Controversies in the follow-up and management of well-differentiated thyroid cancer.

2004 ◽  
Vol 11 (1) ◽  
pp. 97-116 ◽  
Author(s):  
M D Ringel ◽  
P W Ladenson
Keyword(s):  
Thyroid Cancer ◽  
Residual Disease ◽  
Wide Spectrum ◽  
Preoperative Assessment ◽  
Staging System ◽  
Primary Treatment ◽  
Long Term Monitoring ◽  
Well Differentiated ◽  
Term Monitoring

Thyroid cancer is a common malignancy with an apparent increasing incidence and a wide spectrum of clinical behavior and therapeutic responsiveness. Recent advances in diagnosis, primary treatment, and long-term monitoring have led to enhanced detection of primary and recurrent disease and improvements in therapy. Controversy still surrounds several issues: the most accurate predictive staging system and histological subclassification scheme, optimal preoperative assessment and surgical extent, appropriate use of radioiodine for remnant ablation, goal for thyrotropin-suppressive thyroid hormone therapy, best practices in immediate postoperative and long-term monitoring, and approach to the patient with thyroglobulin evidence of residual disease. In this paper, recent data related to these controversial issues are critically reviewed.

scholarly journals Undetectable Sensitive Serum Thyroglobulin (<0.1 ng/ml) in 163 Patients with Follicular Cell-Derived Thyroid Cancer: Results of rhTSH Stimulation and Neck Ultrasonography and Long-Term Biochemical and Clinical Follow-Up

2012 ◽  
Vol 97 (8) ◽  
pp. 2714-2723 ◽  
Author(s):  
A. M. Chindris ◽  
N. N. Diehl ◽  
J. E. Crook ◽  
V. Fatourechi ◽  
R. C. Smallridge
Keyword(s):  
Thyroid Cancer ◽  
Radioactive Iodine ◽  
Stage Iv ◽  
Needle Aspiration ◽  
Serum Thyroglobulin ◽  
Iodine Treatment ◽  
Long Term Monitoring ◽  
Term Monitoring

Abstract Context: Surveillance of patients with differentiated thyroid cancer (DTC) is achieved using serum thyroglobulin (Tg), neck ultrasonography (US), and recombinant human TSH (rhTSH)-stimulated Tg (Tg-stim). Objective: Our primary aim was to assess the utility of rhTSH Tg-stim in patients with suppressed Tg (Tg-supp) below 0.1 ng/ml using a sensitive assay. Our secondary aims were to assess the utility of US and to summarize the profile of subsequent Tg-supp measures. Design: This is a retrospective study conducted at two sites of an academic institution. Patients: A total of 163 patients status after thyroidectomy and radioactive iodine treatment who had Tg-supp below 0.1 ng/ml and rhTSH Tg-stim within 60 d of each other were included. Results: After rhTSH stimulation, Tg remained below 0.1 ng/ml in 94 (58%) and increased to 0.1–0.5 in 56 (34%), more than 0.5–2.0 in nine (6%), and above 2.0 ng/ml in four (2%) patients. Serial Tg-supp levels were obtained in 138 patients followed over a median of 3.6 yr. Neck US were performed on 153 patients; suspicious exams had fine-needle aspiration (FNA). All positive FNA were identified around the time of the initial rhTSH test. Six of seven recurrences were detected by US (Tg-stim &gt;2.0 ng/ml in one, 0.8 in one and ≤0.5 in four). One stage IV patient had undetectable Tg-stim. Conclusion: In patients with DTC whose T4-suppressed serum Tg is below 0.1 ng/ml, long-term monitoring with annual Tg-supp and periodic neck US are adequate to detect recurrences. In our experience, rhTSH testing does not change management and is not needed in this group of patients.

Future Needs for Long-Term Monitoring Design

2003 ◽  
Author(s):  
Barbara S. Minsker ◽  
Charles Davis ◽  
David Dougherty ◽  
Gus Williams
Keyword(s):  
Monitoring Design ◽  
Future Needs ◽  
Long Term Monitoring ◽  
Term Monitoring

Investigations on potential methods for the long-term monitoring of the state of fuel elements in dry storage casks

Kerntechnik ◽  
2018 ◽  
Vol 83 (6) ◽  
pp. 513-522 ◽  
Author(s):  
U. Hampel ◽  
A. Kratzsch ◽  
R. Rachamin ◽  
M. Wagner ◽  
S. Schmidt ◽  
...  
Keyword(s):  
The State ◽  
Dry Storage ◽  
Long Term Monitoring ◽  
Potential Methods ◽  
Fuel Elements ◽  
Term Monitoring

Long-Term Monitoring of the Effects of Weather and Marking Techniques on Body Condition in the Kuhl's Pipistrelle Bat, Pipistrellus Kuhlii

2019 ◽  
Vol 21 (1) ◽  
pp. 87 ◽  
Author(s):  
Andrea G. Locatelli ◽  
Simone Ciuti ◽  
Primož Presetnik ◽  
Roberto Toffoli ◽  
Emma Teeling
Keyword(s):  
Body Condition ◽  
Long Term Monitoring ◽  
Term Monitoring
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