Document Detail

The predictive value of serum thyroglobulin in the follow-up of differentiated thyroid cancer.
MedLine Citation:
PMID:  9211756     Owner:  NLM     Status:  MEDLINE    
A strict and careful strategy has to be adopted to cure thyroid cancer. Diagnostic iodine-131 whole-body scan (WBS) and serum thyroglobulin (Tg) are important tools to detect thyroid remnants after thyroidectomy and radioiodine therapy. The aim of this retrospective study was to compare the relative sensitivity of WBS and Tg in the detection of thyroid remnants or metastases and to evaluate the predictive value of Tg in the clinical and scintigraphic course of the disease. Ninety-three patients were followed up after total thyroidectomy and the administration 4-6 weeks later of an ablative dose of 100 or 150 mCi 131I. Eighty-five percent of the patients were free of regional or distant metastases. The follow-up scheme included clinical examination of the patient followed by WBS, Tg, thyroid-stimulating hormone and free thyroxine measurements performed 4 weeks after thyroxine withdrawal and the observance of a low-iodine diet for at least 1 week. WBS (+) patients received a 100- or 150-mCi therapeutic dose of 131I. All patients were further followed up in the same way every 6 months until both WBS and Tg became negative, and thereafter at 1-, 2- and 4-year intervals. Six months after the postoperative radioiodine treatment (first visit), the sensitivity of WBS and Tg was 87% and 26% respectively. Among patients who were WBS(+) at the first visit, 95% of those who were Tg(-) and 47% of those who were Tg(+) had become disease-free at a median of 4 years after surgery (chi2=13.6; P<0.05). Patients whose tests were both positive required more radioiodine to be cured (335+/-90 vs 250+/-95 mCi; P<0.05). Our data indicate that in early diagnosed thyroid cancer, serum Tg measured 6 months after the postoperative 131I ablative dose is less sensitive than WBS for the demonstration of persistence of residual thyroid tissue but provides predictive information on the disease course. WBS(+) and Tg(-) patients are cured earlier and with less radioiodine than those who remain Tg(+).
V Roelants; P D Nayer; A Bouckaert; C Beckers
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of nuclear medicine     Volume:  24     ISSN:  0340-6997     ISO Abbreviation:  Eur J Nucl Med     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-09-08     Completed Date:  1997-09-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7606882     Medline TA:  Eur J Nucl Med     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  722-7     Citation Subset:  IM    
Center of Nuclear Medicine, University of Louvain Medical School, Brussels, Belgium.
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MeSH Terms
Adenocarcinoma, Follicular / blood*,  radionuclide imaging,  therapy
Carcinoma, Papillary / blood*,  radionuclide imaging,  therapy
Combined Modality Therapy
Follow-Up Studies
Iodine Radioisotopes / diagnostic use*
Middle Aged
Neoplasm, Residual
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Thyroglobulin / blood*
Thyroid Neoplasms / blood*,  radionuclide imaging,  therapy
Time Factors
Reg. No./Substance:
0/Iodine Radioisotopes; 9010-34-8/Thyroglobulin

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