Document Detail


The relationship between 24 h/4 h radioiodine-131 uptake ratio and outcome after radioiodine therapy in 1402 patients with solitary autonomously functioning thyroid nodules.
MedLine Citation:
PMID:  19322512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the role of 24 h/4 h uptake ratio (UR) in response to radioiodine-131 ((131)I) therapy in patients with autonomously functioning thyroid nodules (AFTN). METHODS: A total of 1402 consecutive hyperthyroid patients were treated with (131)I, between 1958 and 2005. Therapeutic doses (D) were calculated according to the formula: D = weight of nodule x dose per gram of nodular tissue (q)/24 h (131)I uptake. The ratios of the 24 and 4 h uptake were retrospectively calculated and the patients were grouped according to outcome and q into three groups of UR (< or =1.25; 1.26-1.68; > or =1.69) by means of terziles. RESULTS: Of the 1402 patients, 95 did not respond to (131)I treatment while 93/1307 developed hypothyroidism. Most non-responders (55.8%) had UR < or =1.25, while many hypothyroid patients (66.7%) had UR > or =1.69 (chi (2): P < 0.001). As q increased, the proportion of successfully treated patients increased (level of significance) only in the group with UR < or =1.25; while in the other two terziles, with increasing dose per gram of nodular tissue, the number of successfully treated patients did not increase (level of significance). The cumulative incidence of hypothyroidism was 2.2% at the 1st year after (131)I treatment, increasing to 13.9% at 5 years and 26.2% at 10 years. CONCLUSIONS: The (131)I UR can predict the outcome of (131)I treatment in AFTN and may have utility in modifying treatment in some patients to limit post-radioiodine induced hypothyroidism and treatment failures in order to achieve euthyroidism.
Authors:
Mauro Filesi; Laura Travascio; Teresa Montesano; Angelo D Di Nicola; Marzia Colandrea; Fabio Ugolini; Rocco Bruno; Milton D Gross; Annarita Vestri; Domenico Rubello; Giuseppe Ronga
Publication Detail:
Type:  Journal Article     Date:  2009-03-26
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  23     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-13     Completed Date:  2009-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  229-34     Citation Subset:  IM    
Affiliation:
Department of Clinical Sciences, Nuclear Medicine, Policlinico Umberto I, 'La Sapienza' University, Viale del Policlinico 155, 00161 Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Humans
Iodine Radioisotopes / metabolism*,  therapeutic use*
Radiotherapy Dosage
Retrospective Studies
Thyroid Nodule / metabolism*,  pathology,  radiotherapy*,  therapy
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes

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