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01-07-2015 | Original Article

The role of ultrasound in the follow-up of children with differentiated thyroid cancer

Authors: Reza Vali, Marianna Rachmiel, Jill Hamilton, Mohamad El Zein, Jonathan Wasserman, Danny L. Costantini, Martin Charron, Alan Daneman

Published in: Pediatric Radiology | Issue 7/2015

Abstract

Background

Thyroid cancer is the most common endocrine malignancy with relatively good prognosis in children. However, unlike adults, children usually present with more advanced disease and have a higher local recurrence and distant metastases. Thus surveillance for recurrence is a major goal of long-term follow-up.

Objective

This retrospective study evaluates the diagnostic value of ultrasound (US) imaging in the post-therapy surveillance of children with differentiated thyroid cancer.

Materials and methods

We reviewed the charts of 54 children (40 girls; mean age 14.3 ± 3.6 years) with differentiated thyroid cancer treated with total or near-total thyroidectomy. Forty children (29 girls and 11 boys) who had routine follow-up US examinations (112 studies) were included for the evaluation of US accuracy in the follow-up of pediatric differentiated thyroid cancer. Histopathology, stimulated thyroglobulin determination, post-therapy whole-body iodine scan and clinical follow-up were used as the standards of reference.

Results

Mean period of follow-up was 34 months. The frequency of recurrence was 42% (17/40). Seventeen percent of the children had lung metastases either at presentation or on follow-up. In all cases of lung metastases, stimulated thyroglobulin level was greater than 10 ng/ml. The sensitivity was 85.7%, specificity 89.4%, negative predictive value 94.4% and positive predictive value 75% for US in detecting loco-regional recurrence in follow-up studies of pediatric differentiated thyroid cancer. In 17.3% (18/104) of studies, the results of stimulated thyroglobulin and US were discordant.

Conclusion

US showed very good sensitivity and specificity and a high negative predictive value for evaluation of loco-regional involvement in follow-up of pediatric differentiated thyroid cancer. Diagnostic whole-body iodine scan is indicated when serum anti-thyroglobulin Ab is high, or in cases of discordant findings between US and stimulated thyroglobulin levels, or when stimulated thyroglobulin levels are >10 ng/ml (to evaluate for lung metastasis).

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Title: The role of ultrasound in the follow-up of children with differentiated thyroid cancer
Authors: Reza Vali
Marianna Rachmiel
Jill Hamilton
Mohamad El Zein
Jonathan Wasserman
Danny L. Costantini
Martin Charron
Alan Daneman
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 7/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-014-3261-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of ultrasound in the follow-up of children with differentiated thyroid cancer

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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