engleski

Serum thyroglobulin, 1-131 whole body scan and neck ultrasonography in the follow-up of low risk patients with differentiated thyroid cancer

The aim of this retrospective study was to assess the utility of serum thyroglobulin (TG), (131) I- wholebody scan (WBS) and neck ultrasonography (US) in the fol¬ ; ; low up of low risk patients with differentiated thyroid cancer (DTC). The study included 121 consecutive patients with DTC submitted to total thyroidectomy and subsequent (131) I thyroid ablation between 1992 and 2002 at our department (Osijek University Hospi¬ ; ; tal). Patients with uptake outside the thyroid bed on the postablative (131) I-WBS (high-risk patients) were excluded from the study. The routine procedure in the follow up of DTG was based on serum Tg measurements during thyroid hormone withdrawal (Tg-off), diagnostic (131) I-WBS and neck US. The mean follow up period was 8.2+7-3.6 years. Clinically persistent or recurrent disease was diagnosed in 16 of 121 patients (13.2%). Serum thyroglobulin (Tg-off) was elevated (Tg >2 ng/ mL) in 13 patients with recurrence (sensitivity: 81%), (131) I-WBS was positive (uptake outside the thyroid bed) in 4 patients with recurrence (sensitivity: 25%) and neck US identified (confirmed by fine-needle aspi¬ ; ; ration cytology) 12 patients with recurrent disease (sen¬ ; ; sitivity: 75%). Neck US identified 3 (18.7%) patients that were not previously detected by serum Tg and (131) I-WBS (Tg (-), (131) I WBS (-)). The combined use of serum thyroglobulin (Tg- off) and neck US detected all patients with recurrence of DTC. Serum thyroglobulin levels (Tg- off) and neck US were sufficient diagnostic tools for detection of persistent or recurrent disease in the follow up of low risk patients with DTC. The rou¬ ; ; tine use of diagnostic WBS in the follow up of low risk patients did not show significant clinical benefit.

serum thyroglobulin ; 1-131 whole body scan ; neck ultrasonography ; thyroid cancer

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