The Role of Recombinant Human Thyrotropin for Diagnostic Monitoring of Patients with Differentiated Thyroid Cancer

The use of recombinant human thyrotropin (rhTSH) testing in the diagnosis and therapy of differentiated thyroid cancer (DTC) has been adopted over the last two decades as an alternative to the classical thyroid hormone withdrawal avoiding the threat of hypothyroidism. Serum thyroglobulin (Tg) measurement is crucial for monitoring DTC patients over time. Until about a decade ago, optimal sensitivity of Tg assays for the detection of smaller disease foci required Tg measurement after thyrotropin (TSH) stimulation, carried out following thyroid hormone withdrawal or rhTSH administration. In very recent years, significant improvements in assay technology have resulted in highly sensitive Tg (hsTg) assays, sufficiently sensitive to obviate the need for rhTSH stimulation in most DTC patients. The aim of this paper is to review and discuss, via a ‘pros and cons’ approach, the current clinical role of rhTSH to stimulate radioiodine (RAI) uptake for treatment and/or imaging purposes and to increase the clinical sensitivity of Tg measurement for monitoring DTC patients when high-sensitive Tg assays are available.

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The Role of Recombinant Human Thyrotropin for Diagnostic Monitoring of Patients with Differentiated Thyroid Cancer

Endocrine Practice ◽

10.4158/ep12315.ra ◽

2013 ◽

Vol 19 (1) ◽

pp. 157-161 ◽

Cited By ~ 11

Author(s):

Steven Sherman

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Recombinant Human Thyrotropin

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The role of radioiodine SPECT/CT in differentiated thyroid cancer

Endocrine Abstracts ◽

10.1530/endoabs.32.p1097 ◽

2013 ◽

Author(s):

Emese Mezosi ◽

Laszlo Bajnok ◽

Karoly Rucz ◽

Csaba Weninger ◽

Erzsebet Schmidt ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer

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The role of preoperative serum thyroglobulin values in the diagnosis of differentiated thyroid cancer

Endocrine Abstracts ◽

10.1530/endoabs.49.ep1370 ◽

2017 ◽

Author(s):

Blertina Dyrmishi ◽

Taulant Olldashi ◽

Ema Lumi ◽

Entela Puca ◽

Dorina Ylli ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Serum Thyroglobulin ◽

Preoperative Serum

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The role of Hashimoto thyroiditis in predicting radioiodine ablation efficacy and prognosis of low to intermediate risk differentiated thyroid cancer

Annals of Nuclear Medicine ◽

10.1007/s12149-021-01644-1 ◽

2021 ◽

Author(s):

Domenico Albano ◽

Francesco Dondi ◽

Valentina Zilioli ◽

Maria Beatrice Panarotto ◽

Alessandro Galani ◽

...

Keyword(s):

Thyroid Cancer ◽

Treatment Response ◽

Differentiated Thyroid Cancer ◽

Hashimoto Thyroiditis ◽

Prognostic Impact ◽

Intermediate Risk ◽

Excellent Response ◽

Radioiodine Ablation ◽

One Year

Abstract Objective The baseline treatment of differentiated thyroid cancer (DTC) consists of thyroidectomy followed by postoperative risk-adapted radioiodine therapy (RAIT) when indicated. The choice of most appropriate RAI activities to administer with the aim to reach an efficient remnant ablation and reduce the risk of recurrence is yet an open issue and the detection of basal factors that may predict treatment response seems fundamental. The aim of this study was to investigate the potential role of Hashimoto thyroiditis (HT) in predicting 1-year and 5-year treatment response after RAIT and prognosis. Methods We retrospectively included 314 consecutive patients (174 low-risk and 140 intermediate-risk) who received thyroidectomy plus RAIT. One-year and 5-year disease status was evaluated according to 2015 ATA categories response based upon biochemical and structural findings. Results HT was reported histopathologically in 120 patients (38%). DTC patients with concomitant HT received a higher number of RAITs and cumulative RAI activities. Initial RAIT reached an excellent response in 63% after one year and 84% after 5 years. The rate of excellent response one year and 5-year after first RAIT was significantly lower in HT groups, compared to not HT (p < 0.001). Instead, HT did not have a prognostic role considering PFS and OS; while stimulate thyroglobulin (sTg) at ablation was significantly related to survival. Conclusions HT may affect the efficacy of RAIT in low to intermediate risk DTC, particularly reducing the successful rate of excellent response after RAIT. Instead, HT did not have a prognostic impact such as stimulated sTg.

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