Hyungju Kwon1,2, June Young Choi2, Jae Hoon Moon3, Hyo Jin Park4, Won Woo Lee5, Kyu Eun Lee1. 1. Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Korea. 2. Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea. 3. Department of Internal Medicine, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea. 4. Department of Pathology, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea. 5. Department of Nuclear Medicine, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea.
Abstract
BACKGROUND: Radioactive-iodine remnant ablation is an integral part of the papillary thyroid carcinoma (PTC) treatment. Although a minimum dose is usually recommended, there is controversy as to whether the low-dose (1100 MBq) radioactive-iodine remnant ablation is adequate for selected patients. METHODS: A retrospective cohort study was conducted on 691 patients. Patients with no remnant thyroid on the follow-up whole body scan and low stimulated thyroglobulin (sTg) level (<2.0 ng/mL) were deemed as successful treatment cases. RESULTS: Initial low-dose radioactive-iodine remnant ablation was successful in 431 patients (62.3%). Multivariate analysis demonstrated a negative correlation between successful radioactive-iodine remnant ablation and coexisting Hashimoto thyroiditis based on histopathology diagnosis (odds ratio [OR] = 3.23; p < .001) as well as elevated preablation sTg (OR = 1.24; p < .001). CONCLUSION: Our data suggest that coexisting Hashimoto thyroiditis and elevated sTg are negative predictive factors for successful low-dose radioactive-iodine remnant ablation treatment. An appropriate risk-adjusted approach may improve the efficacy of radioactive-iodine remnant ablation treatment.
BACKGROUND:Radioactive-iodine remnant ablation is an integral part of the papillary thyroid carcinoma (PTC) treatment. Although a minimum dose is usually recommended, there is controversy as to whether the low-dose (1100 MBq) radioactive-iodine remnant ablation is adequate for selected patients. METHODS: A retrospective cohort study was conducted on 691 patients. Patients with no remnant thyroid on the follow-up whole body scan and low stimulated thyroglobulin (sTg) level (<2.0 ng/mL) were deemed as successful treatment cases. RESULTS: Initial low-dose radioactive-iodine remnant ablation was successful in 431 patients (62.3%). Multivariate analysis demonstrated a negative correlation between successful radioactive-iodine remnant ablation and coexisting Hashimoto thyroiditis based on histopathology diagnosis (odds ratio [OR] = 3.23; p < .001) as well as elevated preablation sTg (OR = 1.24; p < .001). CONCLUSION: Our data suggest that coexisting Hashimoto thyroiditis and elevated sTg are negative predictive factors for successful low-dose radioactive-iodine remnant ablation treatment. An appropriate risk-adjusted approach may improve the efficacy of radioactive-iodine remnant ablation treatment.
Authors: Domenico Albano; Francesco Dondi; Valentina Zilioli; Maria Beatrice Panarotto; Alessandro Galani; Carlo Cappelli; Francesco Bertagna; Raffaele Giubbini; Claudio Casella Journal: Ann Nucl Med Date: 2021-06-21 Impact factor: 2.668