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Berson, Yalow, Sorrentino and Roswit (1) designed a simplified technic for estimating the rate at which the thyroid gland clears the plasma of intravenously administered radioiodide (I'3s). The amount of I18' taken up by the thyroid in 30 minutes is correlated with the average concentration of I131 in the plasma during the half hour. Plasma I131 is not actually measured, but is determined on the assumption that its concentration is a function of the weight of the body. Regardless of this and other assumptions involved, the method is one of the most precise in evaluation of thyroidal function in our experience (2, 3). Calculation of clearances at periods of time less than 30 minutes has been found necessary on those infrequent occasions when there was an electronic or mechanical failure of the radiation detector, or when the patient was so restless that the uptake tracing became erratic before the 30 minute time was concluded. In an attempt to determine whether the Berson procedure might be shortened, 1,250 of our records were reviewed. One hundred particularly uniform tracings, with clearance values of not less than 10 to more than 300 ml of plasma cleared of I131 per minute, were analyzed at various intervals between 5 and 30 minutes to establish new mathematical constants for practical application of the test. During the course of our review, 11 tracings were found in which an initial uptake of 1131 was succeeded, after about 10 or 20 minutes usually, by a reversal of the curve. Not only do these cases present a problem in the calculation of clearance of plasma 1131, but their rarity (about 1 per cent) seems to warrant their presentation.

the journal of clinical investigation/the journal of clinical investigation

ABBREVIATION OF BERSON TECHNIC FOR ESTIMATION OF THYROIDAL CLEARANCE OF PLASMA RADIOIODIDE: USE OF BERSON TEST TO RECOGNIZE THYROIDAL PROTEIN-BINDING DEFECTS