scholarly journals Thyroid Remnant Estimation by Diagnostic DoseI131Scintigraphy orTcO4-99mScintigraphy after Thyroidectomy: A Comparison with Therapeutic DoseI131Imaging

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Guanghui Liu ◽  
Na Li ◽  
Xuena Li ◽  
Song Chen ◽  
Bulin Du ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Therapeutic Dose ◽  
Radioactive Iodine ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Thyroid Remnant ◽  
Diagnostic Dose ◽  
Thyroid Scan ◽  
Remnant Thyroid

In this clinical study, we have compared routine diagnostic dose131I scan andTcO4-99mthyroid scintigraphy with therapeutic dose131I imaging for accurate thyroid remnant estimation after total thyroidectomy. We conducted a retrospective review of the patients undergoing total thyroidectomy for differentiated thyroid carcinoma (DTC) and subsequently receiving radioactive iodine (RAI) treatment to ablate remnant thyroid tissue. All patients had therapeutic dose RAI whole body scan, which was compared with that of diagnostic dose RAI,TcO4-99mthyroid scan, and ultrasound examination. We concluded that therapeutic dose RAI scan reveals some extent thyroid remnant in all DTC patients following total thyroidectomy. Diagnostic RAI scan is much superior to ultrasound andTcO4-99mthyroid scan for the postoperative estimation of thyroid remnant. Ultrasound andTcO4-99mthyroid scan provide little information for thyroid remnant estimation and, therefore, would not replace diagnostic RAI scan.

Effectiveness of Reduced Radioiodine Activity for Thyroid Remnant Ablation after Total Thyroidectomy in Patients with Low to Intermediate Risk Differentiated Thyroid Carcinoma

2017 ◽  
Vol 56 (06) ◽  
pp. 211-218 ◽  
Author(s):  
Sabine Haidvogl ◽  
Wolfgang Peter Fendler ◽  
Harun Ilhan ◽  
Axel Rominger ◽  
Alexander Robert Haug ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
High Standard ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Success Rates ◽  
Thyroid Remnant ◽  
Remnant Ablation ◽  
Activity Group ◽  
Reduced Activity

Summary Aim: To compare the success rates of radioiodine therapy (RIT) for thyroid remnant ablation (TRA) after the administration of a high-standard activity (3700 MBq; 100 mCi) to a lower-activity regimen of 2000 MBq (54 mCi) I-131 in a cohort of differentiated thyroid carcinoma (DTC) patients (papillary, follicular, mixed, pT1a(m) – pT3, N0 – NX, R0). Methods: 135 patients received approx. 2000 MBq I-131 (54 mCi) for thyroid remnant ablation after total thyroidectomy for DTC, 137 patients received approx. 3700 MBq (100 mCi) I-131. Ablation success was defined as thyroglobulin (TG) levels < 0.5 ng/ml after stimulation, negative I-131 whole-body scan and inconspicuous results on neck ultrasonography approximately 6 months after initial RIT. Results: In the follow-up 84.4 % of patients in the reduced-activity group and 87.6 % of the patients in the standard-activity group did not show any relevant residual I-131 uptake in the thyroid bed (p = 0.454). 90 % in the reduced-activity group and 91 % in the standard-activity group demonstrated a stimulated TG level < 0.5 ng/ml (p = 0.969). All patients were unre-markable in cervical ultrasonography. The success rate was comparable in both groups (81.5 % in the reduced-activity group vs. 83.9 % in the standard-activity group, p = 0.592). No re-therapy was required in 85.2 % of the patients in the low-activity group as compared to 87.6 % of the patients in the standard-activity group (p = 0.563). Conclusions: We could demonstrate that irrespective of the activity administered, the patients had comparable success rates with regard to TRA as defined by our criteria. We thus consider the use of a reduced-activity regimen for TRA safe and feasible in the patient cohort examined in this study.

scholarly journals Radioiodine in Differentiated Thyroid Carcinoma: Do We Need Diagnostic Pre-Ablation Iodine-123 Scintigraphy to Optimize Treatment?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 553
Author(s):  
Elizabeth de Koster ◽  
Taban Sulaiman ◽  
Jaap Hamming ◽  
Abbey Schepers ◽  
Marieke Snel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Treatment Success ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Thyroid Remnant ◽  
Node Metastasis ◽  
Unsuccessful Treatment

Changing insights regarding radioiodine (I-131) administration in differentiated thyroid carcinoma (DTC) stir up discussions on the utility of pre-ablation diagnostic scintigraphy (DxWBS). Our retrospective study qualitatively and semi-quantitatively assessed posttherapy I-131 whole-body scintigraphy (TxWBS) data for thyroid remnant size and metastasis. Findings were associated with initial treatment success after nine months, as well as clinical, histopathological, and surgical parameters. Possible management changes were addressed. A thyroid remnant was reported in 89 of 97 (92%) patients, suspicion of lymph node metastasis in 26 (27%) and distant metastasis in 6 (6%). Surgery with oncological intent and surgery by two dedicated thyroid surgeons were independently associated with a smaller remnant. Surgery at a community hospital, aggressive tumor histopathology, histopathological lymph node metastasis (pN1) and suspicion of new lymph node metastasis on TxWBS were independently associated with an unsuccessful treatment. Thyroid remnant size was unrelated to treatment success. All 13 pN1 patients with suspected in situ lymph node metastases on TxWBS had an unsuccessful treatment, opposite 19/31 (61%) pN1 patients without (p = 0.009). Pre-ablative knowledge of these TxWBS findings had likely influenced management in 48 (50%) patients. Additional pre-ablative diagnostics could optimize patient-tailored I-131 administration. DxWBS should be considered, especially in patients with pN1 stage or suspected in situ lymph node metastasis. Dependent on local surgical expertise, DxWBS is not recommended to evaluate thyroid remnant size.

scholarly journals Developing anterior mediastinum mass after orthotopic thyroidectomy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Rita Meira Soares Camelo ◽  
José Maria Barros
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Anterior Mediastinum ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Ectopic Tissue ◽  
Thyroid Scan ◽  
Imaging Results ◽  
Adjacent Structures

Abstract Background Ectopic thyroid tissue is a rare embryological aberration described by the occurrence of thyroid tissue at a site other than in its normal pretracheal location. Depending on the time of the disruption during embryogenesis, ectopic thyroid may occur at several positions from the base of the tongue to the thyroglossal duct. Ectopic mediastinal thyroid tissue is normally asymptomatic, but particularly after orthotopic thyroidectomy, it might turn out to be symptomatic. Symptoms are normally due to compression of adjacent structures. Case presentation We present a case of a 66-year-old male submitted to a total thyroidectomy 3 years ago, due to multinodular goiter (pathological results revealed nodular hyperplasia and no evidence of malignancy), under thyroid replacement therapy. Over the last year, he developed hoarseness, choking sensation in the chest, and shortness of breath. Thyroid markers were unremarkable. He was submitted to neck and thoracic computed tomography, magnetic resonance imaging, and radionuclide thyroid scan. Imaging results identified an anterior mediastinum solid lesion. A radionuclide thyroid scan confirmed the diagnosis of ectopic thyroid tissue. The patient refused surgery. Conclusions Ectopic thyroid tissue can occur either as the only detectable thyroid gland tissue or in addition to a normotopic thyroid gland. After a total thyroidectomy, thyroid-stimulating hormone can promote a compensatory volume growth of previously asymptomatic ectopic tissue. This can be particularly diagnosis challenging since ectopic tissue can arise as an ambiguous space-occupying lesion.

Use of radioiodine-131 scan to measure influence of surgical discipline, practice, and volume on residual thyroid tissue after total thyroidectomy for differentiated thyroid carcinoma

Head & Neck ◽  
2018 ◽  
Vol 40 (10) ◽  
pp. 2129-2136 ◽  
Author(s):  
Jin Soo A. Song ◽  
Nico Moolman ◽  
Steven Burrell ◽  
Murali Rajaraman ◽  
Martin Joseph Bullock ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma

Graves’ disease and recurrence in ectopic thyroid tissue after total thyroidectomy

2021 ◽  
Vol 14 (7) ◽  
pp. e243313
Author(s):  
Clara Cunha ◽  
Catia Ferrinho ◽  
Catarina Saraiva ◽  
João Sequeira Duarte
Keyword(s):  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Thyroid Tissue ◽  
Neck Mass ◽  
Thyroid Stimulating Hormone ◽  
Ectopic Thyroid ◽  
Treatment Withdrawal ◽  
Graves Disease ◽  
Receptor Antibodies ◽  
Levothyroxine Treatment

We report a case of a 46-year-old woman who presented with a midline neck mass 2 years after total thyroidectomy for Graves’ disease. Despite levothyroxine treatment withdrawal, she remained biochemically with subclinical hyperthyroidism. Her thyroid stimulating hormone receptor antibodies were consistently elevated. Neck ultrasonography revealed an infrahyoid solid nodule and pertechnetate scintigraphy confirmed an increased uptake at the same level, without any uptake in the thyroid bed. Treatment with methimazole 5 mg/day was initiated with clinical improvement and achievement of euthyroidism. After that, she received 10 mCi of radioactive iodine. Since then, she experienced regression of the neck mass and is doing well on a replacement dose of levothyroxine. Recurrence of Graves’ disease in ectopic thyroid following total thyroidectomy is extremely rare. This diagnose should be considered in patients who underwent total thyroidectomy and remained with thyrotoxicosis despite decreasing the levothyroxine dose.

scholarly journals Optimization of Predictive Performance for the Therapeutic Response Using Iodine Scan-Corrected Serum Thyroglobulin in Patients with Differentiated Thyroid Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 262
Author(s):  
Su Woong Yoo ◽  
Md. Sunny Anam Chowdhury ◽  
Subin Jeon ◽  
Sae-Ryung Kang ◽  
Sang-Geon Cho ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Predictive Performance ◽  
Response Prediction ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Focal Uptake ◽  
Uptake Pattern ◽  
Iodine Scan

We investigated whether the performance of serum thyroglobulin (Tg) for response prediction could be improved based on the iodine uptake pattern on the post-therapeutic I-131 whole body scan (RxWBS) and the degree of thyroid tissue damage with radioactive iodine (RAI) therapy. A total of 319 patients with differentiated thyroid carcinoma who underwent total thyroidectomy and RAI therapy were included. Based on the presence/absence of focal uptake at the anterior midline of the neck above the thyroidectomy bed on RxWBS, patients were classified into positive and negative uptake groups. Serum Tg was measured immediately before (D0Tg) and 7 days after RAI therapy (D7Tg). Patients were further categorized into favorable and unfavorable Tg groups based on the prediction of excellent response (ER) using scan-corrected Tg developed through the stepwise combination of D0Tg with ratio Tg (D7Tg/D0Tg). We investigated whether the predictive performance for ER improved with the application of scan-corrected Tg compared to the single Tg cutoff. The combined approach using scan-corrected Tg showed better predictive performance for ER than the single cutoff of D0Tg alone (p < 0.001). Therefore, scan-corrected Tg can be a promising biomarker to predict the therapeutic responses after RAI therapy.

scholarly journals Focal Bronchiectasis Causing Abnormal Pulmonary Radioiodine Uptake in a Patient with Well-Differentiated Papillary Thyroid Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Ash Gargya ◽  
Elizabeth Chua
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Iodine Uptake ◽  
Papillary Thyroid ◽  
Radioiodine Uptake ◽  
Well Differentiated ◽  
Radioactive Iodine Uptake

Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions.Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an undetectable stimulated serum thyroglobulin in the absence of interfering thyroglobulin antibodies. Contrast-enhanced chest computed tomography has confirmed that the abnormal pulmonary radioiodine uptake correlates with focal bronchiectasis.Summary. Bronchiectasis can cause abnormal chest radioactive iodine uptake in the followup of differentiated thyroid carcinoma.Conclusions. Recognition of potential false-positive chest radioactive iodine uptake, simulating pulmonary metastases, is needed to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine.

scholarly journals Longitudinal Change of Postoperative Serum Anti-thyroglobulin Antibody Levels in Patients Without Total Thyroidectomy and Remnant Ablation

2021 ◽  
Author(s):  
Katsuhiro Tanaka ◽  
Tsuyoshi Mikami ◽  
Shiori Kawano ◽  
Azusa Sasaki ◽  
Mai Sohda ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Thyroid Tumor ◽  
Longitudinal Change ◽  
Remnant Thyroid ◽  
Thyroglobulin Antibody ◽  
Number Of Patients ◽  
Postoperative Serum ◽  
Antibody Levels

Abstract Background: There is little information regarding postoperative thyroglobulin antibody (TgAb) changes in patients without a total thyroidectomy and ablation. This study aimed to analyze the longitudinal change of TgAb levels in patients with remnant thyroid.Methods: The study group were patients who had undergone a non-total thyroidectomy for a thyroid tumor from 1996 to 2018. The median follow-up period was 3.5 years (1–7.5 years). Eligible patients had a combined serum Tg and TgAb measurement at least three times biannually. We excluded patients with thyroid dysfunction at the initial diagnosis or with papillary carcinoma who had persistent or any recurrence of disease. Results: A total of 222 patients were enrolled. In the preoperative analysis, 42 (30%) patients had positive TgAb values, and 98 were negative (70%). Seventeen years after the operation, a TgAb value over 1000 IU/ml was not seen. The positive TgAb ratio was stable for 12 years (20%–30%); however, its positivity gradually increased from 13 years onward to 53.8%. The number of patients with consistently negative and positive TgAb values was 151 (68.0%) and 48 (21.6%), respectively. The number of patients with a mixture of positive and negative TgAb values was 10 (4.5%). The number of patients who changed from positive to negative values was six (2.7%) and, inversely, seven (3.2%). Conclusions: We found positivity of TgAb after surgery gradually increases over about 10 years in patients with normal remnant thyroid. We should measure both serum Tg and TgAb values concurrently for the patients with remnant thyroid tissue throughout.

scholarly journals Thyroid remnant volume and Radioiodine ablation in Differentiated thyroid carcinoma

2015 ◽  
Vol 17 (1) ◽  
pp. 55-60
Author(s):  
Md Sayedur Rahman Miah ◽  
Md Reajul Islam ◽  
Tanjim Siddika
Keyword(s):  
Thyroid Carcinoma ◽  
Atomic Energy Commission ◽  
Thyroid Volume ◽  
Differentiated Thyroid Carcinoma ◽  
High Dose ◽  
Thyroid Remnant ◽  
Complete Ablation ◽  
Successful Ablation ◽  
Remnant Thyroid ◽  
Radioiodine Ablation

Aims: The aims of the study were to determine the thyroid remnant volume and to see the effect of radioiodine ablation on thyroid remnant volume. Methods: A retrospective analysis of seventy-one differentiated thyroid carcinoma patients treated with high dose radioiodine (I-131) for post surgical ablation of thyroid remnants were done in Institute of Nuclear Medicine & Allied Sciences, Comilla of Bangladesh Atomic Energy Commission. Female were 60 and male were 11 with female-male ration of 5.5:1. All patients enrolled during the period from January 2001 to December 2011. The age range of the patients was 15 years to 90 years. The thyroid remnant volumes were determined by SPECT scintigraphy. High dose radioiodine (I-131) ablations were done with doses ranged from 2.77 GBq (75mCi) to 5.55 GBq (175 mCi). A successful ablation was defined as the absence of activity in the thyroid bed on subsequent imaging studies. Results: Fifty-nine patients (83.1%) showed complete ablation and twelve (16.9%) showed partial ablation of thyroid remnants after radioiodine therapy. The remnant thyroid volume as determined from scintigraphic images was significantly different (p = 0.048) between them who were completely ablated and them who were partially ablated. It was also observed that in complete ablation, 52.5% had thyroid remnant volume <1.0 gm, 40.7% had 1.1 to 2.0 gm, 5.1% had 2.1 to 3.0 gm and 1.7% had > 3.0 gm. i.e., The smaller the volume of thyroid remnant, better the response and larger the volume, the poorer the response to radioiodine. Conclusions: Successful ablation of thyroid remnants significantly depends on their volume and the successful ablation is inversely related with thyroid remnant volume. DOI: http://dx.doi.org/10.3329/bjnm.v17i1.22492 Bangladesh J. Nuclear Med. 17(1): 55-60, January 2014

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