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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 11/2004

01-11-2004 | Original Article

Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases

Authors: Levent Kabasakal, Nalan Alan Selçuk, Hojjet Shafipour, Ozlem Ozmen, Cetin Onsel, Ilhami Uslu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2004

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Abstract

Purpose

During the follow-up of patients with well-differentiated thyroid carcinoma, some patients have elevated serum thyroglobulin (Tg) levels without any evidence of radioiodine accumulation on diagnostic whole-body scan (d-WBS). The treatment strategy in these patients is considered a clinical dilemma, with some groups recommending blind use of high-dose radioiodine therapy. The aim of this study was to evaluate whether or not high doses of radioiodine have beneficial effects in these patients.

Methods

Twenty-seven patients were included in the study. All patients had negative d-WBS and elevated levels of Tg. All received high doses of radioiodine. The mean follow-up period was 6.3±5.8 years. There were 11 patients with macrometastases and 16 with micrometastases.

Results

Post-treatment WBS revealed radioiodine accumulation in 19 of 24 (79%) patients. Serum Tg levels were decreased in 8 of 16 (50%) patients. Among patients with micrometastases, five out of seven (71%) demonstrated a decrease in serum Tg levels. Among patients with macrometastases, three out of nine (33%) demonstrated a decrease in Tg values and three (33%) have died due to metastatic thyroid cancer.

Conclusion

Radioiodine treatment may have a beneficial therapeutic effect in patients who have elevated levels of serum Tg and negative d-WBS. This is especially true in those patients with micrometastases; in patients with macrometastases, a beneficial effect of this approach may be observed less frequently.
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Metadata
Title
Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases
Authors
Levent Kabasakal
Nalan Alan Selçuk
Hojjet Shafipour
Ozlem Ozmen
Cetin Onsel
Ilhami Uslu
Publication date
01-11-2004
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2004
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-004-1516-y

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