title: Radioiodine treatment of multinodular non-toxic goitre.
abstract: OBJECTIVE
  To investigate the long term effect of radioactive iodine on thyroid function and size in patients with non-toxic multinodular goitre.
  
  
  METHODS
  Consecutive patients with multinodular non-toxic goitre selected for radioactive iodine treatment and followed for a minimum of 12 months (median 48 months) after an intended dose of 3.7 MBq/g thyroid tissue corrected to a 100% uptake of iodine-131 in 24 hours.
  
  
  METHODS
  69 patients with a growing multinodular non-toxic goitre causing local compression symptoms or cosmetic inconveniences. The treatment was chosen because of a high operative risk, previous thyroidectomy, or refusal to be operated on.
  
  
  METHODS
  Standard thyroid function variables and ultrasonically determined thyroid volume before treatment as well as 1, 2, 3, 6, and 12 months after treatment and then once a year.
  
  
  RESULTS
  56 patients were treated with a single dose of 131I, 12 with two doses, and one with four doses. In 45 patients treated with one dose and remaining euthyroid the median thyroid volume was reduced from 73 (interquartile range 50-106) ml to 29 (23-48) ml at 24 months in the 39 patients in whom this was measured during follow up. The median reduction was 40 (22-48) ml (60% reduction, p < 0.0001), half of which occurred within three months. Patients treated with two doses as well as those developing hypothyroidism and hyperthyroidism had a significant reduction in thyroid volume. Eleven patients developed hypothyroidism (cumulative five year risk 22%, 95% confidence interval 4.8% to 38.4%). Side effects were few: three cases of hyperthyroidism and two cases of radiation thyroiditis. Only one patient was dissatisfied with the result; she was referred for operation six months after treatment.
  
  
  CONCLUSIONS
  A substantial reduction in thyroid volume accompanied by a low incidence of hypothyroidism and few side effects makes the use of radioactive iodine an attractive alternative to surgery in selected cases of non-toxic multinodular goitre.
authors.affiliation: Department of Internal Medicine, Herley University Hospital, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Nygaard
authors.forename: L
authors.initials: L
authors.lastname: Hegedüs
authors.forename: M
authors.initials: M
authors.lastname: Gervil
authors.forename: H
authors.initials: H
authors.lastname: Hjalgrim
authors.forename: P
authors.initials: P
authors.lastname: Søe-Jensen
authors.forename: J M
authors.initials: JM
authors.lastname: Hansen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006044:Goiter, Nodular / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology; D007037:Hypothyroidism / Q000209:etiology; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013961:Thyroid Gland / Q000473:pathology / Q000503:physiopathology
chemical_list: D007457:Iodine Radioisotopes