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Reproducibility of whole-body 131I scan and serum thyrotropin and stimulated thyroglobulin values in patients studied twice after injection of recombinant human thyrotropin

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Recombinant human TSH (rhTSH) is used to increase radioiodine uptake during imaging of thyroid cancer, obviating the need to render the patient hypothyroid. We assessed the reproducibility of radioiodine uptake, serum thyrotropin (TSH), and stimulated serum thyroglobulin (Tg) levels after rhTSH administration.

Methods

A retrospective review was performed of patients at Stanford who underwent whole-body 131I scanning for surveillance of thyroid cancer twice after thyroidectomy and 131I ablation, with rhTSH prior to each scan. Forty-eight hour radioiodine uptake, peak serum TSH, and stimulated serum Tg levels for each study were recorded. Paired t tests and correlation analysis were used to assess interexamination repeatability.

Results

Twenty-three patients underwent two scintiscans with rhTSH, for a total of 46 exams. There was no significant difference between percent uptake at 48 h in the paired exams (p=0.40). Serum TSH level was measured in 45 of 46 exams; TSH exceeded 50 mIU/l in all cases, and there was no significant difference between paired TSH levels (p=0.93). All patients had stimulated serum Tg levels measured, with no significant difference between paired Tg levels (p=0.40); after excluding one patient whose Tg changed from 15.8 ng/ml to undetectable between scans without interval treatment, the p value rose to 0.95. There was a strong correlation among paired uptake values (r=0.85, p<0.0001), peak serum TSH (r=0.69, p=0.0003), and stimulated Tg levels (r=0.81, p<0.0001). No discordant scan interpretations were reported.

Conclusion

Forty-eight hour radioiodine uptake, peak serum TSH, and stimulated serum Tg levels after administration of rhTSH are repeatable between studies, demonstrating reproducibility of diagnostic results without rendering patients hypothyroid.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Stanford University Medical Center, 300 Pasteur Drive, Room H-0101, Stanford, CA, 94305-5281, USA

    Ryan D. Niederkohr & I Ross McDougall

Authors
  1. Ryan D. Niederkohr
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  2. I Ross McDougall
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Correspondence to I Ross McDougall.

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Disclosures

No funding was received for the completion of this study. Neither author claims any financial relationship or conflict of interest with any of the material presented. The authors have had full control of primary data, and allow the EJNMMI to review the data if requested.

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Niederkohr, R.D., McDougall, I.R. Reproducibility of whole-body 131I scan and serum thyrotropin and stimulated thyroglobulin values in patients studied twice after injection of recombinant human thyrotropin. Eur J Nucl Med Mol Imaging 34, 363–367 (2007). https://doi.org/10.1007/s00259-006-0227-y

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  • DOI: https://doi.org/10.1007/s00259-006-0227-y

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