Document Detail

Serum thyroglobulin and iodine-131 whole-body scan in the diagnosis and assessment of treatment for metastatic differentiated thyroid carcinoma.
MedLine Citation:
PMID:  8294995     Owner:  NLM     Status:  MEDLINE    
Because of the limitations of periodic 131I whole-body scans, including suspension of substitution therapy, questionable sensitivity and low yield in detecting metastases in patients who have undergone thyroidectomy, serum thyroglobulin and 131I whole-body scans were evaluated for sensitivity in detecting local, regional or distant metastases in 261 patients with differentiated thyroid carcinoma after total thyroidectomy and ablation. METHODS: A noncompetitive immunoradiometric assay was used for serum thyroglobulin determination. An 131I whole-body scan was obtained after replacement therapy had been suspended for 6 wk or when TSH reached levels higher than 50 microU/ml. In patients who underwent radiological procedures with iodinated contrast media, the waiting period before the 131I whole-body scan was no less than 10 wk. RESULTS: Of the 58 patients with proven metastases who were followed for 12 yr (mean 7 +/- 3.3 yr), 51 (88.4%) had high serum thyroglobulin assays performed while under full replacement therapy and 32 (55%) showed clear 131I whole-body scan localization. There were no instances of positive whole-body scans and negative serum thyroglobulin. CONCLUSION: In patients treated with 131I, serum thyroglobulin assay was an excellent method to assess treatment. Patients with metastatic disease and negative whole-body scans with or without serum thyroglobulin exhibited a trend toward higher mortality. This trend may also indicate that the lack of 131I trapping and low thyroglobulin is a sign of metabolic dedifferentiation of otherwise histologically differentiated thyroid tumors.
E Lubin; S Mechlis-Frish; S Zatz; A Shimoni; K Segal; A Avraham; R Levy; R Feinmesser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  35     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-02     Completed Date:  1994-03-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  257-62     Citation Subset:  IM    
Department of Nuclear Medicine, Beilinson Medical Center, Petah Tiqva, Israel.
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MeSH Terms
Adenocarcinoma, Follicular / pathology,  radionuclide imaging,  surgery
Carcinoma, Papillary / pathology,  radionuclide imaging,  surgery
Follow-Up Studies
Iodine Radioisotopes / diagnostic use*,  therapeutic use
Middle Aged
Neoplasm Metastasis
Thyroglobulin / blood*
Thyroid Neoplasms / pathology*,  radionuclide imaging,  surgery
Reg. No./Substance:
0/Iodine Radioisotopes; 9010-34-8/Thyroglobulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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