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International Journal of Endocrinology
Volume 2017 (2017), Article ID 7354673, 7 pages
Clinical Study

Thyroid Isthmus Length and Iodine Turnover as Predictors of Successful Radioactive Iodine Therapy in Patients with Graves’ Disease

1Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
2Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
3Chaum Life Center, CHA University School of Medicine, Seoul 06062, Republic of Korea
4Division of Endocrinology, Department of Internal Medicine, Inseong Hallym Hospital, Incheon 21079, Republic of Korea

Correspondence should be addressed to Dong Yeob Shin

Received 25 June 2017; Revised 10 October 2017; Accepted 18 October 2017; Published 5 December 2017

Academic Editor: Jack Wall

Copyright © 2017 Se Hee Park et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Radioactive iodine (RAI) therapy is an effective treatment option for Graves’ disease. However, predicting treatment failures after RAI therapy remains controversial. The objective of this study was to investigate the factors associated with the success rate of RAI therapy for treatment of Graves’ hyperthyroidism. Thyroid functional outcome, pre-RAI ultrasonographic features, and clinical parameters were evaluated retrospectively in 98 patients followed up for at least 12 months after RAI (mean RAI dose was 11.7 ± 1.8 mCi). Hypothyroidism was achieved in 59 patients (60.2%), and euthyroidism in 16 patients (16.3%), while 23 patients (23.5%) remained hyperthyroid. Age, sex, body mass index, pre-RAI thyroid function, or thyroid-stimulating immunoglobulin levels were not associated with treatment outcome. Length of thyroid isthmus () and 2- to 24-hour iodine uptake ratios () were significantly associated with treatment failure, which was defined as a persistent hyperthyroid status after RAI therapy. Patients with a longer isthmus had a higher risk of remaining hyperthyroid, with a threshold for isthmus length of 5.2 mm, with a sensitivity of 69.6% and specificity of 70.3% for treatment success. Measuring the length of the thyroid isthmus can be a simple and useful way to predict RAI treatment outcome.