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KMID : 1148920210550010015
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Nuclear Medicine and Molecular Imaging
2021 Volume.55 No. 1 p.15 ~ p.26
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Is There Any Need for Adjusting 131I Activity for the Treatment of High Turnover Graves’ Disease Compared to Normal Turnover Patients? Results from a Retrospective Cohort Study Validated by Propensity Score Analysis
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Arora Saurabh
Bal Chandrasekhar
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Abstract
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Purpose: To compare 131I-therapy outcomes in high turnover and normal turnover Graves’ disease patients and predict optimal first 131I activity for high turnover patients.
Methods: Retrospective cohort design (1:2) validated by propensity score analysis. Cohort 1, high turnover (2-h RAIU/24-h RAIU ≥?1), n?=?104, and cohort 2, normal turnover (ratio
Results: First 131I cure rates of 28% in high turnover and 66% in normal turnover groups (p?=?0.001) were noted. The therapy cycles (median, 2 vs. 1) and cumulative 131I activity (median, 15 vs. 7 mCi) were required to cure hyperthyroidism in cohort 1 and cohort 2, respectively. Age (>?44 years), higher grade of goitre, and 2-h RAIU (>?37%) were associated with 131I therapy failure. The high turnover patients needed a factor of 1.5?2 times more 131I activity to achieve a similar cure rate compared to the normal turnover patients. The first-dose cure rate was 31% vs. 60% by propensity score analysis (n?=?154), no way different (28% vs.66%) from the whole group of 312 patients.
Conclusion: High turnover Graves’ disease patients, if administered standard 131I activity, the outcomes shall be poor. To improve the success rate, 131I activity should be increased by 1.5 to 2 times in the high turnover patients.
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KEYWORD
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Graves’ disease, Turnover, High turnover, Normal turnover, Radioiodine therapy
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