Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan

We investigated the association between a 500 MBq dose of radioactive iodine treatment (RAIT) and both thyroid nodule volume and thyroid function in patients with a single autonomous functioning thyroid nodule (AFTN). We retrospectively studied 201 patients with an AFTN who received RAIT at a dose o...

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Main Authors: Ai Yoshihara, Jaeduk Yoshimura Noh, Kosuke Inoue, Masakazu Koshibu, Rei Hirose, Masahiro Ichikawa, Nami Suzuki, Masako Matsumoto, Miho Fukushita, Natsuko Watanabe, Kiminori Sugino, Koichi Ito
Format: Article
Language:English
Published: The Japan Endocrine Society 2025-05-01
Series:Endocrine Journal
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Online Access:https://www.jstage.jst.go.jp/article/endocrj/72/5/72_EJ24-0578/_html/-char/en
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author Ai Yoshihara
Jaeduk Yoshimura Noh
Kosuke Inoue
Masakazu Koshibu
Rei Hirose
Masahiro Ichikawa
Nami Suzuki
Masako Matsumoto
Miho Fukushita
Natsuko Watanabe
Kiminori Sugino
Koichi Ito
author_facet Ai Yoshihara
Jaeduk Yoshimura Noh
Kosuke Inoue
Masakazu Koshibu
Rei Hirose
Masahiro Ichikawa
Nami Suzuki
Masako Matsumoto
Miho Fukushita
Natsuko Watanabe
Kiminori Sugino
Koichi Ito
author_sort Ai Yoshihara
collection DOAJ
description We investigated the association between a 500 MBq dose of radioactive iodine treatment (RAIT) and both thyroid nodule volume and thyroid function in patients with a single autonomous functioning thyroid nodule (AFTN). We retrospectively studied 201 patients with an AFTN who received RAIT at a dose of 500 MBq and were followed up for more than 2 years. Thyroid function at diagnosis, thyroid antibody positivity, treatment with antithyroid drugs before RAIT, cystic components of the nodule, and 131I uptake outside the nodule were assessed. Nodule enlargement was observed in 18 patients (9%), persistent hyperthyroidism in 13 patients (6.5%), and hypothyroidism in 45 patients (22.3%). Nodule volume before RAIT was significantly larger in the nodule enlargement group compared to the non-enlargement group. The risk factors for persistent hyperthyroidism were larger nodule volume and absence of a cystic component in multivariate analysis. The cutoff nodule volume before RAIT for predicting nodule enlargement was 15.5 mL, and for predicting persistent hyperthyroidism was 16.6 mL. Nodule volume decreased to 47% in the first year and continued to gradually decrease thereafter. This study provided long-term outcome data regarding nodule volume change and thyroid function in AFTN patients following single fixed-dose RAIT, and it identified risk factors for nodule enlargement and persistent hyperthyroidism after RAIT. Nodule volume before treatment was a good predictor of treatment response.
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id doaj-art-ba0265819a0b43c4bef4cfb0b63df65b
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issn 1348-4540
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publishDate 2025-05-01
publisher The Japan Endocrine Society
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spelling doaj-art-ba0265819a0b43c4bef4cfb0b63df65b2025-08-20T01:59:18ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402025-05-0172548749410.1507/endocrj.EJ24-0578endocrjLong-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in JapanAi Yoshihara0Jaeduk Yoshimura Noh1Kosuke Inoue2Masakazu Koshibu3Rei Hirose4Masahiro Ichikawa5Nami Suzuki6Masako Matsumoto7Miho Fukushita8Natsuko Watanabe9Kiminori Sugino10Koichi Ito11Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Internal Medicine, Ito Hospital, Tokyo 150-8308, JapanDepartment of Surgery, Ito Hospital, Tokyo 150-8308, JapanDepartment of Surgery, Ito Hospital, Tokyo 150-8308, JapanWe investigated the association between a 500 MBq dose of radioactive iodine treatment (RAIT) and both thyroid nodule volume and thyroid function in patients with a single autonomous functioning thyroid nodule (AFTN). We retrospectively studied 201 patients with an AFTN who received RAIT at a dose of 500 MBq and were followed up for more than 2 years. Thyroid function at diagnosis, thyroid antibody positivity, treatment with antithyroid drugs before RAIT, cystic components of the nodule, and 131I uptake outside the nodule were assessed. Nodule enlargement was observed in 18 patients (9%), persistent hyperthyroidism in 13 patients (6.5%), and hypothyroidism in 45 patients (22.3%). Nodule volume before RAIT was significantly larger in the nodule enlargement group compared to the non-enlargement group. The risk factors for persistent hyperthyroidism were larger nodule volume and absence of a cystic component in multivariate analysis. The cutoff nodule volume before RAIT for predicting nodule enlargement was 15.5 mL, and for predicting persistent hyperthyroidism was 16.6 mL. Nodule volume decreased to 47% in the first year and continued to gradually decrease thereafter. This study provided long-term outcome data regarding nodule volume change and thyroid function in AFTN patients following single fixed-dose RAIT, and it identified risk factors for nodule enlargement and persistent hyperthyroidism after RAIT. Nodule volume before treatment was a good predictor of treatment response.https://www.jstage.jst.go.jp/article/endocrj/72/5/72_EJ24-0578/_html/-char/enautonomous functioning thyroid nodulehyperthyroidismvolume reductionradioactive iodine
spellingShingle Ai Yoshihara
Jaeduk Yoshimura Noh
Kosuke Inoue
Masakazu Koshibu
Rei Hirose
Masahiro Ichikawa
Nami Suzuki
Masako Matsumoto
Miho Fukushita
Natsuko Watanabe
Kiminori Sugino
Koichi Ito
Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan
Endocrine Journal
autonomous functioning thyroid nodule
hyperthyroidism
volume reduction
radioactive iodine
title Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan
title_full Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan
title_fullStr Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan
title_full_unstemmed Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan
title_short Long-term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in Japan
title_sort long term outcomes after a radioactive iodine treatment for a single autonomous functioning thyroid nodule in japan
topic autonomous functioning thyroid nodule
hyperthyroidism
volume reduction
radioactive iodine
url https://www.jstage.jst.go.jp/article/endocrj/72/5/72_EJ24-0578/_html/-char/en
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