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The Impact of Iodinated Contrast Agent Administered During Preoperative Computed Tomography Scan on Body Iodine Pool in Patients with Differentiated Thyroid Cancer Preparing for Radioactive Iodine Treatment
- Source :
- Thyroid. 24:872-877
- Publication Year :
- 2014
- Publisher :
- Mary Ann Liebert Inc, 2014.
-
Abstract
- Iodine in iodinated contrast agents (ICAs) interferes with radioactive iodine treatment (RAIT) and diagnostic scans in patients with differentiated thyroid carcinoma (DTC) because it can compete with ¹³¹I. Published guidelines recommend delaying RAIT for three to four months in patients who have been exposed to ICA. Spot urinary iodine concentration is a useful marker to reflect the body iodine pool. We investigated the impact of ICAs administered at preoperative computed tomography (CT) scan on the body iodine pool to determine the proper time interval between preoperative CT and RAIT in DTC patients.We performed a retrospective review of 1023 patients with DTC who underwent a preoperative CT scan with ICA, total thyroidectomy, and one week of low-iodine diet in preparation for RAIT. Urine iodine excretion (UIE) was measured in spot urine by inductively coupled plasma mass spectrometry and reported both in simple concentration (μg/L) and divided by gram creatinine (μg/gCr). Patients were divided into five groups by time interval in days between preoperative CT scan and spot urine iodine measurement (A, 31-60 [n=29]; B, 61-90 [n=155]; C, 91-120 [n=546]; D, 121-150 [n=226]; E, 151-180 [n=67]).The median (interquartile range) of UIE (μg/gCr) in each group was 44.4 (27.7-73.2) in group A, 33.3 (22.8-64.7) in group B, 32.7 (20.8-63.0) in group C, 32.0 (20.6-67.0) in group D, and 30.4 (19.6-70.8) in group E. There was no significant difference between group A and the remaining groups (p0.05) Also, the proportion of patients who achieved the appropriate UIE for RAIT according to our hospital's cutoff (≤66.2 μg/gCr) was not different between groups (A, 72.4%; B, 76.1%; C, 77.5%; D, 74.8%; E, 74.6%) (p=0.78).This study shows that a UIE of one month after preoperative CT scan with ICA was not higher than that of six months after CT scan in patients who underwent total thyroidectomy for DTC. Thus, current guidelines that recommend delay of RAIT for three to four months after CT scan with ICA should be revisited and future studies to clarify the appropriate time interval between CT scan with ICA and RAIT are warranted.
- Subjects :
- Adult
Male
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Thyroid Gland
Contrast Media
chemistry.chemical_element
Iodinated Contrast Agent
Iodine
Preoperative care
Iodine Radioisotopes
Tertiary Care Centers
Endocrinology
Iodinated contrast
Preoperative Care
Republic of Korea
medicine
Humans
Drug Interactions
Thyroid Neoplasms
Thyroid cancer
Retrospective Studies
business.industry
Carcinoma
Thyroid
Thyroidectomy
Middle Aged
medicine.disease
Carcinoma, Papillary
Renal Elimination
medicine.anatomical_structure
chemistry
Thyroid Cancer, Papillary
Practice Guidelines as Topic
Female
Radiotherapy, Adjuvant
Radiology
Radiopharmaceuticals
Tomography, X-Ray Computed
Nuclear medicine
business
Biomarkers
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 15579077 and 10507256
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Thyroid
- Accession number :
- edsair.doi.dedup.....e5325a54c838e82becb980b357474e7a