Results of a risk adapted and functional radioiodine therapy in Graves’ disease

Dunkelmann, S.; Neumann, Vera; Staub, U.; Groth, Peter; Künstner, H.; Schümichen, C.

doi:10.1055/s-0038-1625320

Cited by 11 publications

(4 citation statements)

References 6 publications

(8 reference statements)

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“…To date, the unsatisfactory long-term outcome of GD patients treated according to the functional dose concept resulting in a higher incidence of recurrent hyperthyroidism and the risk of possible GO worsening is the main reason for the currently preferred ablative dose concept [ 6 , 77 ]. Accordingly, our panel members favor the implementation of the ablative dose concept for all GD patients.…”

Section: Rai Therapy For Patients With Autoimmune Hyperthyroidism (Gr...mentioning

confidence: 99%

“…However, in these patients, thyroid surgery will produce hypothyroidism too [ 92 ]. Conversely, hypothyroidism represents the optimal result (i.e., main goal) when RAI therapy is performed in GD patients according to the newest ablative dose concept [ 1 , 6 , 9 , 52 , 76 , 77 ]. However, some patients experience transient hypothyroidism that may manifest 2–5 months after RAI therapy and spontaneously recover within a few months without the development of symptoms or signs of hypothyroidism [ 1 , 205 ].…”

Section: Adverse Effects Of Rai Therapymentioning

confidence: 99%

“…-The functional dose concept in which the aim of RAI therapy is to correct subclinical or overt hyperthyroid-ism with the goal of reaching euthyroidism as soon as possible. -The ablative dose concept in which the aim of RAI therapy is to achieve hypothyroidism as soon as possible, based on evidence that the definitive success rate in controlling hyperthyroidism is much higher than that obtained with the functional dose concept (> 90% vs. < 70%, respectively) [ 6,9,52,76,77]. In addition, ablative RAI therapy reduces the volume of the gland correcting both mechanical issues (e.g., dyspnea, dysphagia) and aesthetic features of the neck [ 78].…”

Section: Concepts For Rai Therapy Delivery In Graves' Disease: Functi...mentioning

confidence: 99%

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The EANM guideline on radioiodine therapy of benign thyroid disease

Campennì

Avram

Verburg

et al. 2023

Eur J Nucl Med Mol Imaging

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This document provides the new EANM guideline on radioiodine therapy of benign thyroid disease. Its aim is to guide nuclear medicine physicians, endocrinologists, and practitioners in the selection of patients for radioiodine therapy. Its recommendations on patients’ preparation, empiric and dosimetric therapeutic approaches, applied radioiodine activity, radiation protection requirements, and patients follow-up after administration of radioiodine therapy are extensively discussed.

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Section: Rai Therapy For Patients With Autoimmune Hyperthyroidism (Gr...mentioning

confidence: 99%

Section: Adverse Effects Of Rai Therapymentioning

confidence: 99%

Section: Concepts For Rai Therapy Delivery In Graves' Disease: Functi...mentioning

confidence: 99%

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The EANM guideline on radioiodine therapy of benign thyroid disease

Campennì

Avram

Verburg

et al. 2023

Eur J Nucl Med Mol Imaging

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“…Target doses specific to the disease entity are well established for Graves’ disease [10–12], non-toxic goiter [2], and toxic multinodular [13, 14] and toxic uninodular goiter [15]. Several methods exist for calculation of the activity to be administered, each aiming to achieve a predefined dose to the thyroid gland appropriate for the treatment of that specific thyroid disease [16].…”

Section: Introductionmentioning

confidence: 99%

Impact of different approaches to calculation of treatment activities on achieved doses in radioiodine therapy of benign thyroid diseases

et al. 2018

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PurposeRadioiodine has been used for the treatment of benign thyroid diseases for over 70 years. However, internationally, there is no common standard for pretherapeutic dosimetry to optimally define the individual therapy activity. Here, we analyze how absorbed tissue doses are influenced by different approaches to pretherapeutic activity calculation of varying complexity.MethodsPretherapeutic determination of treatment activity was retrospectively recalculated in 666 patients who had undergone radioiodine therapy for benign thyroid diseases (Graves’ disease, non-toxic goiter, and uni- and multinodular goiter). Approaches considering none, some, or all of a set of individual factors, including target volume, maximum radioiodine uptake, and effective half-life, were applied. Assuming individually stable radioiodine kinetics, which had been monitored twice a day under therapy, hypothetically achieved tissue doses based on hypothetically administered activities resulting from the different methods of activity calculation were compared to intended target doses.ResultsThe Marinelli formula yields the smallest deviations of hypothetically achieved doses from intended target doses. Approaches taking individual target volume into consideration perform better than fixed therapy activities, which lead to high variances in achieved doses and high deviations of hypothetically achieved doses from intended target doses.ConclusionElaborate pretherapeutic dose planning, taking individual radioiodine uptake, half-life, and target volume into consideration, should be used whenever possible. The use of disease-specific fixed activities cannot be recommended. Deviations of achieved tissue doses from target doses can already be significantly lowered by application of volume-adapted treatment activities if more elaborate means are not available.

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