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Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases

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

Abstract

Purpose

During the follow-up of patients with well-differentiated thyroid carcinoma, some patients have elevated serum thyroglobulin (Tg) levels without any evidence of radioiodine accumulation on diagnostic whole-body scan (d-WBS). The treatment strategy in these patients is considered a clinical dilemma, with some groups recommending blind use of high-dose radioiodine therapy. The aim of this study was to evaluate whether or not high doses of radioiodine have beneficial effects in these patients.

Methods

Twenty-seven patients were included in the study. All patients had negative d-WBS and elevated levels of Tg. All received high doses of radioiodine. The mean follow-up period was 6.3±5.8 years. There were 11 patients with macrometastases and 16 with micrometastases.

Results

Post-treatment WBS revealed radioiodine accumulation in 19 of 24 (79%) patients. Serum Tg levels were decreased in 8 of 16 (50%) patients. Among patients with micrometastases, five out of seven (71%) demonstrated a decrease in serum Tg levels. Among patients with macrometastases, three out of nine (33%) demonstrated a decrease in Tg values and three (33%) have died due to metastatic thyroid cancer.

Conclusion

Radioiodine treatment may have a beneficial therapeutic effect in patients who have elevated levels of serum Tg and negative d-WBS. This is especially true in those patients with micrometastases; in patients with macrometastases, a beneficial effect of this approach may be observed less frequently.

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Acknowledgement

This work was supported by the research fund of the University of Istanbul, project numbers BYP-151/15012003 and B-578/1702000.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Cerrahpaşa Medical Faculty, Istanbul University, 34303, Istanbul, Turkey

    Levent Kabasakal, Nalan Alan Selçuk, Hojjet Shafipour, Ozlem Ozmen, Cetin Onsel & Ilhami Uslu

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  1. Levent Kabasakal
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  2. Nalan Alan Selçuk
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  3. Hojjet Shafipour
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  4. Ozlem Ozmen
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  5. Cetin Onsel
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Correspondence to Levent Kabasakal.

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Kabasakal, L., Selçuk, N.A., Shafipour, H. et al. Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases. Eur J Nucl Med Mol Imaging 31, 1500–1504 (2004). https://doi.org/10.1007/s00259-004-1516-y

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  • DOI: https://doi.org/10.1007/s00259-004-1516-y

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