Radioiodine therapy for thyroid volume reduction of large goitres

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Abstract

Objective

To evaluate the effect of radioiodine therapy for volume reduction in large goitres.

Methods

A retrospective study was performed involving 88 patients treated between 2001 and 2007 with radioiodine for toxic or nontoxic goitres. The goitres were between 80 and 250 ml in volume (median 127 ml±38.57). Activities of 131I to be administered were calculated individually through radioiodine testing with uptake measurements over 5 days, the mean activity being 1721±440 MBq 131I (714–2395 MBq 131I), equivalent to a mean of 14±4.19 MBq 131I/g of thyroid tissue (6–24 MBq 131I/g of thyroid tissue). The designated dose was 150 Gy for the entire thyroid volume, and post-therapeutic dosimetry revealed a mean thyroid dose of 175±45.92 Gy (64–300 Gy). Control examinations were performed, including thyroid blood testing and thyroid ultrasound at 6 weeks and at 3, 6, 12, 24, 36, 48 and 72 months after radioiodine therapy.

Results

The mean volume reduction was 41.9% after 3 months and 65.9% after 1 year. Thyroid volume reduction was highly significant (P<0.001) in the first year after radioiodine therapy. No volume increase was observed in any patient during follow-up. Unfortunately, many patients were lost during follow-up (n = 84 after 3 months, n = 38 after 1 year).

Conclusion

Radioiodine therapy is an effective treatment for both nontoxic and toxic goitres, resulting in a highly significant thyroid volume reduction of nearly 66% within 1 year.

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