Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin.
Radioiodine ablation (RA) of normal thyroid remnants after thyroidectomy for differentiated thyroid carcinoma improves the sensitivity of subsequent radioiodine scans and serum thyroglobulin measurements for detection of residual thyroid carcinoma. Local cancer recurrences are also lower after RA. One standard preparation for RA involves rendering the patient hypothyroid in order to stimulate endogenous thyrotropin (TSH) secretion and sodium iodide symporter (NIS) activity. An alternative approach is to prescribe thyroxine after thyroidectomy and to stimulate NIS with exogenous recombinant human thyrotropin (rhTSH). This latter approach was used in 10 patients at our medical center. Complete resolution of all visible 131I thyroid bed uptake was achieved in all when follow-up scans were performed 5 to 13 months later. This approach has the potential to successfully ablate thyroid remnants without the need to induce hypothyroidism.
Robbins
R J
RJ
Department of Medicine, Memorial Hospital for Cancer and Allied Diseases, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. robbinsr@mskcc.org
Tuttle
R M
RM
Sonenberg
M
M
Shaha
A
A
Sharaf
R
R
Robbins
H
H
Fleisher
M
M
Larson
S M
SM
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery; D002291:Carcinoma, Papillary / Q000601:surgery; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011877:Radionuclide Imaging; D011994:Recombinant Proteins / Q000627:therapeutic use; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000528:radiation effects*; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy; D013972:Thyrotropin / Q000627:therapeutic use*
D007457:Iodine Radioisotopes; D011994:Recombinant Proteins; D013972:Thyrotropin