Türk Bir Popülasyonda Normal Tiroid Teknesyum- 99m Perteknetat Alım Aralığının Belirlenmesi

Yıl 2021, Cilt: 26 Sayı: 3, 265 - 270, 27.09.2021

Serkan Güngör

https://doi.org/10.21673/anadoluklin.917241

Öz

Amaç: Bu çalışmada Türk bir popülasyonda normal tiroid teknesyum-99m perteknetat alım aralığını belirlemek amaçlanmıştır.
Yöntem: Retrospektif çalışmamız paratiroid adenom lokalizasyonu için uygulanan paratiroid sintigrafisinin bir bileşeni olarak teknesyum-99m perteknetat ile tiroid sintigrafisi yapılan ardışık 73 (54 kadın, 19 erkek) ötiroid hasta içerdi. Her hasta için 20. dakikada tiroid teknesyum- 99m perteknetat alım değeri hesaplandı.
Bulgular: Ortalama hasta yaşı 56,4±15,2 yıl, ortalama tiroid uyarıcı hormon düzeyi 1,15±0,48 uIU/mL idi. Medyan ve çeyrekler arası aralık teknesyum-99m perteknetat alım değerleri sırasıyla %0,8 ve %0,56–1,15 idi. Belirlenen normal tiroid teknesyum-99m perteknetat alım aralığı %0,26–1,64 oldu. Yaş ve teknesyum-99m perteknetat alımı arasında negatif korelasyon gözlendi (r=-0,33; p=0,002).
Sonuç: Türkiye’de kullanımda olanlara kıyasla anlamlı biçimde daha düşük değerlere dayanan yeni normal tiroid teknesyum-99m perteknetat alım aralığımızın, İstanbul nüfusunda tiroid hastalıklarında tiroid fonksiyonu değerlendirmelerinde kullanılmaya uygun olduğu savındayız.

Anahtar Kelimeler

Tiroid;, teknesyum-99m perteknetat;, tiroid sintigrafisi

Determination of the Normal Range for Thyroid Uptake of Technetium-99m Pertechnetate in a Turkish population

Öz

Aim: This study aimed to determine the normal range for thyroid uptake of technetium-99m (99mTc) pertechnetate in a Turkish population.
Methods: The retrospective study included 73 (54 females, 19 males) consecutive euthyroid patients, all of whom underwent thyroid scintigraphy using 99mTc-pertechnetate as a component of parathyroid scintigraphy for parathyroid adenoma localization. The value of thyroid uptake of 99mTc-pertechnetate at the 20th minute was calculated for each patient.
Results: The mean patient age was 56.4±15.2 years; the mean thyroid-stimulating hormone level was 1.15±0.48 uIU/mL. The median and interquartile range values of 99mTc-pertechnetate uptake were 0.8% and 0.56–1.15%, respectively. The normal range for thyroid uptake of 99mTc-pertechnetate was determined to be 0.26–1.64%. There was a negative correlation between 99mTc-pertechnetate uptake and age (r =-0.33, p=0.002).
Conclusion: We propose that our new normal range for thyroid uptake of 99mTc-pertechnetate based on significantly lower values compared with those currently in use in Turkey is appropriate for use to evaluate thyroid function in thyroid disorders in the population of Istanbul.

Anahtar Kelimeler

technetium-99m pertechnetate;, Thyroid;, thyroid scintigraphy

Kaynakça

• Van’t Hoff W, Pover GG, Eiser NM. Technetium-99m in the diagnosis of thyrotoxicosis. Br Med J. 1972;4(5834):203–6.
• Giovanella L, Avram AM, Iakovou I, Kwak J, Lawson SA, Lulaj E, et al. EANM practice guideline/SNMMI procedure standard for RAIU and thyroid scintigraphy. Eur J Nucl Med Mol Imaging. 2019;46(12):2514–25.
• Paras P, Hamilton DR, Evans C, Herrera NE, Lagunas-Solar MC. Iodine-123 assay using a radionuclide calibrator. Int J Nucl Med Biol. 1983;10(2–3):111–5.
• Stanley MM, Astwood EB. The response of the thyroid gland in normal human subjects to the administration of thyrotropin, as shown by studies with I131. Endocrinology. 1949;44(1):49–60.
• Halnan KE. The radioiodine uptake of the human thyroid in pregnancy. Clin Sci. 1958;17(2):281–90.
• Kearns JE, Philipsborn HF Jr. Values for thyroid uptake of I-131 and protein-bound iodine in “normal” individuals from birth to twenty years. Q Bull Northwest Univ Med Sch. 1962;36(1):47–50.
• Blum M, Chandra R. Lower normal values for 131 I thyroid uptake not related to the ingestion of white bread. J Nucl Med. 1971;12(11):743–5.
• Schneider PB. Simple, rapid thyroid function testing with 99mTc-pertechnetate thyroid uptake ratio and neck/thigh ratio. AJR Am J Roentgenol. 1979;132(2):249–53.
• Selby JB, Buse MG, Gooneratne NS, Moore DO. The Anger camera and the pertechnetate ion in the routine evaluation of thyroid uptake and imaging. Clin Nucl Med. 1979;4(6):233–7.
• Anjos DA, Etchebehere EC, Santos AO, Lima MC, Ramos CD, Paula RB, et al. Normal values of [99mTc]pertechnetate uptake and excretion fraction by major salivary glands. Nucl Med Commun. 2006;27(4):395–403.
• Ramos CD, Wittmann DEZ, Etchebehere EC, Tambascia MA, Silva CA, Camargo EE. Thyroid uptake and scintigraphy using 99mTc pertechnetate: standardization in normal individuals. Sao Paulo Med J. 2002;120(2):45–8.
• Hamunyela RH, Kotze T, Philotheou GM. Normal reference values for thyroid uptake of technetium-99m pertechnetate for the Namibian population. J Endocrinol Metab Diabetes S Afr. 2013;18(3):142–7.
• Macauley M, Shawgi M, Ali T, Curry A, Howe K, Howell E, et al. Assessment of normal reference values for thyroid uptake of technetium-99m pertechnetate in a single centre UK population. Nucl Med Commun. 2018;39(9):834–8.
• Wang C, Zhao Y, Shen Y. Inaccuracy of thyroid to background uptake ratio in evaluating technetium-99m-pertechnetate thyroid uptake and establishing an improved algorithm. Asia Ocean J Nucl Med Biol. 2019;7(2):160–71.
• Atkins HL, Richards P. Assessment of thyroid function and anatomy with technetium-99m as pertechnetate. J Nucl Med. 1968;9(1):7–15.
• de Garreta AC, Fisicas CS, Glass HI, Goolden AW. Measurement of the uptake of 99mTc by the thyroid. Br J Radiol. 1968;41(492):896–8.
• Hurley PJ, Maisey MN, Natarajan TK, Wagner HN Jr. A computerized system for rapid evaluation of thyroid function. J Clin Endocrinol Metab. 1972;34(2):354–60.
• Chung JK. Sodium iodide symporter: its role in nuclear medicine. J Nucl Med. 2002;43(9):1188–200.
• Bähre M, Hilgers R, Lindemann C, Emrich D. Physiological aspects of the thyroid trapping function and its suppression in iodine deficiency using 99mTc pertechnetate. Acta Endocrinol. 1987;115(2):175–82.
• Reinhardt MJ, Högerle S, Trupkovic T, Krause TM, Moser E. Influence of urinary iodine excretion on thyroid technetium-99m pertechnetate uptake with and without TSH suppression: what happens when iodine supply increases? Eur J Nucl Med. 1998;25(11):1475–81.
• Steinmaus C, Miller MD, Howd R. Impact of smoking and thiocyanate on perchlorate and thyroid hormone associations in the 2001–2002 national health and nutrition examination survey. Environ Health Perspect. 2007;115(9):1333–8.
• Gatseva P, Vladeva S, Argirova M. Evaluation of endemic goiter prevalence in Bulgarian schoolchildren: results from national strategies for prevention and control of iodine-deficiency disorders. Biol Trace Elem Res. 2007;116(3):273–8.
• Ozpinar A, Kelestimur F, Songur Y, Can O, Valentin L, Caldwell K, et al. Iodine status in Turkish populations and exposure to iodide uptake inhibitors. PLoS One. 2014;9(2):e88206.
• Erdoğan MF, Ağbaht K, Altunsu T, Ozbaş S, Yücesan F, Tezel B, et al. Current iodine status in Turkey. J Endocrinol Invest. 2009;32(7):617–22.
• Gul SS. Wrongs known as right in thyroid scintigraphy and uptake study. Eur Res J. 2019;5(1):142–7.
• Kidokoro-Kunii Y, Emoto N, Cho K, Oikawa S. Analysis of the factors associated with Tc-99m pertechnetate uptake in thyrotoxicosis and Graves’ disease. J Nippon Med Sch. 2006;73(1):10–7.
• Griffin JE. Hypothyroidism in the elderly. Am J Med Sci. 1990;299(5):334–45.