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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
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REVIEW  UPDATE ON THE DIAGNOSIS AND TREATMENT OF DIFFERENTIATED THYROID CANCER


The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2009 October;53(5):482-9

lingua: Inglese

Serum thyroglobulin measurement in the follow-up of patients treated for differentiated thyroid cancer

Zucchelli G. 1, Iervasi A. 1, Ferdeghini M. 2, Iervasi G. 1

1 CNR of Clinical Physiology, Pisa, Italy;
2 Nuclear Medicine University of Verona, Verona, Italy


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Determination of thyroglobulin (Tg) in serum represents a key element in the follow-up of patients treated for differentiated thyroid cancer (DTC). The sensitivity and the specificity of the assay strongly affects the clinical impact. Most of patients are disease-free after thyroidectomy and iodine radioablation; 15% of them show over time persistent or recurrent disease; of these, 5% dies due to worsening of disease. This implies that the follow-up procedures should have a high negative predictive value to reduce as possible the unnecessary diagnostic tools and a high positive predictive value to identify the few patients with persistent/recurrent disease. The recent international guidelines are based on thyroglobulin measurement after thyroid-stimulating hormone (TSH) stimulation. More recent studies suggest that follow up based on serial measurements of basal (i.e. unstimulated) Tg show a higher predictive value than the single measurement after stimulation. Large and multicenter studies are necessary to modify the current guidelines.

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zucchell@ifc.cnr.it