Saurabh Arora 1 , Chandrasekhar Bal 1 Show Affiliations »
Abstract
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 < 1), n = 208, patients were compared for post 131I outcome. The cure was defined as a combined euthyroid and stable hypothyroid state following 131I treatment. Logistic regression analysis was used for identifying prognostic factors. The propensity score was applied; 77 matched pairs (1:1 ratio) of high and normal turnover patients were selected as a validation set. 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13139-020-00674-3. © Korean Society of Nuclear Medicine 2021.
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 < 1), n = 208, patients were compared for post 131I outcome. The cure was defined as a combined euthyroid and stable hypothyroid state following 131I treatment. Logistic regression analysis was used for identifying prognostic factors. The propensity score was applied; 77 matched pairs (1:1 ratio) of high and normal turnover patients were selected as a validation set. 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13139-020-00674-3. © Korean Society of Nuclear Medicine 2021.
Entities: Chemical
Keywords:
Graves’ disease; High turnover; Normal turnover; Radioiodine therapy; Turnover
Year: 2021
PMID： 33643485 PMCID： PMC7881070 DOI： 10.1007/s13139-020-00674-3
Source DB: PubMed Journal: Nucl Med Mol Imaging ISSN： 1869-3474