OBJECTIVE:When using radioiodine for hyperthyroidism there is no consensus regarding the administration of fixed or calculated doses. Guidelines do not specify the preferable approach or the parameters to use to calculate the dose. Therefore, the dose might be quite different with regard to the chosen procedure. This study was undertaken to evaluate the variability of the amount of radioiodine administered in Belgium in various cases of hyperthyroidism. DESIGN AND PATIENTS:Twenty-one Belgian nuclear medicine physicians received summarized clinical files from 10 patients suffering from overt hyperthyroidism (n = 7) or subclinical hyperthyroidism (n = 3). Five patients had homogeneous goiters, one had multinodular goiter, and four had hot nodule. Participants had to determine the radioiodine dose (millicuries, mCi) they would give in each case. RESULTS:Proposed doses varied between 2 mCi and 25 mCi. Mean proposed dose for nodular disease was 10.71 mCi; it was 6.79 mCi for homogeneous goiter. For individual cases, a difference between the lowest and the highest dose of more than 17 mCi was observed in more than 50% of the cases. CONCLUSIONS:We believe that more precise guidelines are mandatory, underlying uncertainties, controversies but recommending however, as minimal and maximal doses to administer, as well as clinical and biological parameters, if any, to be taken into account in order to modulate these doses.

译文

目的:使用放射性碘治疗甲状腺功能亢进症时,关于固定剂量或计算剂量的使用尚无共识。指南未指定用于计算剂量的首选方法或参数。因此,就所选择的程序而言,剂量可能会完全不同。进行这项研究是为了评估比利时在各种甲亢患者中施用的放射性碘的量的变异性。
设计和患者:21名比利时核医学医生从10例患有明显甲状腺功能亢进(n = 7)或亚临床甲状腺功能亢进(n = 3)的患者那里获得了总结的临床档案。 5例均患有甲状腺肿,1例患有多结节性甲状腺肿,4例患有热结节。参与者必须确定每种情况下的放射性碘剂量(毫厘米,mCi)。
结果:建议剂量在2 mCi和25 mCi之间变化。结节性疾病的平均建议剂量为10.71 mCi。均匀甲状腺肿为6.79 mCi。对于个别病例,在超过50%的病例中,观察到的最低剂量和最高剂量之间的差异超过17 mCi。
结论:我们认为,更精确的指南是强制性的,潜在的不确定性,争议,但建议作为调节这些剂量的最小和最大剂量,以及临床和生物学参数(如有),都应考虑在内。

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