Pyramidal lobe decreases endogenous TSH stimulation without impact on radio-iodine therapy outcome in patients with differentiated thyroid cancer

2014 ◽  
Vol 75 (3) ◽  
pp. 141-147 ◽  
Author(s):  
Nadia Sawicka-Gutaj ◽  
Aleksandra Klimowicz ◽  
Jerzy Sowinski ◽  
Robert Oleksa ◽  
Maria Gryczynska ◽  
...  
2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.


2014 ◽  
Vol 53 (02) ◽  
pp. 32-38 ◽  
Author(s):  
H.-Y. Nam ◽  
J.-K. Chung ◽  
K.W. Kang ◽  
G.J. Cheon ◽  
Y. Kim ◽  
...  

Summary Aim: Serum antithyroglobulin antibody (TgAb) has been reported as a surrogate marker for differentiated thyroid cancer (DTC) in some conditions. We investigated changes in serum TgAb levels after stimulation with thyroid- stimulating hormone (TSH) and the clinical implications for monitoring DTC. Patients, methods: We retrospectively enrolled 53 DTC patients who had undergone total thyroidectomy and were negative for serum Tg and positive for TgAb. Patients underwent highdose radioactive iodine treatment, and serum TgAb was measured before (TgAbBAS) and after TSH stimulation (TgAbSTIM). TgAb was followed up 6 to 12 months later (TgAbF/U). The change in TgAb after TSH stimulation ΔTgAb- STIM) was calculated as a percentage of the baseline level. Patient disease status was classified into no residual disease (ND) and residual or recurred disease (RD) by follow-up imaging studies and pathologic data. The characteristics and diagnostic value of serum TgAb levels and ΔTgAbST|M were investigated with respect to disease status. Results: 38 patients were in the ND group and 15 were in the RD group. TgAbBAS, TgAbSTIM and TgAbF/U were significantly higher in the RD compared to the ND group (p = 0.0008, 0.0002, and < 0.0001, respectively). ΔTgAbSTIM was also significantly higher in the RD group (p = 0.0009). In the patients who presented with obviously high (> 50%) or low (< -50%) ΔTgAbSTIM, the proportions in the RD group were markedly different at 100% and 7%, respectively. ΔTgAbSTIM had significant diagnostic value for RD (p < 0.001). Conclusion: The change in serum TgAb level after TSH stimulation is different between the RD and ND groups, and thus, it may be used as a surrogate diagnostic marker for DTC when the serum Tg is negative and TgAb is positive.


2015 ◽  
Vol 173 (6) ◽  
pp. 873-881 ◽  
Author(s):  
Daria Handkiewicz-Junak ◽  
Tomasz Gawlik ◽  
Jozef Rozkosz ◽  
Zbigniew Puch ◽  
Barbara Michalik ◽  
...  

AimAlthough recombinant human thyrotropin (rhTSH) is widely used in treating differentiated thyroid cancer (DTC), almost all clinical investigation has been in adults. The aim of our retrospective study was to evaluate outcomes of adjuvant, rhTSH-aided radioiodine treatment in children/adolescents with DTC and to compare them to131I therapy duringl-thyroxin withdrawal (THW).MethodsPatients with the diagnosis of DTC who were ≤18 years of age and had no signs of persistent disease at the time of131I treatment were included; 48 patients were treated after rhTSH (rhTSH group) and 82 after THW group. The median time of follow-up after therapy was 67 months and was longer in the THW group (99 vs 43 months,P<0.05).ResultsOn the day of131I administration, all but one patient had TSH levels above 25 μIU/ml. Peak TSH concentration was significantly higher in the rhTSH group (152 μIU/ml vs 91 μIU/ml). Similarly, the thyroglobulin concentration was higher in the rhTSH group (9.7 ng/ml vs 1.8 ng/ml). No side effects requiring medical intervention were recorded after rhTSH administration. The evaluation of disease outcomes during TSH stimulation (6–18 months after131I treatment) revealed equal rates of thyroid ablation (71%) in both groups. During subsequent follow-up, five patients showed recurrence (P>0.05).ConclusionsIn children/adolescents, rhTSH-aided adjuvant radioiodine treatment is associated with rates of remnant ablation and short-term recurrence similar to THW. As this preparation has several advantages over THW, rhTSH may become the preferred method of TSH stimulation once studies of long-term outcomes show non-inferiority to THW in this age group.


Thyroid ◽  
2008 ◽  
Vol 18 (10) ◽  
pp. 1049-1053 ◽  
Author(s):  
Umberto Crocetti ◽  
Cosimo Durante ◽  
Marco Attard ◽  
Adele Maniglia ◽  
Salvatore Tumino ◽  
...  

1986 ◽  
Vol 25 (05) ◽  
pp. 194-200 ◽  
Author(s):  
C. Schneider ◽  
M.-Th. Tempel ◽  
H.-W. Müller-Gärtner

The diagnostic accuracy of serum thyroglobulin (S-TG) determination as measured under endogenous thyrotropin(TSH)stimulation (ETS) has been investigated in 372 patients with completed therapy for differentiated thyroid cancer. In 51 of these (13.7%) S-TG could be detected by means of the IRMA-technique. In 34 S-TG determination was additionally performed during suppressive thyroxine therapy (SSH): S-TG in SSH was significantly lower as compared with S-TG in ETS (p <0.001). In seven cases with proven metastases S-TG values were pushed below the minimal detection level by SSH. Tumor manifestations with suppressive S-TG were significantly smaller (x͂ = 5 ccm, range 1-25 ccm) than those with non-suppressible S-TG (x͂ = 90 ccm, range 11-125 ccm, p <0.005) and displayed a papillary histology. There was a moderate correlation between S-TG concentration and tumor volume (r = 0.71 ; p <0.001). 21 % (n = 66) of patients with undetectable S-TG in ETS showed 131l-uptake in the thyroid region; 2% (n = 7) had proven metastases. Sensitivity of S-TG determination for the detection of metastases amounted to 82.5% in ETS and 53.3% in SST, specificity was 94.6% in ETS and 99.7% in SST. It is concluded that small metastases of papillary thyroid carcinomas may escape S-TG screening more readily than follicular carcinoma metastases when S-TG concentrations are measured during thyroxine treatment.


2003 ◽  
Vol 42 (03) ◽  
pp. 123-125 ◽  
Author(s):  
J. Dressler ◽  
W. Eschner ◽  
B. Leisner ◽  
C. Reiners ◽  
H. Schicha ◽  
...  

SummaryThe version 2 of the procedure guideline for iodine-131 whole-body scintigraphy for differentiated thyroid cancer is an update of the procedure guideline published in 1999. The following statements are added or modified: The two alternatives of an endogenous TSH-stimulation by the withdrawal of the thyroidal hormone medication and of an exogenous TSH-stimulation by the injection of the recombinant human TSH (rhTSH) have an equal sensitivity for the diagnostic use of radioiodine and for the measurement of thyroglobulin. Image acquisition under rhTSH is obtained approximately 48 h after the radioiodine administration, while an interval of about 72 h is preferred under endogenous TSH-stimulation. If iodine-negative metastases are expected, the feasibility of scintigraphy using 99mTc sestamibi or preferably positron emission tomography using 18F-fluorodeoxyglucose should be considered. The sensitivity of FDG-PET is increased by TSH-stimulation. Before planning the iodine-131 scintigraphy the patient has to avoid iodine-containing medication and the possibility of additives of iodine in vitamin- and electrolyte-supplementation has to be considered.


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