Radioiodine ablation with 1,850 MBq in association with rhTSH in patients with differentiated thyroid cancer.
The aim of this study was to evaluate the efficacy of post-operative radioiodine ablation with 1,850 MBq after recombinant human thyrotropin (rhTSH) administration in patients with differentiated thyroid carcinoma (DTC). We also aimed to assess the prognostic role of several patient features on the outcome of ablation.



We retrospectively analyzed data from a total of 125 patients with DTC who underwent post-operative radioiodine ablation with 1,850 MBq of ¹³¹I after preparation with rhTSH. One injection of 0.9 mg rhTSH was administered on each of two consecutive days; ¹³¹I therapy was delivered 24 h after the last injection, followed by a post-therapy whole-body scan. Successful ablation was assessed 6-12 months later and defined as an rhTSH-stimulated serum thyroglobulin (Tg) level ≤1.0 ng/ml and a normal neck ultrasound.



Patients were stratified according to the American Thyroid Association (ATA) Management Guidelines for Differentiated Thyroid Cancer. Successful ablation was achieved in 82.4 % of patients, with an ablation rate of 95.1 % in low-risk patients and 76.2 % in intermediate-risk patients. Analyzing the correlation between ablation outcome and patient characteristics, we found a statistically significant association between failure to ablate and class of risk based on ATA guidelines (p = 0.025) and a stimulated Tg value at ablation of above 5 ng/ml (p < 0.001).



The use of 1,850 MBq post-operative radioiodine thyroid remnant ablation in association with rhTSH is effective for low- and intermediate-risk patients. Moreover, in our study, we found a statistical correlation between failure to ablate and class of risk based on ATA guidelines for DTC and a stimulated Tg value at ablation.
Unit of Endocrinology, Humanitas Research Hospital, Rozzano, MI, Italy.
Alberto S
AS
Tresoldi
Unit of Endocrinology, Humanitas Research Hospital, Rozzano, MI, Italy.
Laura F
LF
Sburlati
Nuclear Medicine Department, Humanitas Research Hospital, Via A. Manzoni 56, 20089, Rozzano, MI, Italy.
Marcello
M
Rodari
Leyden University, Leiden, The Netherlands.
Mink S
MS
Schinkelshoek
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.|Endocrine Unit, Fondazione IRCCS Ca' Granda, Milan, Italy.
Michela
M
Perrino
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.|Endocrine Unit, Fondazione IRCCS Ca' Granda, Milan, Italy.
Simone
S
De Leo
Unit of Endocrine Diseases and Diabetology, Ospedale San Giuseppe Multimedica, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Laura
L
Montefusco
Unit of Endocrinology, Humanitas Research Hospital, Rozzano, MI, Italy.
Paolo
P
Colombo
Unit of Endocrine Diseases and Diabetology, Ospedale San Giuseppe Multimedica, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Maura
M
Arosio
Unit of Endocrinology, Humanitas Research Hospital, Rozzano, MI, Italy.|Department of Biotechnologies and Translational Medicine, University of Milan, Milan, Italy.
Andrea Gerardo Antonio
AGA
Lania
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.|Endocrine Unit, Fondazione IRCCS Ca' Granda, Milan, Italy.
Laura
L
Fugazzola
Nuclear Medicine Department, Humanitas Research Hospital, Via A. Manzoni 56, 20089, Rozzano, MI, Italy. arturo.chiti@humanitas.it.
Arturo
A
Chiti
D018263:Adenocarcinoma, Follicular / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002291:Carcinoma, Papillary / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018265:Carcinoma, Papillary, Follicular / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000453:epidemiology / Q000517:prevention & control; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012306:Risk; D000077273:Thyroid Cancer, Papillary; D013961:Thyroid Gland / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D013972:Thyrotropin / Q000235:genetics / Q000627:therapeutic use*; D051598:Whole Body Imaging
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D011994:Recombinant Proteins; D013972:Thyrotropin