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Indian J Nucl Med. 2020 Jan-Mar;35(1):17-20. doi: 10.4103/ijnm.IJNM_158_19. Epub 2019 Dec 31.

Radioiodine Therapy of Graves' Disease and the Uptake Paradox.

Author information

1
Department of Radiotherapy, Nuclear Medicine Division, Kasturba Medical College, Manipal, Karnataka, India.
2
Department of Nuclear Medicine, AMRI Hospital, Kolkata, West Bengal, India.
3
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Purpose of the Study:

Radioiodine (131I) therapy is approved and well-accepted modality for the treatment of hyperthyroidism. The dosage of 131I for successful treatment is based on many factors; however, an objective tool to determine the dose was missing. In a retrospective study, we found that high 131I uptake values required more dose to achieve desirable results contrary to the belief.

Materials and Methods:

Clinically and scintigraphically proven Graves' disease patients with high 131I uptake (>50%) were accrued for this study and block randomized into low-dose (Group I) and high-dose (Group II) groups. Low activity (5 mCi) was administered in Group I and higher activity (10 mCi) in Group II. The patients were followed up after 3 months with thyroid function tests to determine the outcome.

Results:

A total of 344 patients were analyzed at the end of 3 months, with 174 in low-dose group and 170 in high-dose group. Euthyroidism/hypothyroidism was achieved in significantly higher number of patients as compared to the low-dose group.

Conclusion:

The higher dose of 131I is required to achieve euthyroidism/hypothyroidism in patients with high 131I uptake.

KEYWORDS:

Hyperthyroidism; radioiodine therapy; radioiodine uptake

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