the mixture is the doubly labelled 4,5-diiodo-3,7-bis(methylamino) phenazathionium chloride. The separated components show similar tumour selectivity in athymic mice bearing human pigmented melanomas

  15. Variations in the chemical speciation behaviour of radioiodines in the Tarapur Boiling Water Reactor

    International Nuclear Information System (INIS)

    Venkateswaran, G.; Gokhale, A.S.; Moorthy, P.N.

    1998-01-01

    The chemical behaviour of radioiodines in the primary coolant of the Tarapur Boiling Water Reactor has been studied under different operating conditions. During normal operation, radioiodines speciated mainly as I - (≅60%) and IO 3 - (≅35%) with 2 . At 1-5 h into reactor shutdown conditions, radioiodines existed predominantly as IO 3 - species (>80%). Beyond 5 h after shutdown, quantitative conversion of IO 3 - to I - was observed to occur in about 20 h duration. Long time after reactor shutdown, radioiodines were present in the coolant as I - species only. A quantitative conversion of near carrier-free IO 3 - to I - was observed in laboratory low dose rate (0.95 kGy/h), low and high dose gamma irradiation experiments in near neutral solutions both in absence and presence of externally added H 2 O 2 . However, near carrier-free I - solutions irradiated under the same conditions yielded ≅15% IO 3 - species only which is in agreement with the literature data. The radioiodine speciation behaviour in reactor water has been explained by a qualitative model coupling iodine release from defective fuel elements and the associated gamma irradiation effects. (author)

  16. Direct application of radioiodinated aminoacyl tRNA for radiolabeling nascent proteins

    International Nuclear Information System (INIS)

    Scherberg, N.H.; Barokas, K.; Murata, Y.; Refetoff, S.

    1985-01-01

    A two-step procedure to incorporate 125 I-iodotyrosine into protein synthesized in a reticulocyte lysate is described. In the first step, the iodination of tyrosyl tRNA was catalyzed by a solid-state glycouril compound. More than one-third of 200 microCi of radioiodine became bound to 70 micrograms of aminoacyl tRNA after 15 min at 0 degrees C. The isotope was distributed in a three-to-one ratio of monoiodotyrosine to di-iodotyrosine. In the second step, the soluble product of the radioiodination was transferred directly into a nuclease-treated reticulocyte lysate coded with RNA isolated from the human hepatoma cell line Hep G2. Fractional recovery of radioiodine in nascent protein was maximally 7.6%. Reaction of the product of translation with antibody against alpha-antitrypsin separated an 125 I-containing protein having a molecular weight estimated as 47,000. The synthesis of unprocessed alpha-antitrypsin was confirmed by cleavage of the labeled protein with leader peptidase and by its displacement from immunocomplex formation with purified alpha-antitrypsin. The amount of 125 I incorporated into alpha-antitrypsin was proportionate to iodinated tRNA additions up to a concentration of 70 micrograms/ml. The synthesis of alpha-antitrypsin as detected in radioautograms after gel electrophoresis was more than twice as sensitive using radioiodinated aminoacyl tRNA as compared with [ 35 S]methionine. Iodine labeling of thyroxine-binding globulin was also demonstrated in the translation product of Hep G2 RNA. Since the specific activity of the radioiodine is high and the means for detection of the isotope efficient, the method described can facilitate the demonstration of quantitatively minor translation products

  17. Synthesis and radioiodination of a nido-1,2-carboranyl derivative of 2-nitroimidazole

    International Nuclear Information System (INIS)

    Wilbur, D.S.; Hamlin, D.K.; Livesey, J.C.; Srivastava, R.R.; Laramore, G.E.; Griffin, T.W.

    1994-01-01

    The synthesis of a nido-carboranyl congener of misonidazole, 1-(3'-nido-carboranyl-2'-hydroxy)propyl-2-nitromidazole, has been carried out. Alternative methods of preparations were conducted to optimize the chemical yield, with a five step synthesis giving an overall yield (from 1,2-carborane) of 36%. A diastereomeric pair of nido-carboranyl compounds was obtained. The diastereomeric nido-carboranyl misonidazole congeners were (radio)iodinated to yield (> 90%) a mixture of diastereomeric compounds in which the iodine had bonded to a boron atom on the nido-carborane moeity. These compounds will be investigated for their application to boron neutron capture therapy (BNCT) and hypoxia imaging of cancer. (author)

  18. 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)

  19. The catabolism of radioiodinated anti-lung-cancer monoclonal antibodies in tumor-bearing nude mice

    International Nuclear Information System (INIS)

    Shi Xubao

    1991-01-01

    Nude mice bearing humor lung cancer xenografts were injected intravenously or intraperitoneally with a mixture of radioiodinated anti-lung-cancer monoclonal antibodies, 2E3 and 6D1. The blood radioactivity versus time curve was fitted to a two-compartment open model with a 3.4 day blood radioactivity clearance half-life and a 636 ml/kg apparent distribution volume. Radioiodinated 2E3 and 6D1 given intraperitoneally were rapidly absorbed, with a 2.08 absorption half-life and 89% bioavailability. The highest radioactivity levels were found in the tumor, blood, liver and spleen 1-3 days after injection; next came the lung, kidney, stomach and intestine. The relative radioactivity increased in the tumor as levels in blood and normal tissues decreased. The in vivo deiodination of radioiodinated 2E3 and 6D1 was about 18.6% and free radioiodine was excreted in the urine

  20. Bilateral breast uptake of radioiodine in a male patient with gynecomastia: A case report

    International Nuclear Information System (INIS)

    Uslu, Lebriz; Ozbayrak, Mustafa; Vatankulu, Betul; Sonmezoglu, Kerim

    2015-01-01

    A 56-year-old male patient with papillary thyroid carcinoma was given radioiodine for the treatment of persistent disease. Post radioiodine whole body scan revealed uptake at the thyroidal region and bilateral uptake at the upper thoracic region. Single photon emission computed tomography/computed tomography (SPECT/CT) confirmed uptake at the left thyroid lobe, and additional symmetrical mammary gland uptake was observed at both breasts. The patient had obesity-related gynecomastia, but he did not have any history of breast cancer, mastitis, hyperprolactinemia, or galactorrhea. Although breast uptake of radioiodine is a common finding in postpartum or lactating women, it is uncommon in male patients. To our knowledge, this is the first case of a male patient with breast uptake of radioiodine documented with SPECT/CT. SPECT/CT is useful in male patients in the differentiation of benign breast uptake with lung metastases or axillary metastases of thyroid cancer

  1. 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

  2. Recommendation for KIT-formulation of radioiodinated [{sup *}I] meta-iodo benzyl guanidine (M*IBG). Vol. 3.

    Energy Technology Data Exchange (ETDEWEB)

    El-shaboury, G; El-Kolaly, M T; Raieh, M; El-Bayoumy, S [Radioisotope Production and Labelled Compounds Department, Cairo (Egypt); Zakareia, N [Chemistry of Nuclear Fuel Department, Hot laboratories Center, Atomic Energy Authority, Cairo (Egypt)

    1996-03-01

    A recommended simple technique for preparation of radioiodinated [{sup *}I{sup -}] meta - iodobenzylguanidine (M{sup *} IBG) is presented. The technique is based on a schematic procedure for the synthesis of inactive M IBG using meta -iodo benzoic as substrate, results into a chemical yield of 80% as pure as M IBG 0.5 substrate, then recrystallized from water - ethyl alcohol as crystalline powder of M.P. 165 Degree C - 167 degree C. The radioiodination process is performed through an isotropic exchange reaction between the inactive M IBG and radioiodine as iodine ion ({sup *}I{sup -}) in 0.2 M acetate buffer pH 4.2 - 4.25 at 100 degree C within 30 min in the presence of metal as exchange catalyst. Following these processes, the reaction solution is allowed for purification by passing it through an AgCl - impregnated filter to remove the unreacted radioiodine as Ag{sup *}I (5%). According of these results and reaction conditions it was possible to develop a technology for the radiopharmaceutical production of radioiodinated M{sup *} IBG using the currently used short - lived radioiodine nuclides by a simple kit like - type technique, where the radiochemical yield % is 95 - 99% as pure as M{sup *} IBG. 5 figs., 3 tabs.

  3. A method for the radiohalogenation of proteins resulting in decreased thyroid uptake of radioiodine

    International Nuclear Information System (INIS)

    Zalutsky, M.R.; Narula, A.S.

    1987-01-01

    A procedure is described for the radioiodination of proteins using an iodinated derivative of N-succinimidyl 3-(tri-n-butylstannyl) benzoate (ATE). Adequate removal of unreacted ATE from [ 125 I]ATE was necessary for optimal protein radioiodination. Labelling efficiencies of greater than 60% could be obtained after a 20 min incubation of goat IgG with [ 125 I]ATE at 4 0 C. Paired-label experiments with goat IgG labeled with 125 I using ATE and 131 I using Iodogen demonstrated that use of the ATE reagent for protein labeling significantly reduced (P < 0.005) the thyroid uptake of radioiodine. (author)

  4. 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.

  5. Distribution and pharmacokinetic analysis of angiostatin radioiodine labeled with high stability

    International Nuclear Information System (INIS)

    Song, Sung Hee; Jung, Kyung-Ho; Paik, Jin-Young; Koh, Bong-Ho; Bae, Joon-Sang; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae

    2005-01-01

    Objective: Radiotracers of anticancer agents provide important information on its in vivo handling. Angiostatin (AST) is a promising anticancer drug with potent antiangiogenic effects, but reported AST radiotracers suffer from poor in vivo stability. In this study, we synthesized an AST probe radioiodinated via the Bolton-Hunter reagent ( 125 I-BH-AST) and investigated its stability and biokinetics in mice. Methods: 125 I-BH-AST and conventional direct radioiodinated 125 I-AST were evaluated for human endothelial cell binding characteristics. In vivo stability of the radiotracers was compared by biodistribution studies in normal ICR mice. Angiostatin pharmacokinetics was analyzed by serial blood sampling after intravenous injection of 125 I-BH-AST with varying AST concentrations in mice. Results: Both 125 I-AST and 125 I-BH-AST retained selective endothelial binding as demonstrated by dose-dependent inhibition by nonradiolabeled AST. 125 I-BH-AST was substantially more stable in mice than 125 I-AST, with 28- and 7-fold lower 24-h thyroid and blood activities, respectively (15.5±1.5 vs. 430.9±32.2 and 0.1±0.0 vs. 0.8±0.0 %ID/g; both P 125 I-BH-AST, we found that 24-h AST accumulation was highest in the kidneys, followed by the liver and lungs. Kinetic analysis of 125 I-BH-AST revealed AST to have linear pharmacokinetics with a T 1/2 of 5.8±2.6 h, volume of distribution (V d ) of 6.8±1.3 ml and clearance of 0.8±0.1 ml/h. Conclusion: Radioiodine-labeled AST prepared by the BH method provides a radioprobe with superior stability and improved in vivo biokinetics that is useful for distribution and pharmacokinetic studies

  6. Mudanças evolutivas no tratamento da doença de Graves com iodo radioativo: 12 anos de experiência em um hospital universitário Changing trends in the treatment of Graves' disease with radioiodine: a 12-year experience in a university hospital

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius Leitão de Souza

    2009-04-01

    Full Text Available OBJETIVO: Avaliar a mudança no perfil e abordagem dos pacientes com doença de Graves submetidos a dose terapêutica de radioiodo. MATERIAIS E MÉTODOS: Avaliamos, retrospectivamente, 226 pacientes portadores de doença de Graves submetidos a dose terapêutica de radioiodo entre janeiro de 1990 e dezembro de 2001. O período de 12 anos foi dividido em três períodos de 4 anos para fins de análise estatística, sendo comparadas variáveis clínicas e laboratoriais nos períodos descritos. RESULTADOS: Constatamos que o número de pacientes encaminhados para a dose terapêutica, assim como o percentual de pacientes do sexo feminino (de 62% para 86%; p = 0,005, tiveram incremento significativo. Houve aumento significativo no percentual de pacientes em uso de metimazol previamente à dose terapêutica (de 9,1% para 35,6%; p = 0,03. A dose média de iodo administrada também teve incremento significativo (de 7,6 mCi para 12,7 mCi; p = 0,000003, com reflexo direto em um maior percentual de pacientes curados (de 55,6% para 83,7%; p = 0,004 um ano pós-dose terapêutica. CONCLUSÃO: A dose terapêutica de radioiodo tem sido um método cada vez mais aceito nos pacientes com doença de Graves e a dose administrada tem sido cada vez maior, no intuito de cura permanente e diminuição das chances de recidiva.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

  7. Quality control of radioiodinated gastrin for radioimmunoassay

    International Nuclear Information System (INIS)

    Ginabreda, M.G.P.; Borghi, V.C.; Bettarello, A.

    1988-07-01

    Radioiodinated human gastrin has been prepared at IPEN laboratory for radioimmunoassay use. This work developed the quality control of this tracer analyzing parameters of the labelling reaction, chromatographic purification and radioimmunoassay. The radioiodination yield obtained in five experiments was reproducible and similar when analyzed on 7% polyaraylamide gel eletrophoresis - PAGE - (mean + - SD of 51.70 + - 10.76%) and by1 25 I incorporation checked through thrichloroacetic acid precipitation - TCA - (57-36 + - 9.69%). Similary, after purification the labelled gastrin revaled high and reproducible purity degree when submitted to PAGE (96.57 + - 1.06%) and CA (94.82 + - 4.20%) analysis. The respective specific activities varied from 62 to 307 uCi/ug, being determined by the self-displacement method, which is based on the immunoactivity of the tracer. In this way, the antibody titers required to bind 50% of the tracer ranged from 1:32.000 to 1:180.000. Consequently, the respective doses producing 50% fall in the maximum response of the radioimmunoassays ranged from 155.0 to 24.0 pmol/1, but remained unchanged for each tracer even after three months of its preparations. The tracers presented very low non-specific binding values (1.78 + - 0.79%), stablespecific binding values (46.49 + - 5.65%) and a good between-assay precision, evaluated by an internal quality control sample (25.71 + - 4.30%) with coefficient of variation of 16.74%). The PAGE analysis of the unlabeled gastrin used in the first and last radioiodination revealed an unique and unaltered component, confirming the quality of the tracers. (author) [pt

  8. Radioiodine (1-131) Dose for the Treatment of Hyperthyroidism in Rajavithi Hospital.

    Science.gov (United States)

    Kuanrakcharoen, Pichit

    2016-02-01

    The main cause of hyperthyroidism is diffuse toxic goiter (Graves' disease), and the treatment of choice after medical therapy failure is radioiodine (I-131). There are two common methods of determining the optimal I-131 dose: calculated dose or fixed dose. The calculated dose method is based on the following formula: 75-200 microcuri/gram of thyroid gland divided by the percentage of radioiodine uptake at 24 hours (24-hour RAIU). As this is quite complex, some centers use fixed doses, such as 5, 10 or 15 mCi because it is simpler. At Rajavithi Hospital, the applied dose of I-131 is determined based on the thyroid gland weight assessed by palpation and other clinical factors. To study the mean I-131 dose for the initial treatment of hyperthyroidism in Rajavithi Hospital, to find the clinical factors that correlate with I-131 treatment dose, and to devise a formula to predict the optimal I-131 treatment dose. This was a retrospective study of 510 patients with a diagnosis of hyperthyroidism who received initial I-131 treatment at the Department of Nuclear Medicine in Rajavithi Hospital between January 2014 and June 2015. Baseline characteristics including age, sex, age at diagnosis, duration of antithyroid drug (ATD) therapy, gland weight (g), 3-hour RAIU and I-131 treatment dose were reviewed from medical records. The mean age ± SD was 41.93 ± 14.11 years (range 14-81 years), and the male to female ratio was 4.1:1. The mean duration of ATD therapy was 3.54 ± 4.02 years (min-max, 0.8-40.6 years). The mean gland weight was 54.35 ± 32.95 grams, and the mean 3-hour RAIU was 55.5 ± 23.69%. The mean I-131 treatment dose was 14.84 ± 5.71 mCi (min-max, 7-30 mCi). There was no significant correlation between dose and age, age at diagnosis, duration of A TD therapy or 3-hour RAIU. The study showed a significant correlation between I-131 dose and gland size, r = 0.938 (p treatment of choice for hyperthyroidism after medical therapy failure, and there are various

  9. New insights into the chemical behaviour of radioiodine in aquatic environments

    International Nuclear Information System (INIS)

    Behrens, H.

    1982-04-01

    It was found that in surface fresh water and in soil water iodine is to a large extent chemically converted by processes which are instigated by microbial action. The reactions involve extracellular oxidation of iodide with subsequent incorporation of the iodine into organic compounds, probably proteins. Furthermore it was found that iodate is reduced, probably also by a biochemical reaction. This reduction is more pronounced in soil than in surface water. In surface fresh water the formed organic radioiodine compounds are mainly in solution. In soils the radioiodine becomes to a larger extent bound to insoluble organic substances by these processes. The dissolved form of organic iodine is not precipitable as silver halide. Some other chemical and physico-chemical properties are described. Details on how the iodine conversion influences its fixation processes in soil are given. Possible consequences of these reactions on the migration behaviour of radioiodine and on the performance as well as on the interpretation of experiments in this context are discussed. (orig.)

  10. Clinical applications of radioiodine 131 (I131) in the thyroid diseases

    International Nuclear Information System (INIS)

    Gonzalez Rivero, Levi; Turcios Trista, Silvia Elena; Velasco Mirabal, Milagros

    2012-01-01

    Radioiodine 131 is a radioactive isotope that is successfully used for the diagnosis and the treatment of benign and malignant thyroid diseases. Its quality of selectively integrating to the thyroid metabolism and emitting a signal allows it to describe the gland functioning through capture studies, and to delimit the morphology and location of the tissues that capture iodine by means of scintigraphy. It is also a simple, safe and cost-effective radiotherapy used as first-line therapeutics in the control of hyperthyroidism. The dose and right time of application should be individualized according to the etiology and the clinic of each patient. Radioiodine 131 offers an efficient alternative to reduce the size of non-toxic goiter in addition to supporting the surgical treatment of the differentiated thyroid carcinoma and destroying with ablative doses the tissular remains and the metastatic lesions that can be detected during the gammagraphic follow-up. Radioiodine 131 depends on the fulfillment of safety regulations against radioactivity

  11. Clinical applications of radioiodine 131 (I131) in the thyroid diseases

    International Nuclear Information System (INIS)

    Gonzalez, Rivero Levi; Turcios Trista, Silvia Elena; Velasco Mirabal, Milagros

    2012-01-01

    Radioiodine 131 is a radioactive isotope that is successfully used for the diagnosis and the treatment of benign and malignant thyroid diseases. Its quality of selectively integrating to the thyroid metabolism and emitting a signal allows it to describe the gland functioning through capture studies, and to delimit the morphology and location of the tissues that capture iodine by means of gammagraphy. It is also a simple, safe and cost-effective radiotherapy used as first-line therapeutics in the control of hyperthyroidism. The dose and right time of application should be individualized according to the etiology and the clinic of each patient. Radioiodine 131 offers an efficient alternative to reduce the size of non-toxic goiter in addition to supporting the surgical treatment of the differentiated thyroid carcinoma and destroying with ablative doses the tissular remains and the metastatic lesions that can be detected during the gammagraphic follow-up. Radioiodine 131 depends on the fulfillment of safety regulations against radioactivity

  12. Mixed species radioiodine air sampling readout and dose assessment system

    International Nuclear Information System (INIS)

    Distenfeld, C.H.; Klemish, J.R. Jr.

    1978-01-01

    This invention provides a simple, reliable, inexpensive and portable means and method for determining the thyroid dose rate of mixed airborne species of solid and gaseous radioiodine without requiring highly skilled personnel, such as health physicists or electronics technicians. To this end, this invention provides a means and method for sampling a gas from a source of a mixed species of solid and gaseous radioiodine for collection of the mixed species and readout and assessment of the emissions therefrom by cylindrically, concentrically and annularly molding the respective species around a cylindrical passage for receiving a conventional probe-type Geiger-Mueller radiation detector

  13. Procedure guideline for radioiodine test (version 3); Verfahrensanweisung zum Radioiodtest (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); Nuklearmedizinische 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; 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). Abt. fuer Nuklearmedizin; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    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 has to avoid iodine-containing medication and the possibility of additives of iodine in vitamin- and electrolyte-supplementation has to be considered. (orig.)

  14. Effect of pH value of applied solution on radioiodine sorption by soils

    International Nuclear Information System (INIS)

    Szabova, T.

    1976-01-01

    Sorption of radioiodine by soils was followed under static conditions at different pH values of the initial solution in five soil types. Sorption of radioiodine by soils is affected by the amount of the organic mass and by the pH of solutions. With the same pH, soils containing a higher amount of the organic mass absorb more radioiodine. The highest sorption percentage of 131 I - for all pH values was found in meadow chernozem soil and the lowest in the rendzina and in carboniferous meadow soils. The highest sorption of 131 I - for degraded chernozem, meadow chernozem soils and brown soil was recorded at pH 5 and for carboniferous meadow soil and rendzina at pH 7. (author)

  15. Cost-effectiveness of using recombinant human thyroid-stimulating hormone before radioiodine ablation for thyroid cancer treatment in Spanish hospitals.

    Science.gov (United States)

    Vallejo, J A; Muros, M A

    In thyroid cancer treatment, the thyroid-stimulating hormone (TSH) must be elevated before radioiodine ablation, either by exogenous (with recombinant human thyrotropin [rhTSH]) or endogenous stimulation by thyroid hormone withdrawal (THW). The use of rhTSH avoids hypothyroidism and favours the subsequent elimination of radioiodine, but involves the cost of the product. For this reason, a cost-effectiveness analysis was performed, taking into account all costs involved and the benefits associated with the use of this therapy. Using a Markov modelling with two analysis arms (rhTSH and THW), stratified into high (100mCi/3700 MBq) and low (30mCi/1110 MBq) radioiodine doses, and using 17 weekly cycles, the incremental cost per quality-adjusted life-year (QALY) related to the use of rhTSH was determined. The clinical inputs included in the model were based on published studies and in a treatment survey conducted in Spain. Radioablation preparation with rhTSH is superior to THW, showing additional benefits (0.048 AVAC), as well as cost savings (-€614.16), with an incremental cost-effectiveness rate (ICER) of -€12,795/QALY. The univariate and multivariate sensitivity analyses showed the result to be robust. The use of rhTSH previous to radioablation in Spain has cost savings, as well as a series of health benefits for the patient, making it highly cost-effective. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  16. Can dosimetry help to predict euthyroidism after 131I radioiodine treatment of solitary thyroid nodule?

    International Nuclear Information System (INIS)

    Skanjeti, A.; Pia, A.

    2015-01-01

    Full text of publication follows. Introduction: recent SNM guidelines suggest to administer 3-8 MBq for each gram of thyroid tissue in order to reach a non hyperthyroid status, while EANM guidelines suggest to reach a dose of 100-400 Gy depending on type of disease. This second point of view is based on the principle that dosimetry, i.e. the metabolism of radioiodine within the thyroid can determine the outcome of radiation in the gland. However, although reasonable, it has not been shown unequivocally that dosimetry allows better outcome. The aim of this pilot study was to evaluate whether dosimetry and parameters that consent a dose evaluation can be useful in order to predict outcome in hyperthyroid patients with solitary nodule and successfully treated with radioiodine. Material and methods. Thirty-one consecutive patients with solitary nodule and successfully treated with 131 I radioiodine were included. In 27 patients euthyroidism was durably reached during the follow up, while in 4 hypothyroid state was the final outcome. All of them underwent Radioiodine Uptake Test (RUT) with 5 measurements (6 h, 24 h, 48 h, 72 h, and 96 h), thyroid scintigraphy to estimate gland mass and radioiodine administration. Bi-compartmental model was used to estimate residence time and dose was estimated according to EANM guidelines based on administered activities of radioiodine. Uptake at 6 h, uptake at 24 h, mass gland, dose, age, residence time, activity and activity/mass were compared in patients with stable euthyroidism versus patients with hypothyroidism in the follow up. Results: only uptake at 6 h was different in these groups of patients (p=0.05 at Welch t-test), the logistic regression seemed to confirm the significant correlation (p=0.08) between uptake at 6 h and outcome of the treatment. The other parameters were not significantly correlated with the treatment effect. Conclusion: this pilot study, performed in a very small population, did not show any significant

  17. Comparison of mortality in hyperthyroidism during periods of treatment with thionamides and after radioiodine.

    Science.gov (United States)

    Boelaert, Kristien; Maisonneuve, Patrick; Torlinska, Barbara; Franklyn, Jayne A

    2013-05-01

    Hyperthyroidism is common, but opinions regarding optimal therapy with antithyroid drugs or radioiodine (131-I) differ. There are no randomized trials comparing these options in terms of mortality. The aim of the study was to determine whether mortality associated with hyperthyroidism varies with treatment administered or other factors. We conducted a prospective observational population-based study of 1036 subjects aged ≥ 40 years presenting to a single specialist clinic from 1989-2003 with a first episode of hyperthyroidism who were followed until June 2012. Antithyroid drugs or radioiodine (131-I) were administered. We compared causes of death with age-, sex-, and period-specific mortality in England and Wales and used within-cohort analysis of influence of treatment modality, outcome, disease etiology, severity and control, and comorbidities. In 12 868 person-years of follow-up, 334 died vs 290.6 expected (standardized mortality ratio [SMR], 1.15 [95% confidence interval (CI),1.03-1.28]; P = .01). Increased all-cause mortality largely reflected increased circulatory deaths (SMR, 1.20 [95% CI, 1.01-1.43]; P = .04). All-cause mortality was increased for the person-years accumulated during thionamide treatment (SMR, 1.30 [95% CI, 1.05-1.61]; P = .02) and after 131-I not associated with hypothyroidism (SMR, 1.24 [95% CI, 1.04-1.46]; P = .01) but not during T₄ replacement for 131-I-induced hypothyroidism (SMR, 0.98 [95% CI, 0.82-1.18]; P = .85). Within-cohort analysis comparing mortality during thionamide treatment showed a similar hazard ratio (HR) for all-cause mortality when 131-I did not result in hypothyroidism (HR, 0.95 [95% CI, 0.70-1.29]), but reduced mortality with 131-I-induced hypothyroidism (HR, 0.70 [95% CI, 0.51-0.96]). Reduced mortality associated with hypothyroidism was seen only in those without significant comorbidities and not in those with other serious diseases. Atrial fibrillation at presentation (P = .02) and an increment of 10 pmol/L in

  18. The value of estimating serum apoptotic marker concentrations in the monitoring and prognosis of 131I -therapy in Graves disease. Preliminary report

    International Nuclear Information System (INIS)

    Rogowski, F.; Parfienczyk, A.; Sopotyk, A.; Budlewski, T.; Szumowski, P.; Jablonska, E.; Kiersnowska-Rogowska, B.

    2004-01-01

    The effect of radioiodine ( 131I ) in Graves disease (GD) is probably due to the direct physical destruction of thyrocytes by beta radiation, and by the indirect action through stimulation of apoptosis in these cells. The aim of our study was to investigate the changes in serum concentrations of sFas and sFasL as stimulators of apoptosis, and Bcl-2 as an inhibitor of apoptosis in patients with GD following 131I administration. The study was performed on 30 patients with GD (29 female and 1 male aged 25-45). All patients were euthyroid (biochemical and clinical) prior to radioiodine therapy. The target absorbed dose ranged between 90 and 160 Gy. We assessed markers of apoptosis and hormone concentrations (fT3, fT4 and TSH) in the following manner: before 131I administration, then two weeks, one month, two, three, four, and five months after 131I administration. After four months, the concentrations of sFas and sFasL rose by 50% and decreased during the next month. Pretherapeutic concentrations of Bcl-2 were elevated, and peaked two weeks after ingestion, showing a gradual decrease with time. We found a significant increase in serum TSH, and a decrease of fT3 and fT4 concentrations by the end of the third month of radioiodine therapy. Decreases in serum levels of sFas and sFasL and increases of Bcl-2 are regarded as characteristic for GD patients before radioiodine therapy. Radioiodine therapy reverses the ratio of estimated markers after four months. The concentrations of hormones reflect actual thyroid function, whereas concentrations of markers of apoptosis may suggest morphological changes. (author)

  19. Radioiodination of vasoactive intestinal peptide (VIP)

    International Nuclear Information System (INIS)

    Wang, Y.; Wang, L.; Yin, D.

    2002-01-01

    In recent years, increasing biochemical and radiochemical research has been performed to develop radiolabelled peptides as specific ligands for tumour associated receptors. VIP, a 28-amino acid peptide containing two tyrosines and three lysines, has demonstrated that various tumour cells express significantly higher amounts of VIP-receptors and could be applied to the clinic diagnosis. For these purposes, radiohalogenation of VIP by direct and indirect method was studied. Direct labelling works well for radioiodine but is limited to dehalogenation of labelling products in vivo. Conjugate labelling methods including Boltonhunter and wood reagents were developed but introduction of such a molecule to peptides may lead to the decrease of biological activity in vivo. In order to resolve these problems, N-Succinimidyl-3-(tri-nbutylstannyl) benzoate (ATE) was elected for the radioiodination of VIP and already employed to radioiodination of IgG successfully. The in vitro stability and biological activity would be compared in these two methods. Vasoactive intestinal peptide (VIP) and human immunoglobulin (IgG) were radioiodinated by direct and indirect methods. Iodogen was employed in direct method and N-Succinimidyl-3-(tri-n-butylstannyl) benzoate (ATE) was applied as a prosthetic group in the conjugation labelling. The subject of our study was optimizing the radiohalogenation of IgG and VIP followed by separation and analysis of reaction products. The advantages and disadvantages were illustrated by comparing the in vitro stability and biological activity in these two methods. Na 123 I was prepared by nuclear reaction of 124 Te(p, 2n) 123 I using cyclone-30. More than 95% of radiochemical purity, more than 95% of radionuclide purity and about 100 mCi/mL of radioactivity concentration were obtained. ATE was supplied by Dr. Pozzi and radioiodinated with iodogen and 96% of labelling efficiency was obtained. The stability of radioactive S 125 IB kept well in dark at 4

  20. Radioiodine treatment of Graves' disease. An assessment of its potential risks

    International Nuclear Information System (INIS)

    Graham, G.D.; Burman, K.D.

    1986-01-01

    Concern about the side effects of radiation exposure has deterred physicians from using radioiodine treatment for Graves' disease, although the efficacy and safety of this treatment have been established in the 35 years since its introduction. In that time, no significant side effects have been discovered. We believe iodine-131 should be considered the treatment of choice in most patients with Graves' disease. This article reviews the current understanding of the risks in radioiodine treatment of Graves' disease, including the risks for teratogenicity, genetic damage, carcinogenesis, and cellular dysfunction

  1. The risk for cancer and genetic abnormalities after radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Reiners, C.

    1997-01-01

    According to recent studies, the risk for thyroid cancer is not increased after radioiodine treatment in patients with hyperthyroidism. Only the risk of cancer of the stomach seems to be increased slightly in patents treated with I-131 because of functional autonomy. However, the risk for gastric cancer is not increased after higher activities of I-131 because of thyroid cancer. There is no increased risk for genetic abnormalities after radioiodine treatment of hyperthyroidism. (orig.) [de

  2. Standard dose 131I therapy for hyperthyroidism caused by autonomously functioning thyroid nodules

    International Nuclear Information System (INIS)

    Fui, S.C.N.T.; Maisey, M.N.

    1979-01-01

    Thirty-one patients with hyperthyroidism shown on scintigrams to have autonomously functioning thyroid nodules were treated with a standard dose of 15mCi of 131 I. Of thirty patients who have been followed up for at least 6 months to over 3 years, all but one patient were euthyroid after a single dose. Repeat scintigram and Thyrotropin Releasing Hormone test after therapy confirmed that twenty-five patients were cured of the disease. Only one patient developed hypothyroidism. This simplified dose regimen of radioiodine is effective in the treatment of hyperthyroidism caused by autonomously functioning nodules and is not complicated by the high incidence of hyperthyroidism that is observed following radioiodine therapy of Grave's disease. (author)

  3. Iodine-131 Therapy and Nasolacrimal Duct Obstructions: What We Know and What We Need to Know.

    Science.gov (United States)

    Ali, Mohammad Javed

    2016-01-01

    The aims of the current review are to summarize the etiopathogenesis, symptomatology, management, complications, and outcomes of iodine-131-induced nasolacrimal duct obstructions, to propose a screening protocol and elucidate the potential avenues of future research. The authors performed an electronic database (PubMed, MEDLINE, EMBASE, and Cochrane Library) search of all articles published in English on nasolacrimal duct obstructions following radioiodine therapy. These articles were reviewed along with their relevant cross references. Data reviewed included demographics, presentations, investigations, management, complications, and outcomes. In addition, based on relevant unanswered questions and current lacunae in literature, potential avenues for further research have been elucidated. The frequency of nasolacrimal duct obstruction is reported to range from 2.2% to 18% following I-131 therapy. They are mostly bilateral and noted in patients who receive more than 150 mCi radioiodine. Exact etiopathogenesis is unknown but radiotoxicity to lacrimal sac and nasolacrimal duct is believed to be mediated through a sodium-iodine symporter protein. Although uncommon, it is important to increase awareness among treating physicians and patients receiving radioiodine therapy about the potential side effect of nasolacrimal duct obstruction. Imaging modalities are useful adjuncts in the diagnosis. Dacryocystorhinostomy is the most common modality of management with good outcomes. Nasolacrimal duct obstruction following radioiodine treatment is a distinct clinical entity. Increased awareness would facilitate timely diagnosis, management, and an enhanced quality of life for the patients.

  4. 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)

  5. A review of countermeasures to reduce radioiodine in milk of dairy animals

    International Nuclear Information System (INIS)

    Howard, B.J.; Voigt, G.; Segal, M.G.

    1996-01-01

    The most effective countermeasure for radioiodine contamination of milk is to provide dairy animals with uncontaminated feed, with the added advantage that it will be effective for other radionuclides in the fallout. Another effective response is to process the milk into storable dairy products for an appropriate length of time to allow for physical decay. The use of additives given to ruminants to reduce radioiodine in milk is an alternative countermeasure which could be effective. Stable iodine administration is a practically feasible option which has the potential to reduce radioiodine levels in milk by at most a factor of three. Stable iodine supplementation should be at sufficiently high rates to be effective (and at least 1 g d -1 for dairy cows), particularly for ruminants already receiving high amounts of iodine in the diet. Currently available data are inadequate to recommend a suitable stable iodine administration rate for different species of ruminants. Other compounds, such as perchlorate and thiocyanate, also reduce the transfer to radioiodine to milk (and thyroid). Some of these compounds seem to be potentially equally as effective as stable iodine. However, currently there is inadequate information on their effectiveness and possible toxicity to both ruminants and humans for these compounds to be considered as suitable countermeasure additives. 85 refs., 2 figs., 3 tabs

  6. Differentiated thyroid cancer. New concept of radioiodine ablation; Differenziertes Schilddruesenkarzinom. Fortschritte bei der Radioiodablation

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Kobe, C. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Universitaetsklinikum Koeln (Germany), Zentrum fuer Integrierte Onkologie Koeln-Bonn; Luster, M. [Universitaetsklinikum Ulm (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    Ablative radioiodine therapy is the treatment of choice in patients with differentiated thyroid cancer, the only exception being the unifocal, very small papillary thyroid cancer. The TSH-stimulation can be achieved by a waiting period for 2-3 weeks after thyroidectomy without medication or by the use of recombinant human TSH (rhTSH). Both options lead to high success rates. 'Single dose cure' using activities between 1.85 and 3.7 GBq {sup 131}I is standard. Since 2010 rhTSH is approved by the EMA for the indications pT1-4, N0-1, cM0. Survey studies did not find any inferiority of ablation with rhTSH or iatrogenic hypothyroidism in the high-risk patient group. Renal clearance is not reduced after rhTSH administration, thus the {sup 131}I blood dose and the whole body doses are lower in patients under rhTSH. Comparing identical {sup 131}I activities after endogeneous or exogeneous stimulation, rhTSH will minimize the acute adverse effects of {sup 131}I. A short-term withdrawal of levothyroxine some days before rhTSH-injection lowers the iodine plasma level, which may be advantageous for the ablation success if lower 131I activities are used. A rhTSH-based diagnostic {sup 131}I whole-body scintigraphy 3-6 months after ablation is standard for therapy control. At this time, the rhTSH-stimulated thyroglobulin-level is essential for a personalized risk stratification. Tg-measurements by a second generation assay should be used for follow-up care. Metaanalyses have shown that radioiodine ablation lowers the mortality rate, the risk of locoregional recurrences and the risk of late metastasizing. Therefore, ablation has shown a clear benefit. (orig.)

  7. Twenty-five years after Chernobyl: outcome of radioiodine treatment in children and adolescents with very high-risk radiation-induced differentiated thyroid carcinoma.

    Science.gov (United States)

    Reiners, Christoph; Biko, Johannes; Haenscheid, Heribert; Hebestreit, Helge; Kirinjuk, Stalina; Baranowski, Oleg; Marlowe, Robert J; Demidchik, Ewgeni; Drozd, Valentina; Demidchik, Yuri

    2013-07-01

    After severe reactor emergencies with release of radioactive iodine, elevated thyroid cancer risk in children and adolescents is considered the main health consequence for the population exposed. We studied thyroid cancer outcome after 11.3 years' median follow-up in a selected, very high-risk cohort, 234 Chernobyl-exposed Belarusian children and adolescents undergoing postsurgical radioiodine therapy (RIT) in Germany. Cumulatively 100 children with or (without; n = 134) distant metastasis received a median 4 (2) RITs and 16.9 (6.6) GBq, corresponding to 368 (141) MBq/kg iodine-131. Outcomes were response to therapy and disease status, mortality, and treatment toxicity. Of 229 patients evaluable for outcome, 147 (64.2%) attained complete remission [negative iodine-131 whole-body scan and TSH-stimulated serum thyroglobulin (Tg) 10 μg/L, decrease from baseline in radioiodine uptake intensity in ≥ 1 focus, in tumor volume or in Tg). Except for 2 recurrences (0.9%) after partial remission, no recurrences, progression, or disease-specific mortality were noted. One patient died of lung fibrosis 17.5 years after therapy, 2 of apparently thyroid cancer-unrelated causes. The only RIT side effect observed was pulmonary fibrosis in 5 of 69 patients (7.2%) with disseminated lung metastases undergoing intensive pulmonary surveillance. Experience of a large, very high-risk pediatric cohort with radiation-induced differentiated thyroid carcinoma suggests that even when such disease is advanced and initially suboptimally treated, response to subsequent RIT and final outcomes are mostly favorable.

  8. Transfer factors of radioiodine from volcanic-ash soil (Andosol) to crops

    Energy Technology Data Exchange (ETDEWEB)

    Ban-Nai, Tadaaki; Muramatsu, Yasuyuki [National Inst. of Radiological Sciences, Chiba (Japan). Environmental and Toxicological Sciences Research Group

    2003-03-01

    In order to obtain soil-to-plant transfer factors (TFs) of radioiodine from volcanic-ash soil to agricultural crops, we carried out radiotracer experiments. The mean values of TFs (on a wet weight basis) of radioiodine from Andosol to edible parts of crops were as follows: water dropwort, 0.24; lettuce, 0.00098; onion, 0.0011; radish, 0.0044; turnip, 0.0013 and eggplant, 0.00010. The mean value of the TFs of radioiodine for edible parts of wheat (on a dry weight basis) was 0.00015. We also studied the distributions of iodine in crops. There was a tendency for the TFs of leaves to be higher than those of tubers, fruits and grains. A very high TF was found for water dropwort, because this plant was cultivated under a waterlogged condition, in which iodine desorbed from soil into soil solution with a drop in the Eh value. The data obtained in this study should be helpful to assess the long-lived {sup 129}I (half life: 1.57 x l0{sup 7} yr) pathway related to the fuel cycle. (author)

  9. Transfer factors of radioiodine from volcanic-ash soil (Andosol) to crops

    International Nuclear Information System (INIS)

    Ban-Nai, Tadaaki; Muramatsu, Yasuyuki

    2003-01-01

    In order to obtain soil-to-plant transfer factors (TFs) of radioiodine from volcanic-ash soil to agricultural crops, we carried out radiotracer experiments. The mean values of TFs (on a wet weight basis) of radioiodine from Andosol to edible parts of crops were as follows: water dropwort, 0.24; lettuce, 0.00098; onion, 0.0011; radish, 0.0044; turnip, 0.0013 and eggplant, 0.00010. The mean value of the TFs of radioiodine for edible parts of wheat (on a dry weight basis) was 0.00015. We also studied the distributions of iodine in crops. There was a tendency for the TFs of leaves to be higher than those of tubers, fruits and grains. A very high TF was found for water dropwort, because this plant was cultivated under a waterlogged condition, in which iodine desorbed from soil into soil solution with a drop in the Eh value. The data obtained in this study should be helpful to assess the long-lived 129 I (half life: 1.57 x l0 7 yr) pathway related to the fuel cycle. (author)

  10. COMBINATION OF MOLECULAR ADSORBENT RECIRCULATING SYSTEM AND RADIOIODINE FOR THE TREATMENT OF CONCURRENT HYPERTHYROIDISM AND SEVERE LIVER DYSFUNCTION: A RETROSPECTIVE COHORT STUDY.

    Science.gov (United States)

    Zhang, Qing; Guan, Yanxing; Xiang, Tianxin; Liu, Shaozheng; Chen, Qingjie; Zhang, Qing

    2017-02-01

    The treatment of hyperthyroidism associated with severe liver dysfunction (LD) is a clinical challenge, and there has been no unified examination of this problem. The objective of this study was to assess the efficacy and safety of radioiodine ( 131 I) in combination with a molecular adsorbent recirculating system (MARS) for the treatment of hyperthyroidism complicated by severe liver LD. A total of 116 hyperthyroidism patients with concomitant LD who received MARS treatment were studied retrospectively. The patients were grouped according to whether or not they also received 131 I treatment: Group 1 (59 patients) received 131 I following MARS treatment, while Group 2 (57 cases) received only MARS. Clinical outcomes, including thyroid hormone levels, liver function parameters, and therapeutic efficacy were calculated. The overall response rate was significantly greater in Group 1 than in Group 2 (Ptreatment compared with before treatment (Ptreatments (Ptreatment of hyperthyroidism complicated by severe LD was effective and safe. The use of this system could rapidly improve liver function and metabolism, allowing 131 I therapy to be applied as early as possible with a shortened recovery time of liver function. ALSS = artificial liver support system ALT = alanine transaminase AST = aspartate transaminase ATD = antithyroid drugs DBil = direct bilirubin FT3 = free tri-iodothyronine FT4 = free thyroxine 131 I = radioiodine INR = international normalized ratio LD = liver dysfunction MARS = molecular adsorbent recirculating system MELD = model for end-stage liver disease PT = prothrombin time TBil = total bilirubin TSH = thyroid-stimulating hormone.

  11. The Hypothalamic-Pituitary-Thyroid Axis in Infants and Children: Protection from Radioiodines

    Directory of Open Access Journals (Sweden)

    Jeffrey Fisher

    2014-01-01

    Full Text Available Potassium iodide (KI is recommended as an emergency treatment for exposure to radioiodines, most commonly associated with nuclear detonation or mishaps at nuclear power plants. Protecting the thyroid gland of infants and children remains a priority because of increased incidence of thyroid cancer in the young exposed to radioiodines (such as 131I and 133I. There is a lack of clinical studies for KI and radioiodines in children or infants to draw definitive conclusions about the effectiveness and safety of KI administration in the young. In this paper, we compare functional aspects of the hypothalamic-pituitary-thyroid (HPT axis in the young and adults and review the limited studies of KI in children. The HPT axis in the infant and child is hyperactive and therefore will respond less effectively to KI treatment compared to adults. Research on the safety and efficacy of KI in infants and children is needed.

  12. Sorption studies of radioiodine on soils with special references to soil microbial biomass

    International Nuclear Information System (INIS)

    Bors, J.; Erten, H.; Martens, R.

    1991-01-01

    In batch experiments with two types of soils, chernozem and podzol, radioiodine ( 125 I) showed an initial rapid sorption, followed by a long and slow further increase. Very little sorption (R d d -values were observed for the chernozem soil, characterized by a higher amount of organic substance and of soil biomass. The sorption process was predominantly irreversible, the isotherms were linear at low ion concentrations and deviated from linearity starting at 10 -5 mmol.ml -1 . Sorption ratio was found to increase with increasing volume to mass ratio. The composition of liquid phases (bidistilled water, synthetic soil water, rain water) highly affected iodine sorption. In experiments with KBr solution, the sorption of I - was found to be strongly preferred to Br - . Incubation of soil samples under varied conditions (decreased or increased soil biomass, O 2 -concentration, incubation temperature, soil water content and storage conditions) delivered indications for the participation of soil microflora in iodine immobilization. Test with isolated soil bacteria and fungi showed that radioiodine can be incorporated by soil microorganisms under certain conditions only: Considerable uptake of radioiodine was found in washed (NaCl, CaCl 2 ) cells with both bacteria and fungi, but no incorporation was detected into cells incubated with radioiodine in the culture medium. (orig.)

  13. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    Energy Technology Data Exchange (ETDEWEB)

    Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile); Del Campo, G; Ide, A; Wiener, R [Department of Endocrinology of the Military Hospital, Santiago (Chile)

    2002-09-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  14. An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department

    International Nuclear Information System (INIS)

    Jofre, M.J.; Sierralta, M.P.; Del Campo, G.; Ide, A.; Wiener, R.

    2002-01-01

    An eighteen year experience of differentiated thyroid carcinoma treatment with 131 radioiodine at the Military Hospital Nuclear Medicine Department. Since the beginning of Nuclear Medicine, the thyroid gland has been an important subject for study. In the fifties, the complimentary use of 131 radioiodine after differentiated thyroid carcinoma (DTC) surgery was postulated. The aim of the study was to analyze our experience of the management of patients with DTC. Material and methods: An 18-year retrospective analysis was made including 109 patients with previous diagnosis of DTC, 90 % females, mean age 47 +/- 17 y.o. (range: 19-85 y.o). Tumoral histology was 67 % papillary, 28 % follicular and 5% non-determined in the medical record. First doses of 131 radioiodine were between 50 and 200 mCi. In all, 156 radioiodine doses were given and 6 patients received 4 doses or more, with total doses between 300 and 570 mCi. Results: The distribution of first and total radioiodine doses is presented in the table below. Of the group of patients who received a first radioiodine dose of less than 100 mCi post surgery, 79% were treated before 1990. Those who received 150mCi or more had cervical ganglionar compromise, trachea invasion or subtotal thyroidectomy. In 50% of the patients who received 4 or more doses, the first two doses were 50 mCi. It is important to mention that there was one patient who received 8 radioiodine doses in 4 years , seven of them were 50 mCi ( total dose 438 mCi). This patient presented trachea and larynx invasion in the early stages, with a persistent focus in the left supraclavicular region. She later developed pulmonary fibrosis, for which she was treated with complimentary radiotherapy (30 Gy), before dying. Distribution of radioiodine doses is presented. Conclusion: It is important to emphasize the validity of a first 131 radioiodine dose after surgery of DTC patients of 100 mCi or more, to obtain the ablation of the remaining thyroid tissue. This

  15. Play Therapy: Role in Reading Improvement.

    Science.gov (United States)

    Carmichael, Karla

    1991-01-01

    Reviews the literature concerning the role of play therapy (particularly sandplay and nondirected play therapy) in the improvement of reading. Suggests that the role of play therapy is to support the child, encourage the child, and build self-esteem thus creating the optimal learning environment for reading improvement. (RS)

  16. 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)

  17. 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.

  18. Radioiodination of melagenine-II with I-125 (preliminary study)

    International Nuclear Information System (INIS)

    Caso, R.; Ruiz, M.

    1996-01-01

    Radioiodination of Melagenine-II with I-125 farmacokinetic studies was made, using Chloramine-T method. Radiochemical purity and stability of the labelled product were determined by radiochromatography. The labelled Melagenine-II showed two radioactive fractions

  19. 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)

  20. Indirect labeling of proteins with radioiodine

    International Nuclear Information System (INIS)

    Araujo, Elaine Bortoleti de; Lavinas, Tatiana; Muramoto, Emiko; Pereira, Nilda P.S. de; Silva, Constancia P.G.; Tavares, Leoberto C.

    2000-01-01

    A procedure is described for the radioiodination of proteins using an iodinated derivative of N succinimidyl 3-(tri-n-butylstannyl)benzoate (ATE), previously described by Zalutsky. ATE was obtained in a high pure form and the iodination has been performed with 131-Iodine in 70-80% yield. Protein labeling studies performed with human IgG indicate that the ATE intermediate is an important alternative to conventional labeling methods. (author)

  1. 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

  2. Determination of the radioiodine species in the exhaust air of nuclear facilities

    International Nuclear Information System (INIS)

    Deuber, H.

    1977-01-01

    Using the selective I 2 sorption materials DSM 10 and DSM 11 measurements were performed with radioiodine species samplers in the exhaust air of a research reactor and of several nuclear power stations (BWR, PWR). The radioiodine species samplers were used upstream and downstream of iodine filters (containment exhaust air stand-by filter, shutoff room exhaust air filter) as well as in the exhaust air of the stack. The results obtained by use of DSM 10 and DSM 11 generally agreed. The percentage of aerosol iodine was low in all cases ( [de

  3. 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

  4. Sorption studies of radioiodine on soils with special references to soil microbial biomass

    Energy Technology Data Exchange (ETDEWEB)

    Bors, J. (Niedersaechsisches Inst. fuer Radiooekologie, Hannover (Germany, F.R.)); Erten, H. (Bilkent Univ., Ankara (Turkey). Dept. of Chemistry); Martens, R. (Bundesforschungsanstalt fuer Landwirtschaft, Braunschweig (Germany, F.R.). Inst. fuer Bodenbiologie)

    1991-01-01

    In batch experiments with two types of soils, chernozem and podzol, radioiodine ({sup 125}I) showed an initial rapid sorption, followed by a long and slow further increase. Very little sorption (R{sub d} < 1) was detected in clay minerals. Generally, higher R{sub d}-values were observed for the chernozem soil, characterized by a higher amount of organic substance and of soil biomass. The sorption process was predominantly irreversible, the isotherms were linear at low ion concentrations and deviated from linearity starting at 10{sup -5} mmol.ml{sup -1}. Sorption ratio was found to increase with increasing volume to mass ratio. The composition of liquid phases (bidistilled water, synthetic soil water, rain water) highly affected iodine sorption. In experiments with KBr solution, the sorption of I{sup -} was found to be strongly preferred to Br{sup -}. Incubation of soil samples under varied conditions (decreased or increased soil biomass, O{sub 2}-concentration, incubation temperature, soil water content and storage conditions) delivered indications for the participation of soil microflora in iodine immobilization. Test with isolated soil bacteria and fungi showed that radioiodine can be incorporated by soil microorganisms under certain conditions only: Considerable uptake of radioiodine was found in washed (NaCl, CaCl{sub 2}) cells with both bacteria and fungi, but no incorporation was detected into cells incubated with radioiodine in the culture medium. (orig.).

  5. Critical analysis of radioiodination techniques for micro and macro organic molecules

    International Nuclear Information System (INIS)

    Sajid Mushtaq; Jongho Jeon; Beom Su Jang; Sang Hyun Park; Korea University of Science and Technology, Daejeon; Aqeela Shaheen

    2016-01-01

    A variety of radioiodination methods is available in the literature depending upon the nature of organic compound to be labeled, however only few can completely fulfill manufacturing requirements.Ideally a selected method should be one which offers maximum benefits like regioselectivity, minimum reaction steps, minimum reaction time, high radiochemical yield and high specific activity. In this review radioiodination techniques were critically analyzed. Advantages, drawbacks, possible mode of action and special reaction conditions required to get high radiochemical yield were taken into account. The influence of iodine introduction on physicochemical properties, in vivo or in vitro pharmacological properties of pharmaceutical due to increase of lipophilicity were discussed along with examples. (author)

  6. Air Monitoring to Control the Intake of Airborne Radioiodine-131 Contaminants by Nuclear Medicine Workers

    International Nuclear Information System (INIS)

    Jiemwutthisak, P.; Sritongkul, N.; Chaudakshetrin, P.; Kanchanaphiboon, P.; Tuntawiroon, M.

    2012-01-01

    Inhalation of radioiodine-131 is the largest cause of internal dose to nuclear medicine workers. The concentration of radioiodine-131 in air is limited by the Derived Air Concentration (DAC) of 416.67 Bq/m3. In this study air monitoring shall be performed to measure the radioiodine-131 contaminant in air by sample collection and analysis. Air samples were drawn from areas where there is a potential for I-131 airborne radioactivity e.g. in the hot laboratory, radioiodine treatment rooms, radioactive waste collection areas and waste water treatment plant. A portable battery-operated air sampler, Gilian BDX II with carbon- impregnated cellulose filters was used for air sampling. The flow rate was adjusted to 3 liters per minute and the sampler run for 180 minutes. Iodine-131 radioactivity on filter was measured for 10 minutes by 2 NaI(Tl) gamma counters, Perkin Elmer Wallac Wizard 1480 (3''x3'') and Atomlab 950 PC (2''x2'') with and objective for inter comparison. Counting efficiency of the counters are 57 and 39 percent respectively. Agreeable results of I-131 radioactivity were obtained from both gamma counters. The mean I-131 concentrations measured by Wallac(Atomlab) were 31.59±16.31 (29.84±14.74) Bq/m 3 in radioiodine fume hood for treatment dose dispensing, 8.98±4.33 (7.58±5.10) Bq/m 3 in fume hood accommodated with a dose calibrator, 7.80±5.39 (7.54±5.04) Bq/m 3 in radioactive waste storage area, 0.03±0.54 (0.03±0.57) Bq/m 3 in patient waiting area, 2.94±3.60 (2.55±2.98) Bq/m 3 in hospital ward waste collection area and 0.03±0.01 (0.03±0.01) Bq/m 3 in the water treatment plant area. Radioiodine concentrations in patient's room increases linearly as the administered dose was increasing. Mean±SD of the measured concentrations were 11.63±9.30 (9.86±8.98) Bq/m 3 , 18.57±13.24 (17.35±12.33) Bq/m 3 and 31.90±22.32 (30.90±22.49) Bq/m 3 for the administered doses of 3.7, 5.55 and 7.4 Bq respectively. Radioiodine concentrations in all specified areas

  7. Targeting breast carcinoma with radioiodinated anti-HER2 Nanobody

    International Nuclear Information System (INIS)

    Pruszynski, Marek; Koumarianou, Eftychia; Vaidyanathan, Ganesan; Revets, Hilde; Devoogdt, Nick; Lahoutte, Tony; Zalutsky, Michael R.

    2013-01-01

    Introduction: With a molecular weight an order of magnitude lower than antibodies but possessing comparable affinities, Nanobodies (Nbs) are attractive as targeting agents for cancer diagnosis and therapy. An anti-HER2 Nb could be utilized to determine HER2 status in breast cancer patients prior to trastuzumab treatment. This provided motivation for the generation of HER2-specific 5F7GGC Nb, its radioiodination and evaluation for targeting HER2 expressing tumors. Methods: 5F7GGC Nb was radioiodinated with 125 I using Iodogen and with 131 I using the residualizing agent N ε -(3-[ 131 I]iodobenzoyl)-Lys 5 -N α -maleimido-Gly 1 -GEEEK ([ 131 I]IB-Mal-D-GEEEK) used previously successfully with intact antibodies. Paired-label internalization assays using BT474M1 cells and tissue distribution experiments in athymic mice bearing BT474M1 xenografts were performed to compare the two labeled Nb preparations. Results: The radiochemical yields for Iodogen and [ 131 I]IB-Mal-D-GEEEK labeling were 83.6 ± 5.0% (n = 10) and 59.6 ± 9.4% (n = 15), respectively. The immunoreactivity of labeled proteins was preserved as confirmed by in vitro and in vivo binding to tumor cells. Biodistribution studies showed that Nb radiolabeled using [ 131 I]IB-Mal-D-GEEEK, compared with the directly labeled Nb, had a higher tumor uptake (4.65 ± 0.61% ID/g vs. 2.92 ± 0.24% ID/g at 8 h), faster blood clearance, lower accumulation in non-target organs except kidneys, and as a result, higher concomitant tumor-to-blood and tumor-to-tissue ratios. Conclusions: Taken together, these results demonstrate that 5F7GGC anti-HER2 Nb labeled with residualizing [ 131 I]IB-Mal-D-GEEEK had better tumor targeting properties compared to the directly labeled Nb suggesting the potential utility of this Nb conjugate for SPECT ( 129 I) and PET imaging ( 124 I) of patients with HER2-expressing tumors.

  8. Chinese hamster ovary cell lysosomes retain pinocytized horseradish peroxidase and in situ-radioiodinated proteins

    International Nuclear Information System (INIS)

    Storrie, B.; Sachdeva, M.; Viers, V.S.

    1984-01-01

    We used Chinese hamster ovary cells, a cell line of fibroblastic origin, to investigate whether lysosomes are an exocytic compartment. To label lysosomal contents, Chinese hamster ovary cells were incubated with the solute marker horseradish peroxidase. After an 18-h uptake period, horseradish peroxidase was found in lysosomes by cell fractionation in Percoll gradients and by electron microscope cytochemistry. Over a 24-h period, lysosomal horseradish peroxidase was quantitatively retained by Chinese hamster ovary cells and inactivated with a t 1/2 of 6 to 8 h. Lysosomes were radioiodinated in situ by soluble lactoperoxidase internalized over an 18-h uptake period. About 70% of the radioiodine incorporation was pelleted at 100,000 X g under conditions in which greater than 80% of the lysosomal marker enzyme beta-hexosaminidase was released into the supernatant. By one-dimensional electrophoresis, about 18 protein species were present in the lysosomal membrane fraction, with radioiodine incorporation being most pronounced into species of 70,000 to 75,000 daltons. After a 30-min or 2-h chase at 37 degrees C, radioiodine that was incorporated into lysosomal membranes and contents was retained in lysosomes. These observations indicate that lysosomes labeled by fluid-phase pinocytosis are a terminal component of endocytic pathways in fibroblasts

  9. Therapy with radionuclides

    International Nuclear Information System (INIS)

    Biersack, H.J.; Hotze, A.L.

    1992-01-01

    Radioiodine therapy of benign and malignant thyroid diseases is a well-established procedure in Nuclear Medicine. However, the therapeutic use of radioisotopes in other diseases is relatively unknown among our refering physicians. The therapeutic effects of intraarticular (rheumatoid arthritis) and intracavitary (pleural and peritoneal carcinosis) applications yields good results. The radiophosphorus therapy in polycythemia vera rubra has always to be considered as an alternative to chemotherapy. The use of analgetics may be reduced by pain therapy of bone metastasis by injection of bone-seeking beta emitters like Rh-186 HEDP. Other procedures like therapeutic application of meta-iodo-benzylguanidine in neuroblastoma and malignant pheochromocytoma resulted in at least remissions of the disease. Radioimmunotherapy needs further evaluation before it can be recommended as a routine procedure. (orig.) [de

  10. 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...

  11. Evaluation of radioiodinated and radiocopper labeled monovalent fragments of monoclonal antibody chCE7 for targeting of neuroblastoma

    International Nuclear Information System (INIS)

    Carrel, Francois; Amstutz, Hanspeter; Novak-Hofer, Ilse; Schubiger, P. August

    1997-01-01

    Monovalent fragments of antineuroblastoma antibody mAb chCE7 were evaluated for their in vitro and in vivo tumor cell binding properties. Single chain fragments were constructed from the variable region genes cloned from hybridoma cells, expressed in E.coli and purified by metal chelate affinity chromatography. Radioiodinated CE7-scFv fragments were found to bind with high affinity (K d ∼10 -9 M) to target cells in vitro but formed aggregates at 37 deg. C, and bound to serum proteins in vitro and in vivo. Circular Dichroism spectra revealed the protein to be in a conformationally altered form and no permanent 'refolding' could be achieved. In contrast, chCE7-Fab fragments were found to bind to target tumor cells with similar affinity than the parent mAb chCE7 (K d ∼10 -10 M), showed no tendency to aggregate and were stable in serum both in vitro and in vivo. Kinetics of association and dissociation of radioiodinated scFv and Fab fragments were found to be rapid. Radioiodination with the Iodogen method led to impaired immunoreactivity which was found to further increase the off- rates of radioiodinated fragments from tumor cells. Radioiodination with the Bolton-Hunter reagent as well as labeling of chCE7-Fab fragments with 67 Cu via the macrocyclic CPTA ligand led to fully immunoreactive Fab fragments. Radioiodinated and radiocopper labeled monovalent CE7 fragments did not internalize into target tumor cells as the parent mAb and its F(ab') 2 fragment. A comparison of the biodistribution in tumor bearing nude mice of the radiocopper labeled monovalent, non internalizing Fab fragments with the internalizing divalent F(ab') 2 fragments showed in both cases high levels of radioactivity in the kidneys. Concerning tumor uptake, radioactivity from both internalizing and non internalizing fragments remained associated with tumor tissue for longer times than in case of the corresponding radioiodinated fragments. When compared with the radioiodinated forms, tumor uptake

  12. Synthesis, radioiodination, and biodistribution of some nido- and closo-monocarbon carborane derivatives

    International Nuclear Information System (INIS)

    Wilbur, D. Scott; Hamlin, Donald K.; Srivastava, Rajiv R.; Chyan, Ming-Kuan

    2004-01-01

    Iodination and radioiodination reactions of several anionic nido- and closo-monocarbon carboranes were conducted. Iodinations occurred more rapidly with nido-carboranes than with closo-carboranes. The most rapid iodination and radioiodination reactions occurred with unsubstituted carboranes. C-amino and C-ammonium derivatives did not iodinate under the conditions studied. Both nido- and closo-carboranes with C-NH-acetyl and C-NH-succinyl substituents iodinated, but the nido-carboranes iodinated under milder reaction conditions. Biodistributions of nido-1-succinylamido-[ 131 I]carborane and closo-1-succinylamido-[ 125 I]carborane were similar in mice, but blood clearance of the nido- compound was slower

  13. Treatment with radioiodine of Graves' disease. Calculated activity; fixed activity or ablation. Were are we going?

    International Nuclear Information System (INIS)

    Degrossi, O.

    2006-01-01

    The new tendencies of radioiodine ( 131 I) treatment of Graves'disease are presented . One group have the objective of administrate an activity of radioiodine to bring back the patient to euthyroidism , using individual activities to each patient. Others propose a fixed dose, with high activity to cure the disease and anticipating the hypothyroidism of the patient. The third group propose directly the ablation of the thyroids with a calculated activity to deliver 300 Gy .This calculi demand the investigation of the maximum uptake of radioiodine, the biological half life, and the thyroid weight with adequate method (US, TC, MR) Finally, the dose to not thyroid tissues are discussed and the risk of these procedures are presented. (author)

  14. Disparity of radioiodine and radiothallium concentrations in chronic thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Shimaoka, K.; Parthasarathy, K.L.; Friedman, M.; Rao, U.

    1980-01-01

    Three cases of chronic thyroiditis (Hashimoto's disease) presented with thyroid nodules, showed disparate uptakes of radioiodine and radiothallium. All patients were clinically euthyroid and had positive antithyroid antibody titers. On cytological and/or pathological examinations, they were consistent with chronic thyroiditis.

  15. Synthesis of substrates for gene therapy monitoring of HSV1-TK system

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Hyun; Ahn, Soon Hyuk; Choi, Chang Woon; Lim, Sang Moo; Awh, Ok Doo [College of Medicine, Yonsei Univ., Wonju (Korea, Republic of)

    2002-04-01

    In gene therapy, tumor cells expressing the herpes simplex virus thymidine kinase are sensitive to prodrugs. Potential prodrugs IVDU and IVFRU were synthesized and radiolabeled with radioiodine for noninvasive imaging of herpes simplex virus type 1 gene expression. 5-(2-trimethysilyl) vinyl-2'-deoxyuridine and 5-t(2-trimethylsilyl)vinyl-2'-fluoro-2'-deoxyuridine, precursors of 5-(2-iodo)viny 1-2'-deoxy uridine(IVDU) and 5-(2-iodo)-2'-vinyl-2'-deoxy-2'-fluorotibofuranosyl uracil(IVFRU), were synthesized from reaction of trans-1-trimethylsillyl-2-tri-n-butylstannylethylene with 5-iodo-2'-deoxyuridine and 5-iodo-2'-fluoro-2'-deoxyuridine, respectively, on the condition of Pd catalyst. These precursors were separated from reaction mixture by silica gel column chromatography method. Each precursor was radioiodinated with radioiodine by mixing with ICI oxidizing agent. These radioiodinated compounds were purified with HPLC. Radiohalogen exchange has been shown to be effective for the synthesis of products with lower specific activity. Similarly, carrier-added and high specific activity products have been isolated in respectable radiochemical yields using ICI method. Synthetic yield of precursors, IVDU and IVFRU were 43% and 18%, respectively. Radiochemical purity of both compunds was over 98%. We synthesized precursors of IVDU and IVFRU for monitoring of HSV1-tk gene expression. Radiotracers were radioiodinated with high radiolabeling yield by ICI method.

  16. 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

  17. Design and development of a lead jar for oral administration of radioiodine In hyperthyroid patients

    International Nuclear Information System (INIS)

    Rahman, M.S.; Paul, A.K.; Rahman, H.A.; Begum, F.

    2005-01-01

    Full text: Nuclear Medicine practices involve use of radioisotopes for diagnosis and treatment of diseases. Radioiodine is one of such radioisotopes, being used in the diagnosis and treatment of diseases since 1942. Handling of radioiodine involves radiation hazards both for the patients as well as for the technologists. Though radioiodine is supplied in a lead container, for treatment purpose, it is administered after dispensing into a glass jar that does not adequately protect radiation hazards. For this reason, we designed and developed a lead jar and radioiodine is dispensed into that lead jar to minimize radiation hazards. For oral administration of radioiodine to hyperthyroid patients, a lead jar was designed and developed with lead in Centre for Nuclear Medicine and Ultrasound, Khulna in December 2004 by own expertise and technologies in such a way that a glass jar could be introduced into that lead jar. The thickness of lead was 4.04 mm and the thickness of glass jar was 0.7 mm and thus the whole thickness of lead jar became 4.74 mm. The desired dose of radioiodine (8 mCi) that should be given to the patients were dispensed into that lead jar and administered orally to the patients. Radiation levels in 10 such cases were measured by Mini-Rad Series-1000 survey meter at 0.5 meter, 1 meter and 3 meters distances both lead jar and glass jar. The mean radiation level of lead jar and glass jar during oral administration of 8 mCi of Na 131 I solution in 10 cases at 0.5 meter, 1 meter and 3 meters distances were 62.4 ± 1.96 microSv/h, 17.7 ±1.95 microSv/h, 3.39 ± .12 microSv/h and 20.3± 2.16 microSv/h, 79.8 ± 0.79 microSv/h, 1.97 ± 0.23 microSv/h respectively. We have found that radiation level reduced by 67.47%, 61.58%, and 41.89% with lead jar at 0.5 meter, 1 meter and 3 meters distances. In conclusion, the locally designed and developed lead jar is safe, easy to handle and reduces radiation burden significantly in oral administration of radioiodine to

  18. Extremes of environmental temperature and the transfer of radioiodine into milk

    International Nuclear Information System (INIS)

    Lengemann, F.W.; Wentworth, R.A.

    1979-01-01

    Two goats were kept at 33 0 C and 5 0 C to determine the amount of radioiodine transferred to milk after an oral dose. At 33 0 C, 16.8% of the oral 125 I was in the milk as opposed to 2.6% at 5 0 C. This is a 6.5-fold difference and suggests difficulties for prediction equations based upon actual amounts of radioiodine secreted into milk. Using F values it was judged that the shape of the milk secretion curve was relatively the same between goats and temperatures. This suggests that prediction procedures based on the shape of the milk transfer curve could be more precise. (author)

  19. Development of a stable radioiodinating reagent to label monoclonal antibodies for radiotherapy of cancer

    International Nuclear Information System (INIS)

    Wilbur, D.S.; Hadley, S.W.; Hylarides, M.D.; Abrams, P.G.; Beaumier, P.A.; Morgan, A.C.; Reno, J.M.; Fritzberg, A.R.

    1989-01-01

    A method of radioiodinating monoclonal antibodies such that the labeled antibodies do not undergo in vivo deiodination has been studied. The method utilizes conjugation of succinimidyl para-iodobenzoate to the antibody. The iodobenzoate was radiolabeled by using an organometallic intermediate to facilitate the reaction. Thus, succinimidyl para-tri-n-butylstannylbenzoate was radiolabeled in 60-90% radiochemical yield and subsequently conjugated to the antibody in 80-90% yield. Animal biodistribution studies were carried out with two separate anti-melanoma antibodies (9.2.27 and NR-M1-05) labeled by this method, and examined in nude mice bearing human melanoma tumor xenografts. Very large differences in the localization of radioactivity were observed in the thyroids and stomachs of mice when the iodobenzoyl-labeled antibodies were compared with the same antibodies labeled using the chloramine-T method of radioiodination. Few other significant differences in the tissue distribution of the radioiodinated antibodies were seen

  20. Determination of very small activities of radioiodine and plutonium in air

    International Nuclear Information System (INIS)

    Irlweck, K.; Karg, V.; Schoenfeld, T.; Sorantin, H.; Steger, F.

    1982-01-01

    A mobile high volume sampler with the following characteristics was developed: air flow rate 5000 m 3 .h - 1 , total cross section of the seven activated charcoal filter units 0.6 m 2 , diameter of each filter unit 33 cm, thickness of charcoal layer 4 - 7 cm. The sorbed radioiodine is eluted from the charcoal in a circulation unit by a circulating solution (sodium hydroxide/hydrazine) and is transfered into a sorbent containing silver (ion exchange resin with colloidal silver), thereby bringing about a reduction in volume by a factor of approximately 1000. The radioiodine activity is then determined by gamma spectrometric measurement of the silver containing sorbent. The overall radioiodine yield measured with 123 I spike (sorption on charcoal and transfer to the silver containing sorbent) is 75 (+- 7)%. A detection limit of 0.02 mBq.m - 3 is achieved for 131 I. If the sampler is operated with the standard throughput of 5000 m 3 .h - 1 , this limit applies to one hour average concentration values. Results of environmental monitorings for the period 1979 - 1982 at the Research Center Seibersdorf for 131 I (up to 2,6 mBq/m 3 ) and for plutonium (up to 4 μBq/m 3 ) are given. (Author)

  1. 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)

  2. 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

  3. The Effect of Radioiodine on the Intima Media Thickness of the Carotid Artery

    Directory of Open Access Journals (Sweden)

    Erdem Sürücü

    2013-12-01

    Full Text Available Aim: The radiation can induce vessel injury. The result of this injury can be severe and life-threatening. There are a few studies demonstrating an increase in intima-media thickness (IMT of the common carotid artery (CCA after radiotherapy, especially in head and neck cancers. We evaluated the effect of I-131 to the IMT of the CCA in the patients who were treated for hyperthyroidism. Methods: 38 patients (25M, 13W referred to our department for radioiodine treatment with the diagnosis of nodular goitre (25 patients and diffuse hyperplasia (Graves disease (GD, 13 patients were included to the prospective study. An USG was performed for all the patients before therapy, 3, 6 and 12 months after radioiodine therapy in order to measure IMT of CCA and the femoral artery (FA. The IMT was measured at the level of proximal part of bulbus anteriorly on the left and right side. The IMT of FA was measured just before the bifurcation. Results: There was a statistically significant increase in IMT of both CCA and FA bilaterally in nodular hyperthyroid patients. However, in the patients with Graves disease, there was only statistically significant increase in the left IMT of CCA at 0-3rd, 0-6th month measurements and in the right IMT of FA at 0-3rd month measurements. Conclusion: Though the limitation of the study is the interobserver and intraobserver variability, it was seen that I-131 therapy might affect the IMT of CCA in the patients with NG. I-131 effect on the IMT of CCA in patients with nodular goitre was higher than the IMT of CCA in patients with GD. I-131 effect on the IMT of CCA might be due to administered dose and adjacency. The interesting point of our study was the increased thickness of IMT in FA. We think that the increase in IMT is due to the systemic effect of radioactivity circulating in the blood vessel. I-131 effect on the IMT of FA in patients with nodular goitre was higher than the IMT of FA in the patients with GD due to I-131 uptake

  4. Improvement of dosimetry for I-131 therapy of lung metastases with special regard to children with thyroid cancer from Belarus following the Chernobyl accident. Final report 1997-1999

    International Nuclear Information System (INIS)

    Lassmann, M.; Reiners, C.; Allen, S.

    2000-01-01

    The main problem in treating disseminated pulmonary metastases in children with papillary thyroid cancer is to find a balance between an insufficient dose for the ablation of metastatic tissue and unnecessary high radiation exposure to the lungs and the bone marrow. This can hardly be achieved without quantitative dosimetry for the more or less inhomogeneously distributed 1-131 in high dosed radioiodine therapy. The major goal of this project is to improve the concept for treating patients with lung metastases induced by thyroid carcinoma. Almost all of the patients with lung metastases are treated in more than one therapy course. After each course the knowledge of the doses to the tumor tissue, the lung, and the bone marrow is of crucial importance for a well funded decision about further treatment. In the cases of either the tumor doses being inefficient for ablation or substantial impairment of residuing pulmonary metastases or the cumulated doses to lung and bone marrow exceeds empirically defined ''critical'' limits the fractionated radioiodine treatment has to be stopped to avoid side effects such as lung fibrosis or leukemia in patients with papillary thyroid cancer. The decision which has to be taken must consider that prognosis with respect to mortality and quality of life even in the case of persisting lung metastases may be better than after the induction of progressive pulmonary fibrosis. Up to now, patients are treated more or less empirically until complete remission is achieved and no tumor uptake is visible in post-therapeutic scans with a gamma camera or the cumulative activity of 1-131 taken up by the lungs exceeds 3 GBq (80 mCi) according to recommendations given by Benua and Leaper in 1962. This project combines empirical approaches with theoretical research at cellular level to optimize the dose to the tumor cells with protection of healthy lung tissue. (orig.)

  5. Isolation, lactoperoxidase catalyzed radioiodination, and recovery of proteins bound to insoluble immunoadsorbents

    International Nuclear Information System (INIS)

    Cort, S.; McDougall, J.S.

    1977-01-01

    A method for the direct radioiodination and recovery of proteins specifically adsorbed to an insoluble immunoadsorbent is described. The optimal conditions for adsorption, washing, radiolabelling by lactoperoxidase-catalyzed iodination, and elution of radio-labelled proteins from the immunoadsorbent have been determined. The technique is a rapid and efficient means of isolating and radioiodinating specific proteins present in biological fluids and has been applied to the detection of immunoglobulin and histocompatibility antigens in mouse cell culture supernates. This method should be particularly applicable in research situations in which the specific antisera are available but the antigen concentration is low or the volume of material to be analyzed is limited

  6. A review of available countermeasures to reduce radioiodine transfer to milk. With special regard to the use of stable iodine

    International Nuclear Information System (INIS)

    Howard, B.

    1993-03-01

    Contamination of milk by 131 I constitutes an important potential component of the collective dose to the population after a nuclear accident, and a relatively large dose saving can be gained by applying suitable countermeasures. Stable iodine prophylaxis is recommended for humans to prevent or reduce by the thyroid of inhaled radioiodine but controls on food are more appropriate to reduce radioiodine intakes from ingestion. Therefore it is important to have effective, practical countermeasures available to prevent radioiodine contamination of milk. This review evaluates currently available countermeasures which can be used to reduce radioiodine contamination of milk. In particular, it critically assesses available data on the effectiveness of stable iodine administration. The simplest and most effective countermeasure is to provide dairy animals with uncontaminated feed, this countermeasure has the added advantage that it will be effective for other radionuclides which may be present in the fallout. Alternatively, another effective response is to process the milk into storable dairy products for an appropriate length of time to allow for physical decay. The use of additives given to ruminants to reduce radioiodine in milk should be viewed as an alternative countermeasure which could be effective, but would not be the preferred option. However, it should be considered, particularly if difficulties are anticipated with the first two options. Stable iodine administration is a practical, and feasible option which has the potential to reduce radioiodine levels in milk, by at most a factor of three and the radiation dose to the animals thyroid. However, the stable iodine supplementation at low doses, and after the ingestion of radioiodine, may lead to increases in radioiodine levels in milk. Similarly, if ruminants are already receiving high iodine intakes, stable iodine is unlikely to be effective. Currently available data is inadequate to recommend a suitable dose

  7. [Prevention and multimodal therapy of hyperthyroidism].

    Science.gov (United States)

    Palitzsch, K-D

    2008-12-01

    Subclinical and overt hyperthyroidism have been associated with various negative clinical outcomes as for example an increased risk of atrial fibrillation or increased cardiovascular mortality, especially in old age. In order to avoid hyperthyroidism it is strongly recommended not to start any iodine containing drug therapy or to avoid application of contrast agents unless the patient presents with an unremarkable clinical course. TSH suppressive therapy for the treatment of endemic goiter or differentiated low risk thyroid carcinoma is unnecessary, since it favours the development of subclinical hyperthyroidism. Overt hyperthyroidism is treated with antithyroid drugs and/or radioiodine therapy or surgery according to the underlying disease (toxic nodular goiter, Graves' disease).

  8. Low-dose radioiodine given six-monthly in Graves' disease

    International Nuclear Information System (INIS)

    Hoskin, P.J.; McCready, V.R.; Harmer, C.L.; Spathis, G.S.; Cosgrove, D.O.

    1985-01-01

    Experience using low-dose radioiodine given six-monthly instead of yearly in hyperthyroid patients with Graves' disease is reported. One hundred and thirty-five patients have been treated over a three-year period with 74 MBq (2 mCi) doses of 131 I. |Thirty-eight|percent| were controlled with a single dose. Those patients requiring more than one dose were treated with a further 74 MBq (2 mCi) 131 I at six-monthly intervals until euthyroid. Using this approach, 46% were euthyroid one year after starting treatment, and 75% were euthyroid at two years. The incidence of hypothyroidism following treatment was 2.2% at one year, with a yearly incidence thereafter of 4-6%. Six-monthly scheduling of low-dose radioiodine in Graves' disease can reduce the time taken to become euthyroid, compared with conventional yearly low-dose treatments. Further follow up is required to confirm the present low incidence of hypothyroidism following treatment. (author)

  9. 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

  10. Stereoselective synthesis of an iodinated resveratrol analog: Preliminary bioevaluation studies of the radioiodinated species

    Energy Technology Data Exchange (ETDEWEB)

    Dhyani, Manish V.; Kameswaran, Mythili; Korde, Aruna G.; Pandey, Usha [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085 (India); Chattopadhyay, Subrata [Bio-Organic Division, Bhabha Atomic Research Centre, Mumbai 400085 (India); Banerjee, Sharmila, E-mail: sharmila@barc.gov.i [Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085 (India)

    2011-07-15

    Stereoselective synthesis of an E-hydroxystilbene has been carried out using the McMurry reaction. Synthesis of a monoiodinated hydroxystilbene has been carried out by a McMurry cross-coupling reaction. For the purpose of biological evaluation, the facile electrophilic substitution route has been attempted to radioiodinate it with {sup 125}I. The HPLC pattern of the radioiodinated hydroxystilbene, which could be obtained in >90% radiochemical purity, was found to be identical to that of its non-radioactive analog that has been independently prepared using the McMurry cross-coupling route. In vitro cell uptake studies were carried out in breast cancer cells MCF7, overexpressing estrogen receptors. In vivo biodistribution studies in female Swiss mice show a uterine uptake of 0.85{+-}0.4% ID/g at 3 h.p.i. with a uterus to muscle ratio of 2.83. Uptake in the thyroid was insignificant indicating good in vivo stability of the radioiodinated hydroxystilbene.

  11. Evaluation of the radioprotective effect of turmeric extract and vitamin E in mice exposed to therapeutic dose of radioiodine

    International Nuclear Information System (INIS)

    Bhartiya, Uma S.; Raut, Yogita S.; Joseph, Lebana J.; Hawaldar, Rohini W.; Rao, Badanidiyoor S.

    2008-01-01

    The aim of this study was to evaluate the radioprotective effect of turmeric extract (40 mg/kg body weight) and vitamin E (α - tocopherol acetate, 400 IU/kg body weight) supplementation on lipid peroxidation, reduced glutathione and antioxidant defense enzymes in various organs like liver, kidney and salivary glands at 24 h in adult Swiss mice. 131 Iodine exposure significantly increased lipid peroxidation in kidney and salivary glands in comparison to control animals. Pre supplementation with turmeric extract for 15 days showed significant lowering of lipid peroxidation in kidney. On the other hand vitamin E pre supplementation showed marked reduction in lipid peroxidation in salivary glands. Reduced glutathione levels decreased significantly in liver after radiation exposure. However, pre supplementation with turmeric extract and vitamin E did not improve glutathione levels in liver. In conclusion we have observed differential radioprotective effect of turmeric extract and vitamin E in kidney and salivary glands. However, Vitamin E seems to offer better radioprotection for salivary glands which is known to be the major site of cellular destruction after radioiodine therapy in patients. (author)

  12. Prevention, screening and therapy of thyroid diseases and their cost-effectiveness

    International Nuclear Information System (INIS)

    Dietlein, M.; Moka, D.; Schmidt, M.; Theissen, P.; Schicha, H.

    2003-01-01

    Cost-effectivness analyses focused on benign thyroid diseases are under-represented in the literature. The calculation of costs per additionally gained life year is difficult: The benefit of prevention is shifted into the distant future. The influence of an untreated subclinical thyroid disease on life expectancy can only be demonstrated by a long-term follow-up and by epidemiological databases. Iodine supplementation and programs for the prevention of tobacco smoking (primary prevention) are very cost-effective. Smoking increases the risk both of multinodular goiter and of Graves' disease. Screening programs (secondary prevention) are discussed for the laboratory parameters thyrotropin (TSH), calcium and calcitonin. TSH testing seems to be very cost-effective for epidemiological considerations in a certain lifespan (newborn, pregnancy, postpartal), older persons, hospitalisation due to acute diseases and in persons with previously elevated TPO-antibodies for TSH-values >2 mU/l, but dedicated cost-effectiveness analyses are lacking. On the other hand, the cost-effectiveness of a routine TSH testing beyond the age of 35 years has been shown by a high-quality decision analysis. Therapeutic strategies (tertiary prevention) aim at the avoidance of complications (atrial fibrillation, myocardial infarction, death for cardiac reasons) and of iatrogenic complications. Examples of a tertiary prevention are: firstly the definitive therapy of Graves' disease in patients who have on increased risk of relapse after antithyroid drugs (ATD), secondly the radioiodine therapy for subclinical hyperthyroidism and the radioiodine therapy of large goiters in older patients or in patients suffering from a relevant comorbidity. Cost-effectiveness analyses for different therapeutic strategies of Graves' disease were published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a fist line therapy if the risk of relapse after ATD exceeds 60%. (orig

  13. The exposure of relatives to patients of a nuclear medical ward after radio iodine therapy by inhalation of 131I in their home

    International Nuclear Information System (INIS)

    Wellner, U.; Eschner, W.; Hillger, H.W.; Schicha, H.

    1998-01-01

    From a model of iodine metabolism exhalation coefficients shall become derived to calculate 131 I exhalation by patients after a radioiodine treatment. The validity of these exhalation coefficients shall be reviewed by whole body activity measurements of relatives of patients, who inhaled the radioiodine exhaled by the patients in their homes. The exposure of relatives to patients of a nuclear medical ward after release by exhalation of iodine-131 is investigated. Methods: Iodine 131 I-activity of 17 relatives to patients who had to undergo a radioiodine therapy became measured in a whole body counter only a few days after release of the patient form the nuclear medical ward. The results of the measurements have been compared with the results of calculations according to the model of iodine metabolism. Results: The calculated values of incorporated radioiodine in the relatives of the patient at time of measurement (A model ) correlate with the measured whole body activity (A GK ) according to the regression: A model = A GK -47.3 (r 2 =0.959). This relation holds if 2.1 μg of iodine become exhaled per day of the 60 μg of iodine which are the daily intake of iodine by food. The exposure of all relatives did never exceed 100 μSv eff . Using the same model parameters the effective dose equivalent of the relatives to our patients rises up to 6.5 mSv under ambulant radio therapy conditions. Conclusion: the daily exhalation of 131 I is able to be calculated by a mathematical model of iodine metabolism. After staying of patients at least 3 days in a nuclearmedical ward the exposure of relatives to patients in their home does not exceed the value of 100 μSv eff by inhalation of iodine-131. This are 10% of the limit of 1 mSv eff according to the Recommendations of the Commission on Radiological Protection (ICRP 60). Radioiodine therapy outside of a hospital and 'iodine therapy tourisme' of German patients to other countries cannot be accepted. (orig.) [de

  14. Separation of Radioiodine Fraction in the Processing Line of 235U Fission Produced 99Mo and Its Utilization For Preparation of Hippuran131I

    International Nuclear Information System (INIS)

    Soenarjo Sunarhadijoso; HG Adang; W Kadarismanto; Purwadi B; Sukmana A; Sriyono; Rukman

    1998-01-01

    Production process of 99Mo from fission of 235U in RPC- BATAN produces non-moly radioactive fractions, which are classifiable into 3 fraction, i.e.; radioiodine fraction, radioxenon (noble gas) fraction and post-irradiated uranium fraction. The radioiodine fraction is expectable to be used as a source for providing radioisotope of 131I, and, therefore, an effort for separation of the radioiodine fraction was carried out. The separation was performed by trapping the radioiodine in a copper-wool column followed by purification using charcoal column. The bulk solution of Na131I bulk solution was relatively low, presumable due to the escape of the radioiodine from the copper-wool column into the cold finger originally used for trapping the noble gas fraction

  15. Hepatic uptake of radioiodine in patients with thyroid cancer: the good, the bad and the aesthetically impaired

    International Nuclear Information System (INIS)

    Roman, M.; Larcos, G.; Gruenewald, S.; Devadas, M.; Boyages, S.

    2002-01-01

    Full text: There is debate over the prognostic significance of diffuse hepatic uptake (DHU) of radioiodine in patients with thyroid cancer (DTC). Accordingly we compared outcome in DTC patients with and without DHU and no abnormality on their radioiodine scan. We reviewed 408 studies in 198 patients who underwent radioiodine scanning (treatment or surveillance) for DTC over a five-year period. Of these 234 (57%) showed DHU; 100/408 showed no evidence of functioning thyroid tissue. These were 22 high dose I 131 treatments, 48 I 131 and 30 I 123 surveillance scans in 72 patients (54 women, 18 men, age: 43( 14 years; tumour type: 88% papillary, 10% follicular, 2% other; mean follow-up 12.2 (11.1 months). Outcome was assessed by clinical, pathological (thyroglobulin or histopathology) and/or radioiodine scanning. Of the 100 scans there were 17 (17%) that had DHU (group A) and 83 (83%) that were negative (group B). In group A, eight of 17 (47%) had or developed residual functioning thyroid tissue or DTC versus 29 of 83 (35%) in group B (p=ns). The only factor associated with DHU was high dose I 131 (p<0.001) but not the gender, age or type of cancer. We conclude that (a) DHU is common in patients with DTC; (b) if there is otherwise physiological distribution of radioiodine, DHU does not indicate an adverse short term outcome in DTC patients. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  16. Direct and indirect radioiodination of protein: comparative study of chemotactic peptide labeling; Radioiodacao de proteina por via direta e indireta: estudo comparativo da marcacao de peptideo quimiotatico

    Energy Technology Data Exchange (ETDEWEB)

    Lavinas, Tatiana

    2004-07-01

    The development of simple methods for protein radioiodination have stimulated the use of radioiodinated peptides in vivo. There are two basic methods for labeling proteins with radioiodine: direct labeling, reaction of an electrophilic radioiodine with functional activated groups on protein, like the phenol ring in the tyrosine residue, and the conjugation of a previously radioiodinated molecule to the protein, referred as indirect method. The great problem related to the direct radioiodination of proteins is the in vivo dehalogenation. This problem can be minimized if a non-phenolic prosthetic group is used in the indirect radioiodination of the peptide. The ATE prosthetic group, N-succinimidyl 3-(tri-n-butylstannyl) benzoate, when radioiodinated by electrophilic iododestannilation produces N-succinimidyl 3-[{sup 123}l/{sup 131}l] iodine benzoate (SIB) that is subsequently conjugated to the protein by the acylation of the lysine group. There are many radiopharmaceuticals employed in scintigraphic images of infection and inflammation used with some limitations. These limitations stimulated the improvement of a new class of radiopharmaceuticals, the receptor-specific related labeled peptides, as the mediators of the inflammatory response, that presents high affinity by receptors expressed in the inflammation process, and fast clearance from blood and non-target tissues. One of these molecules is the synthetic chemotactic peptide fNleLFNIeYK that presents potent chemotaxis for leukocytes, with high affinity by the receptors presented in polymorphonuclear leukocytes and mononuclear phagocytes. The objective of this work included the synthesis of ATE prosthetic group and comparative radioiodination of the chemotactic peptide fNleLFNIeYK by direct and indirect methods, with radiochemical purity determination and evaluation of in vivo and in vitro stability of the compounds. This work presented an original contribution in the comparative biological distribution studies

  17. Radioiodinated VEGF to image tumor angiogenesis in a LS180 tumor xenograft model

    International Nuclear Information System (INIS)

    Yoshimoto, Mitsuyoshi; Kinuya, Seigo; Kawashima, Atsuhiro; Nishii, Ryuichi; Yokoyama, Kunihiko; Kawai, Keiichi

    2006-01-01

    Introduction: Angiogenesis is essential for tumor growth or metastasis. A method involving noninvasive detection of angiogenic activity in vivo would provide diagnostic information regarding antiangiogenic therapy targeting vascular endothelial cells as well as important insight into the role of vascular endothelial growth factor (VEGF) and its receptor (flt-1 and KDR) system in tumor biology. We evaluated radioiodinated VEGF 121 , which displays high binding affinity for KDR, and VEGF 165 , which possesses high binding affinity for flt-1 and low affinity for KDR, as angiogenesis imaging agents using the LS180 tumor xenograft model. Methods: VEGF 121 and VEGF 165 were labeled with 125 I by the chloramine-T method. Biodistribution was observed in an LS180 human colon cancer xenograft model. Additionally, autoradiographic imaging and immunohistochemical staining of tumors were performed with 125 I-VEGF 121 . Results: 125 I-VEGF 121 and 125 I-VEGF 165 exhibited strong, continuous uptake by tumors and the uterus, an organ characterized by angiogenesis. 125 I-VEGF 121 uptake in tumors was twofold higher than that of 125 I-VEGF 165 (9.12±98 and 4.79±1.08 %ID/g at 2 h, respectively). 125 I-VEGF 121 displayed higher tumor to nontumor (T/N) ratios in most normal organs in comparison with 125 I-VEGF 165 . 125 I-VEGF 121 accumulation in tumors decreased with increasing tumor volume. Autoradiographic and immunohistochemical analyses confirmed that the difference in 125 I-VEGF 121 tumor accumulation correlated with degree of tumor vascularity. Conclusion: Radioiodinated VEGF 121 is a promising tracer for noninvasive delineation of angiogenesis in vivo

  18. Radioiodination via isotope exchange in pivalic acid

    International Nuclear Information System (INIS)

    Weichert, J.P.; Van Dort, M.E.; Groziak, M.P.; Counsell, R.E.

    1986-01-01

    A variety of benzoic and aryl aliphatic mono and polyiodinated acids and esters (sterol, triglyceride) were radioiodinated in 55-99% radiochemical yield by isotope exchange with Na 125 i in a melt of pivalic acid. In general, the reaction was complete in 1 h at 155 0 C with little or no substrate decomposition. High specific activity studies afforded 125 I-labeled iopanoic acid with a specific activity of over 700 Ci/mmol. (author)

  19. Behaviour of radioiodine in gaseous effluents

    International Nuclear Information System (INIS)

    Barry, P.J.

    1968-01-01

    Because of the different chemical forms in which radioiodine occurs in the gaseous state, it is important when designing efficient filters to know the chemical forms which may be present in the effluent gases when various operations are being carried out and to know the effect of different gaseous environments on the filtration efficiency. To obtain this information it is necessary to have available reliable means of characterizing different chemical forms and to sample gaseous effluents when these operations are being carried out. This paper describes the use for identifying molecular iodine of metallic screens in a multi-component sampling pack in different gaseous environments. Using multi-component sampling packs, the fractionation of iodine nuclides between different chemical forms was measured in the effluent gases escaping from an in-pile test loop in which the fuel was deliberately ruptured by restricting the flow of coolant. Sequential samples were taken for six hours after the rupture and it was possible to follow during this period the individual behaviours of 13 '1I, 133 I and 135 I. Simultaneous samples were also obtained of the noble gases in the effluent gas stream and of the iodine nuclides in the loop coolant. Similar experiments have been carried out with a view to characterizing the different chemical behaviour of radioiodine as it is released from a variety of operations in the nuclear industry including the cutting of fuel sections in metallurgical examination caves and an incinerator. (author)

  20. Observations on radioiodide therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Spencer, R.P.

    1978-01-01

    Procedures for the diagnosis of hyperthyroidism are discussed. Radioiodide therapy is directed against the production site of thyroid hormones and not the initial stimulus or the end organ response to the elevated production of hormone. The principle difficulties involved in radioiodide therapy are considered. Ocular symptoms may be related to secretions from systems other than the thyroid. Increasing quantities of radioiodide must be used in therapy, since uptake values in the population are falling. Radioiodide therapy is contraindicated in pregnancy. Hypothyroidism is in any case a likely end result and its incidence is increased after radioiodide therapy. There are different morphological forms of hyperthyroidism. A sample calculation of the required amount of radioiodine is included, together with a brief summary of practical ways of reducing the whole body radiation dose. (U.K.)