scholarly journals Serum thyroglobulin concentrations and whole-body radioiodine scan in follow-up of differentiated thyroid cancer after thyroid ablation.

BMJ ◽  
1979 ◽  
Vol 2 (6185) ◽  
pp. 298-300 ◽  
Author(s):  
S C Ng Tang Fui ◽  
R Hoffenberg ◽  
M N Maisey ◽  
E G Black
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Thyroid Ablation ◽  
Radioiodine Scan

scholarly journals Serum thyroglobulin and 131I whole body scan after recombinant human TSH stimulation in the follow-up of low-risk patients with differentiated thyroid cancer

2003 ◽  
pp. 19-24 ◽  
Author(s):  
M Torlontano ◽  
U Crocetti ◽  
L D'Aloiso ◽  
N Bonfitto ◽  
A Di Giorgio ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Whole Body Scan ◽  
Serum Thyroglobulin ◽  
Risk Patients ◽  
Node Metastases

OBJECTIVE: The 'standard' postoperative follow-up of patients with differentiated thyroid cancer (DTC) has been based upon serum thyroglobulin (Tg) measurement and (131)I whole body scan ((131)I-WBS) after thyroid hormone (T(4)) treatment withdrawal. However, (131)I-WBS sensitivity has been reported to be low. Thyroid hormone withdrawal, often associated with hypothyroidism-related side effects, may now be replaced by recombinant human thyroid stimulating hormone (rhTSH). The aim of our study was to evaluate the diagnostic accuracy of (131)I-WBS and serum Tg measurement obtained after rhTSH stimulation and of neck ultrasonography in the first follow-up of DTC patients. DESIGN: Ninety-nine consecutive patients previously treated with total thyroidectomy and (131)I ablation, with no uptake outside the thyroid bed on the post-ablative (131)I-WBS (low-risk patients) were enrolled. METHODS: Measurement of serum Tg and (131)I-WBS after rhTSH stimulation, and ultrasound examination (US) of the neck. RESULTS: rhTSH-stimulated Tg was <or=1 ng/ml in 78 patients (Tg-) and >1 ng/ml (Tg+) in 21 patients, including 6 patients with Tg levels >5 ng/ml. (131)I-WBS was negative for persistent or recurrent disease in all patients (i.e. sensitivity = 0%). US identified lymph-node metastases (confirmed at surgery) in 4/6 (67%) patients with stimulated Tg levels >5 ng/ml, in 2/15 (13%) with Tg>1<5 ng/ml, and in 2/78 (3%) who were Tg-negative. CONCLUSIONS: (i) diagnostic (131)I-WBS performed after rhTSH stimulation is useless in the first follow-up of DTC patients; (ii) US may identify lymph node metastases even in patients with low or undetectable serum Tg levels.

scholarly journals Mediastinal Images Resembling Thymus Following 131-I Treatment for Thyroid Cancer

2005 ◽  
Vol 63 (2) ◽  
Author(s):  
L. Montella ◽  
M. Caraglia ◽  
A. Abbruzzese ◽  
A. Soricelli ◽  
M. Caputi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Thyroid Cancer ◽  
False Positive ◽  
Differentiated Thyroid Cancer ◽  
Thymic Hyperplasia ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Pathological Tissues ◽  
Metastatic Thyroid Cancer

The follow-up of Differentiated Thyroid Cancer conventionally includes serum thyroglobulin and periodic Whole Body Scans. The uptake of 131-I in normal and pathological tissues different from metastatic thyroid cancer sites is a cause of false-positive scans. Among them, mediastinal uptake caused by thymic hyperplasia can be observed. The aim of the present study was to review a series of 573 patients with differentiated thyroid cancer treated with 131-I after surgery between 1992 and 2003 looking above all for those with mediastinal images resembling thymus. This evaluation is presented together with some hypotheses on the relationships between thymus and thyroid. Moreover, some considerations are made on the differential diagnosis between thymus and mediastinal tumour thyroid residues.

scholarly journals Diagnostic 131I whole body scanning after thyroidectomy and ablation for differentiated thyroid cancer

2004 ◽  
Vol 150 (5) ◽  
pp. 649-653 ◽  
Author(s):  
H Taylor ◽  
S Hyer ◽  
L Vini ◽  
B Pratt ◽  
G Cook ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Recurrent Disease ◽  
Clinical Findings ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Body Scanning ◽  
Extra Information ◽  
Disease Free

OBJECTIVE: To assess the value of the diagnostic whole body (131)I scan after thyroidectomy and (131)I ablation. DESIGN: Retrospective analysis of all patients with differentiated thyroid cancer treated in one centre between 1990 and 2000. RESULTS: A total of 153 consecutive patients who underwent diagnostic scanning following ablative therapy were identified. This diagnostic scan was positive in 20 patients (13%) and faintly positive in 16 patients (11%). The majority (117 patients) had negative scans. Of the 20 patients with positive scans, four received no further treatment, nine showed no abnormal uptake following a second ablative (131)I dose and seven had uptake in the thyroid bed (six) or in neck nodes (one) after repeat ablation. OUTCOME: In the group with positive scans, the four patients who received no further treatment and the nine with a negative second ablation scan remained disease free during follow-up. No patient with a positive diagnostic scan received additional (131)I therapy which would not otherwise have been given based on the clinical findings, serum thyroglobulin (Tg) values or the presence of anti-Tg antibodies. Ten of the patients with negative scans developed recurrent disease which was always detected clinically or by a rising serum Tg value. CONCLUSIONS: Diagnostic whole body (131)I scans add little extra information and in our experience do not influence patient management. They should be reserved for patients in whom serum Tg levels are unreliable because of the presence of antibodies or when there is clinical suspicion of tumour.

scholarly journals Pulmonary metastases in differentiated thyroid cancer: efficacy of radioiodine therapy and prognostic factors

2015 ◽  
Vol 173 (3) ◽  
pp. 399-408 ◽  
Author(s):  
Hong-Jun Song ◽  
Zhong-Ling Qiu ◽  
Chen-Tian Shen ◽  
Wei-Jun Wei ◽  
Quan-Yong Luo
Keyword(s):  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Whole Body ◽  
Metastatic Node ◽  
Serum Thyroglobulin

ContextData from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed.ObjectiveTo assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC.MethodsA total of 372 patients with pulmonary metastasis from DTC treated with131I entered the study. According to the results of131I whole-body scan (WBS), pulmonary metastases were classified as131I-avid and non-131I-avid. For patients with131I-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic131I-WBS. Overall survival was calculated by the Kaplan–Meier method. Factors predictive of the outcome were determined by multivariate analyses.ResultsAmong patients demonstrating131I-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after131I therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of131I-avid and non-131I-avid.ConclusionThis study indicated that, most131I-avid pulmonary metastases from DTC can obtain partial or complete remission after131I therapy. Younger patients (<40 years old) with only pulmonary metastases and small (‘fine miliaric’ or micronodular) metastases appear to have relative favorite outcomes. Patients who do not respond to131I treatment have a worse prognosis.

Sequential Follow-up of Serum Thyroglobulin and Whole Body Scan in Thyroid Cancer Patients without Initial Metastasis

Thyroid ◽  
2006 ◽  
Vol 16 (12) ◽  
pp. 1273-1278 ◽  
Author(s):  
Shu-Hua Huang ◽  
Pei-Wen Wang ◽  
Yu-Erh Huang ◽  
Fong-Fu Chou ◽  
Rue-Tsuan Liu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Serum Thyroglobulin ◽  
Initial Metastasis

Long-Term Follow-Up of Patients With Differentiated Thyroid Cancer Who had Negative 131I Whole-Body Scan at First Evaluation After Treatment

2013 ◽  
Vol 38 (10) ◽  
pp. 765-769 ◽  
Author(s):  
Luciana Souza Cruz Caminha ◽  
Denise Prado Momesso ◽  
Fernanda Vaisman ◽  
Rossana Corbo ◽  
Mario Vaisman
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Long Term Follow Up

scholarly journals A Consensus Report of the Role of Serum Thyroglobulin as a Monitoring Method for Low-Risk Patients with Papillary Thyroid Carcinoma

2003 ◽  
Vol 88 (4) ◽  
pp. 1433-1441 ◽  
Author(s):  
E. L. Mazzaferri ◽  
R. J. Robbins ◽  
C. A. Spencer ◽  
L. E. Braverman ◽  
F. Pacini ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Clinical Evidence ◽  
Low Risk ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Thyroid Hormone Withdrawal ◽  
Body Scanning ◽  
Risk Patients

Recent studies have provided new information regarding the optimal surveillance protocols for low-risk patients with differentiated thyroid cancer (DTC). This article summarizes the main issues brought out in a consensus conference of thyroid cancer specialists who analyzed and discussed this new data. There is growing recognition of the value of serum thyroglobulin (Tg) as part of routine surveillance. An undetectable serum Tg measured during thyroid hormone suppression of TSH (THST) is often misleading. Eight studies show that 21% of 784 patients who had no clinical evidence of tumor with baseline serum Tg levels usually below 1 μg/liter during THST had, in response to recombinant human TSH (rhTSH), a rise in serum Tg to more than 2 μg/liter. When this happened, 36% of the patients were found to have metastases (36% at distant sites) that were identified in 91% by an rhTSH-stimulated Tg above 2 μg/liter. Diagnostic whole body scanning, after either rhTSH or thyroid hormone withdrawal, identified only 19% of the cases of metastases. Ten studies comprising 1599 patients demonstrate that a TSH-stimulated Tg test using a Tg cutoff of 2 μg/liter (either after thyroid hormone withdrawal or 72 h after rhTSH) is sufficiently sensitive to be used as the principal test in the follow-up management of low-risk patients with DTC and that the routine use of diagnostic whole body scanning in follow-up should be discouraged. On the basis of the foregoing, we propose a surveillance guideline using TSH-stimulated Tg levels for patients who have undergone total or near-total thyroidectomy and 131I ablation for DTC and have no clinical evidence of residual tumor with a serum Tg below 1 μg/liter during THST.

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