Nuclear doctors could very well assess the risk of thyroid disease through their expertise and thus also very well assess which treatment is the most suitable, Alexander Becherer, specialist group chairman for nuclear medicine in the Austrian Medical Association (ÖÄK), and Michael Gabriel, President of the Austrian Society for Nuclear Medicine and Theranostics, are reminiscent of (OGNT), on the occasion of the world thyroid day on May 25, the importance of nuclear medicine also in the area of the thyroid gland. Nevertheless, too many affected people are still under -supplied in Austria and would not be given adequate care, which is not least due to the unwillingness of the health insurance companies, the experts criticize.
“The thyroid produces vital hormones that are indispensable for normal development in infant and childhood,” explains Bencer. “In later years they regulate our metabolism and functions of the central, the vegetative nervous system and the cardiovascular system.” In Central Europe, around a third of the population of changes in the thyroid gland and thyroid diseases are affected with and without disrupting the function. “Functional disorders can become as life -threatening as some malignant tumors of the organ,” says Becherer. Therefore, symptoms that could indicate a disease of the thyroid gland, such as the discovery of a knot on the neck, sudden performance paired with heartbeat, nervousness and sweating or unusual tiredness and inexplicable aftermath of mental performance, should be clarified as quickly as possible. A weight gain due to an underactive thyroid gland only occurs in advanced cases, but other factors are usually to blame.
“Nuclear medicine has a very important role here,” says Gabriel. Early detection has now become very good through frequent co -entry of thyroid hormones in routine laboratory examinations and broadly available ultrasound devices. “In order to then distinguish the predominantly harmless changes in serious diseases, special technical expertise is needed,” because the majority of the findings only require an observation and must not be over therapy. This is quite different with diseases such as a significant sub- or overfunction of the thyroid gland. “These have to be treated adequately and checked for a while,” emphasizes Gabriel.
The entire management of a thyroid disease is usually adopted by institutions for nuclear medicine. This is also important, because nuclear medicine could offer a “one-stop shop” where all important steps could be taken during a single initial examination: from a comprehensive diagnosis with the help of imaging methods such as ultrasound, scintigraphy or tomography, blood recording for hormone determination to the puncture of suspicious nodes. “Conservative treatments with medication for sub- and overfunction and treatment with radioactive iodine in the event of overfunction or thyroid carcinomas also take place by doctors for nuclear medicine,” explain Becherer and Gabriel. In the case of surgical indications, there is also close coordination with the correspondingly specialized surgical departments.
However, all of this is only possible if the health insurance companies would create the necessary requirements. “At the moment, however, it is unfortunately the case that the lack of willingness to reward the services of nuclear doctors, and an artificial appointment passport is generated, especially since the inpatient facilities alone do not apply capacity despite great efforts,” says Bencerer. “To date, there is no cash register and in no federal state an overall contract for nuclear medicine,” adds Gabriel. The implementation of the uniform catalog of performance that was worked out by the ÖäK in a hard mega project itself and already proposed three years ago would also be urgently needed, since it would also have a positive change in the situation of nuclear medicine.
“Our attempts to improve the situation fail to improve the lack of will of the health insurance companies,” criticize the experts. Only recently had a letter to the chairman of the Board of Directors of the Austrian Health Insurance Fund with the request for a conversation not even answered. “The health insurance companies have to finally give up their blockage and come into action. We are simply owed to our patients that they are not denied that they are not denied smoothly and quickly to diagnosis and treatment.