A New Age for Recombinant Human Thyroid-Stimulating Hormone?

TO THE EDITOR: I read with interest the recent article by Tuttle et al. (1). For years, patients have been prepared for 131I administration after thyroid cancer surgery. It is believed that the increase of thyroid-stimulating hormone concentration by either thyroid hormonewithdrawal (the traditional method of preparation) or injection of recombinant human thyroid-stimulating hormone (rhTSH) promotes 131I uptake and retention in remaining radio-iodine-avid cells. It is somehow also believed that the same patient preparation applies regardless of whether 131I is given for diagnosis or for therapy. There is, however, no in vivo evidence that the thyroidal absorbed dose rate or dose per unit of administered therapeutic 131I activity (or any other pivotal radiobiologic factor) has clear benefits over the traditional patient preparation. On the contrary, there are data in contrast to the common paradigms (2–6). An R ·C contingency table is a tablewith R rows and C columns