Indian Journal of Nuclear Medicine
Home | About IJNM | Search | Current Issue | Past Issues | Instructions | Ahead of Print | Online submissionLogin 
Indian Journal of Nuclear Medicine
  Editorial Board | Subscribe | Advertise | Contact
Users Online: 211 Print this page  Email this page Small font size Default font size Increase font size
Year : 2018  |  Volume : 33  |  Issue : 2  |  Page : 93-98

Role of Preablative Stimulated Thyroglobulin in Prediction of Nodal and Distant Metastasis on Iodine Whole-Body Scan

1 Department of Nuclear Medicine, Narayana Health City, Bengaluru, Karnataka, India
2 Department of ENT, Narayana Health City, Bengaluru, Karnataka, India
3 Department of Head and Neck Surgical Oncology, Narayana Health City, Bengaluru, Karnataka, India
4 Department of Endocrinology, Diabetes and Metabolism, Narayana Health City, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Subramanian Kannan
258/A Bommasandra Industrial Area, Hosur Road, Bengaluru - 560 099, Karnataka
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijnm.IJNM_130_17

Rights and Permissions

Background: Preablative stimulated thyroglobulin (ps-Tg) is an important investigation in the follow-up of patients with Differentiated thyroid cancer(DTC) after surgery. Levels of ps-Tg >2–10 ng/ml have been suggested to predict metastasis to cervical and extracervical sites. There is still debate on the need for routine iodine whole-body scan (131I WBS) in the management of low-to-intermediate-risk DTC patients. Objective: We analyzed our data of patients with DTC who underwent total thyroidectomy to discuss the predictability of ps-Tg on metastatic disease on the 131I WBS. Materials and Methods: Retrospective analysis of patient records. Results: One hundred and seventeen patients with DTC (95 papillary thyroid cancer [71 had classic histology, 8 had tall cell variant, 16 had follicular variant] and 22 follicular thyroid cancer [18 minimally invasive, 2 hurtle cell, and 2 widely invasive cancers]) had undergone total thyroidectomy. All these patients underwent ps-Tg assessment and an 131I WBS. About 65% of them went on to have radioiodine ablation along with a posttherapy 131I WBS. We divided the cohort into four groups based on their ps-Tg levels: Group 1 (ps-Tg <1), Group 2 (ps-Tg 1–1.9), Group 3 (ps-Tg 2–5), and Group 4 (ps-Tg >5). None of the patients in Group 1, 7% of those combined in Groups 2 and 3 (2 out of 28 patients), and 26% (12 out of 47) of those in Group 4 had either cervical or extracervical metastasis. Those with extracervical metastatic disease to lungs and bones had a mean (standard deviation) ps-Tg value of 436 (130) and median of 500 ng/ml and those with cervical metastatic disease had a mean Tg value of 31 (64) and median 6.6 ng/ml. Conclusions: A ps-Tg value in the absence of anti-Tg antibodies <1 ng/ml reliably excludes metastatic disease in DTC, while a value >5 ng/ml has a 26% risk of having either cervical or extracervical metastasis.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded323    
    Comments [Add]    
    Cited by others 1    

Recommend this journal