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Chromatographic Identification in Serum of Endogenously Radioiodinated Thyroid Hormones After Iodine-131 Whole-Body Scintigraphy in the Follow-up of Patients with Differentiated Thyroid Carcinoma

CNR Institute of Clinical Physiology and Nuclear Medicine Center of the University of Pisa; Pisa, Italy

Correspondence: For correspondence or reprints contact: Romano Bianchi, MD, Director, Nuclear Medicine Center of the University of Pisa, Via Roma 67, I-56126 Pisa, Italy.

ABSTRACT

Patients with differentiated thyroid cancer (DTC) are conventionally followed with serial ¹³¹I whole-body scintigraphy (WBS) and serum thyroglobulin (hTg) assay. Given the 15%–20% incidence of discordant results, we developed a sensitive and specific procedure for monitoring such patients, based on the assumption that ¹³¹I uptake, even if too low to be detected by ¹³¹I WBS, could be assayed inserum as thyroid products (hTg, T₃ and T₄) endogenously labeled with ¹³¹I. Our study included 125 patients routinely monitored for tumor recurrence or for the persistence of functioning thyroid tissue after complete primary treatment for DTC (surgery and ¹³¹I ablation of remnants). A plasma sample, taken 72 hr after administering ¹³¹I for WBS was fractionated on a Sephadex-G25 superfine column by first eluting all of the radioactive species except the thyroid hormones and then the radioiodothyronines. The sensitivity and specificity of chromatography in detecting functioning thyroid tissue after primary treatment for DTC were 98.4% and 100% (accuracy 99.2%), respectively, versus 90.6% and 95.1% for ¹³¹I WBS (accuracy 92.8%) and 60.9% and 100% for hTg (accuracy 80%). Combining chromatography with serum hTg gave the highest gains in diagnostic performance (100% for all parameters). This chromatographic method can be used in addition to conventional procedures in the follow-up of patients with DTC and represents a highly sensitive test for assessing the results of ¹³¹I ablation of postsurgical remnants.

This article has been cited by other articles:

				A. Z. Rudavsky and L. M. Freeman Treatment of Scan-Negative, Thyroglobulin-Positive Metastatic Thyroid Cancer Using Radioiodine 131I and Recombinant Human Thyroid Stimulating Hormone--Authors' Responseh J. Clin. Endocrinol. Metab., December 1, 1997; 82(12): 4277b - 4278. [Full Text]