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Radiation Exposure and Thyroid Disease in Hiroshima and Nagasaki Atomic Bomb Survivors—Reply
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In Reply: Drs Völzke and Hoffmann raise questions about the cutoff point we used for determining TPOAb positivity in our participants. Setting of a defined cutoff point for thyroid autoantibody assay is a point of debate among clinical researchers. Our decision to use a 10-IU/mL value was based only in part on this being the value recommended by the manufacturer of the TPOAb enzyme-linked immunosorbent assay.1 More importantly, this cutoff value has been shown to be highly specific in terms of diagnosing autoimmune thyroid diseases (AITDs), with a specificity as high as 94.9%.2
Völzke and Hoffmann also comment on thyroid echogenicity as a diagnostic criterion for AITD. The accuracy of echogenicity assessment is partly operator dependent. Although every participant had undergone ultrasound examination, we felt it would be inappropriate to include thyroid echogenicity in the diagnostic criteria due to insufficient objectivity of the testing procedure. Studying the relationship between radiation . . . [Full Text of this Article]
Misa Imaizumi, MD
misaima@rerf.or.jp
Kiyoto Ashizawa, MD;
Masazumi Akahoshi, MD
Department of Clinical Studies
Radiation Effects Research Foundation
Nakagawa, Japan
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ABSTRACT
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