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European Journal of Nuclear Medicine and Molecular Imaging

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01-08-2008 | Original article

Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

Authors: Elisa Caballero-Calabuig, Carmen Cano-Terol, Ramón Sopena-Monforte, Dolores Reyes-Ojeda, Pedro Abreu-Sánchez, José Ferrer-Rebolleda, Pablo Sopena-Novales, Carmen Plancha-Mansanet, Jesús Félix-Fontestad

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2008

Abstract

Purpose

Stimulated thyroglobulin (Tg) and ¹³¹I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful.

Material and methods

Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant.

Results

Discordant ¹³¹I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants.

Conclusions

We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative.

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Title: Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning
Authors: Elisa Caballero-Calabuig
Carmen Cano-Terol
Ramón Sopena-Monforte
Dolores Reyes-Ojeda
Pedro Abreu-Sánchez
José Ferrer-Rebolleda
Pablo Sopena-Novales
Carmen Plancha-Mansanet
Jesús Félix-Fontestad
Publication date: 01-08-2008
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-008-0789-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

Abstract

Purpose

Material and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusions

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