[Is radioiodine therapy conducted too late in patients suffering from thyroid autonomy?]

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.

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.

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.

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.