Journals / Turkish Journal of Medical Sciences / 2011 / Cilt: 41 - Sayı: 6

Prognostic role of Tc-99m pertechnetate thyroid scintigraphy prior to fixed-dose radioiodine therapy of toxic multinodular goiters*

Pages
981–988
Publication Date
2011-06-01
DOI
—
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Conclusion: The Tc-99m pertechnetate uptake level of hot nodules calculated from the pretreatment of thyroid scintigraphy in patients with TMNG treated with a fixed 740-MBq I-131 dose may predict early hypothyroidism in patients.

📌 3 Key Takeaways

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Objective & Hypothesis:To investigate the prognostic role of Tc-99m pertechnetate thyroid scintigraphy pretreatment in patients with toxic multinodular goiters (TMNG) who were then treated with fixed I-131 doses.
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Key Findings & Data:Materials and methods: We retrospectively evaluated 28 patients (18 females and 10 males; mean ± SD = 63 ± 11 years) that were treated with 740 megabecquerels (MBq) of I-131 for TMNG.
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Conclusion & Impact:Conclusion: The Tc-99m pertechnetate uptake level of hot nodules calculated from the pretreatment of thyroid scintigraphy in patients with TMNG treated with a fixed 740-MBq I-131 dose may predict early hypothyroidism in patients.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Key words: Radioiodine · I-131 · toxic multinodular goiter

Abstract

To investigate the prognostic role of Tc-99m pertechnetate thyroid scintigraphy pretreatment in patients with toxic multinodular goiters (TMNG) who were then treated with fixed I-131 doses. Materials and methods: We retrospectively evaluated 28 patients (18 females and 10 males; mean ± SD = 63 ± 11 years) that were treated with 740 megabecquerels (MBq) of I-131 for TMNG. Information, including age, Tc-99m pertechnetate thyroid scintigraphy and ultrasonography findings, antithyroid medication, thyroid hormone profile, and clinical status before treatment, was recorded. The regions of interest were drawn over the hot nodules, salivary glands, and the background on the anterior thyroid images. The net nodule counts, net salivary counts, nodule-to-salivary ratios, and nodule-to-background ratios were then calculated. The data were statistically compared for the hypothyroid and euthyroid patient groups after radioiodine treatment. Results: In the study group, the mean follow-up period was 7 ± 2 months (range: 6-12 months). We detected hyperthyroidism in 1 patient, euthyroidism in 19 patients, and hypothyroidism in 8 patients. The pretreatment mean net nodule counts (34.79 ± 14.06 counts) in the patients that developed hypothyroidism were significantly higher than in those patients that developed euthyroidism (26.80 ± 11.04 counts) (P = 0.014). The other 3 parameters did not show significant differences between the 2 groups. Conclusion: The Tc-99m pertechnetate uptake level of hot nodules calculated from the pretreatment of thyroid scintigraphy in patients with TMNG treated with a fixed 740-MBq I-131 dose may predict early hypothyroidism in patients.

Özet

To investigate the prognostic role of Tc-99m pertechnetate thyroid scintigraphy pretreatment in patients with toxic multinodular goiters (TMNG) who were then treated with fixed I-131 doses. Materials and methods: We retrospectively evaluated 28 patients (18 females and 10 males; mean ± SD = 63 ± 11 years) that were treated with 740 megabecquerels (MBq) of I-131 for TMNG. Information, including age, Tc-99m pertechnetate thyroid scintigraphy and ultrasonography findings, antithyroid medication, thyroid hormone profile, and clinical status before treatment, was recorded. The regions of interest were drawn over the hot nodules, salivary glands, and the background on the anterior thyroid images. The net nodule counts, net salivary counts, nodule-to-salivary ratios, and nodule-to-background ratios were then calculated. The data were statistically compared for the hypothyroid and euthyroid patient groups after radioiodine treatment. Results: In the study group, the mean follow-up period was 7 ± 2 months (range: 6-12 months). We detected hyperthyroidism in 1 patient, euthyroidism in 19 patients, and hypothyroidism in 8 patients. The pretreatment mean net nodule counts (34.79 ± 14.06 counts) in the patients that developed hypothyroidism were significantly higher than in those patients that developed euthyroidism (26.80 ± 11.04 counts) (P = 0.014). The other 3 parameters did not show significant differences between the 2 groups. Conclusion: The Tc-99m pertechnetate uptake level of hot nodules calculated from the pretreatment of thyroid scintigraphy in patients with TMNG treated with a fixed 740-MBq I-131 dose may predict early hypothyroidism in patients.

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Cite This Article

YÜKSEL, D., KIRAÇ, F. S., YAYLALI, O., UĞUZ, İ. D. (2011). Prognostic role of Tc-99m pertechnetate thyroid scintigraphy prior to fixed-dose radioiodine therapy of toxic multinodular goiters*. Turkish Journal of Medical Sciences, Cilt: 41 - Sayı: 6, 981–988. https://ajindex.com/articles/723578

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References (9)

  1. Kaplan MM, Meier DA, Dworkin HJ. Treatment of hyperthyroidism with radioactive iodine. Endocrinol Metab Clin 1998; 1: 205-23. Bähre M, Hilgers R, Lindemann C, Emrich D. Physiological aspects of the thyroid trapping function and its suppression in iodine defi ciency using 99mTc-pertechnetate. Acta Endocrinol (Copenh) 1987; 115: 175-82. 3. Emrich D, Erlenmaier U, Pohl M, Luig H. Determination of the autonomously functioning volume of the thyroid. Eur J Nucl Med 1993; 20: 410-4.
  2. Reinhardt M, Emrich D, Krause T, Bräutigam P, Nitzsche E, Blattmann H et al. Improved dose concept for radioiodine therapy of multifocal and disseminated thyroid autonomy. Eur J Endocrinol 1995; 132: 550-6.
  3. Oexle C, Reinhardt M, Moser E. First results of radioiodine therapy of multifocal and disseminated thyroid gland autonomy and use of a TcTUs-adapted dose concept. Nuklearmedizin 1998; 37: 192-6.
  4. Reinhardt MJ, Högerle S, Trupkovic T, Krause TM, Moser E. Infl uence of urinary iodine excretion on thyroid technetium- 99m pertechnetate uptake with and without TSH suppression: what happens when iodine supply increases? Eur J Nucl Med 1998; 25: 1475-81.
  5. Meller J, Wisheu S, Munzel U, Behe M, Gratz S, Becker W. Radioiodine therapy for Plummer’s disease based on the thyroid uptake of technetium-99m pertechnetate. Eur J Nucl Med 2000; 27: 1286-91. 8. Reinhardt MJ, Joe A, Mallek DV, Zimmerlin M, Manka-Waluch A, Palmedo H et al. Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake. Eur J Nucl Med 2002; 29: 480-5.
  6. Reiners C, Schneider P. Radioiodine therapy of thyroid autonomy. Eur J Nucl Med 2002; 29: 471-8.
  7. Gotthardt M, Nowack M, Behe MP, Schipper ML, Schlieck A, Hoffk en H et al. Negative correlation between therapeutic success in radioiodine therapy and TcTUs: are TcTUs-adapted dose concepts the only possible answer? Eur J Nucl Med Mol Imaging 2003; 30: 1165-8.
  8. Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM et al. AACE Th yroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocrine Practice 2002; 8: 457-69.
  9. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al. Revised American Th yroid Association management guidelines for patients with thyroid nodules and diff erentiated thyroid cancer. Th yroid 2009; 19: 1167-214. Ghar