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Nuclear Medicine and Molecular Imaging
Published in: Nuclear Medicine and Molecular Imaging 4/2013

01-12-2013 | Original Article

Limited Clinical Value of Periablative Changes of Serum Markers in the Prediction of Biochemical Remission in Patients with Papillary Thyroid Cancer

Authors: Heeyoung Kim, Seong-Jang Kim, In-Joo Kim, Keunyoung Kim, Sojung Kim, Bo Hyun Kim, Sang Soo Kim, Jeon Yoon Kyung

Published in: Nuclear Medicine and Molecular Imaging | Issue 4/2013

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Abstract

Purpose

Remnant thyroid ablation and 1-year stimulated thyroglobulin (sTg) measurement are recommended for those who have undergone total thyroidectomy for differentiated thyroid cancer. The serum Tg kinetics in such patients are still unclear. This study was designed to evaluate whether the periablative change in serum markers can predict biochemical remission in papillary thyroid cancer (PTC) patients.

Methods

We reviewed the medical records of 185 patients who were given high-dose radioactive iodine ablation therapy from January 2006 to December 2008. Serum Tg, TSH, and anti-Tg antibody (TgAb) were measured on the day and the following 10th day of radioactive iodine administration. We defined preablative sTg as Tg-1, postablative Tg measured on the 10th day of ablation as Tg-2, and the 1-year sTg as Tg-3. ΔTg means Tg2-Tg1. The same definition was applied to TgAb.

Results

A biochemical remission defined as Tg-3 < 2 ng/ml was achieved in 144 patients. Among the patients who achieved biochemical remission, PTC recurred in six during a median follow-up of 54 months. Tg-1 < 3.3 ng/ml (p < 0.0001) predicted biochemical remission. Neither the ΔTg nor ΔTgAb was useful for predicting biochemical remission. On the evaluation of recurrence after biochemical remission, Tg-1 > 5.32 (p < 0.0001) and Tg-3 > 2.9 (p = 0.01) were proven to be statistically significant cutoff values for predicting recurrence. The ΔTg and ΔTgAb were not able to predict recurrence.

Conclusion

For the prediction of biochemical remission or recurrence after biochemical remission, preablative sTg was demonstrated to be a statistically significant serum marker. However, short-term changes in biochemical markers including Tg and TgAb around the day of ablation could not provide useful clinical information about biochemical remission or disease recurrence. In conclusion, 1-year sTg measurement cannot be omitted with short-term change.
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Metadata
Title
Limited Clinical Value of Periablative Changes of Serum Markers in the Prediction of Biochemical Remission in Patients with Papillary Thyroid Cancer
Authors
Heeyoung Kim
Seong-Jang Kim
In-Joo Kim
Keunyoung Kim
Sojung Kim
Bo Hyun Kim
Sang Soo Kim
Jeon Yoon Kyung
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 4/2013
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-013-0220-x

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