Comparative evaluation of two different dosage calculation protocols of iodine-131 in the treatment of hyperthyroidism.

OBJECTIVE: To compare the effectiveness of radioiodine therapy with estimated dose and calculated dose in hyperthyroid patients. MATERIAL AND METHOD: A prospective randomized study in 144 hyperthyroid patients referred for 131I treatment was performed between June and December 2007. The patients were divided into two groups according to the 131I dose administered, estimated group using dose based on gland size and calculated group using dose based on both gland size and 24-hour 131I uptake. Outcome assessment was done at 12 months post-treatment. RESULTS: Eleven of 144 patients were excluded due to loss to follow-up and five became euthyroid before 131I treatment. Fifty-six of 128 patients (45.3%) experienced persistent/recurrent hyperthyroidism, 26 (20.3%) developed hypothyroidism, and 44 (34.4%) were euthyroid. Outcome was unrelated to the methods of I-131 dosing. Only gender and goiter size were found to be correlated with the clinical outcomes. CONCLUSION: An estimated I-131 dosing method using gland size determined by palpation is as effective as calculated method using 131I uptake. This method is more cost effective and brings greater patient convenience.

Comparability of different pathologic protocols in sentinel lymph node evaluation: an analysis of two step-sectioning methods for the same patients with breast cancer.

CONTEXT: The pathologic protocol for sentinel lymph node evaluation has yet to be standardized. Results from previous studies are troublesome to compare because they have been conducted on different sets of subjects with cancer. OBJECTIVE: To compare the detection of sentinel lymph node metastases by using step-sectioning methods at 20-microm and 150-microm intervals for the same patient with primary breast cancer. DESIGN: A total of 186, initially tumor-negative sentinel lymph nodes from a group of 80 patients with breast cancer were included. For all nodes, each paraffin block was cut serially to produce a total of 10 levels: 5 consecutive levels of sections for each of the 20-microm and 150-microm intervals. The nodal findings obtained at these intervals on hematoxylin-eosin and cytokeratin slides were compared by using the McNemar test. RESULTS: The overall detection rate for sentinel lymph node metastasis at intervals of 20 microm and 150 microm was 27.5% (22/80) and 20% (16/80), respectively. The overall agreement between the 20-microm and 150-microm sections was 82.5%. No macrometastasis was missed by either method. At the 20-microm interval, 2 cases of micrometastasis were missed, while 10 cases of isolated tumor cells were missed at the 150-microm interval. However, no statistical difference was observed for the final sentinel lymph node results with either method. (McNemar test, P = .18 for case-based results and P = .052 for nodal-based results). CONCLUSIONS: The 20-microm and 150-microm interval step-sectioning methods produce comparable results for detection of metastatic deposits in sentinel lymph nodes.