Ultrasound Changes in Salivary Glands after Radioactive Iodine Treatment in Benign Diseases and Differentiated Cancer of Thyroid Glands in Consideration of Dose and Time Dependency

Abstract

Purpose To assess ultrasound (US) features observed in salivary glands after radioactive iodine treatment (RAIT) in relation to the dose and time interval after RAIT.

Materials and Methods A retrospective analysis of US findings regarding the salivary glands of patients presenting after RAIT due to thyroid cancer (Group 1, n=99) or benign thyroid diseases (Group 2, n=25). The control group consisted of randomly selected patients (no RAIT, Group 3, n=100). Groups were compared regarding RAIT dose, symptoms, and US findings (duct dilation, hypoechoic/heterogeneous parenchyma, parenchymal loss). The association of the presence of US parameters after RAIT with various dose levels (2000–15000MBq) and time intervals (24, 60, 120 months) and the differences between the groups was evaluated.

Results Significant differences between US parameters were noted when comparing Group 1 with Group 2 or 3. Nothing of relevant significance was noted when Groups 2 and 3 were compared. US features indicating a slight or moderate sialadenitis showed the most significant associations with doses <4000MBq and time intervals <24 months after RAIT. US changes indicating a serious sialadenitis or even gland atrophy showed the most significant association at doses between >7000–9000MBq and when US was performed >60 months after RAIT.

Conclusion Our results point to a dose and time dependency of pathologic US findings in RAIT-induced effects on the major salivary glands. Based on the US findings, a better estimation of the current impact of RAIT on the salivary glands and the further prognosis appears possible.

Zusammenfassung

Ziel Analyse von Befunden im Ultraschall (US) bei Speicheldrüsen nach Radiojod-Therapie (RJT) in Abhängigkeit von der Dosis und dem Zeitintervall nach RJT.

Material und Methoden Retrospektive Analyse von US-Befunden von Speicheldrüsen bei Patienten nach RJT wegen Karzinomen (Gruppe 1, n=99) oder benignen Erkrankungen (Gruppe 2, n=25) der Schilddrüse. Die Kontrollgruppe bestand aus zufällig selektierten Patienten (keine RJT, Gruppe 3, n=100). Die Gruppen wurden hinsichtlich der RJT-Dosis, der Frequenz von Symptomen und US-Befunden verglichen. Die Häufigkeit von US-Parametern in Abhängigkeit von verschiedenen RJT-Dosen (2000–15000MBq) und Zeitintervallen nach RJT (24, 60, 120 Monate) wurden im Gruppenvergleich evaluiert.

Ergebnisse Pathologische US-Parameter waren signifikant häufiger in der Gruppe 1 nachweisbar im Vergleich zu den Gruppen 2 und 3, jedoch nicht im Vergleich der Gruppen 2 und 3. US-Befunde, welche auf eine moderate Sialadenitis hindeuteten, waren am signifikantesten mit RJT-Dosen <4000MBq und Zeitintervallen von <24 Monaten nach RJT assoziiert. Pathologische US-Befunde, welche auf eine Sialadenitis mit deutlichem oder komplettem Parenchym-Verlust hindeuteten, zeigten die häufigsten und die höchsten signifikanten Assoziationen mit Dosen von >7000–9000MBq und mit einem Zeitintervall von >60 Monaten nach RJT.

Schlussfolgerungen Die im US erhobenen pathologischen Befunde der großen Kopf-Speicheldrüsen nach erfolgter RJT deuten darauf hin, dass die Effekte dosis- und zeitabhängig sein können. Eine Analyse kann helfen, sowohl die aktuelle Ausprägung der RJT-induzierten Sialadenitis als auch deren weitere Prognose besser einzuschätzen.

Keywords

METHODS & TECHNIQUES - ultrasound - salivary gland - thyroid gland - radioactive iodine - treatment

Publication History

Received: 16 January 2023

Accepted after revision: 29 September 2023

Article published online:
03 January 2024

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