Evaluation of the effectiveness of radioiodine ablation for differentiated thyroid carcinoma
Authors:
Vladimír Dedek 1; Martin Formánek 2,3; Petr Matoušek 2,3
Authors‘ workplace:
Klinika nukleární medicíny, Fakultní nemocnice Ostrava
1; Otorinolaryngologická klinika, Fakultní nemocnice Ostrava
2; Katedra kraniofaciálních oborů, Lékařská fakulta, Ostravská univerzita, Ostrava
3
Published in:
NuklMed 2014;3:31-36
Category:
Original Article
Overview
Introduction:
Initial therapeutic procedure for differentiated thyroid carcinoma (DTC) consists of the surgical treatment followed by radioiodine (RI) ablation of residual thyroid tissue.
Aim:
Evaluation of the success of the radioiodine ablation of thyroid remnants in patients operated in the Otorhinolaryngological (ORL) clinic of Faculty hospital Ostrava in the years 2007–2012.
Material:
131 patients with DTC after near-total thyroidectomy (nTTE), of which 109 patients with papillary (83 %) and 22 with follicular carcinoma (17 %). Distribution of patients according to the TNM classification: T1 72 pts, T2 21 pts, T3 5 pts and in the group of 33 pts tumor size was not detected (Tx).
Methods:
Hospitalization 5–6 weeks after nTTE in hypothyroidism, neck scintigraphy for visual assessment of residual thyroid tissue, administration of 3.7 GBq of 131I, rehospitalization after six months in myxedema, diagnostic whole-body scintigraphy after diagnostic dose of 110–185 MBq of radioiodine. The criterion for successful ablation of the thyroid remnants was a negative finding in the area of the thyroid bed. We also watched the success of RI ablation depending on the thyroglobulin level (Tg).
Results:
There was no residual thyroid tissue visible on the follow-up whole-body scintigrams in 105 of 131 patients (80 %). In the rest 26 cases (20 %), RI ablation was not successful and such pts required further RI therapy. The probability of successful RI ablation for Tg level <1 µg/l was 8:1, for Tg level between 1–10 µg/l 4,25:1 and for Tg >10 µg/l 0,75:1.
Conclusion:
We have demonstrated successful RI ablation after nTTE in 80 % of cases, which is comparable with the literature and suggests a satisfactory radical thyroid operation carried out in the ORL clinic in Faculty hospital in Ostrava. We consider the first thyroglobulin level an important factor in the prediction of successful RI thyroid remnant ablation. In cases with higher Tg level (usually above 10 µg/l) we prefer administration of therapeutic dose of 131I directly at repeated hospitalization.
Key Words:
differentiated thyroid cancer, radioiodine ablation, whole-body scintigraphy, thyroglobulin level
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Nuclear Medicine
2014 Issue 2
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