Prognostic value of an increase in the serum thyroglobulin level at the time of the first ablative radioiodine treatment in patients with differentiated thyroid cancer

Bernier, Marie‐Odile; Morel, Olivier; Rodien, Patrice; Muratet, Jean-Pierre; Giraud, P.; Rohmer, V.; Jeanguillaume, Christian; Bigorgne, J. C.; Jallet, P.

doi:10.1007/s00259-005-1866-0

Cited by 52 publications

(55 citation statements)

References 13 publications

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“…A higher Tg ratio (>20) was related to ablation success despite a higher pre-ablation Tg level (≥5 ng/ml). Kim et al [7] also compared pre-ablation stimulated Tg levels with Tg ratios and the result was similar with that of Bernier et al [8].…”

Section: Discussionsupporting

confidence: 67%

“…Bernier et al [8] investigated the prognostic value of an increase in serum Tg in patients with DTC. Tg ratios were calculated by dividing post-ablation Tg (measured 5 days after RAI therapy) by pre-ablation Tg and compared with preablation serum Tg levels.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, the effectiveness of RAI therapy on remnant thyroid tissue was evaluated by measuring changes in serum Tg levels in patients with DTC [7][8][9]. In those studies, serum Tg was measured twice, that is, just before the administration of RAI and at 3 or 5 days after RAI therapy.…”

Section: Introductionmentioning

confidence: 99%

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Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Jeong

Song

Park

et al. 2016

Nucl Med Mol Imaging

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Purpose Serum thyroglobulin (Tg) level is frequently elevated shortly after radioactive iodine (RAI) ablation therapy. The authors studied the relationship between the elevation of serum Tg after RAI therapy and iodine uptake pattern on postablation whole body scans (RxWBSs) in patients with papillary thyroid carcinoma (PTC). Materials and MethodsThe study subjects were patients with PTC that had undergone first RAI therapy with thyroid hormone withdrawal after total thyroidectomy. Patients with a high level of serum anti-Tg antibody (TgAb, ≥ 60 U/mL), possible regional or distant metastasis as determined by preablation or post-ablation studies, and negative iodine uptake of the anterior neck on RxWBS were excluded. Serum Tg was checked twice, that is, 7 days after (post-ablation Tg) and on the day of RAI therapy (pre-ablation Tg). Ratio of pre-ablation Tg to post-ablation Tg (Tg ratio) was used to assess changes in serum Tg levels after RAI therapy. Patients were classified into two groups according to the presence of midline uptake above the thyroidectomy bed on RxWBS (negative (group 1) or positive (group 2) midline uptake). Variables were subjected to analysis to identify differences between the two groups. Results Two hundred and fifty patients were enrolled in this study; 101 in group 1 and 149 in group 2. Based on univariate analysis, post-ablation Tg (8.12 ± 11.05 vs. 34.12 ± 54.31; P < 0.001) and Tg ratio (7.81 ± 8.98 vs. 20.01 ± 19.84; P < 0.001) were significantly higher in group 2. On the other hand, gender, tumor (T) stage, lymph node (N) stage, size, multiplicity or bilaterality of primary tumor, dose of 131 I, serum TgAb and thyroid-stimulating hormone (TSH) level (before or after RAI therapy) were not significantly different in the two groups. Variables with P values of < 0.25 by univariate analysis were subjected to multivariate analysis, which showed post-ablation Tg (OR 1.060, 95 % CI = 1.028-1.092; P < 0.001) and Tg ratio (OR 1.059, 95 % CI = 1.028-1.092; P = 0.001) were significantly higher in group 2. Conclusion Serum Tg level after RAI therapy was significantly higher in patients with midline uptake on RxWBS, compared with patients without midline uptake on RxWBS. Further investigations are needed to reveal the correlation between serum Tg elevation and clinical outcome according to the presence of midline uptake.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Jeong

Song

Park

et al. 2016

Nucl Med Mol Imaging

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“…Bernier et al studied the Tg values in patients just before and 5 days after RAI and concluded that having a TgD5/TgD0 ratio higher than 20 was significantly related to successful ablation [9]. Kim et al also studied 152 patients treated with rh-TSH and found that high elevation of Tg 3 days after RAI compared with preablative stimulated Tg was significantly related to successful ablation [20].…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have also suggested that high levels of serum Tg at the time of RAI could be a prognostic marker for prediction of ablation failure [6][7][8][9]. Also, several studies have reported the serum Tg doubling time under thyrotropin suppression as a prognostic predictor in patients with DTC [10].…”

Section: Introductionmentioning

confidence: 99%

Correlation of Consecutive Serum Thyroglobulin Levels During Hormone Withdrawal and Failure of Initial Radioiodine Ablation in Thyroid Cancer Patients

Yoon

Kim

et al. 2015

Nucl Med Mol Imaging

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Objective The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Methods Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3-4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5-10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. Results A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Conclusions Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

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Prognostic value of postsurgical stimulated thyroglobulin levels after initial radioactive iodine therapy in well‐differentiated thyroid carcinoma

et al. 2008

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Prognostic value of an increase in the serum thyroglobulin level at the time of the first ablative radioiodine treatment in patients with differentiated thyroid cancer

Abstract: Our data show that the TgD5/TgD0 ratio may be used as a new prognostic indicator of (131)I treatment efficacy in patients with DTC.

Cited by 52 publications

References 13 publications

Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Correlation of Consecutive Serum Thyroglobulin Levels During Hormone Withdrawal and Failure of Initial Radioiodine Ablation in Thyroid Cancer Patients

Prognostic value of postsurgical stimulated thyroglobulin levels after initial radioactive iodine therapy in well‐differentiated thyroid carcinoma

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