Outcome of Differentiated Thyroid Cancer with Detectable Serum Tg and Negative Diagnostic 131I Whole Body Scan: Comparison of Patients Treated with High 131I Activities Versus Untreated Patients

摘要: Detectable serum Tg levels associated with negative diagnostic (131)I whole body scan are not infrequently found in patients differentiated thyroid cancer. Several researchers have shown that these the administration of high activity (100 mCi or more) increases sensitivity a posttherapy performed few days later and allows detection neoplastic foci seen doses (131)I. Empirical radioiodine treatment has also been advocated by some researchers, but its therapeutic effect is controversial. In our institute, positive Tg/negative were treated activities before 1984; afterward, almost all radioiodine, was performed. present retrospective study we compared outcome two groups patients, 42 28 untreated, followed for mean periods 6.7 +/- 3.8 11.9 4.4 yr, respectively. group first 12 30 patients. further administered only latter group. At end follow-up complete remission (normalization off L-thyroxine scan) observed 10 (33.3%). 9 cases (30%) became negative, reduced still detectable; 11 (36.6%) detectable, positive. The resolution uptake lung metastases 8 (88.8%) cervical node 18 (61.1%). once because (n = 12), 2 (16.7%) apparent remission, 7 (58.3%) had detectable values without evidence disease, showed lymph mediastinum, 1 patient (8.3%) died metastases. Of untreated none radiological therapy undetectable 19 (67.9%), significantly 6 (21.4%), unchanged increased 3 (10.7%), whom developed 14 yr after diagnosis. summary, results indicate scan, may utility and, to lesser extent, those However, view frequent normalization believe should be considered according result scan. If lung, continued up total remission; surgical preferred metastases, no used bed uptake.