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DOI: 10.1055/s-0029-1241204
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Diagnostic Accuracy of rhTSH Test with Neck Ultrasonography in Differentiated Thyroid Cancer Follow-up
Publikationsverlauf
received 16.06.2009
first decision 06.08.2009
accepted 18.09.2009
Publikationsdatum:
11. Dezember 2009 (online)

Abstract
Serum thyroglobulin levels measurement after injection of recombinant human thyrotropin (rh-TSH) represents the most important advance in the follow-up of patients with differentiated thyroid cancer, obtaining TSH elevation without L-thyroxine withdrawal, avoiding marked hypothyroidism symptoms. During a 4-yr period (2004–2008), 66 consecutive patients with DTC (59 papillary and 7 follicular carcinomas) were examined after rh-TSH Tg test and neck ultrasonography. In all patients basal Tg was <0.25 ng/ml. In twelve (18.5%) examined patients rh-TSH Tg was >0.25 ng/ml, and in seven (58.3%) of these was demonstrated persistent or recurrent disease. These data indicate that rhTSH-Tg>0.25 ng/ml should be considered diagnostic for persistent or recurrent disease and suggests further exams (neck ultrasonography, whole body scan or cytology) to localize the disease. Furthermore, neck ultrasonography has demonstrated high accuracy in detecting lymph nodal metastases and should be always combined with rh-TSH test.
Key words
thyroid cancer - rhTSH - thyroid ablation - thyroglobulin - radio-iodine
References
- 1
Cooper DS, Doherty GM, Haugen BR. et al .
The American Thyroid Association Guidelines Taskforce: Management guidelines for patients
with thyroid nodules and differentiated thyroid cancer.
Thyroid.
2006;
16
109-142
MissingFormLabel
- 2
Frasoldati A, Pesenti M, Gallo M. et al .
Diagnosis of neck recurrences in patients with differentiated thyroid carcinoma.
Cancer.
2003;
97
((1))
90-96
MissingFormLabel
- 3
Jemal A, Siegel R, Ward E. et al .
Cancer statistics, 2008.
CA Cancer J Clin.
2008;
58
71-96
MissingFormLabel
- 4
Pacini F, Castagna MG.
Diagnostic and therapeutic use of recombinant human TSH (rhTSH) in differentiated
thyroid cancer.
Best Pract Res Clin Endocrinol Metab.
2008 Dec;
22
((6))
1009-1021
MissingFormLabel
- 5
Pacini F, Molinaro E, Castagna MG. et al .
Recombinant human thyrotropin-stimulated serum thyroglobulin combined with neck ultrasonography
has the highest sensitivity in monitoring differentiated thyroid carcinoma.
J Clin Endocrinol Metab.
2003 Aug;
88
((8))
3668-3673
MissingFormLabel
- 6
Pacini F, Schlumberger M, Dralle H. et al .
European Thyroid Cancer Taskforce: European consensus for the management of patients
with differentiated thyroid carcinoma of the follicular epithelium.
Eur J Endocrinol.
2006 Jun;
154
((6))
787-803
MissingFormLabel
- 7
Torlontano M, Crocetti U, Augello G. et al .
Comparative evaluation of recombinant human thyrotropin-stimulated thyroglobulin levels,
131I whole-body scintigraphy, and neck ultrasonography in the follow-up of patients
with papillary thyroid microcarcinoma who have not undergone radioiodine therapy.
J Clin Endocrinol Metab.
2006 Jan;
91
((1))
60-63
MissingFormLabel
- 8
Verburg FA, de Keizer B, de Klerk JM. et al .
Value of diagnostic radioiodine scintigraphy and thyroglobulin measurements after
rhTSH injection.
Nuklearmedizin.
2009;
48
((1))
26-29
MissingFormLabel
Correspondence
Prof. A. Fumarola
Sapienza Università di Roma, Experimental Medicine
Viale Regina Elena, 324
00161 Rome
Italy
eMail: angela.fumarola@uniroma1.it