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August 1960

The Evaluation of I131 Therapy of Graves' Disease: Reliability and Prognostic Value of Chemical and Radioactive Iodine Studies

Author Affiliations

US Army; San Antonio, Texas

From the Department of Medicine and Radiology Service, Brooke General Hospital, Fort Sam Houston, Texas, and the Department of Endocrinology, Southwest Foundation for Research and Education, San Antonio, Texas.

Arch Intern Med. 1960;106(2):194-204. doi:10.1001/archinte.1960.03820020034006

The availability of radioactive iodine has unquestionably revolutionized the diagnosis and therapy of thyroid disease. There is less certainty, however, as to the value and meaning of I131 diagnostic studies in the hyperthyroid patient following surgery or the administration of therapeutic doses of radioiodine. Goldsmith,1 in 1954, stated that the thyroidal radioiodine uptake cannot be interpreted in the usual way following treatment with radioiodine; Chapman, Maloof, Maisterrena, and Martin 2 observed that the thyroid I131 uptake was at times disproportionately low when compared to the clinical status, while others 3,4 noted persistently elevated thyroid uptakes or PBI131 values in clinically euthyroid patients. Nodine and his collaborators 5 have further documented this problem with six cases in which there was a discrepancy between the clinical status and diagnostic tests with the use of I131. On the other hand, Schultz and Zieve6 maintained that the thyroidal I131 uptake and PBI are prognostically