EXPERIENCES WITH WHOLE-BODY SCAN AFTER HIGH-DOSE ABLATION OF THYRIOD REMNANT.

Aim: To compare the efficacy and safety of recombinant human TSH (rhTSH) to the conventional remnant ablation with thyroxine withdrawal in patients with thyroid cancer. Material and methods: High-dose ablation (3700 MBq) of thyroid remnant was performed in 32 patient from January 2006, with rhTSH in 12 patients (2 men, 10 women, 46 years, 23–63), and conventional protocol in 20 patients (2 men, 18 women, 48 yeras, 16–76). TSH and thyroblobulin (Tg) levels were measured before and after the ablation. Whole-body (5 cm/min) and anterior jugular scans (100 k) were established in all patients 6 days after the treatment. The counts/million (C) of the whole-body scan and C/Tg (before treatment) rate was calculated. The enhancement of the radioiodine in the remnant and in other localization was observed on both imaging. Results: The C/Tg ratio was higher in the patients prepared with rhTSH (0.33/0.10, p £ 0.05) whereas the whole-body C value was lower (0.18/0.71, p £ 0.05) comparing to the patients with conventional therapy. Remnant thyroid activity was found in 27 patients, iodine enhancement in other localization was found in 11 patients, at whom CT examinations were performed, too. Conclusions: 1. The rhTSH-prepared patients maintained a higher quality of life during the ablation. 2. The radiation exposure to the blood is less while the efficacy of the treatment is equally good. 3. The whole-body and jugular scans are very useful in the investigation of thyroid remnant and metastases in the region of neck and chest, however it can be evaluated with caution in the abdominal region. [ABSTRACT FROM AUTHOR]