Clinical outcomes 1 year after empiric 131I therapy for hyperthyroid disorders

Abstract : Radioiodine is a therapeutic option in Europe for Graves' disease (GD) and toxic multinodular goiter (MNG). PURPOSE: To compare empiric and calculated I activities using 2013 EANM recommendations. To look for predictive factors of therapeutic response to an empiric activity of I. To assess clinical situations favoring calculated treatment modalities. PATIENTS AND METHODS: Prospective monocentric study of clinical outcomes at 1 year follow-up in 86 patients with GD and MNG who received empiric I therapeutic activities (348-939 MBq). Differences between empiric and calculated activities were confronted to clinical outcomes. Physicians were not aware of the calculated activity at the time of prescription. RESULTS: One year after treatment, 9% (5/57) of GD patients and 7% (2/29) of MNG patients were still in a hyperthyroid state. Thyroid volume was reduced by 67% for GD and by 50% for MNG. In GD, empiric I activities were higher than calculated ones (564±131 vs. 316±319 MBq, P<0.001) in 93% (53/57) of patients. Pretherapeutic thyroid volume (>26 ml for GD; >40 ml for MNG) was associated with persistent hyperthyroidism. CONCLUSION: Empirically administered I for GD and MNG was associated with very high efficacy in thyroid function control and no side effects. Thyroid volume reduction did not preclude treatment efficacy. Activity calculation could be a useful method for treating patients with GD and thyroid volumes higher than 26 ml or patients with MNG and thyroid volumes higher than 40 ml. A selective approach based on pretherapeutic thyroid volume and radioiodine biokinetics might improve treatment success.
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https://hal.umontpellier.fr/hal-02292312
Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : jeudi 19 septembre 2019 - 16:12:10
Dernière modification le : mardi 29 octobre 2019 - 16:38:03

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Lavinia Vija Racaru, Charlotte Fontan, Mathilde Bauriaud-Mallet, Séverine Brillouet, Olivier Caselles, et al.. Clinical outcomes 1 year after empiric 131I therapy for hyperthyroid disorders. Nuclear Medicine Communications, Lippincott, Williams & Wilkins, 2017, 38 (9), pp.756-763. ⟨10.1097/MNM.0000000000000705⟩. ⟨hal-02292312⟩

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