Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.

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 underw...

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Autores principales:	Hwanhee Lee, Jin Chul Paeng, Hongyoon Choi, Sun Wook Cho, Young Joo Park, Do Joon Park, Young Ah Lee, June-Key Chung, Keon Wook Kang, Gi Jeong Cheon
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/527c40551e14447dac085597a6382c97
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spelling	oai:doaj.org-article:527c40551e14447dac085597a6382c972021-12-02T20:08:29ZEffect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.1932-620310.1371/journal.pone.0256727https://doaj.org/article/527c40551e14447dac085597a6382c972021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256727https://doaj.org/toc/1932-6203Low-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.Hwanhee LeeJin Chul PaengHongyoon ChoiSun Wook ChoYoung Joo ParkDo Joon ParkYoung Ah LeeJune-Key ChungKeon Wook KangGi Jeong CheonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256727 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hwanhee Lee Jin Chul Paeng Hongyoon Choi Sun Wook Cho Young Joo Park Do Joon Park Young Ah Lee June-Key Chung Keon Wook Kang Gi Jeong Cheon Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
description	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.
format	article
author	Hwanhee Lee Jin Chul Paeng Hongyoon Choi Sun Wook Cho Young Joo Park Do Joon Park Young Ah Lee June-Key Chung Keon Wook Kang Gi Jeong Cheon
author_facet	Hwanhee Lee Jin Chul Paeng Hongyoon Choi Sun Wook Cho Young Joo Park Do Joon Park Young Ah Lee June-Key Chung Keon Wook Kang Gi Jeong Cheon
author_sort	Hwanhee Lee
title	Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
title_short	Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
title_full	Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
title_fullStr	Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
title_full_unstemmed	Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
title_sort	effect of tsh stimulation protocols on adequacy of low-iodine diet for radioiodine administration.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/527c40551e14447dac085597a6382c97
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_version_	1718375181037076480

Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration.

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