Long‐term effect of radioactive iodine on thyroid function and size in patients with solitary autonomously functioning toxic thyroid nodules

Nygaard, Birte; Hegedűs, László; Nielsen, Kamilla Gerhard; Ulriksen, Peter; Hansen, Jens Mølholm

doi:10.1046/j.1365-2265.1999.00635.x

Cited by 124 publications

(85 citation statements)

References 19 publications

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“…Treatment with low-dose 131 I leads to a reduction of the nodule volume by w45% within 2 years of therapy. The incidence of hypothyroidism after 131 I therapy is reported to be w10% within 5 years and increases in frequency over time (1,5,23).…”

Section: Discussionmentioning

confidence: 99%

Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

et al. 2007

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Objective: To compare the efficacy of interstitial laser photocoagulation (ILP) with radioiodine in hot thyroid nodules. Design: Thirty consecutive outpatients with subclinical or mild hyperthyroidism and a scintigraphically solitary hot nodule with extraglandular suppression were randomized to either one ILP session or one radioiodine ( 131 I) dose. Methods: ILP was performed under continuous ultrasound-guidance and with an output power of 2.5-3.5 W.131 I was given as a single dose based on thyroid volume and a 24-h thyroid 131 I uptake. Thyroid function and nodule volume were evaluated at inclusion and at 1, 3 and 6 months after treatment. Results: Normalization of serum TSH was achieved in 7 out of 14 patients in the ILP group and in all 15 patients in the 131 I group (PZ0.0025). In the ILP group, mean thyroid nodule volume reduction was 44G5% (S.E.M.; P!0.001), and in the 131 I group 47G8% (P!0.001), within 6 months, without between-group difference (PZ0.73). The mean reduction of total thyroid volume was 7G5% in the ILP group (PZ0.20) and 26G8% (PZ0.006) in the 131 I group (PZ0.06 between-group). Two patients in the 131 I group developed hypothyroidism but no major side effects were seen. Conclusions: This first randomized study, comparing ILP with standard therapy, demonstrates that ILP and 131 I therapy approximately halves thyroid nodule volume within 6 months; but in contrast to 131 I, extranodular thyroid volume is unaffected by ILP and no patient developed hypothyroidism. Using the present design, ILP seems inferior to 131 I therapy in normalization of serum TSH. The potential value of ILP as a non-surgical alternative to 131 I needs further investigation.European Journal of Endocrinology 157 95-100

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Section: Discussionmentioning

confidence: 99%

Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

et al. 2007

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“…Whereas thyroid surgery is widely available and safe in many centers, it still carries a 2-10 % risk of complications, such as neck scarring, hypothyroidism, postoperative hypoparathyroidism, recurrent laryngeal nerve injury, and the risks associated with general anesthesia. Surgery is also expensive, and may not be appropriate for a surgically high-risk individual [10,[25][26][27][28][29][30]. Over the last decade, thermal ablation techniques, such as laser ablation (LA), radiofrequency ablation (RFA), high-intensity-focus ultrasound (HIFU), and microwave ablation (MWA), have been proposed for the treatment of benign solid thyroid nodules, with encouraging results.…”

Section: Introductionmentioning

confidence: 99%

Image-guided thermal ablation of benign thyroid nodules

et al. 2016

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Benign thyroid nodules are a common disease in the general population. Most often, they are completely asymptomatic and discovered occasionally during routine ultrasound examinations, and do not require any treatment. When thyroid nodules become symptomatic, surgical excision is still considered standard treatment. In the last few years, several experiences in the treatment of benign thyroid nodules through image-guided percutaneous thermal ablation have been reported with encouraging results, so that currently, these treatments are often proposed as first-choice options for patients with symptomatic benign thyroid nodules. In this paper, we discuss the present literature on the topic, focusing on different techniques available for image-guided percutaneous ablation, particularly radiofrequency (RFA), laser (LA), microwave (MWA), and high-intensity-focus ultrasound (HIFU). Little evidence about the efficacy of MWA and HIFU is now available. According to the literature, good results have been obtained with RFA and LA. Regarding RFA, volume reduction after ablative treatment has been found to range from 47 to 84 % at 3-6 months, and from 62 to 93 % at 1 year; LA also seems to be effective in achieving shrinkage of thyroid nodules, with volume reduction from 37 to 81 % at 3-6 months, and from 13 to 82 % at 1-year follow-up. Moreover, applications of advanced image-guidance modality, such as contrast-enhanced ultrasound and virtual navigation with fusion imaging, are discussed.Keywords Laser Á Radiofrequency Á Microwave Á Highintensity focused ultrasound Á Thyroid nodule SOMMARIO I noduli benigni della tiroide sono una evenienza comune nella popolazione generale. Più spesso vengono scoperti occasionalmente durante un esame ecografico fatto per altri motivi, sono asintomatici e non richiedono alcun trattamento. Qualora i noduli diventino sintomatici, l'escissione chirurgica è ancora considerato il trattamento standard. Tuttavia, negli ultimi anni, è cresciuta l'esperienza circa il trattamento di tali noduli tramite ablazione percutanea sotto guida ecografica tanto che, attualmente, questo viene spesso proposto come trattamento di scelta. Lo scopo del nostro lavoro è fare una revisione della letteratura riguardante l'argomento, con un particolare focus sulle differenti tecniche attualmente a disposizione, in particolare radiofrequenza (RFA), laser (LA), microonde (MWA) e high-intensity-focus ultrasound (HIFU). Al momento ci sono ancora poche evidenze sull'efficacia di MWA e HIFU. Secondo quanto riportato in letteratura, buoni risultati sono stati ottenuti con RFA e LA. Riguardo la radiofrequenza, la riduzione volumetrica dopo la procedura ablativa va da 47 a 84 % a 3-6 mesi e da 62 a 93 % a 1 anno; anche il laser sembra essere efficace nel causare la riduzione del nodulo, con percentuali che vanno da 37 a 81 % a 3-6-mesi a da 13 a 82 % a 1 anno di follow-up Abbiamo poi discusso brevemente le

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“…The range of thyroid volume reduction is comparable regardless of whether it is diffuse toxic [15], autonomous solitary toxic thyroid adenoma [16], or diffuse nontoxic [17,18] and nontoxic multinodular goitre [2]. In EU countries (the United Kingdom, France, Belgium, the Netherlands, and Poland) the maximum radioiodine activity allowed in outpatient treatment is 370-800 MBq [19].…”

Section: Discussionmentioning

confidence: 89%

Wole guzowate olbrzymie — ambulatoryjne leczenie radiojodem

Kaniuka-Jakubowska

Lewczuk

Mizan-Gross

et al. 2015

Endokrynologia Polska

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Introduction: 131-I treatment of nodular, especially nontoxic, goitre is still reserved mainly for elderly patients, whose numerous concomitant diseases disqualify them from surgery. Therapy often involves isolation and is available only in selected centres, which may be located far from some patients' places of residence, which is inconvenient for elderly people. The aim of the study was to assess the effectiveness of outpatient fractionated 131-I treatment of patients with large nodular goitres, as well as to evaluate complications and the factors affecting treatment results. Material and methods:The study included 35 patients with a large nodular goitre. Thyroid volume and treatment results were evaluated using US and CT neck examination.

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Long‐term effect of radioactive iodine on thyroid function and size in patients with solitary autonomously functioning toxic thyroid nodules

Cited by 124 publications

References 19 publications

Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

Image-guided thermal ablation of benign thyroid nodules

Wole guzowate olbrzymie — ambulatoryjne leczenie radiojodem

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