99m Tc-pertechnetate thyroid scintigraphy predicts clinical outcomes in personalized radioiodine treatment for Graves' disease.

Autor: Zhao L; Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, PR China., Zhang W; Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, PR China., Xin Y; Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, PR China., Wen Q; Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, PR China., Bail L; Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, PR China., Guan F; Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, Jilin, PR China. Electronic address: ad4696@sina.com., Bin J; Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, Jilin, PR China. Electronic address: jibin1983104@163.com.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de medicina nuclear e imagen molecular [Rev Esp Med Nucl Imagen Mol (Engl Ed)] 2018 Nov - Dec; Vol. 37 (6), pp. 349-353. Date of Electronic Publication: 2018 Nov 06.
DOI: 10.1016/j.remn.2018.04.005
Abstrakt: Objective: The aim of this study was, first, to ascertain the efficacy of radioiodine therapy (RIT) for Graves' disease (GD) based on a calculated-dose regime and, second, to determine the value of 99m Tc-pertechnetate thyroid scintigraphy in predicting the clinical outcomes of RIT.
Methods: One hundred and thirty 9consecutive GD patients who underwent RIT using a calculated-dose method in our hospital from January 2015 to September 2015 were retrospectively evaluated. Radioiodine dose was calculated based on the Marinelli's formula. 99m Tc-pertechnetate uptake, age, gender, thyroid mass, duration of the disease, previous antithyroid drugs treatment, serum levels of TSH, FT3 and FT4, a positive rate of TPOAb and Anti-TRAb, radioiodine dose and follow-up were evaluated as potential interference factors for RIT success.
Results: One hundred and 8(77.7%) GD patients including 71 (51.1%) euthyroid and 37 (26.6%) hypothyroid were successful, but 31 (22.3%) remained hyperthyroid (treatment failure). Significant differences were found between the treatment success group and the failure group in 99m Tc-pertechnetate uptake (p<0.0001), the duration of disease (P=.0140) and positive rate of Anti-TRAb (P=.0103). 99m Tc-pertechnetate uptake is an independent risk factor for predicting treatment failure (P=.0394). Using a cut-off value of 18.4%, 99m Tc-pertechnetate uptake could predict treatment failure with a sensitivity of 84.3%, and a specificity of 80.6%.
Conclusion: Our study has shown that a calculated radioiodine dose is effective in treating GD patients with a consequent low rate of hypothyroid. A 99m Tc-pertechnetate uptake above 18.4% is a significant predictor of treatment failure and these patients should receive a higher radioiodine dose in this scenario.
(Copyright © 2018. Publicado por Elsevier España, S.L.U.)
Databáze: MEDLINE
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