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Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients.
Eur J Endocrinol 2009; 160(3):431-6EJ

Abstract

OBJECTIVE

(a) To compare the efficacy of low-activity (2 GBq; 54 mCi) (131)I ablation using l-thyroxine withdrawal or rhTSH stimulation, and (b) to assess the influence of thyroid remnants volume on the ablation rate.

DESIGN

Patients underwent neck ultrasound, (131)I neck scintigraphy and radioiodine uptake. Post-therapy whole body scan (WBS) was acquired after 4-6 days. Ablation was assessed after 6-12 months by WBS, Tg and TgAb following l-thyroxine withdrawal.

METHODS

Group A: preparation by L-T(4) withdrawal (37 days); 21 patients received (131)I (2.02+/-0.22 GBq; 54.6+/-5.9 mCi) and on the day of treatment, TSH, Tg, TgAb were measured; Group B: stimulation by rhTSH; 21 patients received (131)I (1.97+/-0.18 GBq; 53.2+/-4.9 mCi) 24 h after the second injection of rhTSH (0.9 mg) and TSH, Tg and TgAb were measured after 2 days.

RESULTS

At follow-up, 90.0% of patients from group A and 85.0% of patients from group B had Tg levels <1 ng/ml; no uptake was observed in 95.2% and in 90.5% of patients from group A or B respectively, with no statistical differences for both ablation criteria. Before (131)I treatment, small thyroid remnants (<1 ml) were detected by US in <25% of all patients.

CONCLUSIONS

The use of rhTSH for the preparation of low-risk patients to ablation therapy with low activities of (131)I (2 GBq; 54 mCi) is safe and effective and avoids hypothyroidism. The presence of thyroid remnants smaller than 1 ml at US evaluation had no effect on the ablation rate.

Authors+Show Affiliations

Nuclear Medicine Unit, Department of Diagnostics, Regina Apostolorum Hospital, Albano, Rome, Italy. marcochianelli@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19074463

Citation

Chianelli, M, et al. "Low-activity (2.0 GBq; 54 mCi) Radioiodine Post-surgical Remnant Ablation in Thyroid Cancer: Comparison Between Hormone Withdrawal and Use of rhTSH in Low-risk Patients." European Journal of Endocrinology, vol. 160, no. 3, 2009, pp. 431-6.
Chianelli M, Todino V, Graziano FM, et al. Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients. Eur J Endocrinol. 2009;160(3):431-6.
Chianelli, M., Todino, V., Graziano, F. M., Panunzi, C., Pace, D., Guglielmi, R., ... Papini, E. (2009). Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients. European Journal of Endocrinology, 160(3), pp. 431-6. doi:10.1530/EJE-08-0669.
Chianelli M, et al. Low-activity (2.0 GBq; 54 mCi) Radioiodine Post-surgical Remnant Ablation in Thyroid Cancer: Comparison Between Hormone Withdrawal and Use of rhTSH in Low-risk Patients. Eur J Endocrinol. 2009;160(3):431-6. PubMed PMID: 19074463.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-activity (2.0 GBq; 54 mCi) radioiodine post-surgical remnant ablation in thyroid cancer: comparison between hormone withdrawal and use of rhTSH in low-risk patients. AU - Chianelli,M, AU - Todino,V, AU - Graziano,F M, AU - Panunzi,C, AU - Pace,D, AU - Guglielmi,R, AU - Signore,A, AU - Papini,E, Y1 - 2008/12/12/ PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/3/24/medline SP - 431 EP - 6 JF - European journal of endocrinology JO - Eur. J. Endocrinol. VL - 160 IS - 3 N2 - OBJECTIVE: (a) To compare the efficacy of low-activity (2 GBq; 54 mCi) (131)I ablation using l-thyroxine withdrawal or rhTSH stimulation, and (b) to assess the influence of thyroid remnants volume on the ablation rate. DESIGN: Patients underwent neck ultrasound, (131)I neck scintigraphy and radioiodine uptake. Post-therapy whole body scan (WBS) was acquired after 4-6 days. Ablation was assessed after 6-12 months by WBS, Tg and TgAb following l-thyroxine withdrawal. METHODS: Group A: preparation by L-T(4) withdrawal (37 days); 21 patients received (131)I (2.02+/-0.22 GBq; 54.6+/-5.9 mCi) and on the day of treatment, TSH, Tg, TgAb were measured; Group B: stimulation by rhTSH; 21 patients received (131)I (1.97+/-0.18 GBq; 53.2+/-4.9 mCi) 24 h after the second injection of rhTSH (0.9 mg) and TSH, Tg and TgAb were measured after 2 days. RESULTS: At follow-up, 90.0% of patients from group A and 85.0% of patients from group B had Tg levels <1 ng/ml; no uptake was observed in 95.2% and in 90.5% of patients from group A or B respectively, with no statistical differences for both ablation criteria. Before (131)I treatment, small thyroid remnants (<1 ml) were detected by US in <25% of all patients. CONCLUSIONS: The use of rhTSH for the preparation of low-risk patients to ablation therapy with low activities of (131)I (2 GBq; 54 mCi) is safe and effective and avoids hypothyroidism. The presence of thyroid remnants smaller than 1 ml at US evaluation had no effect on the ablation rate. SN - 1479-683X UR - https://www.unboundmedicine.com/medline/citation/19074463/Low_activity__2_0_GBq L2 - https://eje.bioscientifica.com/doi/10.1530/EJE-08-0669 DB - PRIME DP - Unbound Medicine ER -