Radioiodine uptake measurements at 24 hours are sufficient for the evaluation and therapy of hyperthyroidism.
Notice bibliographique
Résumé
237 Objectives: Hyperthyroidism is commonly treated with thyroid radioiodine ablation with varying rates of success. Patients for whom initial treatment has failed often proceed to repeat radioiodine therapy. In this study, we aimed to retrospectively investigate factors that may impact initial treatment success, with particular attention to rapid iodine turnover as a cause of treatment failure. Methods Consecutive patients undergoing radioiodine treatment for hyperthyroidism between 2010 and 2014 at the Hospital of the University of Pennsylvania and at Pennsylvania Hospital were included. We evaluated all patients for whom repeat treatment was necessary. Patients’ charts were retrospectively reviewed for data regarding demographics, diagnosis, thyroid function tests, thyroid size, radioiodine uptake (RAIU), administered radioiodine treatment dose, and competing medications. Results A total of 269 patients with hyperthyroidism underwent initial thyroid radioiodine ablation. Patients were followed for a mean of 35.8 months (range 12-59 months). Fourteen (5%) of these patients required one retreatment for a total of 283 treatments overall. Thyroid uptake was measured at 2 hours and 24 hours in 9 of the retreated patients, with a mean 2- to 24-hour uptake ratio of 0.72 (range: 0.24 - 1.05); only one patient had a 2- to 24-hour ratio > 1 suggestive of rapid iodine turnover. In the other 5 retreated patients an uptake ratio could not be calculated because thyroid uptake was not measured at 2 hours; however, in these patients the mean 24 h uptake was markedly elevated, measuring 83% (range: 71 - 95%), thereby making rapid iodine turnover less likely. With regard to treatment dose, five of the retreated patients (36%) received a dose of radioiodine below our institutional target of 0.2 mCi per gram of thyroid tissue, due to treating physician discretion. The thyroid glad was markedly enlarged in these 5 cases, using thyroid volumes determined by ultrasound (n=4) or physical exam (n=1), with a mean size of 80 g (range: 54 - 124 g) yielding a mean dose of 0.12 mCi/g (range: 0.07 - 0.16 mCi/g). At the time of I-131 treatment none of the patients were taking concurrent anti-thyroid medications (such as methimazole or PTU), or had a recent iodine load (such as iodinated IV contrast). Conclusion Rapid iodine turnover does not appear to be a significant cause of treatment failure in patients undergoing radioiodine ablation for hyperthyroidism at our institution. In addition, the overall treatment failure rate (5%) at our institution seems to be low when a treatment dose of 0.2 mCi/g is adhered to. These findings are limited by the small sample size, and lack of 2-hour uptake measurements in some patients. Also, our treatment failure rate is likely underestimated because patients with recurrent hyperthyroidism that were not retreated with radioiodine, or were retreated at a different institution, were not included in our analysis. Thus, further study is needed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».