Sonographic abnormalities of the thyroid gland following radiotherapy in survivors of childhood Hodgkin's disease.
The aims of this study were as follows. (1) To demonstrate the spectrum, frequency and changes on follow-up of sonographic abnormalities in the thyroid gland of survivors of Hodgkin's disease who had received radiotherapy to the neck in childhood. (2) To compare the sonographic findings with clinical examination and radionuclide imaging. (3) To investigate the association between the presence or absence of focal sonographic abnormalities with age at radiotherapy, the interval from radiotherapy, the presence of a raised thyroid stimulating hormone (TSH) and the length of time the TSH had been raised. 46 patients were scanned prospectively and rescanned at 6-18 months. The mean age at first sonography was 22.7 years, the median age at radiotherapy was 12.5 years, and the median interval post-radiation was 10.3 years. Sonographic abnormalities were seen in all 46 patients. 45 had diffuse atrophy and 30 had focal sonographic abnormalities. 18 patients developed new focal sonographic abnormalities on follow-up. Focal sonographic abnormalities were more commonly associated with longer duration of a raised TSH. Two patients had thyroid carcinoma. Sonographic abnormalities of the thyroid are common in patients following neck radiotherapy in childhood. Focal abnormalities are usually associated with a longer duration of raised TSH.
Healy
J C
JC
Department of Diagnostic Radiology, St Bartholomew's Hospital, West Smithfield, London, UK.
Shafford
E A
EA
Reznek
R H
RH
Webb
J A
JA
Thomas
J M
JM
Bomanji
J B
JB
Kingston
J E
JE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011832:Radiation Injuries / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D017741:Survivors; D013959:Thyroid Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000528:radiation effects; D016606:Thyroid Nodule / Q000000981:diagnostic imaging; D013972:Thyrotropin / Q000097:blood; D013997:Time Factors; D014463:Ultrasonography
D013972:Thyrotropin