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[Treatment of hyperthyroidism by radioactive iodine. Development of methods and difficulties in the surveillance]
C Gibold1, M J Delisle, B Maes
1Unité de Médecine nucléaire et de Biophysique, Institut Jean Godinot, Reims.
The experience of treatment of hyperthyroidism with radioactive iodine in the Nuclear Medicine department of the J. Godinot Institute, Rheims, from 1967 till 1987, is described. One thousand one hundred and fifty patients (723 with diffuse and 427 with nodular hyperthyroidism) received a total of 1,565 doses. The dosage calculation method was considerably simplified, enabling a patient to be treated in 24 hours. Thyroid gland mass evaluation, initially based on the scintigraphic projection area, is now performed by ultrasonography. The mean total radioactivity administered is 370 +/- 320 MBq per patient. All patients are seen on the 8th post-treatment week for clinical examination and hormone control. Seven out of 10 patients are cured with a single dose. Long-term follow-up, based on a computer file, is effected by means of an annual letter sent to the patient and to his family doctor, but in spite of sustained efforts 36 per cent of the patients are lost sight of. The diagnosis of iodine 131-induced hypothyroidism is based on plasma levels of TSH which, since 1984, are measured by the ultrasensitive method. The overall incidence of hypothyroidism is 6.6 per cent in the first year and 3 per cent thereafter. Despite a simplified procedure, the results obtained by the authors are similar to those found in the literature, and the cost-efficiency ratio is excellent.
The experience of treatment of hyperthyroidism with radioactive iodine in the Nuclear Medicine department of the J. Godinot Institute, Rheims, from 1967 till 1987, is described. One thousand one hundred and fifty patients (723 with diffuse and 427 with nodular hyperthyroidism) received a total of 1,565 doses. The dosage calculation method was considerably simplified, enabling a patient to be treated in 24 hours. Thyroid gland mass evaluation, initially based on the scintigraphic projection area, is now performed by ultrasonography. The mean total radioactivity administered is 370 +/- 320 MBq per patient. All patients are seen on the 8th post-treatment week for clinical examination and hormone control. Seven out of 10 patients are cured with a single dose. Long-term follow-up, based on a computer file, is effected by means of an annual letter sent to the patient and to his family doctor, but in spite of sustained efforts 36 per cent of the patients are lost sight of. The diagnosis of iodine 131-induced hypothyroidism is based on plasma levels of TSH which, since 1984, are measured by the ultrasensitive method. The overall incidence of hypothyroidism is 6.6 per cent in the first year and 3 per cent thereafter. Despite a simplified procedure, the results obtained by the authors are similar to those found in the literature, and the cost-efficiency ratio is excellent.