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A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
Online ISSN 1827-1936
Joji KAWABE 1, Shigeaki HIGASHIYAMA 1, Kohei KOTANI 1, Atsushi YOSHIDA 1, Naoyoshi ONODA 2, Susumu SHIOMI 1
1 Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka City, Japan; 2 Department of Surgical Oncology, Graduate School of Medicine, Osaka City University, Osaka City, Japan
BACKGROUND: Radioiodine remnant ablation (RRA) is used to destroy residual normal thyroid tissue after total thyroidectomy in differentiated thyroid carcinoma (DTC) patients. As 1,850 MBq RRA is routinely performed at our facility, we evaluated the outcomes.
METHODS: Sixty-seven DTC patients without macroscopic residual lesions after total thyroidectomy were evaluated. Thyroglobulin (Tg) was measured 2–3 months before RRA with thyroxin administration (pretreatment); just before ablation after a 3-week iodine intake restriction with thyroxin withdrawal (THW) (n = 16) or recombinant human thyroid-stimulating hormone (rhTSH) stimulation (n = 51); and 3 months after RRA after a 2-week iodine intake restriction and 3‒week THW (n = 57) or rhTSH stimulation (n = 10). All patients received 131I (1,850 MBq) treatment followed by 131I scintigraphy about 8 days later (8.18+/- 0.91) and 131I scintigraphy (185 MBq) after the dosage 24 hours later 3months after RRA. Initial RRA goal was defined as negatively visible uptake in 131I thyroid bed (VUT) and a Tg level of <2 ng/mL 3 months after RRA.
RESULTS: Rest 60 patients whose TSH levels were below 0.5 μIU/mL of all 67 patients were evaluated. Negatively VUT on 3 months after RRA was shown in 56 out of 60 patients (93.3%). Initial RRA goal was achieved in 21 (42.0%) of 50 patients, excluding 3 patients whose Tg levels 3 months after RRA were not measured and 7 patients with anti-Tg antibodies. Pretreatment Tg levels (p = 0.0003) was significant predictive factor for Initial RRA goal on multivariate logistic regression analysis.
CONCLUSIONS: RRA with 1,850 MBq is effective by visual diagnosis, about 40% of all intermediate or high risk DTC patients achieved initial RRA goals by both visual and Tg levels diagnosis.