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Related Experiment Videos

Decrease of (99m)Tc-uptake in autonomous thyroid tissue in Germany since the 1970s. Clinical implications for

M Gotthardt1, M Stübinger, J Pansegrau

  • 1Nucleaire Geneeskunde, Radboud Universitair Medisch Centrum, Postbus 9101, 6500 HB Nijmegen, Nederland. m.gotthardt@nucmed.umcn.nl

Nuklearmedizin. Nuclear Medicine
|May 20, 2006
PubMed
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Thyroidal autonomy risk assessment using thyroidal (99m)Tc uptake under TSH suppression (TcTUs) has decreased significantly. The upper limit for normal TcTUs should be lowered to 1-1.4% due to a 40% drop over 25 years.

Area of Science:

  • Endocrinology
  • Nuclear Medicine
  • Thyroidology

Background:

  • Thyroidal autonomy poses a risk of hyperthyroidism upon iodine exposure.
  • Thyroidal (99m)Tc uptake under TSH suppression (TcTUs) estimates this risk.
  • The established upper limit for TcTUs is 2%, set 25 years ago.

Purpose of the Study:

  • To investigate changes in TcTUs per ml of autonomous thyroid volume over time.
  • To assess if increased nutritional iodine uptake has influenced TcTUs.
  • To re-evaluate the upper tolerable limit for TcTUs.

Main Methods:

  • Pilot study of 1166 patients (1980-2003) with benign thyroid disorders to assess TcTU/TcTUs changes.
  • Second analysis of 1063 patients (1987-2004) with unifocal autonomy (UFA) for TcTUs per ml calculation.

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  • Statistical analysis including ANOVA to determine significance.

    • Main Results:

    • TcTUs and total thyroid volume have decreased across all benign thyroid disorders (p < 0.01).
    • In UFA patients, TcTUs per ml of autonomous volume significantly fell from 0.48% to 0.28% (p = 0.032).
    • This represents an approximate 40% reduction over 25 years.

    Conclusions:

    • The TcTUs in relation to autonomous thyroid volume has significantly decreased.
    • The current upper limit for normal TcTUs is likely too high.
    • A revised upper limit of 1-1.4% for TcTUs is proposed, considering regional variations.