HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Døssing, H. Articles by Hegedüs, L. Search for Related Content PubMed PubMed Citation Articles by Døssing, H. Articles by Hegedüs, L.

Randomized prospective study comparing a single radioiodine dose and a single laser therapy session in autonomously functioning thyroid nodules

Department of Oto-Rhino-Laryngology and Neck Surgery, Odense University Hospital, DK-5000 Odense C, Denmark, ¹ Department of Endocrinology and Metabolism, Herlev University Hospital, DK-2730 Herlev, Denmark, ² Departments of Endocrinology and Metabolism and ³ Nuclear Medicine, Odense University Hospital, DK-5000 Odense, Denmark

(Correspondence should be addressed to H Døssing; Email: helle.doessing{at}ouh.fyns-amt.dk)

Objective: To compare the efficacy of interstitial laser photocoagulation (ILP) with radioiodine in hot thyroid nodules.

Design: Thirty consecutive outpatients with subclinical or mild hyperthyroidism and a scintigraphically solitary hot nodule with extraglandular suppression were randomized to either one ILP session or one radioiodine (¹³¹I) dose.

Methods: ILP was performed under continuous ultrasound-guidance and with an output power of 2.5–3.5 W. ¹³¹I was given as a single dose based on thyroid volume and a 24-h thyroid ¹³¹I uptake. Thyroid function and nodule volume were evaluated at inclusion and at 1, 3 and 6 months after treatment.

Results: Normalization of serum TSH was achieved in 7 out of 14 patients in the ILP group and in all 15 patients in the ¹³¹I group (P=0.0025). In the ILP group, mean thyroid nodule volume reduction was 44±5% (S.E.M.; P<0.001), and in the ¹³¹I group 47±8% (P<0.001), within 6 months, without between-group difference (P=0.73). The mean reduction of total thyroid volume was 7±5% in the ILP group (P=0.20) and 26±8% (P=0.006) in the ¹³¹I group (P=0.06 between-group). Two patients in the ¹³¹I group developed hypothyroidism but no major side effects were seen.

Conclusions: This first randomized study, comparing ILP with standard therapy, demonstrates that ILP and ¹³¹I therapy approximately halves thyroid nodule volume within 6 months; but in contrast to ¹³¹I, extranodular thyroid volume is unaffected by ILP and no patient developed hypothyroidism. Using the present design, ILP seems inferior to ¹³¹I therapy in normalization of serum TSH. The potential value of ILP as a non-surgical alternative to ¹³¹I needs further investigation.