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Serum thyroglobulin and 131I whole body scan after recombinant human TSH stimulation in the follow-up of low-risk patients with differentiated thyroid cancer.
- Source :
-
European journal of endocrinology [Eur J Endocrinol] 2003 Jan; Vol. 148 (1), pp. 19-24. - Publication Year :
- 2003
-
Abstract
- 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.<br />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.<br />Methods: Measurement of serum Tg and (131)I-WBS after rhTSH stimulation, and ultrasound examination (US) of the neck.<br />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.<br />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.
- Subjects :
- Adult
Aged
Female
Follow-Up Studies
Humans
Iodine Radioisotopes
Male
Middle Aged
Radionuclide Imaging
Recombinant Proteins therapeutic use
Risk Factors
Ultrasonography
Carcinoma, Papillary, Follicular diagnostic imaging
Carcinoma, Papillary, Follicular drug therapy
Thyroglobulin blood
Thyroid Neoplasms diagnostic imaging
Thyroid Neoplasms drug therapy
Thyrotropin therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0804-4643
- Volume :
- 148
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 12534353
- Full Text :
- https://doi.org/10.1530/eje.0.1480019