Nuklearmedizin. Nuclear medicine · 2008
[Is radioiodine therapy conducted too late in patients suffering from thyroid autonomy?].
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Spilker L, Happel C, Döbert N, Grünwald F
Аннотация
AIM: The effectiveness of radioiodine therapy (RIT) is proven. The aim of this study was to determine, how much time passes between diagnosis of thyroid autonomy or occurrence of functional and/or local symptoms on one hand and RIT on the other hand.
PATIENTS, METHODS: This retrospective study comprises 196 patients, who were treated with radioiodine for thyroid autonomy between 2002 and 2005. Evaluated parameters are begin of functional and/or local symptoms, first scintigraphy with relevant Tc-Uptake as time point of primary diagnosis of thyroid autonomy and time point of implementation of RIT.
RESULTS: Between first scintigraphy with relevant Tc-Uptake and implementation of RIT 0-72 months passed (median: 3 months). 160 patients (81.6%) had a prior diagnosis of goitre by their general practitioner and 163 patients (83.3%) had a prior diagnosis of TSH suppression. The time period between first recommendation of RIT and implementation of RIT was 0-89 months (median: 2 months). In 142 patients (71.4%) functional and/or local symptoms were present over 73 months (median; range: 0-180 months) before the first scintigraphy with therapy relevant Tc-Uptake was conducted.
CONCLUSION: Despite clear recommendations in corresponding guidelines too much time passes between first symptoms (median: 73 months), primary diagnosis of therapy relevant thyroid autonomy (median: 2 months) and implementation of RIT. Patients with functional and/or local symptoms should be examined for thyroid autonomy early. If thyroid autonomy is proven, RIT should be planned immediately, especially in high-risk patients.
PATIENTS, METHODS: This retrospective study comprises 196 patients, who were treated with radioiodine for thyroid autonomy between 2002 and 2005. Evaluated parameters are begin of functional and/or local symptoms, first scintigraphy with relevant Tc-Uptake as time point of primary diagnosis of thyroid autonomy and time point of implementation of RIT.
RESULTS: Between first scintigraphy with relevant Tc-Uptake and implementation of RIT 0-72 months passed (median: 3 months). 160 patients (81.6%) had a prior diagnosis of goitre by their general practitioner and 163 patients (83.3%) had a prior diagnosis of TSH suppression. The time period between first recommendation of RIT and implementation of RIT was 0-89 months (median: 2 months). In 142 patients (71.4%) functional and/or local symptoms were present over 73 months (median; range: 0-180 months) before the first scintigraphy with therapy relevant Tc-Uptake was conducted.
CONCLUSION: Despite clear recommendations in corresponding guidelines too much time passes between first symptoms (median: 73 months), primary diagnosis of therapy relevant thyroid autonomy (median: 2 months) and implementation of RIT. Patients with functional and/or local symptoms should be examined for thyroid autonomy early. If thyroid autonomy is proven, RIT should be planned immediately, especially in high-risk patients.