Treatment of thyrotoxicosis with iodine-125: A clinical and laboratory study

McDougall, Iain Ross (1973) Treatment of thyrotoxicosis with iodine-125: A clinical and laboratory study. PhD thesis, University of Glasgow.

Abstract

This study is primarily a clinical assessment of a new radioisotope of iodine (iodine-125) for the treatment of thyrotoxicosis. The thesis consists of three sections, B and C. The first Chapter of Section A is concerned with the currently used treatments for thyrotoxicosis (Graves' disease), special attention being given, to iodine-131. There is no excuse for the proportion of the Chapter which deals with the poor results, side effects and complications of the therapies, and again prominence is given to iodine-131 in particular the problem of post therapy hypothyroidism. Included in this Chapter is a personally analysed combined radiotherapeutic trial using iodine-131 and carbimazole. The rationale for the use of iodine-125 is detailed in Section A Chapter II. The rich spectrum of low energy short range electrons emitted from iodine-125 preferentially irradiates the hormone producing region at the apox of the follicular cells without killing the cells. It is theoretically possible using iodine-125 to produce rapid control of the disease without causing post-treatment hypothyroidism. Animal experiments carried out by other investigators confirming this hypothesis are described. Section B consists of three Chapters which deal with the clinical trials of iodine-125 in patients. In Chapter I the excellent results of large therapy doses justified this approach and encouraged extension f the trials using smaller but empirioal doses. The method of calculating the rad dose at different levels of the follicular cell is described. The main clinical trial, the treatment of 265 thyrotoxic patients with different dose schedules of iodine-125, is detailed in Chapter II. The outcome is related to the sex and age of the patients, the total dose prescribed, the thyroid size before therapy, the dose of iodine-125 prescribed per gram of thyroid and the length of follow up. Clinical trials of iodine-125 in three centres are discussed and the overall pattern of results integrated. Complications which have arisen after iodine-125 treatment are included in Chapter III as are prospective investigations into potential hazards. Two Chapters in Section C deal with the radiobiological differences in the thyrotoxic thyroid after treatment with iodine-125 compared with iodine-131. In the first Chapter, routine radioiodine tests, an intravenous perchlorate discharge test, radiochromatograms of serum and combined use of serum thyroxine, T3 resin and T.S.H. assay are utilised. In the second mathematical techniques awe employed.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Additional Information: Adviser: E M McGirr
• Keywords: Medicine, Nuclear physics and radiation, Biophysics
• Date of Award: 1973
• Depositing User: Enlighten Team
• Unique ID: glathesis:1973-73221
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 14 Jun 2019 08:56
• Last Modified: 14 Jun 2019 08:56
• URI: https://theses.gla.ac.uk/id/eprint/73221