Thyrotropin variations may explain some positive radioiodine therapy scans in patients with negative diagnostic scans

Autor: J. Y. Devaux, I. Keller, E. Hindié, P. Zanotti-Fregonara, Domenico Rubello, M. Calzada-Nocaudie
Rok vydání: 2009
Předmět:
Zdroj: Journal of Endocrinological Investigation. 32:267-271
ISSN: 1720-8386
0391-4097
Popis: Thyroglobulin (Tg) is a specific marker of residual thyroid cancer or tumor recurrence. In patients with elevated Tg levels and negative diagnostic radioiodine (131I) whole-body scans (dWBS), administration of a therapy dose may reveal foci that were not initially apparent. The aim of this study was to identify factors, other than 131I activity, which might explain why a post-therapy 131I whole-body scan is sometimes positive despite a negative dWBS. Patients and methods: We reviewed data on all patients with elevated Tg levels and negative dWBS with 185 MBq 131I Off-T4 at followup, who subsequently received an empiric therapy dose of 3700 MBq of 131I. During a 5-yr period, 22 patients met these criteria. 131I therapy could be given immediately after negative dWBS in 9 patients, with an average of 8 extra days of hypothyroidism. In the other 13 patients, therapy was given an average of 8 months later. Results: The therapy scan was negative in 16 patients, while it showed uptake in the thyroid bed in 5 patients and distant metastases in two. In the latter two patients, the TSH level was suboptimal at the time of dWBS (9 and 25 μlU/ml), and had risen to 34 and 70 μlU/ml respectively at the time of therapy. Overall, a positive scan following therapy occurred in 7 patients (6/9 patients treated immediately and 1/13 patients treated in a separate setting; p
Databáze: OpenAIRE
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