The Value of Diagnostic Whole-Body Scanning and Serum Thyroglobulin in the Presence of Elevated Serum Thyrotropin During Follow-Up of Anti-Thyroglobulin Antibody–Positive Patients with Differentiated Thyroid Carcinoma Who Appeared to Be Free of Disease After Total Thyroidectomy and Radioactive Iodine Ablation

Thyroid ◽  
2012 ◽  
Vol 22 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Pedro Weslley Rosario ◽  
Augusto Flávio Campos Mineiro Filho ◽  
Rafela Xavier Lacerda ◽  
Davi Alves dos Santos ◽  
Maria Regina Calsolari
Keyword(s):  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Elevated Serum ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Body Scanning ◽  
Thyroglobulin Antibody ◽  
Radioactive Iodine Ablation

scholarly journals The significance of simultaneous measurement of serum thyroglobulin and thyroglobulin antibody during the follow up of patients with differentiated thyroid carcinoma

2011 ◽  
Vol 152 (19) ◽  
pp. 743-752
Author(s):  
Zoltán Lőcsei ◽  
Dóra Horváth ◽  
Károly Rácz ◽  
Erzsébet Toldy
Keyword(s):  
Thyroid Carcinoma ◽  
Antibody Level ◽  
Differentiated Thyroid Carcinoma ◽  
Review Literature ◽  
Antibody Concentration ◽  
Serum Samples ◽  
Serum Thyroglobulin ◽  
Thyroglobulin Antibody ◽  
Current Guidelines

Serum thyroglobulin is an essential marker during the follow-up of patients with differentiated thyroid carcinoma. Demonstration of the total absence of thyroglobulin is not possible by immunoanalytic methods if thyroglobulin antibody is present in serum samples that occur in almost 20% of patients with differentiated thyroid carcinoma. Therefore, current guidelines recommend estimation of thyroglobulin levels only if quantitative level of thyroglobulin antibody is known. However, normal thyroglobulin antibody level fails to exclude interference with the antibody, because antibody concentration within the normal range may interfere with the thyroglobulin assay. In this respect recommendations are not consistent because they distinguish only occasionally cases with normal and those with non-detectable serum thyroglobulin level. In addition, the possible impact of normal thyroglobulin antibody level on the thyroglobulin assay has not been entirely explored. Authors review literature data and current guidelines on the analytical and preanalytical limitations of the thyroglobulin and thyroglobulin antibody measurements. On the basis of their own studies, authors make recommendation for improvement of the diagnostic accuracy of the thyroglobulin measurement. Orv. Hetil., 2011, 152, 743–752.

How to deal with undetectable and low measurable serum thyroglobulin levels in the follow-up of patients with differentiated thyroid carcinoma?

1985 ◽  
Vol 110 (4) ◽  
pp. 487-492 ◽  
Author(s):  
Matti Välimäki ◽  
Bror-Axel Lamberg
Keyword(s):  
Thyroid Carcinoma ◽  
Neck Region ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Cancer Tissue ◽  
Serum Thyroglobulin ◽  
Before And After ◽  
Measurable Serum

Abstract. Serum thyroglobulin (Tg) was measured in 52 patients 3 months to 15 years (mean 5.3 years) after thyroidectomy with or without subsequent radioablation for differentiated thyroid carcinoma, before and after the interruption of suppressive thyroxine (T4) replacement therapy for 5 weeks. Whole body scintigraphy was carried out at the end of the T4 withdrawal period. Serum Tg was undetectable (< 3 μg/l) in 38 patients on T4 therapy, in 18 the scintigraphy showed a minimal accumulation in the neck region and in 20 no uptake anywhere after withdrawal of T4. In the former group Tg rose in 10 patients to 4–21 μg/l when off T4 which seemed to correspond to the normal tissue left in situ, in the latter group Tg rose only in 2 patients to 5 and 21 μg/l, respectively. Two patients out of 14 with detectable Tg on T4 had pulmonary metastases as uncovered by whole body scintigraphy (in one of them Tg rose from 12 μg/l on T4 to 1200 μg/l off T4) and 6 patients were suspected for having recidual cancer tissue (2 patients had a negative scintigraphy) because the Tg rose (66– 215 μg/l) over the upper limit of the reference range (< 50 μg/l) after T4 withdrawal. In conclusion, in the follow-up of patients with differentiated thyroid carcinoma no routine scans are needed as long as serum Tg remains undetectable but further examinations are shortly warranted when detectable Tg is obtained during T4 suppression.

scholarly journals Radioiodine concentration by the thymus in differentiated thyroid carcinoma: report of five cases

2009 ◽  
Vol 53 (7) ◽  
pp. 874-879 ◽  
Author(s):  
Maria Eduarda Mello ◽  
Rodrigo C. Flamini ◽  
Rossana Corbo ◽  
Marcelo Mamede
Keyword(s):  
Thyroid Carcinoma ◽  
False Positive ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Radioiodine Uptake

The radioactive iodine has been used with great value as a diagnostic and therapeutic method in patients with differentiated thyroid carcinoma previously submitted to total thyroidectomy. False-positive whole-body scans may occur due to misinterpretation of the physiologic distribution of the radioisotope or lack of knowledge on the existence of other pathologies that could eventually present radioiodine uptake. Thymic uptake is an uncommon cause of false-positive whole-body scan, and the mechanism through which it occurs is not completely understood. The present paper reports five cases of patients with differentiated thyroid cancer who presented a mediastinum uptake of radioiodine in a whole-body scan during follow-up. The patients had either histological or radiological confirmation of the presence of residual thymus gland. It is very important to know about the possibility of iodine uptake by the thymus in order to avoid unnecessary treatment, such as surgery or radioiodine therapy.

Serum Thyroglobulin Determinations in Patients with Differentiated Thyroid Carcinoma

1983 ◽  
Vol 22 (04) ◽  
pp. 204-211 ◽  
Author(s):  
J. Němec ◽  
V. Zamrazil ◽  
S. Váňa ◽  
D. Pohunková ◽  
S. Rohling ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Healthy Subjects ◽  
Distant Metastases ◽  
Diagnostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Serum Thyroglobulin ◽  
Thyroglobulin Antibody ◽  
Long Term Follow Up

Serum thyroglobulin levels were measured in 636 patients with differentiated thyroid carcinoma, in whom altogether 1240 determinations were performed in different phases of disease and treatment. A modified sensitive radioimmunoassay was employed using an own high-specific thyroglobulin antibody. The results showed that both the majority of patients with functioning metastases accumulating radioiodine and with non-functioning metastases which could not be detected by scanning had higher serum TG levels, compared with a group of healthy subjects. However, “normal” TG values in patients with metastases, especially non-functioning, were found too. Thus, these findings decrease the diagnostic value of the TG determination. The highest TG values were found in patients with distant metastases of differentiated thyroid carcinoma (in lungs and bones); on the other hand, the proportion of patients with lymph-node(s) métastasés and “normal” TG levels was relatively high. We suggest that the serum TG determination cannot generally replace scanning with l31I and cannot serve as the only test, while being a helpful indicator in the long-term follow-up of differentiated thyroid cancer patients.

131J-speichernde pulmonale und ossäre Metastasen differenzierter Schilddrüsenkarzinome bei niedrigem Serum-Thyreoglobulinspiegel – Ausnahme in der Tumornachsorge?

1987 ◽  
Vol 26 (03) ◽  
pp. 139-142 ◽  
Author(s):  
G. Arning ◽  
O. Schober ◽  
H. Hundeshagen ◽  
Ch. Ehrenheim
Keyword(s):  
Serum Level ◽  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Differentiated Thyroid Carcinoma ◽  
Serum Thyroglobulin ◽  
Thyroglobulin Level ◽  
Low Serum

In the follow-up of differentiated thyroid carcinoma it is discussed whether the tumormarker thyroglobulin can replace the1311 scan, especially when the thyroglobulin serum level is normal. A positive1311 scan of metastases in the follow-up of patients with differentiated thyroid carcinoma combined with a low serum thyroglobulin level is extremely rare. The literature shows a frequency of about 4%. Recently we found 3 cases with a positive1311 scan demonstrating pulmonary and bone metastases whereas the serum thyroglobulin level was low.

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