Abstract:
PURPOSE:Recurrences are frequent in thyroid cancer patients and long-term follow-up is therefore necessary. We evaluated the yield of rhTSH stimulation in three groups of patients, classified according to the UICC/TNM risk stratification and the results of first follow-up testing. METHODS:The study population comprised 129 patients referred for rhTSH testing. All had undergone first follow-up testing after thyroid hormone withdrawal (off-T4) within 1 year of 131I ablation. Negative first follow-up testing was defined as Tg <2 ng/ml and no neck uptake on 131I diagnostic whole-body scan. Seventy-five patients had stage I thyroid cancer and negative first follow-up testing (group A), 19 had stage I disease and positive first follow-up testing (group B), and 35 had stage II-IV disease (group C). RhTSH stimulation was performed an average of 6 years after first follow-up testing. RESULTS:131I diagnostic scanning after rhTSH was negative in all 75 group A patients. Only one group A patient had detectable Tg after rhTSH injection (1.5 ng/ml), but Tg had also been detected at baseline in this patient (1.45 ng/ml). Given the absence of a response to stimulation, suggesting an interference, Tg was reassessed with a different technique and proved to be undetectable (<0.1 ng/ml). Stimulation with rhTSH in group B showed residual Tg in seven patients and residual 131I uptake in the thyroid bed in two patients, but none of these patients had signs of disease progression. Five group C patients (14%) had a positive rhTSH test result, and this was suggestive of disease progression in at least two cases. CONCLUSION:The first follow-up testing is essential for prognostic classification after 131I ablation of thyroid cancer. In stage I patients, undetectable Tg and negative 131I scan 1 year after ablation define a large population of subjects who have a very low risk of recurrence and who do not require further stimulation tests. In contrast, periodic rhTSH stimulation tests appear useful in higher-risk patients.
journal_name
Eur J Nucl Med Mol Imagingauthors
Zanotti-Fregonara P,Khoury A,Duron F,Keller I,Christin-Maître S,Kiffel T,Toubert ME,Devaux JY,Hindié Edoi
10.1007/s00259-006-0279-zsubject
Has Abstractpub_date
2007-04-01 00:00:00pages
541-6issue
4eissn
1619-7070issn
1619-7089journal_volume
34pub_type
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:European journal of nuclear medicine and molecular imaging
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更新日期:2009-10-01 00:00:00
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 共识发展会议,指南,杂志文章,实务指引,评审
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章,评审
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journal_title:European journal of nuclear medicine and molecular imaging
pub_type: 杂志文章
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更新日期:2009-12-01 00:00:00
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