title: Thiamazole Pretreatment Lowers the (131)I Activity Needed to Cure Hyperthyroidism in Patients With Nodular Goiter.
abstract: BACKGROUND
  Relatively low radioiodine uptake (RAIU) represents a common obstacle for radioiodine ((131)I) therapy in patients with multinodular goiter complicated by hyperthyroidism.
  
  
  OBJECTIVE
  To evaluate whether thiamazole (MTZ) pretreatment can increase (131)I therapeutic efficacy.
  
  
  METHODS
  Twenty-two patients with multinodular goiter, subclinical hyperthyroidism, and RAIU < 50% were randomized to receive either a low-iodine diet (LID; n = 10) or MTZ 30 mg/d (n = 12) for 42 days. Thyroid function and 24-hour RAIU were measured before and after treatment. Thyroid volume was evaluated by either magnetic resonance imaging or single photon emission computed tomography.
  
  
  RESULTS
  Mean 24-hour RAIU increased significantly from 32 ± 10% to 63 ± 18% in the MTZ group (P < .001). Consequently, there was a 31% decrease in the calculated median therapeutic (131)I activity after MTZ (P < .05). No significant changes in 24-hour RAIU were observed after diet. In the MTZ group, median serum TSH levels increased significantly by 9% and mean serum free T4 and free T3 concentrations decreased by 22% and 15%, respectively, whereas no changes in thyroid function were observed in the LID group. Thyroid volume did not significantly change in either of the two groups. At 12 months after radioiodine treatment, median serum TSH was within the normal range in both groups.
  
  
  CONCLUSIONS
  MTZ treatment before (131)I therapy resulted in an average 2-fold increase in thyroid RAIU and enhanced the efficiency of radioiodine therapy assessed at 12 months. MTZ pretreatment is therefore a safe, easily accessible alternative to recombinant human TSH stimulation and a more effective option than LID.
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Aglaia
authors: A
authors: Kyrilli
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Bich-Ngoc-Thanh
authors: BN
authors: Tang
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Valérie
authors: V
authors: Huyge
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Didier
authors: D
authors: Blocklet
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Serge
authors: S
authors: Goldman
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Bernard
authors: B
authors: Corvilain
authors: Division of Endocrinology (A.K., B.C.), Department of Nuclear Medicine (D.B., S.G., R.M.-R.), Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Nuclear Medicine (B.-N.-T.T.), Clinique St Joseph, 6700 Arlon, Belgium; and Department of Nuclear Medicine (V.H.), Clinique Sainte Anne St Rémi, 1070 Brussels, Belgium.
authors: Rodrigo
authors: R
authors: Moreno-Reyes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006044:Goiter, Nodular / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy*; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D008297:Male; D008713:Methimazole / Q000008:administration & dosage*; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects / Q000528:radiation effects; D011879:Radiotherapy Dosage; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D008713:Methimazole