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Comparison of free thyroxine measurement by chemiluminescence and equilibrium dialysis following 131I therapy in hyperthyroid cats

Lisa Stammeleer (UGent) , Eva Buresova, Emmelie Stock (UGent) , Laurien Feenstra (UGent) , Eva Vandermeulen (UGent) , Luc Duchateau (UGent) , Isabel Van de Maele (UGent) and Sylvie Daminet (UGent)
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Abstract
Objectives The first objective was to assess correlation between free thyroxine (fT4) measurements by equilibrium dialysis (fT4ED; Antech Diagnostics) and a chemiluminescent enzyme immunoassay (fT4CEIA; IMMULITE 2000 Veterinary Free T4 [Siemens Healthcare Diagnostics Products]) in hyperthyroid, otherwise healthy, cats before (T0), 1 month (T1) and 11-23 months (T2) after radioactive iodine (I-131) therapy. The second objective was to determine correlation between thyroid status based on fT4 (by both techniques) and the gold standard, thyroid scintigraphy. Methods Thyroid status, including thyroid-stimulating hormone (TSH), total thyroxine (TT4) and fT4 serum concentrations, were assessed in 45 client-owned hyperthyroid cats before (T0), 1 month (T1) and 11-23 months (T2) after I-131 therapy. fT4 was determined by a chemiluminescent enzyme immunoassay (CEIA) and equilibrium dialysis (ED). Quantitative thyroid scintigraphy (with sodium 99m-Tc-pertechnetate) was performed at T2. Results Spearman correlation between fT4CEIA and fT4ED was 0.81, 0.88 and 0.79 at T0, T1 and T2, respectively. fT4CEIA was consistently lower than fT4ED, with a median difference of -5.4 pmol/l (P <0.001) and -4.9 pmol/l (P <0.0001) at T1 and T2, respectively. At T2, all cats were identified as euthyroid based on thyroid scintigraphy. None of the cats were identified as being hypothyroid, based on serum TT4 and TSH measurements. Nine of 22 (40.9%) cats had an fT4CEIA below the reference interval (RI) at T2, whereas only 2/22 (9.1%) cats had an fT4ED concentration below the RI at T2. Conclusions and relevance Good correlation exists between both assays at T1 and T2, but a significant systematic difference is noted at both time points. This could be an indication for reconsideration of the current RI, although further studies are warranted for assessing test accuracy (in otherwise healthy cats and cats with non-thyroidal illness). At this time, routine use of fT4CEIA after I-131 therapy is not advised in feline patients.
Keywords
Small Animals, Hyperthyroidism, free thyroxine, fT4, chemiluminescent enzyme immunoassay, CEIA, equilibrium dialysis, STIMULATING HORMONE CONCENTRATION, AZOTEMIA

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MLA
Stammeleer, Lisa, et al. “Comparison of Free Thyroxine Measurement by Chemiluminescence and Equilibrium Dialysis Following 131I Therapy in Hyperthyroid Cats.” JOURNAL OF FELINE MEDICINE AND SURGERY, 2020.
APA
Stammeleer, L., Buresova, E., Stock, E., Feenstra, L., Vandermeulen, E., Duchateau, L., … Daminet, S. (2020). Comparison of free thyroxine measurement by chemiluminescence and equilibrium dialysis following 131I therapy in hyperthyroid cats. JOURNAL OF FELINE MEDICINE AND SURGERY.
Chicago author-date
Stammeleer, Lisa, Eva Buresova, Emmelie Stock, Laurien Feenstra, Eva Vandermeulen, Luc Duchateau, Isabel Van de Maele, and Sylvie Daminet. 2020. “Comparison of Free Thyroxine Measurement by Chemiluminescence and Equilibrium Dialysis Following 131I Therapy in Hyperthyroid Cats.” JOURNAL OF FELINE MEDICINE AND SURGERY.
Chicago author-date (all authors)
Stammeleer, Lisa, Eva Buresova, Emmelie Stock, Laurien Feenstra, Eva Vandermeulen, Luc Duchateau, Isabel Van de Maele, and Sylvie Daminet. 2020. “Comparison of Free Thyroxine Measurement by Chemiluminescence and Equilibrium Dialysis Following 131I Therapy in Hyperthyroid Cats.” JOURNAL OF FELINE MEDICINE AND SURGERY.
Vancouver
1.
Stammeleer L, Buresova E, Stock E, Feenstra L, Vandermeulen E, Duchateau L, et al. Comparison of free thyroxine measurement by chemiluminescence and equilibrium dialysis following 131I therapy in hyperthyroid cats. JOURNAL OF FELINE MEDICINE AND SURGERY. 2020;
IEEE
[1]
L. Stammeleer et al., “Comparison of free thyroxine measurement by chemiluminescence and equilibrium dialysis following 131I therapy in hyperthyroid cats,” JOURNAL OF FELINE MEDICINE AND SURGERY, 2020.
@article{8661328,
  abstract     = {Objectives

The first objective was to assess correlation between free thyroxine (fT4) measurements by equilibrium dialysis (fT4ED; Antech Diagnostics) and a chemiluminescent enzyme immunoassay (fT4CEIA; IMMULITE 2000 Veterinary Free T4 [Siemens Healthcare Diagnostics Products]) in hyperthyroid, otherwise healthy, cats before (T0), 1 month (T1) and 11-23 months (T2) after radioactive iodine (I-131) therapy. The second objective was to determine correlation between thyroid status based on fT4 (by both techniques) and the gold standard, thyroid scintigraphy.

Methods

Thyroid status, including thyroid-stimulating hormone (TSH), total thyroxine (TT4) and fT4 serum concentrations, were assessed in 45 client-owned hyperthyroid cats before (T0), 1 month (T1) and 11-23 months (T2) after I-131 therapy. fT4 was determined by a chemiluminescent enzyme immunoassay (CEIA) and equilibrium dialysis (ED). Quantitative thyroid scintigraphy (with sodium 99m-Tc-pertechnetate) was performed at T2.

Results

Spearman correlation between fT4CEIA and fT4ED was 0.81, 0.88 and 0.79 at T0, T1 and T2, respectively. fT4CEIA was consistently lower than fT4ED, with a median difference of -5.4 pmol/l (P <0.001) and -4.9 pmol/l (P <0.0001) at T1 and T2, respectively. At T2, all cats were identified as euthyroid based on thyroid scintigraphy. None of the cats were identified as being hypothyroid, based on serum TT4 and TSH measurements. Nine of 22 (40.9%) cats had an fT4CEIA below the reference interval (RI) at T2, whereas only 2/22 (9.1%) cats had an fT4ED concentration below the RI at T2.

Conclusions and relevance

Good correlation exists between both assays at T1 and T2, but a significant systematic difference is noted at both time points. This could be an indication for reconsideration of the current RI, although further studies are warranted for assessing test accuracy (in otherwise healthy cats and cats with non-thyroidal illness). At this time, routine use of fT4CEIA after I-131 therapy is not advised in feline patients.},
  articleno    = {1098612X20906929},
  author       = {Stammeleer, Lisa and Buresova, Eva and Stock, Emmelie and Feenstra, Laurien and Vandermeulen, Eva and Duchateau, Luc and Van de Maele, Isabel and Daminet, Sylvie},
  issn         = {1098-612X},
  journal      = {JOURNAL OF FELINE MEDICINE AND SURGERY},
  keywords     = {Small Animals,Hyperthyroidism,free thyroxine,fT4,chemiluminescent enzyme immunoassay,CEIA,equilibrium dialysis,STIMULATING HORMONE CONCENTRATION,AZOTEMIA},
  language     = {eng},
  pages        = {7},
  title        = {Comparison of free thyroxine measurement by chemiluminescence and equilibrium dialysis following 131I therapy in hyperthyroid cats},
  url          = {http://dx.doi.org/10.1177/1098612x20906929},
  year         = {2020},
}

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