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European Journal of Nuclear Medicine... Mar 2024To examine whether adherence to a low-iodine diet (LID) enhances the therapeutic efficacy of radioiodine therapy (RAI) in Graves' hyperthyroidism (GH) in iodine-rich...
Effect of previous administration of potassium iodine and different durations of low iodine diets for radioiodine therapy on the treatment of Graves' disease in iodine-rich areas.
PURPOSE
To examine whether adherence to a low-iodine diet (LID) enhances the therapeutic efficacy of radioiodine therapy (RAI) in Graves' hyperthyroidism (GH) in iodine-rich areas.
METHODS
We retrospectively evaluated 185 patients with GH from Aichi (n = 114) and Hokkaido (n = 71) Prefectures. Patients aged ≥ 18 years with GH who underwent RAI between December 2012 and March 2022 were divided into subgroups based on pretreatment with anti-thyroid drug (ATD) or potassium iodide (KI). Patients were followed up with LID from 18 days (group A) or 7 days (group H) before RAI to 3 days after RAI. The dose of radioactive iodine 131 (I) was adjusted to deliver > 100 Gy to the thyroid. The associations between urinary iodine concentration on UIC2 vs. 24hRU and UIC2 vs. the 1-year RAI success rate (SR) were investigated.
RESULTS
Compared with UIC1, UIC2 was significantly decreased in all subgroups (P < 0.01). An inverse correlation between UIC2 and 24hRU was observed in the four groups; however, the difference was insignificant. The SR in groups A and H was 85% and 89%, respectively. Univariate analysis revealed no association between UIC2 and SR in each group. Additionally, stratification of the 185 patients into quartiles using UIC2 yielded no significant differences in SR (p = 0.79).
CONCLUSIONS
LID sufficiently reduced UIC in patients undergoing RAI. Although a lower UIC2 may increase 24hRU, it did not increase the success of RAI. The benefit of LID in enhancing the efficacy of RAI in GH treatment remains uncertain.
Topics: Humans; Iodine Radioisotopes; Iodine; Retrospective Studies; Thyroid Neoplasms; Graves Disease; Hyperthyroidism; Diet; Potassium; Treatment Outcome
PubMed: 38008728
DOI: 10.1007/s00259-023-06523-7 -
Asian Pacific Journal of Cancer... 2013Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few... (Review)
Review
Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of non- randomized trials and evolving trends fueled by recently published randomized studies.
Topics: Humans; Iodine Isotopes; Neoplasm Recurrence, Local; Randomized Controlled Trials as Topic; Risk; Thyroid Neoplasms
PubMed: 24377506
DOI: 10.7314/apjcp.2013.14.11.6209 -
Annals of Nuclear Medicine Nov 2022Radioactive iodine (RAI) therapy is a useful treatment for Graves' disease (GD). Most RAI sessions administer ≤ 500 MBq of iodine (I)-131. Sometimes patients...
OBJECTIVE
Radioactive iodine (RAI) therapy is a useful treatment for Graves' disease (GD). Most RAI sessions administer ≤ 500 MBq of iodine (I)-131. Sometimes patients require repeated RAI, often for longer periods of remission. We investigated the characteristics of patients for whom high dose (mostly 1110 MBq of I-131) RAI was effective as RAI therapy for GD.
METHODS
We retrospectively analyzed the cases of 79 patients who underwent RAI for GD in a multicenter setting. We divided the patients into two groups based on the I-131 dose administered: the low dose (LD) group who received ≤ 500 MBq (n = 44) and the high dose (HD) group who received > 500 MBq (n = 35). The therapeutic effect was defined as achieving remission and reaching the point of participating in thyroid hormone replacement therapy within 1 year after RAI. We compared the LD and HD groups' remission rates and conducted a multivariate logistic regression analysis of predictive factors for remission. In a simulation, using the formula for predicting the probability of remission obtained from the analysis results, we estimated how much the remission rate would change if the I-131 dose is increased from 500 to 1110 MBq.
RESULTS
The mean ± standard deviation I-131 dose administered in the LD group was 480 ± 6 MBq, and that of the HD group was 1054 ± 265 MBq. Thirty-five patients (80%) in the LD group and 26 patients (74%) in the HD group achieved remission; this difference in the remission rate was not significant. The multivariate analysis results demonstrated that the absorbed dose and thyroid-stimulating antibody (TSAb) were independent predictors of remission. Seven patients (8.9%) showed an increased probability of remission from < 50% to > 50% when the higher RAI dose was applied (1110 MBq instead of 500 MBq). The thyroid volume and TSAb values in these patients were relatively large at 54.7 ± 34.2 mL and 1378.4 ± 586.3%, respectively.
CONCLUSION
Although the overall remission rate was not significantly different between the patients who received high- or low-dose I-131, treatment with high-dose RAI may improve the probability of remission in patients with a massive thyroid volume and/or high-TSAb Graves' disease.
Topics: Humans; Iodine Radioisotopes; Retrospective Studies; Thyroid Neoplasms; Treatment Outcome; Graves Disease; Iodine
PubMed: 35972673
DOI: 10.1007/s12149-022-01781-1 -
Journal of Nuclear Medicine : Official... Nov 2019
Topics: Humans; Hyperthyroidism; Iodine Radioisotopes; Thyroid Neoplasms
PubMed: 31586003
DOI: 10.2967/jnumed.119.234849 -
Tidsskrift For Den Norske Laegeforening... Apr 2022
Topics: Humans; Iodine; Radioactivity
PubMed: 35383457
DOI: 10.4045/tidsskr.22.0184 -
Endocrine Journal Oct 2001We evaluated the incidence of childhood thyroid diseases and urinary iodine levels in Nagasaki, Japan and in Gomel, Belarus, which was greatly radio-contaminated by the... (Comparative Study)
Comparative Study
We evaluated the incidence of childhood thyroid diseases and urinary iodine levels in Nagasaki, Japan and in Gomel, Belarus, which was greatly radio-contaminated by the Chernobyl accident, in order to obtain the comparative data of thyroid diseases between iodine-rich (Japan) and -deficient (Belarus) areas. In Nagasaki, the median level of urinary iodine, measured by ammonium persulfate digestion in microplate method, was 362.9 microg/L. In order to evaluate the geographical differences in Japan, other samples were collected in Hamamatsu and in South Kayabe, Hokkaido, where the median levels were 208.4 microg/L and 1015.5 microg/L, respectively. Furthermore, thyroid screening by ultrasound (US) in Nagasaki revealed only four cases that showed goiter (1.6%) and two cases (0.8%) that had cystic degeneration and single thyroid cyst. There was no evidence of thyroid nodule detected by US examination. In contrast, the median of urinary iodine level was 41.3 microg/L in Gomel. The incidences of goiter (13.6%) and echogenic abnormality (1.74%) in Gomel were much higher than in Nagasaki, suggesting the critical involvement of iodine deficiency in increased childhood thyroid abnormality around Chernobyl. Radioactive iodine released just after the Chernobyl accident may have influenced predominantly children residing in iodine-deficient areas. Our results suggest that management of thyroid screening for schoolchildren at ordinary times may be beneficial for monitoring the adverse effects of radioactive iodine from the standpoint of future prospective study.
Topics: Adolescent; Adult; Child; Humans; Iodine; Japan; Nuclear Warfare; Power Plants; Radioactive Hazard Release; Republic of Belarus; Thyroid Diseases; Ultrasonography
PubMed: 11789565
DOI: 10.1507/endocrj.48.591 -
Environment International May 2019Silver-impregnated zeolite (AgIZ) has been used for removing radioiodine from contaminated groundwater and nuclear waste streams and the worldwide inventory of such...
Silver-impregnated zeolite (AgIZ) has been used for removing radioiodine from contaminated groundwater and nuclear waste streams and the worldwide inventory of such secondary waste is rapidly increasing. The objective of this study was to 1) quantify the effectiveness of two grout waste forms for disposing of the used AgIZ, and 2) determine the I speciation leached from AgIZ encapsulated in grout. A 60-day kinetics batch experiment demonstrated that AgIZ encapsulated in slag-free grout was extremely effective at immobilizing I and Ag, a potential non-radioactive carcinogen. However, AgIZ encapsulated in slag-containing grout, the most common type of grout used for low-level radioactive waste disposal, was entirely ineffective at immobilizing I. While the slag-free grout with AgIZ released only 3.3 μg/L I into the contact solution, the slag-containing grout released 19,269 μg/L I. Based on thermodynamic calculations, the strongly reducing conditions of the slag-containing system (Eh was -392 mV) promoted the reductive dissolution of the AgI, forming Ag and releasing iodide (I) into the aqueous phase. The slag-free grout system was maintained under more oxidizing conditions (Eh was 439 mV) and a minimal amount of I was released from the grout. In both grout systems, the aqueous I, originally added to the AgZ as iodide, was composed primarily of iodide and org-I, and essentially no iodate was detected. More organo-I was detected in the slag-free than the slag-containing grout system because the high redox potential of the former system was more conducive to the formation of oxidized I species, such as I, which may be intermediates in the covalent bonding of I with organic C in grout. Iodine K-edge XANES analysis indicated that I existed exclusively as silver iodide in both AgIZ-grout samples. Together, these results indicate that subsurface grout disposal of AgIZ waste should be done under oxidizing conditions and that radioiodide released from AgIZ can undergo speciation transformations that have important implications on subsequent mobility and estimated risk.
Topics: Groundwater; Iodides; Iodine; Iodine Radioisotopes; Oxidation-Reduction; Radioactive Pollutants; Radioactive Waste; Silver Compounds; Waste Management; Zeolites
PubMed: 30852445
DOI: 10.1016/j.envint.2019.02.070 -
The Indian Journal of Medical Research Mar 2017The reference radioactive iodine uptake (RAIU) values established in the 1970s in the era of widespread iodine deficiency were relatively high. Now, after four decades...
BACKGROUND & OBJECTIVES
The reference radioactive iodine uptake (RAIU) values established in the 1970s in the era of widespread iodine deficiency were relatively high. Now, after four decades of successful Universal Salt Iodization (USI) programme in India, there is a need to re-establish these reference ranges. The present study was aimed to quantify the two-hour and 24-h RAIU values in iodine sufficient euthyroid individuals and validate the results in Graves' and Hashimoto's thyroiditis patients.
METHODS
In this prospective study conducted from April 2012 to September 2013, euthyroid volunteers who consented for the investigations were enrolled in the study. Treatment-naive Graves' disease and Hashimoto's thyroiditis patients were recruited from the outpatient clinic. The investigations included neck ultrasonography, thyroid function tests, thyroglobulin (Tg), anti-Tg and anti-thyroid peroxidase antibody and urinary iodine concentration.
RESULTS
Three different groups comprising 110 euthyroid volunteers, 38 Graves' and 17 Hashimoto's thyroiditis patients were enrolled in the study. The mean 2-h RAIU values for the euthyroid group, Hashimoto's thyroiditis and Graves' patients were 3.83±2.77, 4.22±3.41 and 32.67±15.93 per cent, and mean 24-h RAIU values were 12.75±5.51, 11.66±9.55 and 61.85±12.9 per cent, respectively. The mean thyroid volumes were 7.63±2.72, 7.81±1.67 and 20.76±12.56 ml for the euthyroid, Hashimoto's thyroiditis and Graves' disease groups and the mean spot urinary iodine concentrations were 9.0, 7.8 and 13.9 μg/dl in the three groups, respectively. The new reference range (95% confidence interval) for two-hour was 1-7 per cent and 24-h was 7-18 per cent.
INTERPRETATION & CONCLUSIONS
Compared to the previous values, there was a considerable decrease in the RAIU values in euthyroid individuals. This was further corroborated with increase in the urinary iodine concentration and decrease in thyroid volume, attributed to successful USI programme. Further studies with a large sample from different parts of India need to be done to confirm these findings.
Topics: Adult; Autoantibodies; Female; Graves Disease; Hashimoto Disease; Humans; India; Iodine; Iodine Radioisotopes; Male; Middle Aged; Reference Standards; Sodium Chloride, Dietary; Thyroid Gland
PubMed: 28749399
DOI: 10.4103/ijmr.IJMR_1158_14 -
CA: a Cancer Journal For Clinicians 1990A case of metastatic adenocarcinoma of the thyroid is reported in which treatment by means of radioactive iodine has been successful. The patient was completely...
A case of metastatic adenocarcinoma of the thyroid is reported in which treatment by means of radioactive iodine has been successful. The patient was completely thyroidectomized for "malignant adenoma" in 1923, with neither thyrotoxicosis then nor hypothyroidism postoperatively; 15 years later there developed classic symptoms of hyperthyroidism and severe pain in the lower back. In October 1939 a pulsating tumor removed from the level of the 12th thoracic vertebra proved to be metastatic thyroid adenocarcinoma (histologically well differentiated, with small follicles and colloid). In the next two years hyperthyroidism increased and roentgenograms revealed new metastases in the lungs, upper part of the right femur, second rib on the left side, left ilium, and skull. Roentgenologic irradiation of the metastases proved ineffectual. In March 1943 a tracer dose of radioactive iodine revealed iodine retention by all the known lesions and no evidence of residual thyroid tissue in the neck. Therapeutic amounts of radioactive iodine were administered orally between May and October 1943. Definite and lasting clinical improvement followed. In April 1944 and March 1945 additional I* was administered with a resultant disappearance of pain, increase in weight, and progressive change in all clinical criteria in the direction of hypothyroidism. Roentgenographic evidence pointed to an arrest if not a regression of the disease. No untoward effects followed this therapy. Radioactive iodine seems to be an effective therapeutic agent in the control of this type of tumor.
Topics: Adenocarcinoma; History, 20th Century; Humans; Iodine Radioisotopes; Thyroid Neoplasms
PubMed: 2118414
DOI: 10.3322/canjclin.40.5.299 -
Scientific Reports Sep 2021Radioactive iodine (RAI) is safe and effective in most patients with hyperthyroidism but not all individuals are cured by the first dose, and most develop post-RAI... (Clinical Trial)
Clinical Trial
Radioactive iodine (RAI) is safe and effective in most patients with hyperthyroidism but not all individuals are cured by the first dose, and most develop post-RAI hypothyroidism. Postoperative RAI therapy for remnant ablation is successful in 80-90% of thyroid cancer patients and sometimes induces remission of nonresectable cervical and/or distant metastatic disease but the effective tumor dose is usually not precisely known and must be moderated to avoid short- and long-term adverse effects on other tissues. The Collar Therapy Indicator (COTI) is a radiation detection device embedded in a cloth collar secured around the patient's neck and connected to a recording and data transmission box. In previously published experience, the data can be collected at multiple time points, reflecting local cervical RAI exposure and correlating well with conventional methods. We evaluated the real-time uptake of RAI in patients with hyperthyroid Graves' disease and thyroid cancer. We performed a pilot feasibility prospective study. Data were analyzed using R (version 4.0.3, The R Foundation for Statistical Computing, 2020), and Python (version 3.6, Matplotlib version 3.0.3). The COTI was able to provide a quantitative temporal pattern of uptake within the thyroid in persons with Graves' disease and lateralized the remnant tissue in persons with thyroid cancer. The study has demonstrated that the portable collar radiation detection device outside of a healthcare facility is accurate and feasible for use after administration of RAI for diagnostic studies and therapy to provide a complete collection of fractional target radioactivity data compared to that traditionally acquired with clinic-based measurements at one or two time-points.Clinical Trials Registration NCT03517579, DOR 5/7/2018.
Topics: Adult; Female; Graves Disease; Humans; Hypothyroidism; Iodine Radioisotopes; Male; Middle Aged; Radiation Dosage; Radiation Dosimeters; Thyroid Neoplasms; Wearable Electronic Devices
PubMed: 34531443
DOI: 10.1038/s41598-021-97408-y