131I treatment of nodular non-toxic goitre

Nygaard, Birte; Faber, Jens; Hansen, Jens Mølholm

doi:10.1530/eje.0.1340015

Cited by 23 publications

(7 citation statements)

References 31 publications

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“…A cost-effectiveness analysis in patients with toxic thyroid adenoma highlighted that hypothyroidism as well as other local and systemic complications after lobectomy increase with age, making surgery more expensive than other therapeutic strategies when the patient is 70 years old or more (28). Radioiodine therapy has proved to be effective in functioning goiter and, at a lesser extent, in nontoxic goiter, so as to now represent the first choice for treatment of toxic=pretoxic nodules and a possible alternative to surgery in nontoxic goiter (4,(7)(8)(9)29).…”

Section: Discussionmentioning

confidence: 99%

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Thyroid Nodules and Related Symptoms Are Stably Controlled Two Years After Radiofrequency Thermal Ablation

Spiezia

Garberoglio

Milone

et al. 2009

Thyroid

248

256

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RTA is an effective and simple procedure for obtaining lasting shrinkage of TNs, controlling compressive symptoms, and treating thyroid hyperfunction. When performed in experienced medical centers, RTA may be a valid alternative to conventional treatments for nontoxic and pretoxic TNs. It is particularly attractive for elderly people for whom surgery and radioiodine therapy are often contraindicated or ineffective.

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Section: Discussionmentioning

confidence: 99%

“…Thyroid surgery and radioiodine therapy are the main treatments for symptomatic TNs (2)(3)(4)(7)(8)(9). Surgical complications are reported in 7-10% whereas the mortality rate is about 0.5% (10,11).…”

Section: Introductionmentioning

confidence: 99%

Thyroid Nodules and Related Symptoms Are Stably Controlled Two Years After Radiofrequency Thermal Ablation

Spiezia

Garberoglio

Milone

et al. 2009

Thyroid

248

256

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show abstract

“…However, several European studies have shown that it is both safe and effective (55)(56)(57). It resulted in significant goiter size reduction when compared with levothyroxine suppressive therapy, which offered no benefit (58), and improvement in obstructive symptoms (dyspnea, dysphagia) in the majority of patients (59,60).…”

Section: Radioiodine Therapymentioning

confidence: 99%

Approach to the Patient with Nontoxic Multinodular Goiter

Bahn

Castro

2011

The Journal of Clinical Endocrinology &Amp; Metabolism

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Thyroid nodules are very common, and although the majority are benign, approximately 5% may harbor malignancy. The evaluation of the patient with solitary thyroid nodule is generally straightforward and will typically include measurement of serum TSH to assess thyroid function and fine-needle aspiration biopsy of the nodule, with or without ultrasound (US) guidance. The approach to the patient with nontoxic multinodular goiter represents a more difficult problem for the clinician. All patients should have serum TSH measured to assess functional thyroid status and US examination to evaluate the number, size, and sonographic features of the nodules and assist in the selection of nodules that may need fine-needle aspiration biopsy. Patients with nodules yielding malignant cytology should be referred for surgery. Given the lack of reliable markers to predict biological behavior of nodules with suspicious (indeterminate) cytology, patients with such nodules are generally advised to have surgery, unless autonomous function of these nodules can be confirmed by scintigraphy. Most of these patients, however, will ultimately prove to have benign follicular tumors. Many patients with benign but large goiters may experience clinical symptoms of pressure, such as dysphagia, choking sensation, or airway obstruction. Such patients will often require surgery for alleviation of symptoms. In the absence of malignancy, asymptomatic patients may be observed. Radioactive iodine, commonly used in many parts of Europe, is safe and effective and may be a reasonable option for many patients. Periodic follow-up with neck palpation and US exam is recommended for all patients.

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“…I N ADDITION TO RELIEVING HYPERTHYROIDISM, 131 I therapy is able to reduce the size of multinodular goiters by approximately 50% within the first year (1)(2)(3). This fact, in addition to low cost and few side effects, has lead to an increasing use of 131 I therapy for moderately enlarged nontoxic nodular goiters in some countries (4).…”

Section: Introductionmentioning

confidence: 99%

Does Radioiodine Therapy Have an Equal Effect on Substernal and Cervical Goiter Volumes? Evaluation by Magnetic Resonance Imaging

Bonnema

Knudsen

Bertelsen

et al. 2002

Thyroid

Self Cite

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Most often thyroidectomy is recommended in patients with large goiters. However, high-dose (131)I therapy may be used in case of contraindications to surgery. Large goiters are often partially located in the mediastinum. The aim of this study was to evaluate the impact of (131)I therapy on the cervical and the substernal goiter volume, separately. Fourteen patients (median age, 69 years; range, 52-86 years) with a large multinodular goiter (three hyperthyroid) and with a substernal extension greater than 15 mL were included. T1-weighted magnetic resonance (MR) estimates of the thyroid volume in the cervical and substernal compartments were obtained before and 1 year after high-dose (131)I therapy. The total goiter volumes ranged from 182 to 685 mL. The median substernal volume was 66 mL (fraction of total volume, 17.6%; range, 8.0%-78.9%). One year after treatment, the median substernal goiter volume was reduced by 29.2% (range, -6.1%-59.4%, mean: 26.1% +/- 6.0%), and the cervical goiter volume by 30.3% (range, 6.0%-75.4%, mean, 35.6 +/- 5.6%) compared to baseline values; p = 0.25 for difference in a regional effect. The volume reduction was unrelated to initial substernal goiter size. Likewise, deterioration of the inspiratory capacity did not correlate with the magnitude of the substernal goiter extension. In conclusion, high-dose (131)I therapy seems as effective in reducing the substernal as the cervical goiter volume. However, because the overall effect is modest, this therapy should primarily be considered for the patient with a high surgical risk.

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131I treatment of nodular non-toxic goitre

Cited by 23 publications

References 31 publications

Thyroid Nodules and Related Symptoms Are Stably Controlled Two Years After Radiofrequency Thermal Ablation

Thyroid Nodules and Related Symptoms Are Stably Controlled Two Years After Radiofrequency Thermal Ablation

Approach to the Patient with Nontoxic Multinodular Goiter

Does Radioiodine Therapy Have an Equal Effect on Substernal and Cervical Goiter Volumes? Evaluation by Magnetic Resonance Imaging

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