engleski

Diagnostic value of iodine-131 whole body scan in the follow-up of low risk patient with differentiated thyroid cancer

To assess diagnostic value of iodine-131 whole body scan (WBS 131I) in the follow-up of low risk patients with differentiated thyroid cancer (DTC). The study included 121 consecutive patients with DTC submitted to total thyroidectomy and subsequent 131I thyroid ablation, between 1992- 2002 in our department (Osijek University Hospital). Patients with uptake outside the thyroid bed on the post-ablative WBS 131I (high- risk patient) were excluded from the study. The routine procedure in the follow-up of DTC was based on serum thyroglobulin (Tg) measurements during thyroid hormone withdrawal (Tg-off), diagnostic WBS 131I and neck ultrasonography. The mean follow-up period was 8.2 ± 3.6 years. Clinically persistent or recurrent disease was diagnosed in 16 out of 121 patients (13.2%). Serum thyroglobulin (Tg-off) was elevated (Tg>2 ng/ml) in 13 patients with recurrence (sensitivity 81%), 131I-WBS was positive (uptake outside the thyroid bed) in 4 patients with recurrence (sensitivity 25%) and neck ultrasonography identified (confirmed by fine-needle aspiration cytology) 12 patients with recurrent disease (sensitivity 75%). The neck ultrasonography identified 3 patients (18.7%) which were not previously detected with the serum Tg and 131I-WBS. The combined use of serum thyroglobulin (Tg-off) and neck ultrasonography detected all the patients with recurrence of DTC. In 9 disease-free patients, a significant (persistent) thyroid bed uptake was founded on 131I-WBS and these patients received additional 131I ablative therapy. Serum thyroglobulin levels (Tg-off) and neck ultrasonography were sufficient diagnostic tools for detection of persistent or recurrent disease in the follow-up of low risk patient with differentiated thyroid cancer. The routine use of diagnostic whole body scan in the follow-up of low risk patients did not show significant clinical benefit. In 9 disease-free patients (7.4%) 131I- WBS was detected persistent thyroid bed uptake.

iodine-131 ; thyroid cancer ; body scan

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