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Selecting The Dose Of Single Radioiodine Therapy For Goitre
A DGReview of :"Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake"
European Journal of Nuclear Medicine
04/18/2002
By Mark Greener
The single radioiodine regimen for elderly patients with enlarged thyroid glands and autonomous masses can be based on technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTUs).
Researchers from University Hospital Bonn, and other centres in Germany and Switzerland, aimed to optimise treatment of diffuse and nodular toxic goitre using single doses of radioiodine based on TcTUs. This acts as a surrogate for non-suppressible iodine turnover and the functional autonomous mass.
The study enrolled 438 patients, average age 70 years, with a mean thyroid volume of 54 ml. Of these, 261 experienced at least one episode of overt hyperthyroidism. The tissue absorbed doses from single radioiodine therapy ranged from 150 Gy for TcTUs of between 1.5 and 2.49 percent to 300 Gy for a TcTUs of at least 4.5 percent.
Thyroid volume declined by a mean 37 percent a year after treatment. At this time, 96 percent of patients showed normalised TcTUs and 92 percent showed normal thyrotropin levels. Only 0.9 percent of patients developed hypothyroidism. Five patients showed recurrent hyperthyroidism.
The authors recommend selecting the dose of single radioiodine therapy based on TcTUs for elderly patients with enlarged thyroid glands and autonomous masses, and who are likely to develop iodine-induced hyperthyroidism.
Eur J Nucl Med 2002;29: 480-485.
"Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake"
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