title: Ultrasound Evaluation of Thyroid Gland Pathologies After Radiation Therapy and Chemotherapy to Treat Malignancy During Childhood.
abstract: OBJECTIVE
  The purpose of this study was to evaluate correlations between treatment of malignancy by radiation therapy during childhood and the occurrence of thyroid gland pathologies detected by ultrasonography in follow-up examinations.
  
  
  METHODS
  Reductions of thyroid gland volume below 2 standard deviations of the weight-specific mean value, occurrence of ultrasonographically detectable thyroid gland pathologies, and hypothyroidism were retrospectively assessed in 103 children and adolescents 7 months to 20 years of age (median: 7 years of age) at baseline (1997-2013) treated with chemoradiation therapy (with the thyroid gland dose assessable) or with chemotherapy alone and followed by ultrasonography and laboratory examinations through 2014 (median follow-up time: 48 months).
  
  
  RESULTS
  A relevant reduction of thyroid gland volume was significantly correlated with thyroid gland dose in univariate (P<.001) and multivariate analyses for doses above 2 Gy. Odds ratios were 3.1 (95% confidence interval: 1.02-9.2; P=.046) for medium doses (2-25 Gy) and 14.8 (95% confidence interval: 1.4-160; P=.027) for high doses (>25 Gy). Thyroid gland dose was significantly higher in patients with thyroid gland pathologies during follow-up (P=.03). Univariate analysis revealed significant correlations between hypothyroidism and thyroid gland dose (P<.001).
  
  
  CONCLUSIONS
  Ultrasonographically detectable changes, that is, volume reductions, pathologies, and hypothyroidism, after malignancy treatment during childhood are associated with thyroid gland dose. Both ultrasonography and laboratory follow-up examinations should be performed regularly after tumor therapy during childhood, especially if the treatment included radiation therapy.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany. Electronic address: andre.lollert@unimedizin-mainz.de.
authors.forename: André
authors.initials: A
authors.lastname: Lollert
authors.affiliation: Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Gies
authors.affiliation: Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Laudemann
authors.affiliation: Department of Pediatrics and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Faber
authors.affiliation: Department of Radio-oncology and Radiotherapy, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Jacob-Heutmann
authors.affiliation: Institute for Medical Biostatistics, Epidemiology and Informatics, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Jochem
authors.initials: J
authors.lastname: König
authors.affiliation: Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Düber
authors.affiliation: Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Gundula
authors.initials: G
authors.lastname: Staatz
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016543:Central Nervous System Neoplasms / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003560:Cysts / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007037:Hypothyroidism / Q000000981:diagnostic imaging / Q000209:etiology; D007223:Infant; D007938:Leukemia / Q000628:therapy; D008223:Lymphoma / Q000628:therapy; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D009929:Organ Size / Q000187:drug effects / Q000528:radiation effects; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013959:Thyroid Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects*; D013997:Time Factors; D014463:Ultrasonography