Large, compressive goiters treated with radioiodine

Area of Science:

• Endocrinology
• Nuclear Medicine
• Otolaryngology

Background:

• Large multinodular goiters can cause compressive symptoms, particularly in elderly patients.
• Surgery is often the primary treatment but carries high risks for older individuals.

Purpose of the Study:

• To assess radioiodine therapy (131I) as a non-surgical option for large, compressive goiters in elderly patients.
• To objectively measure changes in thyroid volume and tracheal compression post-131I treatment.

Main Methods:

• A prospective study involving 19 elderly patients with high-risk or refused surgery for large, compressive multinodular goiters.
• Patients received a single intravenous dose of 131I, followed by L-thyroxine therapy.
• Magnetic resonance imaging (MRI) was used to measure thyroid volume and tracheal compression before and 1 year after treatment.

Main Results:

• Significant reduction in thyroid volume (40% decrease) and improvement in tracheal compression (20% decrease in deviation, 36% increase in lumen area).
• No exacerbation of compressive symptoms was observed.
• Clinical improvement in dyspnea, inspiratory stridor, and superior vena cava compression reported in treated patients.

Conclusions:

• Radioiodine therapy (131I) is an effective and safe alternative to surgery for elderly patients with large, compressive multinodular goiters.
• Objective measurements confirm significant anatomical and symptomatic improvements after 131I treatment.