Comparison of day 3 and day 5 thyroglobulin results after thyrogen injection in differentiated thyroid cancer patients

Sağer, Sait; Hatipoğlu, Esra; Güneş, Burçak Yılmaz; Asa, Sertaç; Uslu, Lebriz; Sönmezoğlu, Kerim

doi:10.1177/2042018818770108

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…Post therapy whole body scan and serum Tg are obtained 72 h after the second rhTSH injection or 48 h after receiving I-131 (Day 5) [22,23]. These time schedules are supported by studies showing that the highest mean Tg level was achieved more than 48 h after the final rhTSH injection, with most patients achieving a peak serum Tg level 72 h after the second rhTSH injection [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Radiation exposure to allied health personnel handling blood specimens from patients receiving radioactive iodine-131 and recombinant human TSH (thyrogen®) stimulation

et al. 2021

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With increasing use of recombinant human TSH (rhTSH) stimulation protocol in radioactive iodine-131 treatment of thyroidectomised differentiated thyroid carcinoma (DTC), there is increasing concern regarding radiation safety during collection and processing of radioactive blood samples. Our study aims to quantify this radiation exposure in the context of current radiation guidelines to provide a practical safety framework. We analysed 45 patients prospectively referred to a tertiary centre in Singapore, who had histologically proven DTC, and who were thyroidectomised and planned for I-131 with rhTSH stimulation. Each patient received rhTSH for two consecutive days, with I-131 administered 24 h after, and a stimulated Thyroglobulin blood sample collected and processed 72 h after the last rhTSH dose. We measured radiation exposures with dosimeters. Based on the average and maximum exposure rates calculated, we extrapolated and derived the number of radioactive blood samples that could be safely collected and processed. Mean hand and body radiation exposures during venepuncture and blood processing were generally significantly higher than background radiation. Based on average exposure rates, the permissible number of blood samples that can be collected and processed is 9.09 × 103 per year (24 per day) and 8.70 × 104 per year (238 per day), respectively. This is the first study to date to extrapolate permissible thresholds that can serve as a practical guideline to the number of radioactive blood samples which can be safely collected and processed, following radioactive iodine therapy, within the limits of current radiation guidelines. Once validated, generalisations to other radioactive therapies may be considered.

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Section: Introductionmentioning

confidence: 99%

Radiation exposure to allied health personnel handling blood specimens from patients receiving radioactive iodine-131 and recombinant human TSH (thyrogen®) stimulation

et al. 2021

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Prognostic Value of Serum Thyroglobulin Measured at 48 Hours Versus 72 Hours after Second Dose of Recombinant Human Thyrotropin in Surveillance of Well-Differentiated Thyroid Cancer

2021

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Can the basal serum thyroglobulin level be used to predict the recombinant human TSH-stimulated thyroglobulin level in differentiated patients with thyroid cancer?

Jeong¹,

Yoon²,

Lee³

et al. 2019

Medicine

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This study investigated the correlation between basal thyroglobulin (Tg) and recombinant human thyroid-stimulating hormone (rhTSH)-stimulated Tg in differentiated patients with thyroid cancer, and sought to determine whether the basal Tg level predicts the rhTSH-stimulated Tg level. We retrospectively enrolled 177 patients with papillary thyroid cancer (mean age = 44 years; 50 males, 127 females) who received rhTSH before radioiodine therapy (RIT). Serum Tg levels were measured 7 days before the 1st rhTSH injection (basal Tg) and on the days of RIT (rhTSH-stimulated Tg). Patients were divided into 3 groups according to rhTSH-stimulated Tg cut-off levels of 2, 5, and 10 ng/mL. The correlation between basal Tg and rhTSH-stimulated Tg levels was assessed, and whether basal Tg was useful in predicting the rhTSH-stimulated Tg level was determined. A significant positive correlation was observed between basal and rhTSH-stimulated Tg levels (|rho| = 0.48, P < .0001). The basal Tg level had significant diagnostic ability in predicting an rhTSH-stimulated Tg level of 2 ng/mL or higher, and the optimal basal Tg level for this prediction was 0.3 ng/mL (AUC = 0.77, P < .0001). A basal Tg level of 0.5 ng/mL was optimal for predicting rhTSH-stimulated Tg levels of 5 ng/mL or higher (AUC = 0.81, P < .0001), and of 10 ng/mL or higher (AUC = 0.82, P = .0171). The basal Tg level was significantly correlated with the rhTSH-stimulated Tg level. If the basal Tg level is >0.3 or 0.5 ng/mL, then the rhTSH-stimulated Tg level can be expected to be sufficiently high to necessitate clinical examination.

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Comparison of day 3 and day 5 thyroglobulin results after thyrogen injection in differentiated thyroid cancer patients

Abstract: After Thyrogen injection of two consecutive days, blood sampling might be enough on day 3. Day 5 blood sampling may not be necessary routinely for radiation protection of laboratory staff. For the diagnostic group, if Tg and anti-Tg is normal then 5 mCi imaging may not be necessary.

Cited by 4 publications

References 21 publications

Radiation exposure to allied health personnel handling blood specimens from patients receiving radioactive iodine-131 and recombinant human TSH (thyrogen®) stimulation

Radiation exposure to allied health personnel handling blood specimens from patients receiving radioactive iodine-131 and recombinant human TSH (thyrogen®) stimulation

Prognostic Value of Serum Thyroglobulin Measured at 48 Hours Versus 72 Hours after Second Dose of Recombinant Human Thyrotropin in Surveillance of Well-Differentiated Thyroid Cancer

Can the basal serum thyroglobulin level be used to predict the recombinant human TSH-stimulated thyroglobulin level in differentiated patients with thyroid cancer?

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