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Comparing pre-therapeutic 124I and 131I uptake tests with intra-therapeutic 131I uptake in benign thyroid disorders

  • Endocrine Methods and Techniques
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Abstract

Purpose

124I-PET/CT can be used for pre-therapeutic assessment of radioactive iodine uptake in benign thyroid disorders, however systematic comparisons with intra-therapeutic uptake are still lacking for these disorders. The goals of this study were to compare 124I RAIU and conventional 131I RAIU tests with each other; to compare both tests with intra-therapeutic uptake (reference); and to verify the time course of radioactive iodine uptake at three time points (30, 102, and 336 h [14 days] post administration; p.a.).

Methods

Thirteen patients with benign thyroid diseases underwent 131I RAIU test and 124I RAIU test one after another before the intra-therapeutic 131I uptake (reference) was measured via short-range and long-range measurements. After correction for decay, relative uptake differences were calculated and subjected to the Bland-Altman method for the evaluation of levels of agreement.

Results

Radioactive iodine uptake tests with 124I-PET/CT and 131I probe did not show systematic deviations at any time point. Likewise, at 30 and 102 h p.a. there was no systematic discrepancy between pre-therapeutic and intra-therapeutic uptake levels. At 14 days p.a., however, both pre-therapeutic tests tended to overestimate the uptake compared to reference. Findings showed, for the first time with 124I, that radioiodine therapy has some early radiobiological effects possibly limiting the accuracy of pre-therapeutic dosimetry.

Conclusions

124I RAIU tests represent a feasible alternative to standard 131I RAIU tests. The additional benefits of 124I-PET/CT (e.g., functional topography, inclusion of retrosternal areas, possibility to enable fusion imaging) may thus increase the scope of this technology in benign thyroid disorders.

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Acknowledgements

The authors thank Dr. Ernesta Palombo-Kinne for help in reviewing and translating the manuscript and Dominik Driesch for analyzing the data. This study was funded exclusively by intramural grants of the University Hospital Jena.

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Authors and Affiliations

  1. Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany

    Falk Gühne, Christian Kühnel & Martin Freesmeyer

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  1. Falk Gühne
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Correspondence to Martin Freesmeyer.

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The authors declare that they have no competing interests.

Ethical approval

The study was approved by the local ethics committee and the German Federal Office of Radiation Protection. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. The non-anonymized person in Fig. 2 (solely symbolizing a patient), gave additional full permission for publication.

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Gühne, F., Kühnel, C. & Freesmeyer, M. Comparing pre-therapeutic 124I and 131I uptake tests with intra-therapeutic 131I uptake in benign thyroid disorders. Endocrine 56, 43–53 (2017). https://doi.org/10.1007/s12020-017-1267-8

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