Utilidad de una dieta hipoyódica en el rastreo con 131I en los pacientes con cáncer diferenciado de tiroides

Resultados La yoduria media ± desviación estándar fue 4,3 ± 3 μg/dl en el grupo A y 5,8 ± 3,2 μg/dl en el B. Se obtuvo una diferencia estadísticamente significativa (p < 0,05) entre sus yodurias medias. Conclusiones La realización de una estricta dieta hipoyódica consiguió disminuir de forma significativa la yoduria de los pacientes que iban a ser sometidos a RCT- 131 I. Introduction 131 I whole body scanning (WBS) is useful in the follow-up of patients with differentiated thyroid carcinoma (DTC). The need to follow a low-iodide diet (LID) to optimize WBS is widely recognized but there are few reports that justify this practice. The aim of this study was to assess levels of urinary iodide in patients who underwent WBS in our service and the possible impact of some changes to the diet on these levels. Patients and method Between January 2004 and December 2005, we measured iodide levels in 12-h urine samples by paired-ion-reversed-phase HPLC with electrochemical detection (sensitivity, 0.1 μg/dl) in 371 patients with DTC referred to our service for ablation or follow-up. The patients were divided into 2 groups: patients on hormone withdrawal and strict LID (group A) and those on hormone withdrawal and generic LID (group B). Urinary iodide excretion below 10 μg/dl was considered low. Data were analyzed by ANOVA and χ 2 tests. Results The mean ± standard deviation urinary iodide excretion was 4.3 ± 3 μg/dl in group A and 5.8 ± 3.2 μg/dl in group B. The mean urinary iodide excretion in A group was significantly lower than that in group B (p < 0.05). Conclusions Following a strict LID significantly decreased urinary iodide excretion in patients undergoing WBS. Palabras clave Yoduria Cáncer diferenciado de tiroides Rastreo corporal con 131 I Key words Urinary iodide excretion Differen ted thyroid carcinoma 131 I whole body scanning Bibliografía 1. E.L. Mazzaferri N. Massoll Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin Endocr Relat Cancer 9 2002 227 247 2. P. Lind S. Kohlfürst Respective roles of thyroglobulin, radioiodine imaging, and positron emision tomography in the assesment of thyroid cancer Semin Nucl Med 36 2006 194 205 3. F. Pacini M. Schlumberger H. Dralle R. Elisei J.W. Smit W. Wiersinga European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium Eur J Endocrinol 154 2006 781 803 4. D.A. Meier D.R. Brill D.V. Becker S.E. Clarke E.B. Silberstein H.D. Royal Procedure guideline for therapy of thyroid disease with 131iodine J Nucl Med 43 2002 856 861 5. K.B. Ain P.A. Dewitt T.G. Gardner S.W. Berryman Low-iodine tube-feeding diet for iodine-131 scanning and therapy Clin Nucl Med 19 1994 504 507 6. F. Pacini P.W. Ladenson M. Schlumberger A. Driedger M. Luster R.T. Kloos Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin in differentiated thyroid carcinoma: results of an international, randomized, controlled study J Clin Endocrinol Metab 91 2006 926 932 7. J.V. Ruiz Franco-Baux I. Borrego Dorado P. Gómez Camarero J.R. Rodríguez Rodríguez R.J. Vázquez Albertino E. Navarro González PET con 18 FDG en pacientes con cáncer diferenciado de tiroides que presentan niveles elevados de tiroglobulina sérica y rastreos con 131 I negativos Rev Esp Med Nucl 24 2005 5 13 8. J. Rendel S. Seybold W. Börner Urinary iodide determined by paired-ion-reversed-phase HPLC with electrochemical detection Clin Chem 40 1994 908 913 9. J. Rendl D. Bier T. Groh C. Reiners Rapid urinary iodide test J Clin Endocrinol Metab 83 1998 1007 1012 10. J.T. Dunn Editorial: What’s happening to our iodine? J Clin Endocrinol Metab 83 1998 3398 3400 11. WHO, UNICEF, ICCIDD Indicators for assessing iodine deficiency disorders and their control through salt iodization 1994 World Health Organization Geneva 12. D.V. Becker C.T. Sawin Radioiodine and thyroid disease: the beginning Semin Nucl Med 26 1996 155 164 13. N.B. Amstein J.E. Carey S.A. Spaulding J.C. Sisson Determination of iodine-131 diagnostic dose for imaging metastatic thyroid cancer J Nucl Med 27 1986 1764 1769 14. C.M. Intenzo S. Jabbour H.Q. Dam D.M. Capuzzi Changing concepts in the managament of differentiated thyroid cancer Semin Nucl Med 35 2005 257 265 15. M. Luster S.I. Sherman M.C. Skarulis J. Reynolds M. Lassmann H. Hänscheid Comparision of radio-iodine biokinelies following the administration of recombinant human thyroid stimulating hormone and alter thyroid hormone withdrawal in thyroid carcinoma Eur J Nucl Med Mol Imaging 30 2003 1371 1377 16. R.J. Robbins R.M. Tuttle R.N. Sharaf S.M. Larson H.K. Robbins R.A. Ghossein Preparation by recombinant human thyrotropin or thyroid hormone withdrawal are comparable for the detection of residual differentiated thyroid carcinoma J Clin Endocrinol Metab 86 2001 619 625 17. P.W. Souza T. Alvarenga L. Lamego E. Lanza M.A. Riheiro A.L. Barroso Assessing hypotiroidism in the preparation of patients with thyroid cancer cardiovascular risk, renal function, drug metabolism, persistence of elevated thyroid-stimulating hormona, and absence from work Endocrinologist 16 2006 25 29 18. J.C. Reynolds J. Robbins The changing role of radioiodine in the managament of differentiated thyroid cancer Semin Nucl Med 27 1997 152 164 19. J.G. Hollowell N.W. Staehling W.H. Hannon D.W. Flanders E.W. Gunter G.F. Maberly Iodine Nutrition in the United States. Trends and Public Health Implications: Iodine Excretion Data from National Health and Nutrition Examination Surveys I and III J Clin Endocrinol Metab 83 1998 3401 3408 20. H.R. Maxon E.E. Englaro S.R. Thomas V.S. Hertzberg J.D. Hinnefeld L.S. Chen Radioiodine-131 therapy for well-differentiated thyroid cancer-A quantitative radiation dosimetric approach: outcome and validation in 85 patients J Nucl Med 33 1992 1132 1136