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Iodine biokinetics and radioiodine exposure after recombinant human thyrotropin-assisted remnant ablation in comparison with thyroid hormone withdrawal.
J Clin Endocrinol Metab 2010; 95(7):3283-90JC

Abstract

CONTEXT

A few prospective studies have evaluated the use of recombinant human TSH (rhTSH) for radioiodine remnant ablation.

OBJECTIVE

Our objective was to compare the effects of the both TSH regimens on iodine biokinetics in the thyroid remnant, dosimetry, and radiation protection.

DESIGN

We conducted a prospective randomized study.

MATERIALS AND METHODS

Eighty-eight patients were enrolled for radioiodine ablation to either the hypothyroid or rhTSH arms. A whole-body scan was performed at 48 and 144 h after therapy. Dose rates were assessed at 24, 48, and 144 h. Urinary samples were obtained during the first 48 h. Thyroglobulin was assessed before and after therapy. Iodine biokinetics in the remnants were calculated from gamma-count rates. Radiation-absorbed dose was calculated using OLINDA software. Exposure estimation was based on a validated model.

RESULTS

The effective half-life in the remnant thyroid tissue was significantly longer after rhTSH than during hypothyroidism (P = 0.01), whereas 48-h (131)I uptakes and residence times were similar. After therapy, thyroglobulin release (a marker of cell damage) was lower in the rhTSH arm. The mean total-body effective half-life and residence time were shorter in patients treated after rhTSH. Residence time was also lower for the colon and stomach. Absorbed dose estimates were lower in the rhTSH arm for the lower large intestine, breasts, ovaries, and the bone marrow. Dose rates at the time of discharge were lower in the rhTSH group with a reduction in cumulative radiation exposure to contact persons.

CONCLUSIONS

In comparison with thyroid hormone withdrawal, rhTSH is associated with longer remnant half-life of radioactive iodine while also reducing radiation exposure to the rest of the body and also to the general public who come in contact with such patients.

Authors+Show Affiliations

Service central de Biophysique et de Médecine Nucléaire, Centre Hospitalo-Universitaire de la Timone, 264 rue Saint-Pierre 13385 Marseille Cedex 5, France. david.taieb@ap-hm.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20392868

Citation

Taïeb, D, et al. "Iodine Biokinetics and Radioiodine Exposure After Recombinant Human Thyrotropin-assisted Remnant Ablation in Comparison With Thyroid Hormone Withdrawal." The Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 7, 2010, pp. 3283-90.
Taïeb D, Sebag F, Farman-Ara B, et al. Iodine biokinetics and radioiodine exposure after recombinant human thyrotropin-assisted remnant ablation in comparison with thyroid hormone withdrawal. J Clin Endocrinol Metab. 2010;95(7):3283-90.
Taïeb, D., Sebag, F., Farman-Ara, B., Portal, T., Baumstarck-Barrau, K., Fortanier, C., ... Mundler, O. (2010). Iodine biokinetics and radioiodine exposure after recombinant human thyrotropin-assisted remnant ablation in comparison with thyroid hormone withdrawal. The Journal of Clinical Endocrinology and Metabolism, 95(7), pp. 3283-90. doi:10.1210/jc.2009-2528.
Taïeb D, et al. Iodine Biokinetics and Radioiodine Exposure After Recombinant Human Thyrotropin-assisted Remnant Ablation in Comparison With Thyroid Hormone Withdrawal. J Clin Endocrinol Metab. 2010;95(7):3283-90. PubMed PMID: 20392868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Iodine biokinetics and radioiodine exposure after recombinant human thyrotropin-assisted remnant ablation in comparison with thyroid hormone withdrawal. AU - Taïeb,D, AU - Sebag,F, AU - Farman-Ara,B, AU - Portal,T, AU - Baumstarck-Barrau,K, AU - Fortanier,C, AU - Bourrelly,M, AU - Mancini,J, AU - De Micco,C, AU - Auquier,P, AU - Conte-Devolx,B, AU - Henry,J F, AU - Mundler,O, Y1 - 2010/04/14/ PY - 2010/4/16/entrez PY - 2010/4/16/pubmed PY - 2010/7/27/medline SP - 3283 EP - 90 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 95 IS - 7 N2 - CONTEXT: A few prospective studies have evaluated the use of recombinant human TSH (rhTSH) for radioiodine remnant ablation. OBJECTIVE: Our objective was to compare the effects of the both TSH regimens on iodine biokinetics in the thyroid remnant, dosimetry, and radiation protection. DESIGN: We conducted a prospective randomized study. MATERIALS AND METHODS: Eighty-eight patients were enrolled for radioiodine ablation to either the hypothyroid or rhTSH arms. A whole-body scan was performed at 48 and 144 h after therapy. Dose rates were assessed at 24, 48, and 144 h. Urinary samples were obtained during the first 48 h. Thyroglobulin was assessed before and after therapy. Iodine biokinetics in the remnants were calculated from gamma-count rates. Radiation-absorbed dose was calculated using OLINDA software. Exposure estimation was based on a validated model. RESULTS: The effective half-life in the remnant thyroid tissue was significantly longer after rhTSH than during hypothyroidism (P = 0.01), whereas 48-h (131)I uptakes and residence times were similar. After therapy, thyroglobulin release (a marker of cell damage) was lower in the rhTSH arm. The mean total-body effective half-life and residence time were shorter in patients treated after rhTSH. Residence time was also lower for the colon and stomach. Absorbed dose estimates were lower in the rhTSH arm for the lower large intestine, breasts, ovaries, and the bone marrow. Dose rates at the time of discharge were lower in the rhTSH group with a reduction in cumulative radiation exposure to contact persons. CONCLUSIONS: In comparison with thyroid hormone withdrawal, rhTSH is associated with longer remnant half-life of radioactive iodine while also reducing radiation exposure to the rest of the body and also to the general public who come in contact with such patients. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/20392868/Iodine_biokinetics_and_radioiodine_exposure_after_recombinant_human_thyrotropin_assisted_remnant_ablation_in_comparison_with_thyroid_hormone_withdrawal_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2009-2528 DB - PRIME DP - Unbound Medicine ER -