European Journal of Nuclear Medicine and Molecular Imaging

, Volume 38, Issue 3, pp 451–458

Diagnostic 131I whole-body scintigraphy 1 year after thyroablative therapy in patients with differentiated thyroid cancer: correlation of results to the individual risk profile and long-term follow-up

  • Frank Berger
  • Ulla Friedrich
  • Peter Knesewitsch
  • Klaus Hahn
Original Article

DOI: 10.1007/s00259-010-1657-0

Cite this article as:
Berger, F., Friedrich, U., Knesewitsch, P. et al. Eur J Nucl Med Mol Imaging (2011) 38: 451. doi:10.1007/s00259-010-1657-0

Abstract

Purpose

131I whole-body scan (WBS) and serum thyroglobulin (TG) are important in detecting thyroid remnants or recurrent disease in patients with differentiated thyroid cancer. Usually, a diagnostic WBS is carried out 6 months after ablation to exclude residual disease. We retrospectively analysed results of a second routine diagnostic WBS and TG measurements at 1 year after thyroablation and correlated these to the risk profile of patients with long-term follow-up.

Methods

A total of 197 patients were followed up after thyroidectomy and ablative 131I therapy. Follow-up included clinical examination, radioiodine WBS and thyroid-stimulating hormone (TSH), free thyroxine and TG measurements at 3–6 months and 1 year after ablation. WBS (+) patients received a therapeutic activity of 131I. The risk profile of patients was defined according to clinical results before the 1-year control. Clinical results at 1 year after ablation were analysed in correlation to the patient risk profile and long-term follow-up data (mean 7.2 years).

Results

One year after thyroablation, 95.8% of low-risk patients had no residual disease when diagnostic WBS was carried out using 370 MBq 131I; 4.2% of low-risk patients had residual disease at this time point. In the high-risk group of this cohort, 54.5% were disease-free 1 year after ablation, but 45.5% demonstrated residual disease. After the 1-year control, 94% of all applied radioiodine therapies were executed in the high-risk group, compared with 6% in the low-risk group (p < 0.01).

Conclusion

A second routine WBS 1 year after thyroablation is not indicated in low-risk patients. Risk stratification according to the early clinical course effectively identified patients with higher likelihood of persistent or recurrent disease in the long-term follow-up.

Keywords

Diagnostic 131I whole-body scintigraphyThyroablative therapyDifferentiated thyroid cancer

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Frank Berger
    • 2
  • Ulla Friedrich
    • 1
  • Peter Knesewitsch
    • 1
  • Klaus Hahn
    • 1
  1. 1.Department of Nuclear MedicineLudwig-Maximilians University of MunichMunichGermany
  2. 2.Department of Clinical RadiologyLudwig-Maximilians University of MunichMunichGermany