Issn Print: 0143-3636
Publication Date: 2000/04/01
P25. Radioiodine therapy: Audit of fixed dose outcome for Graves' disease and toxic multinodular goitre
D. K.K. Nanayakkara; M. J. Keir; S. G. Ball
Excerpt
The Royal College of Physicians (RCP) has published guidelines for patient selection, recommended activities and acceptable outcome when using radioiodine therapy for thyrotoxicosis. We have analysed the outcome of radioiodine therapy in local patients with Graves' disease (GD) and toxic multinodular goitre (TMNG) who received a single dose 400 MBq of RAI at first presentation from 1993 to 1997. The diagnoses of GD (n=133) and TMNG (n=48) were established by Tc-99m thyroid scanning. Outcome was assessed as hypo, eu- or persistent hyperthyroidism to one year. After radioiodine no patients were hyperthyroid one year from therapy. However, at one year the hypothyroid rate was 90% and 27% in GD and TMNG groups respectively (P<0.001). There was no correlation between pretreatment FT4 and Tc-99m uptake in either group. These results provide evidence that the RCP recommended activity does not give rise to their stated acceptable outcome in patients with GD. They also show that the role of the Tc-99m thyroid scan is in distinguishing between GD and TMNG as this has a significant bearing on treatment outcome.
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