HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) CME Activity Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ma, C. Articles by Ma, T. Search for Related Content PubMed PubMed Citation Articles by Ma, C. Articles by Ma, T.

Possible Explanations for Patients with Discordant Findings of Serum Thyroglobulin and ¹³¹I Whole-Body Scanning^*

¹ Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
² Department of Stomatology, Linyi People’s Hospital, Linyi, Shandong Province, China
³ Department of Nuclear Medicine, The First Affiliated Hospital, Kunming University, Kunming, Yunnan Province, China

The long-term monitoring of patients with differentiated thyroid carcinoma (DTC) is essential throughout the patient’s life after total or near-total thyroidectomy followed by ¹³¹I remnant ablation and thyroid hormone suppression of thyroid-stimulating hormone (TSH). Sensitive surveillance for DTC recurrence and metastases includes radioiodine diagnostic whole-body scanning (DWBS) and measurement of serum thyroglobulin (Tg) after endogenous or exogenous TSH stimulation. Serum Tg levels during thyroid hormone withdrawal (Tg-off) are usually well correlated with the results of DWBS. In general, undetectable Tg levels with negative DWBS (DWBS^–) suggest complete remission, whereas detectable or elevated Tg concentrations are suggestive of the presence of ¹³¹I uptake in local or distant metastases. However, DTC patients with discordant results of Tg measurement and ¹³¹I WBS have been observed in the follow-up study. Negative ¹³¹I DWBS and a positive Tg test (DWBS^– Tg⁺) are found in most of these cases. Positive ¹³¹I DWBS and a negative Tg test (DWBS⁺ Tg^–), though of uncommon occurrence, has also been demonstrated in a small but significant number of cases. With this scenario, one should first attempt to uncover a cause for possibly false-negative or false-positive ¹³¹I WBS or serum Tg. Explanations for the discordance are speculative but should be scrutinized when confronted with discrepant data in a given patient.

Key Words: differentiated thyroid carcinoma • thyroglobulin • ¹³¹I • whole-body scanning

Related articles in JNM:

THIS MONTH IN JNM

JNM 2005 46: 8a-9a. [Full Text]  

This article has been cited by other articles:

				H. T T Phan, P. L Jager, J. E van der Wal, W. J Sluiter, J. T M Plukker, R. A J O Dierckx, B. H R Wolffenbuttel, and T. P Links The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation Eur. J. Endocrinol., January 1, 2008; 158(1): 77 - 83. [Abstract] [Full Text] [PDF]

				A. C.M. Persoon, J. M.W. Van Den Ouweland, J. Wilde, I. P. Kema, B. H.R. Wolffenbuttel, and T. P. Links Clinical utility of an automated immunochemiluminometric thyroglobulin assay in differentiated thyroid carcinoma. Clin. Chem., April 1, 2006; 52(4): 686 - 691. [Abstract] [Full Text] [PDF]

				K. Zophel, G. Wunderlich, and J. Kotzerke A Highly Sensitive Thyroglobulin Assay Has Superior Diagnostic Sensitivity for Recurrence of Differentiated Thyroid Cancer in Patients Undergoing TSH Suppression J. Nucl. Med., March 1, 2006; 47(3): 552 - 553. [Full Text] [PDF]