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| UDK 616.441-006-085 ; 615.849.5:546.15 |
ISSN 035-2899, 39(2014) br.4 p.224-231 |
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Review article Radioiodine therapy in benign thyroid diseases: 50 year experience of centre for nuclear medicine of the Clinical Centre of Serbia (Primena radiojodida u terapiji benignih bolesti štitaste žlezde (sa iskustvom Centra za nuklearnu medicinu Kliničkog centra Srbije) Branislava Radović Centar za nuklearnu medicine Kliničkog centra Srbije |
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| Download in pdf format | Extended summary:
Saul Hertz and Arthur Roberts performed first experiments on the
thyroid gland of rabbits using radioisotope 128J in 1937, and in
1941 they applied radioiodine to a female patient with
hyperthyroidism. A major part of the orally ingested radioactive
iodine is absorbed in the initial portions of the small intestine.
Radioiodine is excreted by the kidneys and faeces, and is
accumulated by salivary glands, gastric mucosa, choroide plexus,
placenta and breasts. Radioiodine thyroid uptake is inversely
proportional to the intake of stable iodine. The indications for
radioiodine therapy in benign thyroid diseases are: failure after
antithyroid drug therapy in Graves-Basedow disease, in Plummer’s
disease as the treatment of choice, in patients with nontoxic goitre
in whom surgery may be high risk, subclinical hyperthyroidism.
Absolute contraindications for radioiodine therapy are pregnancy,
lactation and low radioiodine thyroid uptake. The dose calculation
is based on the estimated thyroid mass (volume), thyroid ability to
accumulate radioiodine and the radioiodine retention time in the
thyroid. The recommended therapeutic doses range from 60Gy to 400Gy.
Smaller doses (60Gy to 150Gy) are associated with more frequent
recurrence. The higher doses are the most suitable for Plummer
disease treatment (up to 400Gy). Permanent hypothyroidism is
considered as the desired effect of the 131I therapy. The most
important factors that influence the 131I therapy are: age, sex,
thyroid size, dietary iodine intake, antithyroid drugs,
corticosteroids, smoking. The first radioiodine therapy in benign
thyroid disease in the Centre for Nuclear Medicine of the Clinical
Centre of Serbia was performed 54 years ago. More than 5,460
patients were treated during that period. On the occasion of the
50th anniversary of radioiodine therapy, 3,027 patients of the
Centre for Nuclear Medicine CCS were evaluated, mostly being women
with Graves-Basedow disease (1426). Nontoxic goitre was treated in
654 patients, Plummer’s disease in 576 patients and subclinical
hyperthyroidism in 96 patients. The largest number of the treated
patients (1865 - 61%) were euthyroid one year after radioiodine
treatment. The experience in radioiodine treatment of benign thyroid
diseases in Centre for Nuclear Medicine of Clinical Centre of
Serbia, confirmed the effectiveness and safeness of 131I therapy.
Key words: radioiodine therapy, benign diseases, thyroid gland, Graves, goitre Napomena: kompletan tekst rada na srpskom jeziku Note: full text in Serbian |
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Corresponding Address: Branislava Radović Centar za nuklearnu medicinu Klinički Centar Srbije, Višegradska 26, 11000 Beograd, Srbija; E-mail: tcmapple@gmail.com |
Paper received: 7.8.2014 Paper accepted: 8.8.2014 Paper Internet issues: 17.11.2014 |
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