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Thyroglobulin-Based Risk Factor Repositioning for Determining Radioactive Iodine Activity in Patients with Papillary Thyroid Carcinoma: a Multicenter Retrospective Cohort Study

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Abstract

Purpose

We aimed to investigate the impact of various factors including radioactive iodine (RAI) activity on the therapeutic response according to the range of serum thyroglobulin (Tg) in patients with papillary thyroid carcinoma (PTC).

Methods

A total of 2809 patients were retrospectively enrolled from 24 hospitals. They were divided into four subgroups according to their serum Tg (stimulated Tg, sTg) or anti-Tg antibody (TgAb) levels, measured just before RAI therapy: sTg < 2 ng/mL, 2 ≤ sTg < 10 ng/mL, sTg ≥ 10 ng/mL, and TgAb > 100 IU/mL. The clinicopathologic factors for therapeutic responses, which were classified as acceptable response (AR) or non-AR, were compared in each subgroup.

Results

Clinical impact of the pN category on therapeutic response was different among subgroups based on sTg levels (subgroups with sTg < 2 ng/mL (P = 0.057), 2 ≤ sTg < 10 ng/mL (P = 0.032), and sTg ≥ 10 ng/mL (P = 0.001)). The pN category was also a significant factor in the subgroup with TgAb > 100 IU/mL (P = 0.006). The pT category was not associated with therapeutic response regardless of the sTg level. High activities of RAI (≥ 3.70 GBq) were associated with favorable therapeutic responses in only the subgroup with sTg ≥ 10 ng/mL (P = 0.044).

Conclusion

Risk factors for response prediction could be repositioned based on the serum Tg before RAI therapy. RAI activity should be determined while considering the serum Tg-aided remnant thyroid or malignant tissues as well as conventional factors.

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Acknowledgements

The authors thank Thyroid Cancer Clinical Trial Network Retrospective Cohort Study Group of Korean Society of Nuclear Medicine and also thank Ms. Cho hee Hwang, Institute for Biomedical Science CNUH, for her assistance in the statistical analysis.

Funding

This study was supported by the Clinical Trial Network Program of the Korean Society of Nuclear Medicine (KSNM-CTN-2016–01-1).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeonnam, 58128, Republic of Korea

    Subin Jeon & Seong Young Kwon

  2. Department of Nuclear Medicine, Kyungpook National University, School of Medicine and Chilgok Hospital, Daegu, Republic of Korea

    Sang-Woo Lee

  3. Department of Nuclear Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea

    Sang Kyun Bae

Authors
  1. Subin Jeon
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  2. Seong Young Kwon
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Contributions

The study was designed by Seong Young Kwon. Material preparation and data collection were performed by Subin Jeon. The data analysis was performed by Seong Young Kwon and Subin Jeon. The first draft of the manuscript was written by Subin Jeon, Seong Young Kwon, Sang-Woo Lee, and Sang Kyun Bae, and all the authors commented on previous versions of the manuscript. Sang Kyun Bae contributed to funding acquisition. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Seong Young Kwon.

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Conflict of Interests

Subin Jeon, Seong Young Kwon, Sang-Woo Lee, and Sang Kyun Bae declare no competing interests.

Ethics Approval and Consent to Participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki declaration as revised in 2013 and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Consent for Publication

This retrospective study was approved by the institutional review boards of each hospital involved and the requirement to obtain informed consent was waived.

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Jeon, S., Kwon, S.Y., Lee, SW. et al. Thyroglobulin-Based Risk Factor Repositioning for Determining Radioactive Iodine Activity in Patients with Papillary Thyroid Carcinoma: a Multicenter Retrospective Cohort Study. Nucl Med Mol Imaging 56, 173–180 (2022). https://doi.org/10.1007/s13139-022-00756-4

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  • DOI: https://doi.org/10.1007/s13139-022-00756-4

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