Negative remnant 99mTc-pertechnetate uptake predicts excellent response to radioactive iodine therapy in low- to intermediate-risk differentiated thyroid cancer patients who have undergone total thyroidectomy

Lan, Wei; Zhao, Guojun; Lv, Ningning; Wen, Qiang; Bai, Lin; Ma, Qingjie; Ji, Bin

doi:10.1007/s12149-018-1314-4

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…Several studies reported that patients with negative Tc-99m pertechnetate uptake have a considerably higher likelihood of successful ablation [4,[10][11][12]. On the contrary Thientunyakit et al [13] reported no significant association between postsurgical Tc-99m pertechnetate scintigraphy and ablation outcome which came in agreement with our results.…”

Section: Discussionsupporting

confidence: 92%

“…It is pretty important to know that the successful ablation rate is inversely correlated with BTG level, in line with this fact we encountered a successful ablation rate of 58.9% when BTG is less than 5 ng/ml which became as high as 68% for patients with BTG <5 ng/ml and concurrent negative Tc-99m pertechnetate uptake, these results are similar to Lan et al . [12] who found that stimulated thyroglobulin and negative Tc-99m pertechnetate uptake were significant independent predictors for excellent response in low- to intermediate-risk patients. And also patients with thyroglobulin <1 ng/ml and concurrent negative Tc-99m pertechnetate uptake may be spared RAI therapy.…”

Section: Discussionmentioning

confidence: 99%

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The prognostic value of post thyroidectomy Tc-99m pertechnetate thyroid scan in patients with differentiated thyroid cancer

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Algizawy

Abdelnaim

et al. 2022

Nuclear Medicine Communications

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AimTo evaluate the prognostic value of postoperative Tc-99m pertechnetate scanning in patients with differentiated thyroid cancer (DTC).Method Patients with pathologically proven low or intermediate-risk DTC were enrolled in this study. Postoperative Tc-99m pertechnetate scintigraphy was performed 20 min after IV of 185 MBq of Tc-99m pertechnetate Positive thyroid residual uptake was characterized as higher Tc-99m pertechnetate uptake at the thyroid bed than the surrounding background's activity. A negative residual was considered if there was no definite abnormal radioactivity at the thyroid bed. Follow-up by thyroglobulin, thyroglobulin antibodies (Tg Abs), neck ultrasound (US) and diagnostic I-131 WBS (Dx WBS) were considered the reference standard. Successful ablation outcome was considered if there was free Dx WBS, stimulated serum thyroglobulin < 1 ng/ml with negative Tg Abs, and free US Result Two hundred and two patients, mean age; of 38.8 years were retrospectively recruited in this study.Positive residual uptake at the thyroid scan was detected in 131 patients wherea the remaining 71 patients had no detectable uptake. According to the reference standard we encountered 114 and 88 cases with successful ablation and unsuccessful ablation respectively, Tc-99m pertechnetate scanning successfully detected 63 true positive and 46 true negative cases giving 72% sensitivity, 40% specificity, 48% positive predictive value and 56% negative predictive value. ConclusionIn low-and intermediate-risk DTC patients; despite the relatively high sensitivity of postoperative Tc-99m pertechnetate thyroid scan, it has low specificity and low negative predictive value so it cannot be used to predict the ablation outcome. Nucl Med Commun

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The prognostic value of post thyroidectomy Tc-99m pertechnetate thyroid scan in patients with differentiated thyroid cancer

Eloteify

Algizawy

Abdelnaim

et al. 2022

Nuclear Medicine Communications

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“…One of the factors contributing to the variability seen in ER from various published studies could be the differences in TN stage to the DTC patients (11). Age, RAI dose, risk stratification, size of thyroid remnants, and Tg levels are predictors influencing therapeutic response to RAI treatment (16)(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Radioiodine (131I) treatment decision-making for low- and intermediate-risk differentiated thyroid cancer

Gao

Huang

Dai

et al. 2023

Archives of Endocrinology and Metabolism

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Objective:The purpose of this study was to investigate the effect and influencing factors of postsurgical radioactive iodine (RAI) therapy for patients with low-and intermediate-risk differentiated thyroid cancer (DTC). Subjects and methods: A retrospective analysis of 423 low-and intermediaterisk DTC patients admitted to the Department of Nuclear Medicine, Sichuan Provincial People's Hospital from January 2005 to December 2020 was performed. All patients were treated with surgery, had a postoperative pathological diagnosis, and were treated with RAI, including 89 males and 334 females. Recurrence risk stratification: 143 cases were low-risk, and 280 cases were intermediaterisk. Results: The excellent response (ER) rate for low-and intermediate-risk were 93.7% and 78.2%, respectively (P < 0.05). There were significant differences in age, cumulative dose of [ 131 I], and pretreatment stimulated-Tg (pre-Tg) levels between the low-and intermediate-risk groups (P < 0.05). There were significant differences in the cumulative dose of 131 I and pre-Tg levels between ER and the non-ER group (P < 0.05). The area under the curve (AUC) values were 0.799 in the low-risk group, and 0.747 in the intermediate-risk group for the ROC curve by ER status of pre-Tg. The ER rate with RAI treatment decreased with an increase in pre-Tg levels. Conclusion: Pre-Tg was an important factor for RAI treatment decision-making and prognostic evaluation and differed between low-risk and intermediate-risk DTC. Aggressive RAI therapy was recommended for low-risk DTC with pre-Tg ≥ 20.0 ng/mL and in intermediate-risk group with pre-Tg ≥ 10.0 ng/mL.

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“…Multivariate regression analysis showed that negative 99m TcO 4 - thyroid imaging was a risk factor for hypocalcemia at five days post-RAI. 99m TcO 4 - thyroid imaging results can be used to predict the residual level of thyroid tissue after surgery ( 13 , 14 ). Negative 99m TcO 4 - thyroid imaging means less residual thyroid tissue after surgery, indicating that the surgical removal may be more thorough.…”

Section: Discussionmentioning

confidence: 99%

Parathyroid Changes After RAI in Patients With Differentiated Thyroid Carcinoma

et al. 2021

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ObjectiveThe purpose of this study was to investigate parathyroid hormone (PTH), serum calcium, phosphorus, and 25-hydroxyvitamin D (25-OH-VD) changes before and after radioactive iodine (RAI) in differentiated thyroid carcinoma (DTC) patients at different time points.MethodsA total of 259 DTC patients who received RAI were prospectively enrolled. We evaluated PTH, serum calcium, phosphorus, and 25-OH-VD levels at baseline pre-RAI, five days, six weeks, and six months post-RAI, respectively. We analyzed the risk factors of hypocalcemia at five days post-RAI.ResultsThe mean PTH, serum calcium and phosphorus values decreased five days post-RAI compared with pre-RAI (PTH 4.18 ± 1.23 pmol/L vs. 3.95 ± 1.41 pmol/L; calcium 2.27 ± 0.09 mmol/L vs. 2.20 ± 0.11 mmol/L; phosphorus 1.25 ± 0.17 vs. 0.98 ± 0.20 mmol/L, P < 0.05), and the differences were statistically significant. The mean 25-OH-VD levels did not significantly decrease at five days post-RAI. 21.2% (55/259) of patients had hypocalcemia at five days post-RAI, and all of them were given oral calcium supplements. At six weeks post-RAI, all of the above parameters were higher than those at five days post-RAI. Multivariate regression analysis showed that baseline pre-RAI serum calcium < 2.27 mmol/L, PTH < 4.18 pmol/L and negative 99mTcO4- thyroid imaging were risk factors for hypocalcemia at five days post-RAI.ConclusionFor DTC patients with normal PTH and serum calcium levels at pre-RAI, their PTH, serum calcium, and phosphorus levels decreased at five days post-RAI. About one-fifth of patients could have hypocalcemia at five days post-RAI. Lower baseline pre-RAI serum calcium and PTH levels and negative 99mTcO4- thyroid imaging were risk factors for hypocalcemia five days post-RAI.

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Negative remnant 99mTc-pertechnetate uptake predicts excellent response to radioactive iodine therapy in low- to intermediate-risk differentiated thyroid cancer patients who have undergone total thyroidectomy

Cited by 9 publications

References 21 publications

The prognostic value of post thyroidectomy Tc-99m pertechnetate thyroid scan in patients with differentiated thyroid cancer

The prognostic value of post thyroidectomy Tc-99m pertechnetate thyroid scan in patients with differentiated thyroid cancer

Radioiodine (131I) treatment decision-making for low- and intermediate-risk differentiated thyroid cancer

Parathyroid Changes After RAI in Patients With Differentiated Thyroid Carcinoma

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