July - September 2021, Volume 17, Issue 3

Sahin M, Aydogan BI, Ozkan E, Emral R, Gullu S, Erdogan MF , Corapcioglu D

Recombinant Human Thyrotropin Versus Thyroid Hormone Withdrawal in Differentiated Thyroid Carcinoma Follow-Up: a Single Center Experience

Acta Endo (Buc) 2021, 17 (3): 337-345
doi: 10.4183/aeb.2021.337

Introduction. Our goal was to evaluate and compare the diagnostic utility of thyroid hormone withdrawal (THW) and recombinant thyroid-stimulating hormone (rhTSH) methods in detecting recurrence/persistence (R/PD) of differentiated thyroid carcinoma (DTC). Methods. The study included 413 patients with DTC who underwent total thyroidectomy and had remnant ablation. DxWBS, s-Tg levels, R/PD were evaluated retrospectively. A s-Tg level≥2 ng/mL was considered as “positive s-Tg”. Results. DxWBS and s-Tg levels were evaluated with rhTSH in 116 and THW in 297 subjects, respectively. The sensitivity and specificity of “positive s-Tg” for R/PD in THW group were 77.3% and 92.7%, with 90.3% accuracy, respectively. The sensitivity and specificity of “positive s-Tg” for R/PD in rhTSH group were 58.8% and 100% with 93.9 % accuracy, respectively. An uptake outside thyroid bed at WBS showed a sensitivity of 17.1%, specificity of 100% for R/PD with 89.4% accuracy in THW group. An uptake outside thyroid bed at WBS showed a sensitivity of 7.7%, specificity of 100% for R/PD with 88.8% accuracy in rhTSH group. Conclusion. Method of TSH stimulation did not influence the reliability of DxWBS. The “positive s-Tg level” had a higher sensitivity with THW when compared to rhTSH in detecting R/PD.

Keywords: differentiated thyroid cancer, thyroid hormone withdrawal, recombinant human thyroidstimulating hormone, whole body scan, stimulated thyroglobulin.

Correspondence: Berna Imge Aydogan MD, Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism Ibni Sina Hospital, Ankara, 06410, Turkey, E-mail: imgehalici@gmail.com