In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 9 ( 2021-9-7), p. e0256727-
Abstract:
Low-iodine diet (LID) is a crucial preparation for radioactive iodine (RAI) treatment or scan in thyroid cancer. The aim of this study is to analyze the influence of thyroid stimulating hormone (TSH) stimulation protocols and other clinical factors on LID adequacy. Thyroid cancer patients who underwent LID for RAI scan or treatment were retrospectively analyzed. Patients were guided to have LID for 2 weeks before RAI administration and urine iodine/creatinine ratio (UICR, μg/g Cr) was measured. TSH stimulation was conducted using either thyroid hormone withdrawal (THW) or recombinant human TSH (rhTSH) injection. Adequacy of LID was classified by UICR as ‘excellent ( 〈 50)’, ‘adequate (50–100)’, ‘inadequate (101–250)’ and ‘poor ( 〉 250)’. A total of 1715 UICR measurements from 1054 patients were analyzed. UICR was significantly higher in case of rhTSH use than THW (72.4 ± 48.1 vs. 29.9 ± 45.8 μg/g Cr, P 〈 0.001). In patients who underwent LID twice using both TSH stimulation protocols alternately, UICR was higher in case of rhTSH than THW regardless of the order of method. Among clinical factors, female, old-age, and the first LID were significant factors to show higher UICR. Although the adequacy of LID was ‘adequate’ or ‘excellent’ in most patients, multivariate analysis demonstrated that THW method, male, young age, and prior LID-experience were significant determinants for achieving ‘excellent’ adequacy of LID. In conclusion, UICR was higher and the proportion of ‘excellent’ LID adequacy was lower with rhTSH than with THW. UICR was higher also in women, old-age, and LID-naïve patients. Further researches are required to suggest effective methods to reduce body iodine pool in case of rhTSH use and to validate the efficacy of such methods on outcomes of RAI treatment.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0256727
DOI:
10.1371/journal.pone.0256727.g001
DOI:
10.1371/journal.pone.0256727.g002
DOI:
10.1371/journal.pone.0256727.t001
DOI:
10.1371/journal.pone.0256727.t002
DOI:
10.1371/journal.pone.0256727.t003
DOI:
10.1371/journal.pone.0256727.t004
DOI:
10.1371/journal.pone.0256727.t005
DOI:
10.1371/journal.pone.0256727.s001
DOI:
10.1371/journal.pone.0256727.s002
DOI:
10.1371/journal.pone.0256727.r001
DOI:
10.1371/journal.pone.0256727.r002
DOI:
10.1371/journal.pone.0256727.r003
DOI:
10.1371/journal.pone.0256727.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
