Journal of Clinical Endocrinology & Metabolism, Vol 78, 629-634, Copyright © 1994 by Endocrine Society

ARTICLES

Clinical utility of posttreatment radioiodine scans in the management of patients with thyroid carcinoma

SI Sherman, ET Tielens, S Sostre, MD Wharam Jr and PW Ladenson
Johns Hopkins Thyroid Tumor Center, Baltimore, Maryland 21287.

A retrospective comparison was performed of whole body scans obtained before and after 143 131I treatments in 93 patients with thyroid carcinoma. Pretreatment scans were performed with 74-185 megabecquerel 131I, and posttreatment scans were performed 5-12 days after dosing with 1.1-7.4 GBq. In 38 (27%) treatment cycles, the results of posttreatment and pretreatment scans differed. Only 14 (10%) posttreatment scans detected new locations of metastatic disease. Seventeen posttreatment scans demonstrated metastatic locations that were already known from previous studies but not seen on the pretreatment scan. Among parameters evaluated (including demographic and histological characteristics), only the combination of age at diagnosis less than 45 yr and history of previous 131I therapy contributed to the likelihood of a new finding on posttreatment scan (relative risk, 3.8). Five of the 14 new posttreatment scan findings were subsequently corroborated by other radiographic studies or thyroglobulin elevations, all in patients with extrathyroidal extension of the primary tumor. Seven (5%) posttreatment scans were unable to detect a focus of uptake seen on the corresponding pretreatment scan. In conclusion, posttreatment scans were most likely to reveal clinically important new information in young patients who had previously received 131I therapy. In older patients and those without previous 131I therapy, posttreatment scans rarely yielded new information that would potentially alter the patient's prognosis.

This article has been cited by other articles:

				K. P. Donahue, N. P. Shah, S. L. Lee, and M. E. Oates Initial Staging of Differentiated Thyroid Carcinoma: Continued Utility of Posttherapy 131I Whole-Body Scintigraphy Radiology, March 1, 2008; 246(3): 887 - 894. [Abstract] [Full Text] [PDF]

				F. Pacini, M. Schlumberger, H. Dralle, R. Elisei, J. W A Smit, W. Wiersinga, and the European Thyroid Cancer Taskforce European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur. J. Endocrinol., June 1, 2006; 154(6): 787 - 803. [Full Text] [PDF]

				C. Ma, A. Kuang, J. Xie, and T. Ma Possible Explanations for Patients with Discordant Findings of Serum Thyroglobulin and 131I Whole-Body Scanning J. Nucl. Med., September 1, 2005; 46(9): 1473 - 1480. [Abstract] [Full Text] [PDF]

				E. L. Mazzaferri Empirically Treating High Serum Thyroglobulin Levels J. Nucl. Med., July 1, 2005; 46(7): 1079 - 1088. [Full Text] [PDF]

				C. Ma, J. Xie, and A. Kuang Is Empiric 131I Therapy Justified for Patients with Positive Thyroglobulin and Negative 131I Whole-Body Scanning Results? J. Nucl. Med., July 1, 2005; 46(7): 1164 - 1170. [Abstract] [Full Text] [PDF]

				G.-U. Hung, S.-T. Tu, I.-S. Wu, and K.-T. Yang Comparison of the Effectiveness Between a Single Low Dose and Fractionated Doses of Radioiodine in Ablation of Post-operative Thyroid Remnants Jpn. J. Clin. Oncol., August 1, 2004; 34(8): 469 - 471. [Abstract] [Full Text] [PDF]

				E. Baudin, C. D. Cao, A. F. Cailleux, S. Leboulleux, J. P. Travagli, and M. Schlumberger Positive Predictive Value of Serum Thyroglobulin Levels, Measured during the First Year of Follow-Up after Thyroid Hormone Withdrawal, in Thyroid Cancer Patients J. Clin. Endocrinol. Metab., March 1, 2003; 88(3): 1107 - 1111. [Abstract] [Full Text] [PDF]

				V. Fatourechi, I. D. Hay, H. Javedan, G. A. Wiseman, B. P. Mullan, and C. A. Gorman Lack of Impact of Radioiodine Therapy in Tg-Positive, Diagnostic Whole-Body Scan-Negative Patients with Follicular Cell-Derived Thyroid Cancer J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1521 - 1526. [Abstract] [Full Text] [PDF]

				L. K. Shankar, A. J. Yamamoto, A. Alavi, MD, and S. J. Mandel Comparison of 123I Scintigraphy at 5 and 24 Hours in Patients with Differentiated Thyroid Cancer J. Nucl. Med., January 1, 2002; 43(1): 72 - 76. [Abstract] [Full Text] [PDF]

				A. S. Alzahrani, S. Bakheet, M. Al Mandil, A. Al-Hajjaj, A. Almahfouz, and A. Al Haj 123I Isotope as a Diagnostic Agent in the Follow-Up of Patients with Differentiated Thyroid Cancer: Comparison with Post 131I Therapy Whole Body Scanning J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5294 - 5300. [Abstract] [Full Text] [PDF]

				A. F. Cailleux, E. Baudin, and M. Schlumberger Authors' Response: Usefulness of the Diagnostic Total Body Scan in Differentiated Thyroid Cancer J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 949a - 950. [Full Text]

				A. F. Cailleux, E. Baudin, J. P. Travagli, M. Ricard, and M. Schlumberger Is Diagnostic Iodine-131 Scanning Useful after Total Thyroid Ablation for Differentiated Thyroid Cancer? J. Clin. Endocrinol. Metab., January 1, 2000; 85(1): 175 - 178. [Abstract] [Full Text]

				J. P. Travagli, A. F. Cailleux, M. Ricard, E. Baudin, B. Caillou, C. Parmentier, and M. Schlumberger Combination of Radioiodine (131I) and Probe-Guided Surgery for Persistent or Recurrent Thyroid Carcinoma J. Clin. Endocrinol. Metab., August 1, 1998; 83(8): 2675 - 2680. [Abstract] [Full Text]

				M. J. Schlumberger Papillary and Follicular Thyroid Carcinoma N. Engl. J. Med., January 29, 1998; 338(5): 297 - 306. [Full Text] [PDF]

				P. Miccoli, A. Antonelli, C. Spinelli, M. Ferdeghini, P. Fallahi, and L. Baschieri Completion Total Thyroidectomy in Children With Thyroid Cancer Secondary to the Chernobyl Accident Arch Surg, January 1, 1998; 133(1): 89 - 93. [Abstract] [Full Text] [PDF]

				A. C. Chiu, E. S. Delpassand, and S. I. Sherman Prognosis and Treatment of Brain Metastases in Thyroid Carcinoma J. Clin. Endocrinol. Metab., November 1, 1997; 82(11): 3637 - 3642. [Abstract] [Full Text] [PDF]