Dosimetry-based treatment for Graves' disease.

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Publication Date
2018-06Author
Hyer, SL
Pratt, B
Gray, M
Chittenden, S
Du, Y
Harmer, CL
Flux, GD
Type
Journal Article
Metadata
Show full item recordAbstract
OBJECTIVE: The aim of this retrospective study was to assess the long-term outcome of a personalized dosimetry approach in Graves' disease aiming to render patients euthyroid from a planned thyroid absorbed dose of 60 Gy. PATIENTS AND METHODS: A total of 284 patients with Graves' disease were followed prospectively following administration of radioiodine calculated to deliver an absorbed dose of 60 Gy. Patients with cardiac disease were excluded. Outcomes were analysed at yearly intervals for up to 10 years with a median follow-up of 37.5 months. RESULTS: A single radioiodine administration was sufficient to render a patient either euthyroid or hypothyroid in 175 (62%) patients, the remainder requiring further radioiodine. The median radioactivity required to deliver 60 Gy was 77 MBq. Less than 2% patients required 400-600 MBq, the standard activity administered in many centres. In the cohort receiving a single administration, 38, 32 and 26% were euthyroid on no specific thyroid medication at 3, 5 and 10 years, respectively. Larger thyroid volumes were associated with the need for further therapy. The presence of nodules on ultrasonography did not adversely affect treatment outcome. CONCLUSION: A personalized dosimetric approach delayed the long-term onset of hypothyroidism in 26% of patients. This was achieved using much lower administered activities than currently recommended. Future studies will aim to identify those patients who would benefit most from this approach.
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Licenseref URL
http://creativecommons.org/licenses/by/4.0/Version of record
Subject
Adolescent
Adult
Aged
Aged, 80 and over
Female
Graves Disease
Humans
Iodine Radioisotopes
Male
Middle Aged
Organ Size
Radiometry
Retrospective Studies
Thyroid Gland
Treatment Outcome
Young Adult
Research team
Radioisotope Physics
Language
eng
License start date
2018-06
Citation
Nucl Med Commun, 2018, 39 (6), pp. 486 - 492