Document Detail

Accuracy considerations when using early (four- or six-hour) radioactive iodine uptake to predict twenty-four-hour values for radioactive iodine dosage in the treatment of Graves' disease.
MedLine Citation:
PMID:  11041455     Owner:  NLM     Status:  MEDLINE    
Although literature has offered methods to predict 24-hour radioactive iodine uptake values from early (4- to 6-hour) measurements, the resultant dosage errors have not been examined. Potential errors include underdosage, overdosage, and a failure to recognize rapid turnover patients (early-to-late uptake ratios > or = 1) who are at high risk for treatment failure and full-body radiation exposure. We developed and tested a novel method for minimizing error involved in using a single early uptake measurement to derive late uptake. From a retrospective analysis of 203 Graves' disease patients, receiver operating characteristic (ROC) curve analysis enabled us to identify patients likely to experience rapid turnover and therefore should receive 24-hour studies. Twenty-four-hour uptake measurements are necessary with 77% or more 4-hour uptake values and 80% or more 6-hour values. After eliminating these patients, we developed linear regression equations to predict the 24-hour uptake from 4-hour (n = 61) and 6-hour (n = 22) rule groups, testing their efficacy on separate 4-hour (n = 61) and 6-hour (n = 21) patient groups. We also used our test population to measure error in four early-to-late uptake conversion formulas presented in the literature. Error involved in these predictions ranged from a 10.6% overestimate for 4-hour calculations to a 5.9% underestimate for 6-hour calculations. When applied to two dosage formulas incorporating gland size, absorbed dose, and 24-hour uptake, average dosage error was 7%. In comparison to the other sources of error radioactive iodine (131I) dosimetry, potential error in predicting 24-hour uptake from 4- or 6-hour uptake values is low.
L F Morris; A D Waxman; G D Braunstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  10     ISSN:  1050-7256     ISO Abbreviation:  Thyroid     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2001-01-17     Completed Date:  2001-02-01     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  779-87     Citation Subset:  IM    
Department of Medicine and Nuclear Medicine, Cedars-Sinai Medical Center-UCLA School of Medicine, Los Angeles, California 90048, USA.
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MeSH Terms
Graves Disease / pathology,  radiotherapy*
Iodine Radioisotopes / pharmacokinetics*,  therapeutic use*
Linear Models
ROC Curve
Radiotherapy Dosage
Sensitivity and Specificity
Thyroid Gland / pathology
Reg. No./Substance:
0/Iodine Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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