L‐thyroxine Treatment of Diffuse Non‐toxic Goitre Evaluated by Ultrasonic Determination of Thyroid Volume

Hansen, Jakob Møller; Jp, Kampmann; Madsen, S. Nistrup; Skovsted, L.; Solgaard, Søren; Grytter, Carl; Grqntvedt, T.; Rasmussen, Sten Nørby

doi:10.1111/j.1365-2265.1979.tb03027.x

Cited by 49 publications

(24 citation statements)

References 15 publications

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“…Levothyroxine therapy LT 4 therapy may have a role in the treatment of diffuse goitre, where clinically relevant goitre size reduction (15-40% after 3 months of therapy) has been documented in controlled trials (21)(22)(23)(24). In uninodular goitre, results are conflicting, but there is a trend toward a positive effect in reducing nodule volume after 6-12 months of therapy (25).…”

Section: Non-surgical Treatment Of Benign Non-toxic Mngmentioning

confidence: 74%

Time to reconsider nonsurgical therapy of benign non-toxic multinodular goitre: focus on recombinant human TSH augmented radioiodine therapy

Fast¹,

Nielsen²,

Bonnema³

et al. 2009

European Journal of Endocrinology

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The treatment of benign multinodular goitre (MNG) is controversial, but surgery is recommended in large compressive goitres. While some patients decline surgery others may have contraindications due to comorbidity, since MNG is prevalent in the elderly. Therefore, non-surgical treatment alternatives are needed. Until recently, levothyroxine therapy was the preferred non-surgical alternative, but due to low efficacy and potential side-effects, it is not recommended for routine use in recent international guidelines. Conventional radioiodine ( 131 I) therapy has been used for two decades as an effective and safe alternative to surgery in the treatment of symptomatic non-toxic MNG. Since much higher activities of 131 I are employed when treating non-toxic rather than toxic MNG, there has been reluctance in many countries to use this treatment modality. Frequently, the 131 I -uptake in a non-toxic MNG is low, which makes 131 I therapy less feasible. Another challenge is the negative correlation between the initial goitre size and goitre volume reduction (GVR). With its ability to more than double the thyroid 131 I-uptake, recombinant human TSH (rhTSH) increases the absorbed radiation dose and thus enhances the GVR by 35-56% at the expense of up to fivefold higher rate of permanent hypothyroidism. An alternative strategy is to reduce the administered 131 I-activity with a factor corresponding to the rhTSH induced increase in 131 I-uptake. Hereby, the extrathyroidal irradiation can be reduced without compromising efficacy. Thus, although in its infancy, and still experimental, rhTSH-augmented 131 I therapy may profoundly alter the non-surgical treatment of benign non-toxic MNG.

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Section: Non-surgical Treatment Of Benign Non-toxic Mngmentioning

confidence: 74%

Time to reconsider nonsurgical therapy of benign non-toxic multinodular goitre: focus on recombinant human TSH augmented radioiodine therapy

Fast¹,

Nielsen²,

Bonnema³

et al. 2009

European Journal of Endocrinology

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“…21 A beneficial effect of thyroid hormones on diffuse goiters has been demonstrated in several controlled trials. [22][23][24][25][26][27][28][29] This has not always been possible to prove with nodular goiters. 25 There are only three controlled studies in which ultrasonography has been used for objective size monitoring.…”

Section: Discussionmentioning

confidence: 99%

Metformin Treatment for Small Benign Thyroid Nodules in Patients with Insulin Resistance

Rezzónico

Pusiol

et al. 2011

Metabolic Syndrome and Related Disorders

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“…In contrast with earlier, more enthusiastic reports based on palpation and neck circumference measurements, it is noticeable that goiter shrinking obtained by suppressive hormone therapy rarely exceeds 40% of the initial value [4,12]. Secondary uses of the ultrasound scanning technique are summarized in table III.…”

Section: Thyroid Volumementioning

confidence: 66%

Ultrasound Evaluation of Thyroid Diseases

Leisner¹

1987

Horm Res

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Ultrasound is very sensitive in evaluating the size of the thyroid gland and the presence of nodules within it. There are no specific signs indicative of malignancy though the majority of the differentiated carcinomas and all anaplastic tumors present as a hypoechoic mass. Since autonomous and ‘cold’ adenomas may show a similar echo pattern, a scintigraphic study is mandatory as part of the basic examination, except for euthyroid subjects without any nodularity on the ultrasound scans. Scintigraphically cold, echo-poor solid lesions require additional diagnostic procedures like aspiration cytology or biopsy until malignancy is definitely excluded. Monitoring of the thyroid volume during suppressive hormonal therapy is highly valuable for the early detection of’non-responders’ who probably will benefit from another management.

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L‐thyroxine Treatment of Diffuse Non‐toxic Goitre Evaluated by Ultrasonic Determination of Thyroid Volume

Cited by 49 publications

References 15 publications

Time to reconsider nonsurgical therapy of benign non-toxic multinodular goitre: focus on recombinant human TSH augmented radioiodine therapy

Time to reconsider nonsurgical therapy of benign non-toxic multinodular goitre: focus on recombinant human TSH augmented radioiodine therapy

Metformin Treatment for Small Benign Thyroid Nodules in Patients with Insulin Resistance

Ultrasound Evaluation of Thyroid Diseases

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