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

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Therapeutic Nuclear Medicine

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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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.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, 94800, Villejuif, France

    Martin Schlumberger, Maryse Brassard & Sophie Leboulleux

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  1. Martin Schlumberger
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  2. Maryse Brassard
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  3. Sophie Leboulleux
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Correspondence to Martin Schlumberger .

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Editors and Affiliations

  1. THERANOSTICS Center for Molecular, Radiotherapy and Molecular Imaging, ENETS Center of Excellence, Bad Berka, Germany

    Richard P. Baum

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© 2012 Springer-Verlag Berlin Heidelberg

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Schlumberger, M., Brassard, M., Leboulleux, S. (2012). Follow-up of Thyroid Cancer Patients and Treatment of Distant Metastases. In: Baum, R. (eds) Therapeutic Nuclear Medicine. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_746

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  • DOI: https://doi.org/10.1007/174_2012_746

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