Tehran University of Medical Sciences
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Davood Beiki

Efficacy of radioiodine therapy in the treatment of elevated serum thyroglobulin in patients with differentiated thyroid carcinoma and negative whole-body iodine scan


Authors: Saghari M, Gholamrezanezhad A, Mirpour S, Eftekhari M, Takavar A, Fard-Esfahani A, Fallahi B, Beiki D,
Nucl Med Commun, Vol.27, No.7, 2006,Page:567-72

INTRODUCTION:

In the management of patients with differentiated thyroid carcinoma, serum thyroglobulin levels are often well correlated with whole-body radioiodine scanning (WBS) results. However, occasionally, a mismatched result - increased thyroglobulin with negative WBS - is observed. Radioiodine therapy has been suggested as a therapeutic choice with controversial results.

METHOD:

We studied 32 differentiated thyroid carcinoma patients with elevated thyroglobulin level and negative WBS who had been treated with high-dose radioiodine. With a mean follow-up of 25.6 months (all follow-ups >11 months), thyroglobulin and thyroid-stimulating hormone levels, WBS, clinical, radiographic and pathological findings following treatment were recorded.

RESULTS:

The mean pre-therapy off-treatment thyroglobulin was 152 +/- 119.0 ng.ml(-1). Although there was a mild trend towards an increase in thyroglobulin in the first post-treatment year, the difference was not significant. At the end of the follow-ups, 22 patients (68.7%) were categorized as non-responders to radioiodine therapy (any change or elevation of thyroglobulin or radiological and pathological evidences of progression), four patients (12.5%) as partial responders (transient reduction but not a normalization of thyroglobulin) and six patients (18.7%) as responders (normalization of thyroglobulin with no evidence of remnant disease). In nine of 10 partial and complete responders, reduction or normalization of thyroglobulin had occurred in the first post-treatment year.

CONCLUSION:

We recommend that in differentiated thyroid carcinoma patients with elevated thyroglobulin and negative WBS, at least one course of radioiodine