THE RADIOIODINE-ACCUMULATING FUNCTION OF THE HUMAN THYROID GLAND AS A DIAGNOSTIC TEST IN CLINICAL MEDICINE*

Abstract

HAMILTON and Soley (1, 2) were the first to observe that the thyroidal accumulation or urinary excretion of ingested radioiodine could be correlated with the clinical state of thyroid function. It has been apparent from the first that this correlation provided a useful research tool and also a functional test which might have practical clinical value in the diagnosis and management of thyroid disease. The numerous studies of radioiodine in patients which have appeared in the past ten years have involved various methods for evaluating the behavior of radioiodine tracers. The methods employed have included a) various observations of urinary excretion of radioiodine (3–6), b) direct in vivo observations of radioiodine in the thyroid (6–9) and c) estimation of various rates derived from observations of the urine (10, 11), the thyroid (12–15); the serum (16) or a combination of these (15, 17, 18). Comparatively few of the published reports have included enough cases to allow critical appraisal of the diagnostic usefulness and clinical limitations of radioiodine tracer tests. Werner, Quimby and Schmidt (19), employing as their criterion of thyroidal accumulating function the quantity observed in the thyroid twenty-four hours after administration of the dose, have published observations on 269 patients having various conditions. Skanse (5) has reported his observations of radioiodine tracer tests of 110 normal subjects and 385 patients who had various disease conditions, employing as a criterion the quantity of radioiodine excreted in the urine within twentyfour and forty-eight hours after administration of the dose.