title: Postoperative Thyroglobulin and Neck Ultrasound in the Risk Restratification and Decision to Perform 131I Ablation.
abstract: There is much debate surrounding the choice of which patient should be submitted to postsurgical remnant radioiodine remnant ablation (RRA), particularly in low-risk (LR) and intermediate-risk (IR) differentiated thyroid cancer (DTC).
  
  
  
  The aim of this study was to evaluate the role of postoperative high-sensitive thyroglobulin (Tg) on L-thyroxine (LT4-HSTg) and postoperative neck ultrasound (US) in risk restratification and decision to perform RRA.
  
  
  
  We evaluated 505 patients with LR or IR DTC 3 to 4 months after total thyroidectomy (TTx). All patients underwent RRA and a posttherapeutic whole body scan (ptWBS).
  
  
  
  After TTx, 29.7% DTC patients had LT4-HSTg <0.1 ng/mL (Group A) and could be restratified as cured: 1 of 150 had lymph node metastases (LN mets) detected by neck US but negative at ptWBS. 56.8% DTC patients had LT4-HSTg between 0.1 and ≤1 ng/mL (Group B) and could be restratified either as cured or not cured. In this group, 15 of 287 (5.2%) had metastases but only 7 were detected by ptWBS; 13.5% DTC patients had LT4-HSTg >1 ng/mL (Group C) and could not be considered as cured by definition. LN mets were present in 11 of 68(16.2%) cases, all detected by neck US. No correlation was found with the presence of metastases and serum LT4-HSTg values or with the level of risk.
  
  
  
  LT4-HSTg measured 3 to 4 months after TTx is important in the risk restratification of DTC patients but is less relevant than neck US in the decision to perform RRA.
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Antonio
authors.initials: A
authors.lastname: Matrone
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Carla
authors.initials: C
authors.lastname: Gambale
authors.affiliation: Phoenix Epidemiology and Clinical Research Branch National institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Phoenix, Arizona 85014.
authors.forename: Paolo
authors.initials: P
authors.lastname: Piaggi
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: David
authors.initials: D
authors.lastname: Viola
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Giani
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Laura
authors.initials: L
authors.lastname: Agate
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Valeria
authors.initials: V
authors.lastname: Bottici
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bianchi
authors.affiliation: Surgical, Medical, Molecular Pathology, and Critical Area, University of Pisa, 56124 Pisa, Italy; and.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Materazzi
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vitti
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Molinaro
authors.affiliation: Departments of Clinical and Experimental Medicine, Unit of Endocrinology, and.
authors.forename: Rossella
authors.initials: R
authors.lastname: Elisei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011184:Postoperative Period; D011877:Radionuclide Imaging; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D013954:Thyroglobulin / Q000097:blood*; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy; D013974:Thyroxine / Q000097:blood*; D047368:Tumor Burden; D014463:Ultrasonography; D051598:Whole Body Imaging; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D007457:Iodine Radioisotopes; C006606:anti-thyroglobulin; D013954:Thyroglobulin; D013974:Thyroxine