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Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of 99mTc-pertechnetate: applicability to unifocal thyroid autonomy?

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Abstract

Purpose

The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on 99mTc-pertechnetate thyroid uptake under thyrotropin suppression (TcTUs) to radioiodine therapy for unifocal thyroid autonomy.

Methods

A total of 425 consecutive patients (302 females, 123 males; age 63.1±10.3 years) with unifocal thyroid autonomy were treated at three different centres with 131I, using Marinelli’s formula for calculation of three different absorbed dose schedules: 100–300 Gy to the total thyroid volume according to the pre-treatment TcTUs (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142).

Results

Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100–300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100–300 Gy per thyroid and 400 Gy per nodule strategies (36±19% and 38±20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28±16%; p<0.01).

Conclusion

A dose strategy based on the TcTUs can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany

    Michael J. Reinhardt, Kim Biermann, Holger Brockmann, Dirk von Mallek, Samer Ezziddin & Alexius Y. Joe

  2. Department of Nuclear Medicine, University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany

    Michael J. Reinhardt, Freimut D. Juengling, Alexius Y. Joe & Thomas M. Krause

  3. Department of Nuclear Medicine, Inselspital Bern, 3010 Bern, Switzerland

    Michael Wissmeyer, Freimut D. Juengling & Thomas M. Krause

Authors
  1. Michael J. Reinhardt
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  2. Kim Biermann
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  3. Michael Wissmeyer
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  4. Freimut D. Juengling
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  5. Holger Brockmann
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  6. Dirk von Mallek
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  7. Samer Ezziddin
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  8. Alexius Y. Joe
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  9. Thomas M. Krause
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Corresponding author

Correspondence to Michael J. Reinhardt.

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Reinhardt, M.J., Biermann, K., Wissmeyer, M. et al. Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of 99mTc-pertechnetate: applicability to unifocal thyroid autonomy?. Eur J Nucl Med Mol Imaging 33, 608–612 (2006). https://doi.org/10.1007/s00259-005-0051-9

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  • DOI: https://doi.org/10.1007/s00259-005-0051-9

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