Stimulated thyroglobulin and diagnostic 131-iodine whole-body scan as a predictor of distant metastasis and association with response to treatment in pediatric thyroid cancer patients
- PMID: 38296913
- DOI: 10.1007/s12020-024-03691-w
Stimulated thyroglobulin and diagnostic 131-iodine whole-body scan as a predictor of distant metastasis and association with response to treatment in pediatric thyroid cancer patients
Abstract
Introduction: Differentiated thyroid carcinoma (DTC) is a rare oncological disease in the pediatric population, presenting with a more aggressive form. Stimulated thyroglobulin (sTg) and the 131-iodine whole-body scans (WBSs) are known adult markers related to the presence of distant metastasis. Little is known about their roles in the pediatric population.
Purpose: To evaluate sTg levels and diagnostic WBS (DxWBS) as predictors of distant metastasis after thyroidectomy and to correlate with the response to treatment at the end of follow-up in pediatric DTC.
Materials and methods: Patients under 19 years old diagnosed with DTC from 1980 to 2022 were retrospectively evaluated. sTg values and WBS were assessed after thyroidectomy and prior radioiodine treatment (RIT) and correlated with the possibility of finding distant metastasis and response to treatment at the end of follow-up.
Results: In a total of 142 patients with a median age of 14.6 (4-18) years who were followed for 9.5 ± 7.2 years and classified according to the ATA risk of recurrence as low (28%), intermediate (16%), and high risk (56%), 127 patients had their sTg evaluated. A sTg value of 21.7 ng/dl yielded a sensitivity of 88% compared to 30% for DxWBS in predicting distant metastasis. Specificity was 60% and 100% respectively. 42% of patients obtained discordant results between DxWBS and RxWBS. In high-risk patients, sTg levels were particularly able to differentiate those who would have distant metastasis with better diagnostic accuracy than the WBSs.
Conclusions: The sTg level had better performance in detecting distant metastases in pediatric DTC than the DxWBS. DxWBS's low performance suggests that caution should be taken in interpreting their findings in terms of the underdiagnosis for metastatic disease, especially when the sTg level already suggests distant disease.
Keywords: Differentiated thyroid cancer; Pediatric thyroid carcinoma; Radioiodine therapy; Thyroglobulin; Whole-body scan.
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Similar articles
-
Is there a role for diagnostic scans in the management of intermediate-risk thyroid cancer?Endocr Relat Cancer. 2022 Jun 27;29(8):475-483. doi: 10.1530/ERC-22-0038. Print 2022 Aug 1. Endocr Relat Cancer. 2022. PMID: 35613335
-
Prediction of treatment response to ¹³¹I therapy by diffuse hepatic uptake intensity on post-therapy whole-body scan in patients with distant metastases of differentiated thyroid cancer.Ann Nucl Med. 2015 Aug;29(7):603-12. doi: 10.1007/s12149-015-0983-5. Epub 2015 May 17. Ann Nucl Med. 2015. PMID: 25980591
-
The value of diagnostic whole-body scanning and serum thyroglobulin in the presence of elevated serum thyrotropin during follow-up of anti-thyroglobulin antibody-positive patients with differentiated thyroid carcinoma who appeared to be free of disease after total thyroidectomy and radioactive iodine ablation.Thyroid. 2012 Feb;22(2):113-6. doi: 10.1089/thy.2011.0020. Epub 2012 Jan 6. Thyroid. 2012. PMID: 22224815
-
Value of diagnostic radioiodine whole-body scanning after initial therapy in patients with differentiated thyroid cancer at intermediate and high risk for recurrence.Thyroid. 2012 Nov;22(11):1165-9. doi: 10.1089/thy.2012.0026. Epub 2012 Oct 10. Thyroid. 2012. PMID: 23050784
-
Respective roles of thyroglobulin, radioiodine imaging, and positron emission tomography in the assessment of thyroid cancer.Semin Nucl Med. 2006 Jul;36(3):194-205. doi: 10.1053/j.semnuclmed.2006.03.002. Semin Nucl Med. 2006. PMID: 16762610 Review.
References
-
- SEER. Cancer stat facts: thyroid cancer. Available at: https://seer.cancer.gov/statfacts/html/thyro.html
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials