RECOMBINANT HUMAN THYROTROPIN STIMULATION OF THYROGLOBULIN IN THE FOLLOW-UP OF PATIENTS WITH STAGE I OR II DIFFERENTIATED THYROID CARCINOMA

SummaryAim: Physicians typically are unaware of the radioiodine uptake (RIU) detection limit (LoD) on scintigrams of differentiated thyroid carcinoma (DTC) patients. We evaluated a novel method to determine LoD as a quantitative upper limit for RIU in negative scans and as a value to contextualize faint visible uptake. Patients, methods: To test whether LoD is related to physicians’ ratings, RIU and LoD were calculated from scintigraphic count statistics for 120 static planar neck scans and were compared with the ratings of five nuclear medicine specialists blinded to patient/ scan characteristics regarding visible cervical uptake. Scans were acquired on days 1 (d1) and 2 (d2) post-administration of 298 ± 30 MBq iodine-131 in 60 consecutive DTC patients after recombinant human thyrotropin (rhTSH) or thyroid hormone withdrawal (THW) (n = 30 each). Results: Indicating good inter-observer agreement, ≥ 4 readers concurred regarding 56 (93.3%) [54 (90.0%)] d1[d2] scans. Seventeen scans from 12 patients received ≥ 3 positive votes; in 15 (88.2%), RIU exceeded LoD. RIU assessed from regions-of-interest over former thyroid beds in scans with ≤ 2 positive votes was typically below the LoD (99/103 scans, 96.1%). In 48 patients with ≤ 2 positive votes in both scans, LoD was a median 0.0094% (0.0050%) in d1(d2) images and was significantly lower (p < 0.01) on early or late scans in 22 euthyroid rhTSH patients versus 26 hypo thyroid THW patients. Conclusion: LoD data obtained by the proposed method closely reflect nuclear medicine specialists’ scan ratings and provide comparators in serial scintigrams, improving diagnostic 131I imaging accuracy in differentiated thyroid carcinoma.

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Abstract #269: Negative Recombinant Human Thyrotropin-Stimulated Serum Thyroglobulin in the Presence of Persistent or Recurrent Disease During the Follow-Up of Patients Affected by Differentiated Thyroid Carcinoma: Report of Two Cases

Endocrine Practice ◽

10.1016/s1530-891x(20)44027-3 ◽

2006 ◽

Vol 12 ◽

pp. 79-80

Author(s):

Giuseppe Francia ◽

Maria Vittoria Davi ◽

Lucia Scilanga ◽

Chiara Colato ◽

Marco Ferdeghini

Keyword(s):

Thyroid Carcinoma ◽

Recurrent Disease ◽

Differentiated Thyroid Carcinoma ◽

Serum Thyroglobulin ◽

Recombinant Human Thyrotropin

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Clinical Value of Different Responses of Serum Thyroglobulin to Recombinant Human Thyrotropin in the Follow-Up of Patients with Differentiated Thyroid Carcinoma

Thyroid ◽

10.1089/thy.2005.15.158 ◽

2005 ◽

Vol 15 (2) ◽

pp. 158-164 ◽

Cited By ~ 8

Author(s):

Alessia David ◽

Annabella Blotta ◽

Roberta Rossi ◽

Maria Chiara Zatelli ◽

Marta Bondanelli ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

Clinical Value ◽

Serum Thyroglobulin ◽

Recombinant Human Thyrotropin

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Clinical Value of Different Responses of Serum Thyroglobulin to Recombinant Human Thyrotropin in the Follow-Up of Patients with Differentiated Thyroid Carcinoma

Thyroid ◽

10.1089/thy.2005.15.267 ◽

2005 ◽

Vol 15 (3) ◽

pp. 267-273 ◽

Cited By ~ 30

Author(s):

Alessia David ◽

Annabella Blotta ◽

Roberta Rossi ◽

Maria Chiara Zatelli ◽

Marta Bondanelli ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

Clinical Value ◽

Serum Thyroglobulin ◽

Recombinant Human Thyrotropin

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A Single Recombinant Human Thyrotropin-Stimulated Serum Thyroglobulin Measurement Predicts Differentiated Thyroid Carcinoma Metastases Three to Five Years Later

Yearbook of Surgery ◽

10.1016/s0090-3671(08)70416-6 ◽

2006 ◽

Vol 2006 ◽

pp. 152-153

Author(s):

T.J. Fahey

Keyword(s):

Thyroid Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

Serum Thyroglobulin ◽

Recombinant Human Thyrotropin

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

Nuklearmedizin ◽

10.1055/s-0038-1628878 ◽

1987 ◽

Vol 26 (03) ◽

pp. 139-142 ◽

Cited By ~ 4

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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Long-term follow-up of differentiated thyroid carcinoma in children and adolescents

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0194 ◽

2020 ◽

Vol 33 (11) ◽

pp. 1431-1441

Author(s):

Montserrat Negre Busó ◽

Amparo García Burillo ◽

Marc Simó Perdigó ◽

Pere Galofré Mora ◽

Maria Boronat de Ferrater ◽

...

Keyword(s):

Complete Remission ◽

Thyroid Carcinoma ◽

Children And Adolescents ◽

Differentiated Thyroid Carcinoma ◽

Radioiodine Treatment ◽

Persistent Disease ◽

Stage 4 ◽

Long Term Follow Up

AbstractObjectivesThe aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC).MethodsEighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated.ResultsSeventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3–18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences.ConclusionsDTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

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Ultrasound-guided implantation of radioactive 125I seed in radioiodine refractory differentiated thyroid carcinoma

BMC Cancer ◽

10.1186/s12885-021-08500-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Chen ◽

Yu kun Luo ◽

Ying Zhang ◽

Qing Song ◽

Jie Tang

Keyword(s):

Thyroid Carcinoma ◽

Reduction Rate ◽

Differentiated Thyroid Carcinoma ◽

Comprehensive Treatment ◽

Efficacy And Safety ◽

Ultrasound Guided ◽

Contrast Enhanced ◽

The Us ◽

Median Volume

Abstract Background Treatment for radioiodine refractory differentiated thyroid carcinoma (RR-DTC) is challenging. The purpose of this study was to assess the efficacy and safety of ultrasound-guided implantation of radioactive 125I-seed in radioiodine refractory differentiated thyroid carcinoma. Methods Thirty-six cervical metastatic lymph nodes (CMLNs) diagnosed with RR-DTC from 18 patients were enrolled in this retrospective study. US and contrast-enhanced ultrasound (CEUS) examinations were performed before implantation. Follow-up comprised US, CEUS, thyroglobulin (Tg) level and routine hematology at 1–3, 6, 9 and 12 months and every 6 months thereafter. The volumes of the nodules were compared before implantation and at each follow-up point. The volume reduction rate (VRR) of nodules was also recorded. Results The median volume of the nodules was 523 mm3 (148, 2010mm3) initially, which decreased significantly to 53mm3 (0, 286mm3) (P < 0.01) at the follow-up point of 24 months with a median VRR as 95% (86,100%). During the follow-up period (the range was 24–50 months), 25 (69%) nodules had VRR greater than 90%, of which 12 (33%) nodules had VVR ≈ 100% with unclear structures and only 125I seed images were visible in the US. At the last follow-up visit, the serum Tg level decreased from 57.0 (8.6, 114.8) ng/ml to 4.9 (0.7, 50.3) ng/ml, (P < 0.01). Conclusion US-guided 125I seed implantation is safety and efficacy in treating RR- DTC. It could be an effective supplement for the comprehensive treatment of thyroid cancer.

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