Risk of post-contrast thyroid dysfunction in non-toxic goiter: a matched cohort study

Area of Science:

• Endocrinology
• Radiology
• Thyroidology

Background:

• Iodinated contrast media (ICM) are widely used in medical imaging.
• Thyroid dysfunction is a potential complication following ICM administration.
• Non-toxic goiter is a common thyroid condition, but its association with post-ICM thyroid dysfunction is not well-established.

Purpose of the Study:

• To quantify the risk of thyroid dysfunction after ICM exposure in adults with non-toxic goiter.
• To identify clinical predictors of post-ICM thyroid dysfunction in this population.

Main Methods:

• Retrospective cohort study of adults with ICM exposure (2010-2023).
• Propensity score matching (1:8) of non-toxic goiter cases to controls.
• Primary outcome: TSH-defined thyroid dysfunction within two years post-ICM.
• Logistic regression analysis to determine adjusted odds ratios (aORs).

Main Results:

• Non-toxic goiter was associated with a 3.46-fold increased risk of TSH-defined thyroid dysfunction post-ICM (aOR 3.10).
• Independent predictors included amiodarone use (aOR 11.34), repeated ICM exposure (aOR 1.54), and female sex (aOR 1.96).
• Findings were consistent across sensitivity analyses, including sonographically defined goiter.

Conclusions:

• Non-toxic goiter significantly increases the risk of thyroid dysfunction following iodinated contrast media administration.
• Targeted screening and TSH monitoring are recommended for patients with non-toxic goiter undergoing ICM procedures.
• Early identification of risk factors can aid in preventing adverse thyroid outcomes.