High pre-therapy [Tc-99m]pertechnetate thyroid uptake, thyroid size and thyrostatic drugs: predictive factors of failure in [I-131]iodide therapy in Graves' disease

dc.creatorZantut-Wittmann, DE
dc.creatorRamos, CD
dc.creatorSantos, AO
dc.creatorLima, MMO
dc.creatorPanzan, AD
dc.creatorFacuri, FO
dc.creatorEtchebehere, ECSC
dc.creatorLima, MCL
dc.creatorTambascia, MA
dc.creatorCamargo, EE
dc.date2005
dc.dateNOV
dc.date2014-07-30T17:49:56Z
dc.date2015-11-26T16:28:43Z
dc.date2014-07-30T17:49:56Z
dc.date2015-11-26T16:28:43Z
dc.date.accessioned2018-03-28T23:09:45Z
dc.date.available2018-03-28T23:09:45Z
dc.identifierNuclear Medicine Communications. Lippincott Williams & Wilkins, v. 26, n. 11, n. 957, n. 963, 2005.
dc.identifier0143-3636
dc.identifierWOS:000233176300004
dc.identifier10.1097/01.mnm.0000183795.59097.42
dc.identifierhttp://www.repositorio.unicamp.br/jspui/handle/REPOSIP/68357
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/68357
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1269540
dc.descriptionBackground and objective Several factors may interfere with the success rate of radioiodine therapy (RIT) in Graves' disease. Our aim was to evaluate, retrospectively, some of these factors in the outcome of RIT. Methods Patient gender, age at diagnosis, ophthalmopathy, disease duration, thyroid size, drug used as clinical treatment, thionamide withdrawal period during RIT preparation, FT4, TSH and [Tc-99m]pertechnetate thyroid uptake prior to RIT were studied as potential interference factors for RIT success. Eighty-two Graves' disease patients were submitted to RIT after thionamide treatment failure. Prior to RIT, 67 patients were receiving methimazole and 15 propylthiouracil. Thirty-three patients received thionamides during RIT; in 49 patients the medication was withdrawn for 2-30 days. [Tc-99m]pertechnetate thyroid uptake was determined before RIT. Fixed doses of 370 MBq of [I-131]iodide were administered to all patients. Results Eleven patients became euthyroid; 40 became hypothyroid and 31 remained hyperthyroid. There was no association between outcome and age at diagnosis, gender, ophthalmopathy, pre-RIT FT4, TSH, antithyroid antibodies or thyrostatic drug. Multiple logistic regression showed higher probability of treatment success in patients with thyroid mass < 53 g (odds ratio (OR) = 8.9), with pre-RIT thyroid uptake < 12.5% (OR=4.1) and in patients who withdrew thionamide before RIT (OR=4.9). Conclusions Fixed doses of 370 MBq of radioiodine seem to be practical and effective for treating Graves' disease patients with [Tc-99m]pertechnetate uptake < 12.5% and thyroid mass < 53 g. This treatment is clearly not recommended for patients with large goitre. In contrast to what could be expected, patients with a high pre-RIT thyroid uptake presented a higher rate of RIT failure.
dc.description26
dc.description11
dc.description957
dc.description963
dc.languageen
dc.publisherLippincott Williams & Wilkins
dc.publisherPhiladelphia
dc.publisherEUA
dc.relationNuclear Medicine Communications
dc.relationNucl. Med. Commun.
dc.rightsfechado
dc.sourceWeb of Science
dc.subjectradioiodine therapy
dc.subjectGraves' disease
dc.subject[Tc-99m]pertechnetate thyroid uptake
dc.subjectautoimmune hyperthyroidism
dc.subjectRadioiodine Therapy
dc.subjectTc-99m Pertechnetate
dc.subjectRadioactive Iodine
dc.subjectHyperthyroidism
dc.subjectPropylthiouracil
dc.subjectPeroxidase
dc.subjectI-131
dc.subjectMethimazole
dc.subjectManagement
dc.subjectI-123
dc.titleHigh pre-therapy [Tc-99m]pertechnetate thyroid uptake, thyroid size and thyrostatic drugs: predictive factors of failure in [I-131]iodide therapy in Graves' disease
dc.typeArtículos de revistas


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