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Follow-up of Thyroid Cancer Patients and Treatment of Distant Metastases

  • Martin Schlumberger
  • Maryse Brassard
  • Sophie Leboulleux
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

 Follow-up of patients with differentiated thyroid cancer is based on serum thyroglobulin determinations and on neck ultrasonography. The first check up is performed at 9-12 months to assess cure that is defined by an undetectable serum Tg following rhTSH stimulation in the absence of anti Tg antibodies and by a normal neck ultrasonography; the risk of recurrence in these patients is low (<1%). Patients with recurrent disease need a complete imaging work-up that includes neck ultrasonography, CT scan of the neck and chest with injection of contrast medium and FDG PET scan. Thyroxine treatment is given at suppressive doses and local treatment modalities are applied whenever feasible. Neck recurrence is treated with radioiodine and with surgery when the size of tumor foci is >1cm in diameter. Radioiodine treatment is used in 2/3 of metastatic patients with significant uptake and provides cure in 45%, in those who are young, with wel-differentiated tumor, with small metastases, with high radioiodine uptake and with no FDG uptake. The other patients are refractory to radioiodine and when disease progression occurs they should be candidate for inclusion in a trial.

Keywords

131I Therapy Thyroid Cancer Patient Neck Ultrasonography Radioiodine Treatment Radioiodine Uptake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg  2012

Authors and Affiliations

  • Martin Schlumberger
    • 1
  • Maryse Brassard
    • 1
  • Sophie Leboulleux
    • 1
  1. 1.Department of Nuclear Medicine and Endocrine OncologyInstitut Gustave RoussyVillejuifFrance

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