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Aim Thyroidectomy followed by administration of large activities of 131‐iodine (131I) is the treatment of choice for differentiated thyroid carcinoma (DTC). The serum thyroglobulin (Tg) measurement during hypothyroidism (offT4‐Tg), just before radioiodine thyroid ablation, has proved to be effective for predicting persistent/recurrent disease. However, the Tg measurement cannot be used as a corresponding value for pre‐ablative offT4‐Tg when recombinant human TSH (rhTSH) is used as stimulus before treatment. The present study was undertaken to evaluate if post‐thyroidectomy Tg values, measured before rhTSH‐stimulated radioiodine ablation is of prognostic value in patients affected by DTC. Methods We enrolled 126 patients with DTC submitted to total thyroidectomy. T4 treatment was started just after surgery to suppress TSH levels and Tg levels (onT4‐Tg) were measured just before rhTSH‐aided thyroid ablation by 131I (3700 MBq). Neck radioiodine uptake (RAIU) was measured just before ablation and a post‐treatment whole body scan (PT‐WBS) was performed. Results A significant relationship was found between thyroid remnants’ RAIU and onT4‐Tg levels (P < 0·001). The 1·10 ng/ml onT4‐Tg threshold selected by ROC curve analysis identifies patients with positive PT‐WBS with 83·3% sensitivity, 65·7% specificity, 44·5% positive predictive value (PPV) and 93·6% negative predictive value (NPV). The 0·65 ng/ml cut‐off level recognizes metastatic patients with 82·9% sensitivity, 55·2% specificity, 43·3% PPV and 97·8% NPV when compared with 12 months restaging results. Among 63 patients with initially undetectable onT4‐Tg (i.e. ≤ 0·2 ng/ml) none had positive PT‐WBS nor DTC relapse at 12‐month restaging (NPV 100%). Conclusions Based on our data we conclude that pre‐ablative onT4‐Tg is a prognostic marker and should be used instead of pre‐ablative TSH‐stimulated Tg measurement when rhTSH‐aided radioiodine ablation is done. 相似文献
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Maas O. Forrer F. Maas M. Panje C. M. Blautzik J. Brhlmeier M. Engel-Bicik I. Giovanella L. Haldemann A. Kamel M. E. Kneifel S. Rottenburger C. Schaefer N. Walter M. A. Weidner S. Putora P. M. 《European journal of nuclear medicine and molecular imaging》2020,47(3):554-560
European Journal of Nuclear Medicine and Molecular Imaging - The role of radioiodine treatment following total thyroidectomy for differentiated thyroid cancer is changing. The last major revision... 相似文献
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Giovanella Luca Verburg Frederik A. Ovariek Petra Petranovi Iakovou Ioannis Mihailovic Jasna Vrachimis Alexis Zerdoud Slimane Hoffmann Martha Luster Markus 《European journal of nuclear medicine and molecular imaging》2020,47(6):1342-1344
European Journal of Nuclear Medicine and Molecular Imaging - 相似文献
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Loss of radioactivity from nude mice was determined after inoculation of human tumor cells prelabeled with [111In]indium oxine (111InOx). Elimination of 111In was increased somewhat by treating the mice with diphtheria toxin (DT), which is toxic selectively for human cells compared to mice. Calcium disodium edetate (CaNa2EDTA), a metal chelating agent, facilitated elimination of 111In and increased the difference in the rates of loss of radioactivity from mice bearing viable compared to DT-killed cells. 相似文献
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At least one microCi of 111indium oxine (111InOx) could be incorporated into 10(6) human tumor cells without cytotoxicity as determined by colony assay or by trypan blue staining. 111In bound to prekilled cells was removed preferentially by washings, and prelabeled cells killed with diphtheria toxin released radioactivity much more rapidly than did viable cells. The metal chelator calcium disodium edetate did not facilitate 111In removal from either viable or dead cells. High sensitivity can be obtained for in vitro or in vivo cytotoxicity assays using human cells prelabeled with 111InOx. 相似文献