B超可以预测Graves病碘剂治疗效果

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Predictors of Radioiodine Therapy Success in Graves' Disease Identified

NEW YORK (Reuters Health) Oct 09 - Thyroid echogenicity predicts outcome of radioiodine therapy in patients with Graves' disease, two researchers from Croatia report in the September issue of the Journal of Clinical Endocrinology and Metabolism.

\"Despite accounting for variations in gland size and iodine kinetics, the success of radioiodine therapy in patients with Graves' disease remains moderately common and unpredictable,\" note Drs. Vinko Markovic and Davor Eterovic of University Hospital Split in their report of a prospective study.

They hypothesized that hypoechogenic glands, \"with large, densely packed cells, are more radiosensitive than normoechogenic glands, in which much radiation is wasted on more abundant colloid.\"

The clinicians tested their hypothesis in a group of 177 patients with Graves' disease who underwent radioiodine therapy and were followed up 1 year after treatment.

Results showed that patients with normoechogenic glands that received 200 Gy had comparable outcomes to patients with hypoechogenic glands that received 100-120 Gy.

\"Clearly, the normoechogenic gland is much more radioresistant, compared with the relatively radiosensitive hypoechogenic gland,\" Drs. Markovic and Eterovic write. \"This was not previously recognized, which may account for a great deal in large uncertainty in the outcome of radioiodine therapy in a single patient with Graves' disease.\"

A large gland volume also emerged as an independent predictor of increased radioiodine therapy resistance.

The authors conclude, based on their findings, that thyroid echogenicity and its size \"must be considered in determining the optimal target dose of radioiodine therapy of patients with Graves' disease. The more echogenic the gland, the greater the absorbed dose required, especially in the case of large glands.\"