A Sensitive Tg Assay or rhTSH Stimulated Tg: What's the Best in the Long-Term Follow-Up of Patients with Differentiated Thyroid Carcinoma?

Adrienne C. M. Persoon, Pieter L. Jager, Wim J. Sluiter, John T. M. Plukker, Bruce H. R. Wolffenbuttel, Thera P. Links*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

15 Citations (Scopus)
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Abstract

Sensitivity of thyroglobulin (Tg) measurement in the follow-up of differentiated thyroid carcinoma (DTC) can be optimized by using a sensitive Tg assay and rhTSH stimulation. We evaluated the diagnostic yield of a sensitive Tg assay and rhTSH stimulated Tg in the detection of recurrences in the follow-up of DTC. Additionally the value of imaging techniques for the localization of recurrences was evaluated. We included 121 disease free patients in long-term follow-up for DTC (median 10 years, range 1-34). Tg during thyroid hormone suppression therapy (Tg-on) and rhTSH stimulated Tg were measured with a sensitive Tg assay. Patients with rhTSH stimulated Tg >= 1.0 ng/ml underwent imaging with neck ultrasound, FDG-PET and post therapy (131)I WBS. Sensitive Tg measurement resulted in 3 patients with Tg-on >= 1.0 ng/ml, recurrence could be localized in 2 of them. RhTSH stimulation resulted in Tg >= 1.0 ng/ml in another 17 of 118 patients. Recurrence could be localized in only 1 additional patient (1 out of 118 patients). Recurrence was localized by neck ultrasound in 1 of 3, by FDG-PET in 2 of 3 and by post therapy (131)I WBS in 2 of 3 patients. In the detection of recurrences in DTC, rhTSH stimulation had very limited additional value in comparison to Tg-on measurement with a sensitive Tg assay. We consider this too low to justify rhTSH stimulation in all patients during long-term follow up. Neck ultrasound, FDG-PET and post therapy (131)I WBS showed complementary value in localization of disease, but were only positive in a small fracture of all procedures.

Original languageEnglish
Article number816
Number of pages8
JournalPLoS ONE
Volume2
Issue number8
DOIs
Publication statusPublished - 29-Aug-2007

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