Volumenreduktion der Schilddrüse nach Radiojodtherapie bei Patienten mit Schilddrüsenautonomie und Morbus Basedow

Dederichs, B.; Otte, R.; Klink, J. E.; Schicha, H.

doi:10.1055/s-0038-1629802

Cited by 18 publications

(12 citation statements)

References 18 publications

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“…Up to now, the effects of a thyroid-specific medication on the glucose metabolism of the thyroid were not subject of detailed investigations and would have to be clarified in further studies. The influence of a radioiodine therapy on these disease-specific changes of glucose metabolism of the thyroid remains unclear so far, whereas the effects of the radioiodine therapy on thyroid iodine metabolism, the TcTU and the volume are well documented (Als et al, 1997;Luster et al, 1995;Dederichs et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Glucose metabolism of the thyroid in autonomous goiter measured by F-18-FDG-PET

Voth²,

Theissen³

et al. 2000

Exp Clin Endocrinol Diabetes

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The radiolabeled glucose analogue F-18-Fluoro-Deoxyglucose (F-18-FDG) and Positron Emission Tomography (PET) were used to measure glucose metabolism of the thyroid in vivo. We evaluated patients with autonomous goitre before therapy with radioiodine in comparison to patients with normal thyroids. 30 patients with autonomous goitre underwent scanning the day before radioiodine therapy. 19 patients with head or brain tumours and normal thyroids were the controls. Overall F-18-FDG uptake was determined for all thyroids and proved to be significantly higher in autonomy patients compared to controls and in disseminated autonomous goitre slightly but not significantly higher than in focal autonomy. In autonomy patients F-18-FDG uptake increased with increasing radioiodine uptake and shorter radioiodine half-life. These results indicate that glucose metabolism is enhanced in the thyroids of patients with focal and disseminated autonomy. The negative correlation of radioiodine half-life and glucose metabolism as well as the positive correlation of radioiodine uptake and glucose metabolism suggest connections of glucose metabolism and iodine-dependent hormone synthesis in thyroid cells.

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Section: Discussionmentioning

confidence: 99%

Glucose metabolism of the thyroid in autonomous goiter measured by F-18-FDG-PET

Voth²,

Theissen³

et al. 2000

Exp Clin Endocrinol Diabetes

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“…Des Weiteren ist nach Radioiodtherapie eine zunehmende Reduktion des Strumavolumens über die folgenden 3-4 Jahre zu erwarten (10). Aufgrund der strahlenschutzrechtlichen Auflagen in Deutschland ist die Radioiodtherapie großvolumiger Strumen mit höheren Aktivitäten und einem längeren Aufenthalt verbunden (54,70).…”

Section: Therapie Der Großvolumigen Strumaunclassified

Prevention, screening and therapy of thyroid diseases and their cost-effectiveness

Dietlein¹,

Moka²,

Schmidt³

et al. 2003

Nuklearmedizin

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Summary:Cost-effectiveness analyses focused on benign thyroid diseases are under-represented in the literature. The calculation of costs per additionally gained life year is difficult: The benefit of prevention is shifted into the distant future. The influence of an untreated subclinical thyroid disease on life expectancy can only be demonstrated by a long-term follow-up and by epidemiological databases. Iodine supplementation and programs for the prevention of tobacco smoking (primary prevention) are very cost-effective. Smoking increases the risk both of multinodular goiter and of Graves’ disease. Screening programs (secondary prevention) are discussed for the laboratory parameters thyrotropin (TSH), calcium and calcitonin. TSH testing seems to be very cost-effective for epidemiological considerations in a certain lifespan (newborn, pregnancy, postpartal, older persons, hospitalisation due to acute diseases) and in persons with previously elevated TPO-antibodies or TSH-values >2 mU/l, but dedicated cost-effectiveness analyses are lacking. On the other hand, the cost-effectiveness of a routine TSH testing beyond the age of 35 years has been shown by a high-quality decision analysis. Therapeutic strategies (tertiary prevention) aim at the avoidance of complications (atrial fibrillation, myocardial infarction, death for cardiac reasons) and of iatrogenic complications. Examples of a tertiary prevention are: firstly the definitive therapy of Graves’ disease in patients who have an increased risk of relapse after antithyroid drugs (ATD), secondly the radioiodine therapy for subclinical hyperthyroidism and the radioiodine therapy of large goiters in older patients or in patients suffering from a relevant comorbidity. Cost-effectiveness analyses for different therapeutic strategies of Graves’ disease were published using a lifelong time-horizon. The ablative radioiodine dose-regime is cost-effective as a first line therapy if the risk of relapse after ATD exceeds 60%.

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“…Auch der Einfluß einer Radioiod-Therapie auf diese krankheitsspezifischen Veränderungen des Glukosemetabolismus der Schilddrüse bleibt leider bisher unklar, während die Auswirkungen der Radioiod-Therapie auf den Iodmetabolismus, den TcTU und das Volumen gut dokumentiert sind (1,7,23).…”

Section: Disseminierte Autonomienunclassified

F-18-FDG-PET bei Schilddrüsen-Autonomien

Börner¹,

Voth²,

Wienhard³

et al. 1999

Nuklearmedizin

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Zusammenfassung: Ziel: Die Schilddrüsenautonomie im lodmangelgebiet beruht in der Mehrzahl der Fälle auf konstitutiven, funktionsaktivierenden Mutationen des Thyreotropin-(TSH-)Rezeptors. Diese Studie evaluiert F-18-Fluoro-Deoxy-Glukose-(F-18-FDG-)PET der Schilddrüse bei Patienten mit funktionell relevanter Autonomie der Schilddrüse. Methoden: 20 Patienten mit fokaler und 10 Patienten mit disseminierter Autonomie der Schilddrüse wurden am Tag vor geplanter Radioiod-Therapie mit FDG-PET untersucht. 20 Patienten mit Kopf/Halstumoren und normaler Schilddrüsenfunktion dienten als Kontrollgruppe. Ergebnisse: Die F-18-FDG-Aufnahme in die Schilddrüse war signifikant höher bei Patienten mit funktionell relevanter Autonomie im Vergleich zu den Kontrollen. Fokale Autonomien zeichneten sich ausnahmslos durch einen intensiven, fokal gesteigerten Glukose-Uptake aus, während disseminierte Autonomien ein variables Muster globaler Steigerungen des Glukose-Uptakes zeigten. Schlußfolgerung: Funktionelle Autonomien der Schilddrüse zeigen einen gleichzeitig gesteigerten Glukose- und lodstoffwechsel als Folge der konstitutiven Mutation des TSH-Rezeptors, wobei das Ausmaß beider Veränderungen positiv korreliert.

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Volumenreduktion der Schilddrüse nach Radiojodtherapie bei Patienten mit Schilddrüsenautonomie und Morbus Basedow

Cited by 18 publications

References 18 publications

Glucose metabolism of the thyroid in autonomous goiter measured by F-18-FDG-PET

Glucose metabolism of the thyroid in autonomous goiter measured by F-18-FDG-PET

Prevention, screening and therapy of thyroid diseases and their cost-effectiveness

F-18-FDG-PET bei Schilddrüsen-Autonomien

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