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Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases
Purpose Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid st...
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| Published in: | Endocrine 2019-03, Vol.63 (3), p.537-544 |
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| container_end_page | 544 |
| container_issue | 3 |
| container_start_page | 537 |
| container_title | Endocrine |
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| creator | Happel, Christian Kranert, Wolfgang Tilman Ackermann, Hanns Binse, Ina Bockisch, Benjamin Gröner, Daniel Herrmann, Ken Grünwald, Frank |
| description | Purpose
Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid stunning in benign thyroid diseases caused by the radioiodine uptake test (RIUT). Therefore, the influence of pre-therapeutic tracer radiation dose on therapeutic iodine-131 uptake was evaluated retrospectively.
Methods
A total of 914 RIT patients were included. Exclusion criteria were anti-thyroid drugs, pre- and/or intra-therapeutic effective half-lives (EHL) beyond 8.04 days and externally performed RIUT or 24 h RIUT. All patients received RIUT 1 week before RIT. Thyroid volume was estimated via ultrasound. Tracer radiation dose to the thyroid was calculated retrospectively. The dependence of changes in the pre-therapeutic to the therapeutic extrapolated-maximum-
131
I-uptake (EMU) from the dose in RIUT was evaluated statistically.
Results
EMU in RIUT ranged from 0.10 to 0.82 (median: 0.35) and EMU in RIT ranged from 0.10 to 0.74 (median: 0.33). Averaged over the whole cohort the therapeutic EMU decreased significantly (2.3% per Gray intra-thyroidal tracer radiation dose). A disease-specific evaluation showed dose-dependent thyroid stunning from 1.2% per Gray in solitary toxic nodules (
n
= 327) to 21% per Gray in goiters (
n
= 135) which was significant for the subgroups of disseminated autonomies (
n
= 114), multifocal autonomies (
n
= 178) and goiters (
p
0.05).
Conclusions
The presented data indicate for the first time a significant dependence of pre-therapeutic radiation dose on thyroid stunning in goiter and disseminated and multifocal autonomy. To achieve the desired intra-thyroidal radiation dose, RIT activity should be adapted depending on the dose in RIUT. |
| doi_str_mv | 10.1007/s12020-018-01833-5 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2191866340</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2191866340</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-2459d3b59e1de56b402d1696ab2052365b186f594398a67014982027c74b115c3</originalsourceid><addsrcrecordid>eNp9kD9PwzAQxS0EoqXwBRhQJObAnZ1z4hFVFJAqsRSJzcofp3VFnWKnQ789LimwMVj2-d57p_sxdo1whwD5fUAOHFLA4nCESOmEjZFIxRLgNL4FUQpQvI_YRQhrAM65zM_ZSAApBYRjNlus9r6zTRL6nXPWLRPrEl82trNdY51JUWDSr4wvt_uka5PKOLt08WdwNTaYMphwyc7a8iOYq-M9YW-zx8X0OZ2_Pr1MH-ZpLXLqU56RakRFymBjSFYZ8AalkmXFgbiQVGEhW1KZUEUpc8BMFXHHvM6zCpFqMWG3Q-7Wd587E3q97nbexZGao4pmKTKIKj6oat-F4E2rt95uSr_XCPqATg_odMSmv9FpiqabY_Su2pjm1_LDKgrEIAix5ZbG_83-J_YL4Bd2vQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2191866340</pqid></control><display><type>article</type><title>Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases</title><source>Springer Nature</source><creator>Happel, Christian ; Kranert, Wolfgang Tilman ; Ackermann, Hanns ; Binse, Ina ; Bockisch, Benjamin ; Gröner, Daniel ; Herrmann, Ken ; Grünwald, Frank</creator><creatorcontrib>Happel, Christian ; Kranert, Wolfgang Tilman ; Ackermann, Hanns ; Binse, Ina ; Bockisch, Benjamin ; Gröner, Daniel ; Herrmann, Ken ; Grünwald, Frank</creatorcontrib><description>Purpose
Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid stunning in benign thyroid diseases caused by the radioiodine uptake test (RIUT). Therefore, the influence of pre-therapeutic tracer radiation dose on therapeutic iodine-131 uptake was evaluated retrospectively.
Methods
A total of 914 RIT patients were included. Exclusion criteria were anti-thyroid drugs, pre- and/or intra-therapeutic effective half-lives (EHL) beyond 8.04 days and externally performed RIUT or 24 h RIUT. All patients received RIUT 1 week before RIT. Thyroid volume was estimated via ultrasound. Tracer radiation dose to the thyroid was calculated retrospectively. The dependence of changes in the pre-therapeutic to the therapeutic extrapolated-maximum-
131
I-uptake (EMU) from the dose in RIUT was evaluated statistically.
Results
EMU in RIUT ranged from 0.10 to 0.82 (median: 0.35) and EMU in RIT ranged from 0.10 to 0.74 (median: 0.33). Averaged over the whole cohort the therapeutic EMU decreased significantly (2.3% per Gray intra-thyroidal tracer radiation dose). A disease-specific evaluation showed dose-dependent thyroid stunning from 1.2% per Gray in solitary toxic nodules (
n
= 327) to 21% per Gray in goiters (
n
= 135) which was significant for the subgroups of disseminated autonomies (
n
= 114), multifocal autonomies (
n
= 178) and goiters (
p
< 0.05) but not for Graves’ diseases (
n
= 160) and solitary toxic nodules (
p
> 0.05).
Conclusions
The presented data indicate for the first time a significant dependence of pre-therapeutic radiation dose on thyroid stunning in goiter and disseminated and multifocal autonomy. To achieve the desired intra-thyroidal radiation dose, RIT activity should be adapted depending on the dose in RIUT.</description><identifier>ISSN: 1355-008X</identifier><identifier>EISSN: 1559-0100</identifier><identifier>DOI: 10.1007/s12020-018-01833-5</identifier><identifier>PMID: 30599051</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Autonomy ; Benign ; Diabetes ; Endocrinology ; Female ; Goiter ; Health risk assessment ; Humanities and Social Sciences ; Humans ; Internal Medicine ; Iodine ; Iodine Radioisotopes - adverse effects ; Iodine Radioisotopes - metabolism ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; multidisciplinary ; Nodules ; Original Article ; Retrospective Studies ; Science ; Thyroid carcinoma ; Thyroid diseases ; Thyroid Diseases - radiotherapy ; Thyroid Gland - metabolism ; Thyroid Gland - radiation effects ; Ultrasound ; Young Adult</subject><ispartof>Endocrine, 2019-03, Vol.63 (3), p.537-544</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Copyright Springer Nature B.V. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-2459d3b59e1de56b402d1696ab2052365b186f594398a67014982027c74b115c3</citedby><cites>FETCH-LOGICAL-c375t-2459d3b59e1de56b402d1696ab2052365b186f594398a67014982027c74b115c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30599051$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Happel, Christian</creatorcontrib><creatorcontrib>Kranert, Wolfgang Tilman</creatorcontrib><creatorcontrib>Ackermann, Hanns</creatorcontrib><creatorcontrib>Binse, Ina</creatorcontrib><creatorcontrib>Bockisch, Benjamin</creatorcontrib><creatorcontrib>Gröner, Daniel</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Grünwald, Frank</creatorcontrib><title>Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases</title><title>Endocrine</title><addtitle>Endocrine</addtitle><addtitle>Endocrine</addtitle><description>Purpose
Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid stunning in benign thyroid diseases caused by the radioiodine uptake test (RIUT). Therefore, the influence of pre-therapeutic tracer radiation dose on therapeutic iodine-131 uptake was evaluated retrospectively.
Methods
A total of 914 RIT patients were included. Exclusion criteria were anti-thyroid drugs, pre- and/or intra-therapeutic effective half-lives (EHL) beyond 8.04 days and externally performed RIUT or 24 h RIUT. All patients received RIUT 1 week before RIT. Thyroid volume was estimated via ultrasound. Tracer radiation dose to the thyroid was calculated retrospectively. The dependence of changes in the pre-therapeutic to the therapeutic extrapolated-maximum-
131
I-uptake (EMU) from the dose in RIUT was evaluated statistically.
Results
EMU in RIUT ranged from 0.10 to 0.82 (median: 0.35) and EMU in RIT ranged from 0.10 to 0.74 (median: 0.33). Averaged over the whole cohort the therapeutic EMU decreased significantly (2.3% per Gray intra-thyroidal tracer radiation dose). A disease-specific evaluation showed dose-dependent thyroid stunning from 1.2% per Gray in solitary toxic nodules (
n
= 327) to 21% per Gray in goiters (
n
= 135) which was significant for the subgroups of disseminated autonomies (
n
= 114), multifocal autonomies (
n
= 178) and goiters (
p
< 0.05) but not for Graves’ diseases (
n
= 160) and solitary toxic nodules (
p
> 0.05).
Conclusions
The presented data indicate for the first time a significant dependence of pre-therapeutic radiation dose on thyroid stunning in goiter and disseminated and multifocal autonomy. To achieve the desired intra-thyroidal radiation dose, RIT activity should be adapted depending on the dose in RIUT.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Autonomy</subject><subject>Benign</subject><subject>Diabetes</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Goiter</subject><subject>Health risk assessment</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Iodine</subject><subject>Iodine Radioisotopes - adverse effects</subject><subject>Iodine Radioisotopes - metabolism</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Nodules</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Science</subject><subject>Thyroid carcinoma</subject><subject>Thyroid diseases</subject><subject>Thyroid Diseases - radiotherapy</subject><subject>Thyroid Gland - metabolism</subject><subject>Thyroid Gland - radiation effects</subject><subject>Ultrasound</subject><subject>Young Adult</subject><issn>1355-008X</issn><issn>1559-0100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kD9PwzAQxS0EoqXwBRhQJObAnZ1z4hFVFJAqsRSJzcofp3VFnWKnQ789LimwMVj2-d57p_sxdo1whwD5fUAOHFLA4nCESOmEjZFIxRLgNL4FUQpQvI_YRQhrAM65zM_ZSAApBYRjNlus9r6zTRL6nXPWLRPrEl82trNdY51JUWDSr4wvt_uka5PKOLt08WdwNTaYMphwyc7a8iOYq-M9YW-zx8X0OZ2_Pr1MH-ZpLXLqU56RakRFymBjSFYZ8AalkmXFgbiQVGEhW1KZUEUpc8BMFXHHvM6zCpFqMWG3Q-7Wd587E3q97nbexZGao4pmKTKIKj6oat-F4E2rt95uSr_XCPqATg_odMSmv9FpiqabY_Su2pjm1_LDKgrEIAix5ZbG_83-J_YL4Bd2vQ</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Happel, Christian</creator><creator>Kranert, Wolfgang Tilman</creator><creator>Ackermann, Hanns</creator><creator>Binse, Ina</creator><creator>Bockisch, Benjamin</creator><creator>Gröner, Daniel</creator><creator>Herrmann, Ken</creator><creator>Grünwald, Frank</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20190301</creationdate><title>Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases</title><author>Happel, Christian ; Kranert, Wolfgang Tilman ; Ackermann, Hanns ; Binse, Ina ; Bockisch, Benjamin ; Gröner, Daniel ; Herrmann, Ken ; Grünwald, Frank</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-2459d3b59e1de56b402d1696ab2052365b186f594398a67014982027c74b115c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Autonomy</topic><topic>Benign</topic><topic>Diabetes</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Goiter</topic><topic>Health risk assessment</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Iodine</topic><topic>Iodine Radioisotopes - adverse effects</topic><topic>Iodine Radioisotopes - metabolism</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Nodules</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Science</topic><topic>Thyroid carcinoma</topic><topic>Thyroid diseases</topic><topic>Thyroid Diseases - radiotherapy</topic><topic>Thyroid Gland - metabolism</topic><topic>Thyroid Gland - radiation effects</topic><topic>Ultrasound</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Happel, Christian</creatorcontrib><creatorcontrib>Kranert, Wolfgang Tilman</creatorcontrib><creatorcontrib>Ackermann, Hanns</creatorcontrib><creatorcontrib>Binse, Ina</creatorcontrib><creatorcontrib>Bockisch, Benjamin</creatorcontrib><creatorcontrib>Gröner, Daniel</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Grünwald, Frank</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Endocrine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Happel, Christian</au><au>Kranert, Wolfgang Tilman</au><au>Ackermann, Hanns</au><au>Binse, Ina</au><au>Bockisch, Benjamin</au><au>Gröner, Daniel</au><au>Herrmann, Ken</au><au>Grünwald, Frank</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases</atitle><jtitle>Endocrine</jtitle><stitle>Endocrine</stitle><addtitle>Endocrine</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>63</volume><issue>3</issue><spage>537</spage><epage>544</epage><pages>537-544</pages><issn>1355-008X</issn><eissn>1559-0100</eissn><abstract>Purpose
Existence and cause of thyroid stunning was controversially discussed for decades but the underlying mechanism remains unclear. Numerous studies describe thyroid stunning in radioiodine-131 therapy (RIT) of differentiated thyroid carcinoma. However, there are no studies evaluating thyroid stunning in benign thyroid diseases caused by the radioiodine uptake test (RIUT). Therefore, the influence of pre-therapeutic tracer radiation dose on therapeutic iodine-131 uptake was evaluated retrospectively.
Methods
A total of 914 RIT patients were included. Exclusion criteria were anti-thyroid drugs, pre- and/or intra-therapeutic effective half-lives (EHL) beyond 8.04 days and externally performed RIUT or 24 h RIUT. All patients received RIUT 1 week before RIT. Thyroid volume was estimated via ultrasound. Tracer radiation dose to the thyroid was calculated retrospectively. The dependence of changes in the pre-therapeutic to the therapeutic extrapolated-maximum-
131
I-uptake (EMU) from the dose in RIUT was evaluated statistically.
Results
EMU in RIUT ranged from 0.10 to 0.82 (median: 0.35) and EMU in RIT ranged from 0.10 to 0.74 (median: 0.33). Averaged over the whole cohort the therapeutic EMU decreased significantly (2.3% per Gray intra-thyroidal tracer radiation dose). A disease-specific evaluation showed dose-dependent thyroid stunning from 1.2% per Gray in solitary toxic nodules (
n
= 327) to 21% per Gray in goiters (
n
= 135) which was significant for the subgroups of disseminated autonomies (
n
= 114), multifocal autonomies (
n
= 178) and goiters (
p
< 0.05) but not for Graves’ diseases (
n
= 160) and solitary toxic nodules (
p
> 0.05).
Conclusions
The presented data indicate for the first time a significant dependence of pre-therapeutic radiation dose on thyroid stunning in goiter and disseminated and multifocal autonomy. To achieve the desired intra-thyroidal radiation dose, RIT activity should be adapted depending on the dose in RIUT.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30599051</pmid><doi>10.1007/s12020-018-01833-5</doi><tpages>8</tpages></addata></record> |
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| ispartof | Endocrine, 2019-03, Vol.63 (3), p.537-544 |
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| language | eng |
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| source | Springer Nature |
| subjects | Adult Aged Aged, 80 and over Autonomy Benign Diabetes Endocrinology Female Goiter Health risk assessment Humanities and Social Sciences Humans Internal Medicine Iodine Iodine Radioisotopes - adverse effects Iodine Radioisotopes - metabolism Male Medicine Medicine & Public Health Middle Aged multidisciplinary Nodules Original Article Retrospective Studies Science Thyroid carcinoma Thyroid diseases Thyroid Diseases - radiotherapy Thyroid Gland - metabolism Thyroid Gland - radiation effects Ultrasound Young Adult |
| title | Thyroid stunning in radioiodine-131 therapy of benign thyroid diseases |
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