Is radioiodine therapy conducted too late in patients suffering from thyroid autonomy?]

Aim: The effectiveness of radioiodine therapy (RIT) is proven. The aim of this study was to determine, how much time posses between diagnosis of thyroid autonomy or occurence of functional and/or local symptoms on one hand and RIT on the other bond. Patients, methods: This retrospective study comprises 196 patients, who were treated with rodioiodine for thyroid autonomy between 2002 and 2005. Evaluated parameters are begin of functional and/ or local symptoms, first scintigraphy with relevant Tc-Uptake as time point of primary diagnosis of thyroid autonomy and time point of implementation of RIT. Results: Between first scintigraphy with relevant Tc-Uptake and implementation of RIT 0-72 months passed (median: 3 months). 160 patients (81.6%) had a prior diagnosis of goitre by their general practitioner and 163 patients (83.3%) had a prior diagnosis of TSH suppression. The time period between first recommendation of RIT and implementation of RIT was 0-89 months (median: 2 months). In 142 patients (71.4%) functional and/or local symptoms were present over 73 months (median; range: 0-180 months) before the first scintigraphy with therapy relevant Tc-Uptake was conducted. Condusion: Despite clear recommendations in corresponding guidelines too much time posses between first symptoms (median: 73 months), primary diagnosis of therapy relevant thyroid autonomy (median: 2 months) and implementation of RIT. Patients with functional and/or local symptoms should be examined for thyroid autonomy early. If thyroid autonomy is proven, RIT should be planned immediately, especially in high-risk patients.