Fong, Lee Yeong (2018) The Outcome Of A Calculated Radioiodine Dose Based On Pertechnetate Study In Treatment For Hyperthyroidism. Masters thesis, USM.
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Abstract
Introduction: Apart from surgery and anti-thyroid drugs, radioactive iodine has been a mainstay of treatment for hyperthyroidism. There a re two widely used methods for dose administration including empirical fixed dose and calculated dose. A recent meta-ana lysis supported that dose calcula tion is better than empirical fixed dose method. However, dose calculation by dosimetry or radioactive iodine thyroid uptake ratio at 24 .hours can be tedious and may pose certain disadvantages to the patients and the provider. Pertechnetate thyroid scintigraphy is a simple nuclear imaging that can be completed on the same day and pertechnetate thyroid uptake ratio, which is determined from the scintigraphy, can be used to calculate the dose for radioactive iodine. Objective: The aim is to optimise treatment efficacy and effective ly treat hyperthyroid patients with a single radioactive iodine dose and this study is done to measure the efficacy of a calculated dose based on pertechnetate thyroid uptake ratio. Methods: Hyperthyroidism patients referred for first radioactive iodi ne therapy were recruited as participants. Pertechnetate thyroid scintigraphy was done and pertechnetate thyroid uptake ratio was determined and used for dose calculation. Followup was done and the outcome of the treatment was determined at three months and s ix months. Clinical data was a nalysed using IBM SPSS software. Results: A total of 95 participants with the mean age of 46.0 years were recruited and the majority consisted of Malay (71.6%) female (76.8%). Graves' disease was the most common type of hyperthyroidism (67.4%) fo llowed by multinodular goitre (30.5%). Among the participants, 52.6% had grade 2 goitre and 91.6% were pre-treated with carbimazole. The median pertechnetate thyroid uptake ratio was 18.0% and the median radioactive iodine dose administered was 22.0mCi. The pertechnetate thyroid uptake ratio and radioactive iodine dose were significantly different based on goitre size (p<0.001) and correlated with thyroid function test (p<0.001). Six months after treatment, 82.1% achieved euthyroid or hypothyroid. Participants with multinodular goitre had higher failure rate than those with Graves' disease (p=0.032). Seventy-five participants had a reduction in goitre size within six months and five participants had transient hypothyroidism before relapsed at six months after treatment. Conclusion: This calculated dose regime showed fairly good outcome with cure rate of 74.7% at three months and 82.1% at six months post treatment. Patients with MNG were more likely to relapse compared to Graves' disease.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine |
| Divisions: | Institut Perubatan & Pergigian Termaju (Advanced Medical & Dental Institute (AMDI)) > Thesis |
| Depositing User: | NOR HASHIMY BIN ABDULLAH |
| Date Deposited: | 07 Oct 2026 03:19 |
| Last Modified: | 07 Oct 2026 03:19 |
| URI: | http://eprints.usm.my/id/eprint/65104 |
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