Thyroid Autonomy

Author(s):  
Luca Giovanella
Keyword(s):  
1996 ◽  
Vol 81 (12) ◽  
pp. 4187-4193 ◽  
Author(s):  
S Dremier ◽  
F Coppée ◽  
F Delange ◽  
G Vassart ◽  
J E Dumont ◽  
...  

2013 ◽  
Vol 52 (05) ◽  
pp. 186-191 ◽  
Author(s):  
P. N. Truong ◽  
B. Bockisch ◽  
K. Zaplatnikov ◽  
W. T. Kranert ◽  
H. Korkusuz ◽  
...  

SummarySince the development of colour coded duplex-sonography (ccds), several attempts have been made to implement this technique for diagnosis of focal lesions in the thyroid. There are controversial discussions on whether ccds might replace thyroid scintigraphy in diagnosis of hyperfunctional thyroid nodules. Aim of this study was the comparison of ccds and thyroid scintigraphy in diagnosis of functional thyroid autonomy. Patients, material and methods: 192 patients with thyroid nodules > 10mm detected by conventional sonography underwent thyroid scintigraphy. Additionally, these patients were subjected to ccds of the thyroid. In total, 286 thyroid nodules were examined by scintigraphy, ccds and blood tests. Results: Thyroid scintigraphy showed 67% of thyroid nodules as hyperfunctional, 19% indifferent and 14% as hypofunctional. Mean 99mTc uptake of hyperfunctional nodules was 2.19%, of indifferent nodules 1.12% and of hypofunctional nodules 1.06% respectively. The ccds allowed perinodular measurement of flow speed (hyperfunctional: 0.23 ± O.1 m/s; hypofunctional: 0.22 ± 0.1; indifferent: 0.21 ± 0.09), resistance index (hyperfunctional: 1.21 ± 1.16; hypofunctional: 0.62 ± 0.48; indifferent: 0.93 ± 1.02) and pulsatility index (hyperfunctional: 0.97 ± 0.45; hypofunctional: 0.84 ± 0.4; indifferent: 1.04 ± 0.6) in all nodules as well as intranodular measurement in some of the nodules (24% in hyperfunctional, 2% in indifferent and 15% in hypofunctional nodules). Statistic analysis of the obtained ccds data did not show any practically relevant correlations (p>0.05) with 99mTc uptake, basal TSH, fT3 or fT4. Conclusion: Thyroid scintigraphy cannot be replaced by ccds for diagnosis of functional thyroid autonomy. Reliable diagnostics still require a combination of thyroid scintigraphy, sonography and blood tests.


Author(s):  
Dirk Becker ◽  
Hans-Jürgen Bair ◽  
Wolfgang Becker ◽  
Erwin Günter ◽  
Walter Lohner ◽  
...  

2008 ◽  
Vol 47 (01) ◽  
pp. 08-12 ◽  
Author(s):  
C. Happel ◽  
N. Döbert ◽  
F. Grünwald ◽  
L. Spilker

SummaryAim: The effectiveness of radioiodine therapy (RIT) is proven. The aim of this study was to determine, how much time passes between diagnosis of thyroid autonomy or occurrence of functional and/or local symptoms on one hand and RIT on the other hand. Patients, methods: This retrospective study comprises 196 patients, who were treated with radioiodine for thyroid autonomy between 2002 and 2005. Evaluated parameters are begin of functional and/ or local symptoms, first scintigraphy with relevant Tc-Uptake as time point of primary diagnosis of thyroid autonomy and time point of implementation of RIT. Results: Between first scintigraphy with relevant Tc-Uptake and implementation of RIT 0–72 months passed (median: 3 months). 160 patients (81.6%) had a prior diagnosis of goitre by their general practitioner and 163 patients (83.3%) had a prior diagnosis of TSH suppression. The time period between first recommendation of RIT and implementation of RIT was 0–89 months (median: 2 months). In 142 patients (71.4%) functional and/or local symptoms were present over 73 months (median; range: 0–180 months) before the first scintigraphy with therapy relevant Tc-Uptake was conducted. Conclusion: Despite clear recommendations in corresponding guidelines too much time passes between first symptoms (median: 73 months), primary diagnosis of therapy relevant thyroid autonomy (median: 2 months) and implementation of RIT. Patients with functional and/or local symptoms should be examined for thyroid autonomy early. If thyroid autonomy is proven, RIT should be planned immediately, especially in high-risk patients.


1995 ◽  
Vol 34 (03) ◽  
pp. 100-103 ◽  
Author(s):  
U. Schrell ◽  
M. Buchfelder ◽  
J. Hensen ◽  
J. Wendler ◽  
M. Gramatzki ◽  
...  

SummaryNeuroendocrine tumors with somatostatin receptor expression may be localized by 111ln-octreotide scintigraphy. This study examines those thyroid conditions where 111 ln-octreotide uptake could be observed also in the thyroid gland. 26 consecutive patients who underwent 111 ln-octreotide scintigraphy for tumor localization were additionally examined for thyroid disease by sonography and 99mTc-pertechnetate scintigraphy. 12 of these patients had no significant thyroid uptake and had an euthyroid normal-sized thyroid gland. 14 patiens with 111ln thyroid uptakes had endemic goiters, two of them with thyroid autonomy and one with Graves’ disease. Thus, 111 ln-octreotide thyroid uptake was predominantly seen in patients with endemic goiter with or without thyroid autonomy.


Thyroid ◽  
2000 ◽  
Vol 10 (12) ◽  
pp. 1073-1079 ◽  
Author(s):  
J. Meller ◽  
A. Jauho ◽  
M. Hüfner ◽  
S. Gratz ◽  
W. Becker

2006 ◽  
Vol 45 (03) ◽  
pp. 101-104
Author(s):  
H. Wengenmair ◽  
J. Kopp ◽  
R. Dorn ◽  
I. Otto ◽  
J. Sciuk ◽  
...  

ZusammenfassungZiel: Die kombinierte Schilddrüsenautonomie wird zurzeit mit unterschiedlichen Konzepten radioiodtherapiert. Der Unterschied liegt in der Berechnung des autonomen Volumens. In dieser retrospektiven Studie wird ein neues Verfahren der Volumenberechnung vorgestellt. Patienten und Methoden: Bei 398 Patienten mit kombinierter Autonomie, die eine gute Korrelation von heißen Knoten und sonographisch zirkumskripten Läsionen aufweisen, wird das Volumen der heißen Knoten anhand der sonographischen und szintigraphischen Messdaten ermittelt und das Volumen der disseminierten Autonomie mit einem Wichtungsfaktor (VF) bewertet. Dieser Faktor entspricht dem Quotienten der Impulsdichte von disseminiertem zu zircumskriptem Gewebe im Schilddrüsenszintigramm. Nach Messung des maximalen Iod-131-Uptakes und der effektiven Halbwertszeit (HWZ) in einem Radioiodtest wird die Aktivitätsmenge für eine Herddosis von 400 Gy ermittelt. Ergebnisse: Die Erfolgsquote beträgt mit und ohne Thyreostase 97% bei einer Hypothyreoserate von 18,6 % in der Bewertung des Therapieerfolges ab dem 4. Monat nach Radiojodtherapie. Schlussfolgerung: Die Radioiodtherapie bei kombinierter Autonomie unter Verwendung eines Wichtungsfaktors (Produkt aus VF und Volumen des perinodulären Gewebes) für die Berechnung der Therapieaktivität des disseminierten Autonomieanteils führt bei Patienten mit guter Korrelation von sonographischem und szintigraphischem Befund zu einer hervorragenden Erfolgsquote.


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