Saeed Akhtar M, Shehzad Afzal M, Javaid Irfanullah, Aleem Khan M, Khan Muhammad, Afzal Nadeem M.
Radioactive Iodine treatment in Diffuse Toxic Goiter by Calculation of Thyroid Volume with Ultrasonography.
J Coll Physicians Surg Pak Jan ;12(8):477-80.

Objective: The goal of radioactive iodine treatment in diffuse toxic goiter is to render the patient euthyroid within a reasonable period of time. Keeping the clinical euthyroid status as the target, radioactive iodine treatment was given to patients. Design: A prospective study. Place and Duration of Study: This study was conducted at Punjab Institute of Nuclear Medicine (PINUM) adjacent to Allied Hospital, Faisalabad from August, 1996 to December, 2000. Patients and Methods: Ninety-two patients with different toxic goiters were included in the study. I131 dose was determined with the formula of 100µCi/g corrected with 24 hour thyroid I131 uptake and thyroid weight. Thyroid volume was determined by ultrasonography. Response of radioiodine was observed clinically and on thyroid profile after 3 months postiodine treatment and then at regular intervals upto 3-5 years. Results: Thirty patients (32.6%) achieved euthyroid status clinically and biochemically within 3 months posttreatment and retained this status upto the follow-up of 3-5 years. Eleven patients (11.95%) showed normal FT3 and FT4 values, however, TSH remained suppressed upto 1 year (subclinical hyperthyroidism). Seven patients (7.6%) became subclinical hypothyroid and remained so upto the follow-up of 2 years. Twenty-seven patients (29.34%) were hyperthyroid after first dose of radioiodine. Hypothyroidism was observed in 17 patients (18.47%) while transient hypothyroidism was not observed. Conclusion: With the formula used in this study clinical euthyroid status was achieved in 52.15% patients (euthyroid, subclinical hyperthyroid and subclinical hypothyroid). Therefore, this method is quite appropriate to achieve the target for a reasonable period of time.

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