根据高锝[99mTc]酸盐的甲状腺摄取情况为临界甲状腺功能亢进患者选择放射性碘治疗剂量：对单灶性甲状腺自主性的适用性？

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

作者信息

Reinhardt Michael J, Biermann Kim, Wissmeyer Michael, Juengling Freimut D, Brockmann Holger, von Mallek Dirk, Ezziddin Samer, Joe Alexius Y, Krause Thomas M

机构信息

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

出版信息

Eur J Nucl Med Mol Imaging. 2006 May;33(5):608-12. doi: 10.1007/s00259-005-0051-9. Epub 2006 Mar 16.

DOI:10.1007/s00259-005-0051-9

PMID:16541268

Abstract

PURPOSE

The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on (99m)Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU(s)) 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 (131)I, 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 TcTU(s) (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 TcTU(s) can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid.

摘要

目的

本研究旨在评估将先前描述的基于促甲状腺素抑制下的（99m）锝高锝酸盐甲状腺摄取量（TcTU(s)）的剂量策略应用于单灶性甲状腺自主性的放射性碘治疗的可行性。

方法

共有425例连续的单灶性甲状腺自主性患者（302例女性，123例男性；年龄63.1±10.3岁）在三个不同中心接受了（131）I治疗，使用Marinelli公式计算三种不同的吸收剂量方案：根据治疗前的TcTU(s)，对甲状腺总体积给予100 - 300 Gy（n = 146），对结节体积给予300 Gy（n = 137），对结节体积给予400 Gy（n = 142）。

结果

在接受甲状腺体积100 - 300 Gy的患者中，94.5%在放射性碘治疗后平均12个月时成功消除功能性甲状腺自主性并伴有甲状腺功能正常或减退；在接受结节体积300 Gy的患者中，89.8%出现此情况；在接受结节体积400 Gy的患者中，94.4%出现此情况。甲状腺体积缩小在甲状腺每侧100 - 300 Gy和结节每侧400 Gy策略中最高（分别为36±19%和38±20%），而在结节每侧300 Gy策略中显著更低（28±16%；p<0.01）。