Recombinant human thyrotropin (rhTSH)-aided radioiodine treatment for non-toxic multinodular goitre

Huo, Yanlei; Xie, Junxia; Chen, Suyun; Wang, Hui

doi:10.1002/14651858.cd010622.pub2

Cited by 3 publications

(5 citation statements)

References 65 publications

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“…Additionally, an increase in tumor RAIU could, similar to that in people, promote 131 I treatment efficacy and, subsequently, reduce the need for multiple treatments to effectively treat TC in dogs. 15 , 16 Depending on the magnitude of impact on treatment efficacy in dogs with TC, optimization of 131 I therapy could enable a 131 I dose reduction with maintenance of the increased treatment efficacy as seen in people with MNG. 19 Both, the reduction of 131 I treatments and 131 I dose, would contribute to the ALARA principle.…”

Section: Discussionmentioning

confidence: 99%

“…11,13 In people, 131 I is mainly applied in the therapeutic management and follow-up of differentiated TC after surgery and in the therapeutic management of multinodular goiter (MNG). 14,15 Therefore, recombinant human thyroid stimulating hormone (rhTSH) is used to prepare these patients for 131 I therapy and follow-up, resulting in an increased RAIU, reduced whole-body and environmental radiation exposure and increased thyroglobulin surveillance sensitivity. [14][15][16] In fact, TSH is responsible for uptake of (radioactive) iodine in the thyroid follicular cell through activation of the TSH receptor (TSHR) in which prolonged activation (>24 hours) stimulates the expression and function of the NIS and, subsequently, increases iodide uptake and organification.…”

Section: Introductionmentioning

confidence: 99%

“…14,15 Therefore, recombinant human thyroid stimulating hormone (rhTSH) is used to prepare these patients for 131 I therapy and follow-up, resulting in an increased RAIU, reduced whole-body and environmental radiation exposure and increased thyroglobulin surveillance sensitivity. [14][15][16] In fact, TSH is responsible for uptake of (radioactive) iodine in the thyroid follicular cell through activation of the TSH receptor (TSHR) in which prolonged activation (>24 hours) stimulates the expression and function of the NIS and, subsequently, increases iodide uptake and organification. 17,18 Exceptionally in MNG, use of rhTSH before 131 I results in a significant greater volume reduction of the thyroid nodules compared to 131 I alone and enables a 131 I dose reduction.…”

Section: Introductionmentioning

confidence: 99%

“…17,18 Exceptionally in MNG, use of rhTSH before 131 I results in a significant greater volume reduction of the thyroid nodules compared to 131 I alone and enables a 131 I dose reduction. 15,19 A similar effect of rhTSH on RAIU is highly desirable in the 131 I treatment of TC in dogs to comply with the "as low as reasonably achievable" (ALARA) principle, a radiation safety principle in radiology. 9 In dogs, rhTSH aids in the diagnosis of hypothyroidism when a TSH stimulation test is indicated.…”

Section: Introductionmentioning

confidence: 99%

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Effect of recombinant human thyroid stimulating hormone on radioactive iodine uptake by thyroid carcinoma in dogs

Scheemaeker,

Peremans,

Vandermeulen

et al. 2024

Veterinary Internal Medicne

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BackgroundThe high doses of radioiodine‐131 (131I) and, subsequently, the high radioactive burden for dog and environment warrants optimization of 131I therapy in dogs with thyroid carcinoma (TC).Hypothesis/ObjectivesTo evaluate the effect of a revised protocol with recombinant human thyroid stimulating hormone (rhTSH) on tumor radioactive iodine uptake (RAIU) in dogs with TC.AnimalsNine client‐owned dogs diagnosed with TC.MethodsA prospective cross‐over study in which tumor RAIU was calculated and compared at 8 hours (8h‐RAIU) and 24 hours (24h‐RAIU) after injection of radioactive iodine‐123 (123I), once with and once without rhTSH (ie, 250 μg, IM, 24 and 12 hours before 123I) in each dog. Simultaneously, serum total thyroxine (TT4) and TSH were measured at baseline (T0), and 6 (T6), 12 (T12), 24 (T24), and 48 hours (T48) after the first rhTSH administration.ResultsTumor RAIU was significantly higher at 24 hours with rhTSH compared to no rhTSH (mean difference = 8.85%, 95% CI of [1.56; 16.14]; P = .03), while this was non‐significant at 8 hours (mean difference = 4.54%, 95% CI of [0.35; 8.73]; P = .05). A significant change of serum TT4 (median difference T24 − T0 = 35.86 nmol/L, interquartile range [IQR] = 15.74 nmol/L) and TSH (median difference T24 − T0 = 1.20 ng/mL, IQR = 1.55 ng/mL) concentrations occurred after administration of rhTSH (P < .001).Conclusions and Clinical ImportanceRecombinant human TSH could optimize 131I treatment in dogs with TC by increasing tumor RAIU and thus 131I treatment efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of recombinant human thyroid stimulating hormone on radioactive iodine uptake by thyroid carcinoma in dogs

Scheemaeker,

Peremans,

Vandermeulen

et al. 2024

Veterinary Internal Medicne

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“…As a result, in nontoxic MNG, rhTSH and RAI treatment provide a greater reduction in thyroid volume, while the risk of hypoparathyroidism increases. [91] After RAI treatment, especially in the first 48 h, one should be prepared for findings such as dyspnea due to an increase in goiter size, difficulty in swallowing, swelling, and tenderness in the goiter area, and tachycardia. Painful thyroiditis or thyrotoxicosis after treatment is usually seen within 1 month.…”

Section: Levothyroxine Suppression Treatment (L-t4 Treatment)mentioning

confidence: 99%

Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment

Unlu¹

2022

Sisli Etfal

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Goiter term is generally used for defining the enlargement of thyroid gland. Thyroid nodules are very common and some of these nodules may harbor malignancy. Multinodular goiter (MNG) disease without thyroid dysfunction is defined as non-toxic MNG. There are many factors in etiology for development of MNG. They can be classified as iodine dependent and non-iodine dependent factors basically. Beyond this basic classification, the effect of many environmental and acquired factors is also effective on the development of goiter. Many methods have described for diagnosis and treatment for non-toxic MNG. Biochemical tests, imagining methods, invasive and non-invasive methods have been used for diagnosis for many years. Each method has advantages and disadvantages, separately. Although the best method for diagnosis is still debatable, distinguishing malignant nodules from benign nodules is the first and most important step for MNG. Biochemical tests such as serum thyroid stimulating hormone (TSH) measurement, thyroid hormone measurement; and thyroid ultrasonography are used for diagnosis of MNG, traditionally. Nowadays, there are some new techniques were developed like ultrasound-elastography. Furthermore, thyroid scintigraphy may be used if there is abnormal TSH measurement. Fine-needle aspiration biopsy and some cross-sectional imaging methods (computed tomography, magnetic resonance imaging, and positron emission tomography) could be used, too. After a certain diagnosis is made, treatment options should be evaluated. Many treatment methods have been used for goiter from ancient times upon today. From non-invasive methods such as medical follow-up to invasive methods such as lobectomy or thyroidectomy are options for treatment. Patients with compression symptoms due to an enlarged thyroid gland are usually candidates for surgery. In this study, it is aimed to determine the most appropriate treatment for the patient by discussing the advantages and disadvantages of all these methods. The present review discusses definition of goiter term, etiology, epidemiology, pathogenesis, diagnostic methods, and treatment methods for nontoxic MNG.

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What are the benefits and harms of recombinant human thyrotropin (rhTSH)-aided radioiodine treatment for people with non-toxic multinodular goiter?

Vincent¹

2022

Cochrane Clinical Answers

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Recombinant human thyrotropin (rhTSH)-aided radioiodine treatment for non-toxic multinodular goitre

Cited by 3 publications

References 65 publications

Effect of recombinant human thyroid stimulating hormone on radioactive iodine uptake by thyroid carcinoma in dogs

Effect of recombinant human thyroid stimulating hormone on radioactive iodine uptake by thyroid carcinoma in dogs

Non-Toxic Multinodular Goiter: From Etiopathogenesis to Treatment

What are the benefits and harms of recombinant human thyrotropin (rhTSH)-aided radioiodine treatment for people with non-toxic multinodular goiter?

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