Efficacy of radioiodine therapy in the treatment of elevated serum thyroglobulin in patients with differentiated thyroid carcinoma and negative whole-body iodine scan

2006 ◽  
Vol 27 (7) ◽  
pp. 567-572 ◽  
Author(s):  
Mohsen Saghari ◽  
Ali Gholamrezanezhad ◽  
Sahar Mirpour ◽  
Mohammad Eftekhari ◽  
Abbas Takavar ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
Elevated Serum ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Iodine Scan

scholarly journals Optimization of Predictive Performance for the Therapeutic Response Using Iodine Scan-Corrected Serum Thyroglobulin in Patients with Differentiated Thyroid Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 262
Author(s):  
Su Woong Yoo ◽  
Md. Sunny Anam Chowdhury ◽  
Subin Jeon ◽  
Sae-Ryung Kang ◽  
Sang-Geon Cho ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Predictive Performance ◽  
Response Prediction ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Focal Uptake ◽  
Uptake Pattern ◽  
Iodine Scan

We investigated whether the performance of serum thyroglobulin (Tg) for response prediction could be improved based on the iodine uptake pattern on the post-therapeutic I-131 whole body scan (RxWBS) and the degree of thyroid tissue damage with radioactive iodine (RAI) therapy. A total of 319 patients with differentiated thyroid carcinoma who underwent total thyroidectomy and RAI therapy were included. Based on the presence/absence of focal uptake at the anterior midline of the neck above the thyroidectomy bed on RxWBS, patients were classified into positive and negative uptake groups. Serum Tg was measured immediately before (D0Tg) and 7 days after RAI therapy (D7Tg). Patients were further categorized into favorable and unfavorable Tg groups based on the prediction of excellent response (ER) using scan-corrected Tg developed through the stepwise combination of D0Tg with ratio Tg (D7Tg/D0Tg). We investigated whether the predictive performance for ER improved with the application of scan-corrected Tg compared to the single Tg cutoff. The combined approach using scan-corrected Tg showed better predictive performance for ER than the single cutoff of D0Tg alone (p < 0.001). Therefore, scan-corrected Tg can be a promising biomarker to predict the therapeutic responses after RAI therapy.

Evaluation of Parotid Salivary Gland Echo Texture by Ultrasound Examinations and Correlation With Whole‐Body Scintigraphy After Radioiodine Therapy in Patients With Differentiated Thyroid Carcinoma

2020 ◽  
Vol 39 (9) ◽  
pp. 1811-1818
Author(s):  
Graziele Aparecida Simões Lima ◽  
Rossana Verónica Mendoza López ◽  
Ricardo Miguel Costa Freitas ◽  
Jose Willegaignon ◽  
Marcelo Tatit Sapienza ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Parotid Salivary Gland

scholarly journals Invasive follicular thyroid carcinoma infiltrating trachea

2011 ◽  
Vol 68 (10) ◽  
pp. 891-894
Author(s):  
Aleksandar Filipovic ◽  
Ljiljana Vuckovic ◽  
Milan Mijovic
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Radioiodine Therapy ◽  
Follicular Thyroid Carcinoma ◽  
Radical Resection ◽  
Left Lobe ◽  
Whole Body ◽  
Suppressive Therapy ◽  
Tracheal Resection ◽  
Serum Thyroglobulin

Introduction. Although follicular thyroid carcinoma is a rare malignant tumor, up to 20% of the patients are threatened by potential complications resulting from infiltrating tumor growth into surrounding tissues. Case report. A 66- year-old female came to hospital with the presence of a growing thyroid nodule of the left lobe. Ultrasonic examination showed a 8 cm hypoechoic nodule in the left lobe. Thyroid scintigraphy showed a cold nodule. CT scan and tracheoscopy showed tracheal infiltration without tracheal obstruction. An extended total thyroidectomy was done, with the left jugular vein, strap muscles and tracheal 2 cm long circular resection. The pathologist confirmed invasive follicular thyroid cancer. After the surgery the patient was treated with radioiodine therapy and permanent TSH suppressive therapy. The patient was followed with measurements of the thyroid hormone and serum thyroglobulin level every six months, as well as the further tests (chest xray, ultrasound of the neck and a whole body scintigraphy) were done. After more than three years the patient had no evidence of the recurrent disease. Conclusion. Radical resection of the tracheal infiltrating thyroid cancer with circular tracheal resection and terminoterminal anastomosis followed by radioiodine therapy should be considered the treatment of choice.

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 Non-suppressed thyrotropin and elevated thyroglobulin are independent predictors of recurrence in differentiated thyroid carcinoma

1999 ◽  
Vol 141 (5) ◽  
pp. 460-467 ◽  
Author(s):  
J Bohm ◽  
VM Kosma ◽  
M Eskelinen ◽  
S Hollmen ◽  
M Niskanen ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Thyroid Carcinoma ◽  
Risk Ratio ◽  
Elevated Serum ◽  
Differentiated Thyroid Carcinoma ◽  
Tumor Type ◽  
Serum Thyroglobulin ◽  
Predictors Of Recurrence ◽  
Ptnm Stage ◽  
Ptnm Classification

OBJECTIVE: Although in most cases differentiated thyroid carcinoma (DTC) responds to surgery and radioiodine (RaI) therapy, some patients will have recurrence and eventually cancer-related death. However, although various prognostic factors of DTC have been identified (e.g. staging, suppressed thyrotropin), none of the previous studies have assessed simultaneously their role in multivariate analysis. DESIGN AND METHODS: In this retrospective population-based study, we reviewed the clinicopathological data of 254 DTC patients treated in eastern Finland during the years 1976-1995, for clinical characteristics, primary treatment, follow-up and cancer recurrence. Tumor stage was based on pathological tumor-node-metastasis (pTNM) classification, and histopathological specimens were re-evaluated. RESULTS: DTC recurrence occurred in 33 patients (13%). In univariate analyses, the predictors of recurrence were older age (>60 years, P<0.05), follicular tumor type (P<0.01), pTNM classification system (P<0.05) and post-ablative radioiodine uptake outside the neck (P<0.05). Non-suppressed serum thyrotropin (TSH) and elevated serum thyroglobulin (>3 microg/l) measured one year after operation were both related to tumor recurrence (P<0.05 and P<0.001 respectively). In multivariate analysis the independent predictors for recurrence were both elevated thyroglobulin (P<0.001) and non-suppressed TSH (P<0.05) independent of histology, pTNM stage and RaI uptake. Adjusted risk ratio for recurrence of DTC for unsuppressed thyrotropin was 2.3, for elevated thyroglobulin 14.0 and, if both conditions were present, the risk ratio increased to 45.1. CONCLUSION: Our results suggest that both non-suppressed serum TSH and elevated serum thyroglobulin are related to an increased risk of DTC recurrence independent of tumor type and pTNM stage.

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