RADIOACTIVE IODINE IN THE TREATMENT OF THE HYPERTHYROIDISM OF NODULAR GOITER*

Abstract

IN PRESENTING to this group the clinical results of the use of radioactive iodine in the treatment of the hyperthyroidism of nodular goiter, there seems little necessity to review the history of the initial discovery of artificial radioactivity, the subsequent production of radioactive iodine, and the part such iodine has played and is playing in the study, diagnosis, and treatment of thyroid disease. In this paper, we consider it more important to confine ourselves to the presentation of the end results of our treatment, together with some evaluation of these results. During the past two years, radioactive iodine has been used at the Cleveland Clinic in the treatment of hyperthyroidism. The patients with nodular goiters who were selected for this therapy have all been 40 years of age or older. The solitary adenoma has never been chosen for such treatment. Radioactive iodine was used in several instances of large nodular goiters because the patient was averse to the idea of operation. In some of our patients the surgical risk was considered too great and thus surgery was contraindicated. A number of patients with small nodular goiters who were not suitable surgical risks were given a trial on definitive treatment with propylthiouracil or with methylthiouracil. Those who experienced prompt recurrence of hyperthyroidism upon cessation of the drug were considered candidates for radioactive iodine therapy.