Document Detail

Association between Excessive Urinary Iodine Excretion and Failure of Radioiodine Thyroid Ablation in Patients with Papillary Thyroid Cancer.
MedLine Citation:
PMID:  23205883     Owner:  NLM     Status:  Publisher    
Background: A low iodine diet (LID) is usually recommended for a week or two prior to radioiodine ablation therapy in papillary thyroid cancer (PTC) patients after total thyroidectomy. However, it is still controversial whether a LID affects ablation outcomes. We therefore evaluated the association between urine iodine excretion (UIE) and the rate of successful ablation and investigated the determinants of successful radioiodine ablation outcomes. Methods: We retrospectively reviewed the records of 295 consecutive patients with PTC who received 1110 MBq radioiodine remnant ablation therapy with thyroid hormone withdrawal after total thyroidectomy. Successful ablation was defined as 1) no visible or faint uptake on a follow-up scan (definition 1) or 2) no visible or faint uptake on a follow-up scan and a stimulated thyroglobulin level of less than 2 ng/mL (definition 2). Results: Proportion of patients with appropriate LID status (defined as <66.2ug/gCr) was significantly higher in successfully ablated group (81% vs 67%, P=0.03). Based on definition 1, 80.3% (237/295) of patients were successfully ablated. The ablation rate was significantly lower in patients who had a UIE > 250 g/gCr at the time of radioiodine ablation (P<0.05). In multivariate analysis, a UIE >250 g/gCr was the only significant variable associated with ablation failure (P=0.001, OR 4.74, 95% CI 1.78-12.63). Based on definition 2, 74.9% (221/295) of patients were successfully ablated. A UIE > 250 g/gCr at radioiodine administration showed a significant association with ablation failure (P<0.05). The odds ratio of a UIE >250 ug/gCr for ablation failure was 3.88 (95% CI 1.42-10.57, P=0.008). Conclusion: Excessive iodine intake (UIE >250 ug/gCr) was associated with poor radioiodine ablation outcomes. Because this amount of iodine is very high, we propose that the level of strictness of the LID protocol should be modified according to the region that the patient is from and the food that the patient is accustomed to eating. Even in those areas where iodine intake is high, too strict compliance with a LID protocol is not necessary and simple recommendations to avoid iodine-rich foods would be appropriate.
Seo Young Sohn; Joon Young Choi; Hye Won Jang; Hye Jeong Kim; Sang Man Jin; Se Won Kim; Sunghwan Suh; Kyu Yeon Hur; Jae Hyeon Kim; Jae Hoon Chung; Sun Wook Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  -     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea, Seoul, Korea, Republic of, 135-710, 82-2-3410-3434;
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