Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2014     Vol 39     No 4
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      UDK 616.441-006-085 ; 615.849.5:546.15

ISSN 035-2899, 39(2014) br.4 p.224-231

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


  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
      Corresponding Address:
Branislava Radović
Centar za nuklearnu medicinu Klinički Centar Srbije, Višegradska 26, 11000 Beograd, Srbija;
Paper received: 7.8.2014
Paper accepted: 8.8.2014
Paper Internet issues: 17.11.2014
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Timočki medicinski glasnik, Zdravstveni centar Zaječar
Journal of Regional section of Serbian medical association in Zajecar
Rasadnička bb, 19000 Zaječar, Srbija

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