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Serum thyroglobulin level after radioiodine therapy (Day 3) to predict successful ablation of thyroid remnant in postoperative thyroid cancer

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Abstract

Objective

The utility of serum thyroglobulin (Tg) level, 3 days after radioactive iodine (RAI) therapy, was assessed as a means of predicting successful ablation of thyroid remnant in patients with postoperative thyroid cancer.

Methods

A total of 152 patients with thyroid cancer (mean age = 44.9 ± 13.7 year) undergoing RAI therapy after total thyroidectomy were included. Levels of TSH-stimulated Tg prior to ablation (stimTg) and serum Tg sampled immediately after RAI therapy (Day 3) were measured (immTg). ImmTg samples were collected during patient hospital visits for scheduled follow-up of radioiodine scans. Successful ablation was determined by the second time stimulated Tg levels (≤1 ng/ml) and negative radioiodine uptake at thyroid bed after 6.1 ± 1.1 months of RAI therapy. Univariate and multivariate analyses were done for immTg, stimTg, change in Tg levels (deltaTg: immTg − stimTg), immTg:stimTg ratio (ratioTg), and other potential clinical and pathologic markers of successful ablation.

Results

Of selected laboratory variables, ratioTg was a significant predictor of successful ablation. StimTg, tumor diameter, metastatic lymph node (LN) numbers, lymphatic invasion were possible clinical markers of successful ablation by univariate analysis. By multivariate analysis, ratioTg (odds ratio = 7.851), stimTg (odds ratio = 16.819), metastatic LN numbers (odds ratio with stimTg = 6.732) proved significant results. Furthermore, combining high ratioTg and low stimTg provided added predictive value.

Conclusions

High ratioTg (reflecting extensive release of Tg to the blood after RAI therapy) and low stimTg (reflecting small remnant thyroid tissue) constitute the indices of successful ablation after RAI therapy. Immediate Tg level could give an useful information on RAI ablation of postoperative thyroid remnant.

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Acknowledgments

This research was supported by the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT and Future Planning (No. 2011-0030680).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Yong-il Kim, Hyung-Jun Im, Jin Chul Paeng, Gi Jeong Cheon, Keon Wook Kang, Dong Soo Lee & June-Key Chung

  2. Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea

    Yong-il Kim, Hyung-Jun Im, Dong Soo Lee & June-Key Chung

  3. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Yong-il Kim, Keon Wook Kang & June-Key Chung

  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Do Joon Park & Young Joo Park

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  1. Yong-il Kim
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  2. Hyung-Jun Im
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  3. Jin Chul Paeng
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  8. Young Joo Park
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Correspondence to June-Key Chung.

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Kim, Yi., Im, HJ., Paeng, J.C. et al. Serum thyroglobulin level after radioiodine therapy (Day 3) to predict successful ablation of thyroid remnant in postoperative thyroid cancer. Ann Nucl Med 29, 184–189 (2015). https://doi.org/10.1007/s12149-014-0927-5

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  • DOI: https://doi.org/10.1007/s12149-014-0927-5

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