COMPARISON OF THE WHOLE BODY SCAN AND THYROGLOBULIN IN DETERMINING THE RESIDUE AND METASTASIS IN DIFFERENTIAL THYROID CANCER
Journal Title: Kocatepe Medical Journal - Year 2022, Vol 23, Issue 1
Abstract
OBJECTIVE: In our study, we compare the importance of thyroglobulin (Tg) and post-treatment whole body scanning (WBS) scintigraphy in detecting residual and/or metastasis in patients with differentiated thyroid cancer (DTC) receiving radioactive iodine (RAI) treatment. MATERIAL AND METHODS: The files of the patients who underwent total or near-total thyroidectomy surgery, who were diagnosed with DTC and subsequently received RAI ablation, were retrospectively reviewed. L-Thyroxine treatment was discontinued to the patients before the RAI treatment and an iodine-poor diet was given to them for 14 days. Serum TSH level was ensured to be higher than 30 IU / ml before treatment. Serum TSH, Tg, and thyroglobulin antibody (Anti-Tg) values were measured before ablation therapy. RAI treatment was given to the patients in the range of 50-250 mCi (mean 135 mCi). WBS was performed on the 7th day of the treatment. RESULTS: Of the 483 patients examined in total, 431 patients with TSH> 30 IU / ml before treatment were included in the study. It was seen as Tg (+) in 243 of 373 patients with WBS (+), and distant metastasis was detected in 28 of these patients. In 13 of 58 patients with WBS (-), it was evaluated as Tg (+). Although 107 (24%) of 431 patients had WBS (+), serum Tg level was found to be true negative (Tg <2 ng/ml and AntiTg <100 U/ml). Distant metastasis was detected in one of these patients, while other patients had residual and / or cervical lymphatic metastasis. CONCLUSIONS: Our findings show that Tg measurement is insufficient to reveal residual tissue and / or cervical lymphatic metastasis in patients with DTC. This study suggests that WBS has a complementary role in detecting and localizing residual and / or lymphatic metastases, especially in the neck area.
Authors and Affiliations
İsmail KOÇAK Hasan ÖNNER Buğra KAYA Oktay SARI
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