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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The Japan Endocrine Society
2025-05-01
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| 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. |
| format | Article |
| id | doaj-art-ba0265819a0b43c4bef4cfb0b63df65b |
| institution | OA Journals |
| issn | 1348-4540 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| 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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