| Undetectable thyroglobulin in patients with differentiated thyroid carcinoma and residual radioiodine uptake on a postablation whole-body scan. | |
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MedLine Citation:
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PMID: 21220971 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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AIM: To assess the impact of laboratory interferences and pitfalls in producing falsely undetectable Tg in differentiated thyroid carcinoma (DTC) patients with residual iodine-avid thyroid tissue on a posttreatment whole-body scan (PT-WBS). METHODS: From 298 consecutive patients with histologically proven DTC, 47 patients (16%) with undetectable serum Tg but residual ¹³¹I uptake on a PT-WBS were selected. Interferences from antithyroglobulin antibodies (TgAb), heterophile antibodies, and hook-effects were screened; in the remaining samples, serum Tg was measured in 3 different immunoassays. RESULTS: Of 47 patients, 11 (23%) showed interference from either thyroglobulin antibodies (n = 10) or heterophile antibodies (n = 1). Among the 36 remaining patients, 18 showed detectable Tg levels after retesting using a different immunoassay, whereas the remaining 18 patients also showed detectable Tg levels in a third Tg immunoassay. However, only 7 patients showed a detectable Tg in both secondarily used assays. Tg levels remained undetectable in all methods in 9 patients (19%) even after extensive laboratory work-up and despite the presence of ¹³¹I-avid tissue found in PT-WBS. CONCLUSIONS: A careful assessment of interferences in Tg measurement significantly reduced the occurrence of undetectable Tg among patients with ¹³¹I uptake in PT-WBS. However, such extensive assessment is difficult in clinical practice and one-fifth of patients still had undetectable Tg in multiple assays despite an intensive laboratory work-up. A benchmark between ¹³¹I imaging and Tg measurement authenticates the interpretation of Tg measurements and, consequently, remains of pivotal value by authenticating the use of serum Tg during further follow-up of DTC patients. |
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Authors:
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Luca Giovanella; Sergio Suriano; Luca Ceriani; Frederik Anton Verburg |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical nuclear medicine Volume: 36 ISSN: 1536-0229 ISO Abbreviation: Clin Nucl Med Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7611109 Medline TA: Clin Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 109-12 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. luca.giovanella@eoc.ch |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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