Clinical outcomes of persistent radioiodine uptake in the neck shown by diagnostic whole body scan in patients with differentiated thyroid carcinoma after initial surgery and remnant ablation

Kim, Eui Young; Kim, Won Gu; Kim, Won; Kim, Tae Yong; Ryu, Jin‐Sook; Gong, Gyungyub; Yoon, Jong Ho; Hong, Suck Joon; Lee, Jeong Hyun; Baek, Jung Hwan; Shong, Young Kee

doi:10.1111/j.1365-2265.2010.03788.x

Cited by 8 publications

(2 citation statements)

References 25 publications

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“…A recent study by Kim et al. demonstrating ablation failure is not an independent risk factor for recurrence in patients with persistent radioiodine uptake in the neck on diagnostic I‐131 scanning following initial surgery and I‐131 remnant ablation is also reassuring 20 . In this study, a significant proportion of patients with residual I‐131 uptake on follow‐up diagnostic scanning had spontaneous disappearance of residual I‐131 activity (and normalization of serum Tg levels) on subsequent scanning.…”

Section: Discussionsupporting

confidence: 57%

Incidence and implications of negative serum thyroglobulin but positive I‐131 whole‐body scans in patients with well‐differentiated thyroid cancer prepared with rhTSH or thyroid hormone withdrawal

Cherk¹,

Francis²,

Topliss³

et al. 2012

Clinical Endocrinology

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Our study confirms that in the setting of I-131 ablation therapy or diagnostic I-131 scanning, a significant proportion of patients (20·2% and 8·3%, respectively) have residual benign or malignant thyroid tissue on whole-body scanning despite a negative stimulated serum Tg level. Whether such patients who would otherwise be missed as having residual thyroid tissue on serum Tg testing alone have a worse clinical outcome remains uncertain. Our findings do however suggest performing both stimulated serum Tg/TgAb levels and I-131 scans for the follow-up of patients with higher-risk thyroid cancer may be important. There may also be a slightly higher incidence of this phenomenon in patients prepared with rhTSH rather than by thyroxine withdrawal.

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Section: Discussionsupporting

confidence: 57%

Incidence and implications of negative serum thyroglobulin but positive I‐131 whole‐body scans in patients with well‐differentiated thyroid cancer prepared with rhTSH or thyroid hormone withdrawal

Cherk¹,

Francis²,

Topliss³

et al. 2012

Clinical Endocrinology

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“…However, few studies have focused on the patients with negative Tg and positive 131 I -WBS results. Several previous studies have shown that negative Tg and positive 131 I -WBS results could be found in 4.4% -28.6% of the patients [3][4][5][6]. However, consensus on the clinical significances and management strategies has not yet been reached.…”

Section: Introductionmentioning

confidence: 98%

Clinical Outcomes and influence factors of differentiated thyroid carcinoma with negative preablative stimulated thyroglobulin and iodine-positive lymph nodes: A retrospective analysis

Wang

et al. 2020

Preprint

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Background To investigate the clinical outcome of postoperative differentiated thyroid carcinoma(DTC)patients with negative preablative-stimulated thyroglobulin (ps-Tg) and iodine-positive lymph node after the first radioablation. Methods A total of 136 DTC patients with ps-Tg<2ng/ml and iodine-positive lymph nodeswho were initially treated by 131I at our hospital from May 2015 to February 2018 were enrolled. These patients were followed up for 6-36 months, and then were classified into 3 groups according to the clinical outcomes as follows: excellent response (ER) group, indeterminate response (IDR) group, and structural incomplete response (SIR) group.Univariate and multivariate analyses were performed to assess thedifferences of factors (e.g. age, gender, extraglandular infiltration) between 3 groups. Results The N stage (P=0.001), sizes of the displayed lymph nodes (P<0.001), ps-Tg level (P=0.002), and TgAb level (P=0.001) were significantly different among the 3 groups. The gender (P=0.615), age (P=0.332), the primary tumor size (P=0.311), extrathyroidal invasion (P=0.549), T stage (P=0.944), rate of lymph node metastasis (P=0.170), locations of the displayed lymph nodes (P=0.099), and degree of recurrence risk (P=0.783) were not significantly different among the 3 groups.The corresponding sensitivity, specificity, positive predictive value, and negative predictive values were 93.3%, 82.6%, 86.4%, and 91.3% respectively when the cut-off value of the lymph node size was 7.25 mm. Conclusion For the DTC patients with negative ps-Tg and iodine-positive lymph nodes, postoperative N stage, size of the displayed lymph nodes, and ps-Tg and TgAb levels could be used as sensitive indicators for predicting clinical outcomes.

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Should patients with remnants from thyroid microcarcinoma really not be treated with iodine-131 ablation?

et al. 2013

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Clinical outcomes of persistent radioiodine uptake in the neck shown by diagnostic whole body scan in patients with differentiated thyroid carcinoma after initial surgery and remnant ablation

Abstract: Neck US and serum sTg, but not DxWBS, were useful diagnostic tools during follow-up of patients with persistent uptake in the neck at DxWBS. A second ablation was not necessary when neck US showed no evidence of disease, especially in patients with very low sTg concentration.

Cited by 8 publications

References 25 publications

Incidence and implications of negative serum thyroglobulin but positive I‐131 whole‐body scans in patients with well‐differentiated thyroid cancer prepared with rhTSH or thyroid hormone withdrawal

Incidence and implications of negative serum thyroglobulin but positive I‐131 whole‐body scans in patients with well‐differentiated thyroid cancer prepared with rhTSH or thyroid hormone withdrawal

Clinical Outcomes and influence factors of differentiated thyroid carcinoma with negative preablative stimulated thyroglobulin and iodine-positive lymph nodes: A retrospective analysis

Should patients with remnants from thyroid microcarcinoma really not be treated with iodine-131 ablation?

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