Diagnostic and therapeutic use of recombinant human TSH (rhTSH) in differentiated thyroid cancer

The introduction of rhTSH into clinical practice has changed dramatically the monitoring and treatment of differentiated thyroid cancer patients. In particular, the post-surgical thyroid ablation with radio-iodine and the periodical follow-up are more and more routinely based on the use of rhTSH as the method of choice for patient preparation. Therapeutic results and sensitivity of follow-up when using rhTSH are not inferior to conventional thyroid hormone withdrawal and, in some regard, are superior if one considers the preservation of quality of life. The latter aspect is very well exemplified by the constant observation that patients who have experienced rhTSH will never accept going back to thyroid hormone withdrawal.

• the issue of ultrasensitive measures of serum Tg in basal condition versus rhTSH-stimulated serum Tg

• prospective clinical trial of rhTSH-aided RAI therapy for metastatic disease

• definition of the best activity of radio-iodine to be used for post-surgical thyroid remnant ablation

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