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Recurrent/metastatic thyroid carcinomas false negative for serum thyroglobulin but positive by posttherapy I-131 whole body scans
Cited 58 time in
Web of Science
Cited 66 time in Scopus
- Authors
- Issue Date
- 2008-09-10
- Publisher
- Springer Verlag
- Citation
- Eur J Nucl Med Mol Imaging. 2009;36(2):172-9
- Keywords
- Adult ; False Negative Reactions ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes/diagnostic use/therapeutic use ; Male ; Middle Aged ; Recurrence ; Thyroglobulin/*blood ; Thyroid Neoplasms/blood/*diagnosis/*secondary/therapy ; Whole Body Imaging
- Abstract
- PURPOSE: Serum Tg and I-131 WBS have been used to detect recurrent and metastatic thyroid cancers postoperatively. Tg is known to be more sensitive than I-131 WBS, and therefore, false-negative WBS cases with elevated Tg levels are frequently found. However, the clinical characteristics of false-negative Tg cases with positive WBS have not been clarified. MATERIALS AND METHODS: The authors evaluated 824 postoperative patients with differentiated thyroid carcinoma who underwent post-ablation/therapy I-131 WBS. Tg negativity was defined as a Tg level of < or = 2 ng/mL without TgAb under thyroid-stimulating hormone stimulation. Remission, recurrence, and metastasis were confirmed using pathologic or clinically findings. RESULTS: Fifty-two patients (6.3%) with functioning metastasis and negativity for TgAb were Tg-negative and posttherapy I-131 WBS-positive (TgN group), and 128 patients with functioning metastases were Tg positive and WBS positive (TgP group). The TgN group consisted of 45 cases of cervical/mediastinal lymph node metastases (86.5%) and seven cases of distant metastasis to lung or bone by follow-up WBS. The TgN group demonstrated significantly higher profiles of regional involvement than the TgP group (P < 0.029). In 47 patients in the TgN group, metastatic uptake disappeared in 33, ameliorated in four, and persisted in ten during follow-up. CONCLUSIONS: A significant number of differentiated thyroid cancer patients were Tg-/TgAb-negative despite a positive WBS finding. Cervical and mediastinal lymph nodes were predominant sites of metastasis in the TgN group. WBS should be undertaken routinely as a complementary modality to detect functioning recurrence and metastasis regardless of serum Tg results.
- ISSN
- 1619-7089 (Electronic)
- Language
- English
- URI
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18779963
http://www.springerlink.com/content/w1j7l7255527q287/fulltext.pdf
https://hdl.handle.net/10371/67914
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