title: Radioiodine therapy in benign thyroid disorders. Evaluation of French nuclear medicine practices.
abstract: OBJECTIVE
  Radioiodine is currently used routinely in the treatment of hyperthyroidism including Graves' disease (GD), toxic multinodular goitre (TMNG) and toxic solitary nodule (TSN) but no consensus exists on the most appropriate way to prescribe iodine--fixed dose or calculated doses based on the gland size or turnover of (131)I. We carried out the first nationwide French survey assessing the current practices in radioiodine treatment of hyperthyroidism.
  
  
  METHODS
  A questionnaire was sent to French nuclear medicine hospital units and cancer treatment centres (n=69) about their practices in 2012.
  
  
  RESULTS
  Euthyroidism was considered the successful outcome for 33% of respondents, whereas hypothyroidism was the aim in 26% of cases. Fixed activities were the commonest therapeutic approach (60.0% of GD prescribed doses and 72.5% for TMNG and TSN), followed by calculated activities from Marinelli's formula (based on a single uptake value and thyroid volume). The fixed administered dose was chosen from between 1 to 3 levels of standard doses, depending on the patient characteristics. Factors influencing this choice were disease, with a median of 370 MBq for GD and 555 MBq for TSN and TMNG, thyroid volume (59%) and uptake (52%) with (131)I or (99m)Tc. Even physicians using fixed doses performed pretherapeutic thyroid scan (98%).
  
  
  CONCLUSIONS
  This study shows that practices concerning the prescription of (131)I therapeutic doses are heterogeneous. But the current trend in France, as in Europe, is the administration of fixed doses. The study provides the baseline data for exploring the evolution of French clinical practices.
authors.affiliation: Department of pharmacy, university hospital A.-Michallon, CS 10217, 38043 Grenoble, France. Electronic address: dbernard@chu-grenoble.fr.
authors.forename: Delphine
authors.initials: D
authors.lastname: Bernard
authors.affiliation: Department of pharmacy, university hospital A.-Michallon, CS 10217, 38043 Grenoble, France.
authors.forename: Marie Dominique
authors.initials: MD
authors.lastname: Desruet
authors.affiliation: Department of endocrinology, CS 10217, 38043 Grenoble, France; Department of nuclear medicine, CS 10217, 38043 Grenoble, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Wolf
authors.affiliation: Department of nuclear medicine, CS 10217, 38043 Grenoble, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Roux
authors.affiliation: Department of pharmacy, university hospital A.-Michallon, CS 10217, 38043 Grenoble, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Boin
authors.affiliation: Department of pharmacy, university hospital A.-Michallon, CS 10217, 38043 Grenoble, France.
authors.forename: Roseline
authors.initials: R
authors.lastname: Mazet
authors.affiliation: Department of nuclear medicine, CS 10217, 38043 Grenoble, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Gallazzini
authors.affiliation: Department of nuclear medicine, CS 10217, 38043 Grenoble, France.
authors.forename: Alex
authors.initials: A
authors.lastname: Calizzano
authors.affiliation: Department of nuclear medicine, CS 10217, 38043 Grenoble, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Vuillez
authors.affiliation: Department of pharmacy, university hospital A.-Michallon, CS 10217, 38043 Grenoble, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Allenet
authors.affiliation: Department of nuclear medicine, CS 10217, 38043 Grenoble, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fagret
mesh_terms: D004307:Dose-Response Relationship, Radiation; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009683:Nuclear Medicine / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013959:Thyroid Diseases / Q000532:radiotherapy*; D013961:Thyroid Gland / Q000378:metabolism; D013971:Thyrotoxicosis / Q000532:radiotherapy
chemical_list: D007457:Iodine Radioisotopes
keywords: Graves’ disease; Hyperthyroidism; Hyperthyroïdie; Iode 131; Maladie de Basedow; Radioiodine dose; Thyroid; Thyroïde