Adedapo Kayode S, Vangu Mboyo Di Tamba
Department of Nuclear Medicine, University College Hospital, P.M.B. 5116 Dugbe Post Office, Ibadan, South West Nigeria.
Hell J Nucl Med. 2011 May-Aug;14(2):131-4.
We present data on repeated iodine-131 whole body scans ((131)I-WBS) in differentiated thyroid cancer patients (DTC) after surgery and (131)I remnant ablation and on increased thyroglobulin (Tg) with negative (131)I-WBS, in a retrospective study at our hospital. A total of 106 patients (91 female and 15 male) treated with (131)I for DTC met the inclusion criteria. The mean age of the patients was 45 years, age range 16-81 years. A total of 101 patients had complete 24 months follow-up following (131)I remnant ablation treatment. The mean (131)I dose administered after the first 6 months of follow- up was 3GBq while mean total dose was 4.9GBq, range 1.1-7.4GBq. Our results showed that at the end of the first 6 months post treatment, 58/101 patients had a negative (131)I-WBS. By the end of the 4th (131)I treatment at 24th months, the remaining 43 patients became negative for (131)I-WBS. We found increased Tg and negative (131)I-WBS in 2 of the 101 patients at the 24th months examination the so called Tg elevated negative (131)I-WBS (TENIS syndrome). The possible explanation of this syndrome is discussed. In conclusion, our study in DTC operated patients does not support the use of repeated diagnostic (131)I-WBS after an undetectable Tg because we found no Tg rebound in patients with negative (131)I-WBS, after 24 months of follow-up with serial measurements of Tg on and of suppression with L thyroxine.
在我们医院的一项回顾性研究中,我们展示了分化型甲状腺癌(DTC)患者术后及碘-131(¹³¹I)残余甲状腺组织消融后重复进行碘-131全身扫描(¹³¹I-WBS)的数据,以及¹³¹I-WBS阴性但甲状腺球蛋白(Tg)升高的数据。共有106例接受¹³¹I治疗的DTC患者符合纳入标准。患者的平均年龄为45岁,年龄范围为16至81岁。共有101例患者在¹³¹I残余甲状腺组织消融治疗后进行了完整的24个月随访。随访前6个月后给予的平均¹³¹I剂量为3GBq,而平均总剂量为4.9GBq,范围为1.1至7.4GBq。我们的结果显示,治疗后前6个月末,101例患者中有58例¹³¹I-WBS为阴性。到第24个月第4次¹³¹I治疗结束时,其余43例患者的¹³¹I-WBS转为阴性。在第24个月检查时,我们发现101例患者中有2例出现Tg升高且¹³¹I-WBS阴性,即所谓的Tg升高阴性¹³¹I-WBS(TENIS综合征)。本文讨论了该综合征的可能解释。总之,我们对DTC手术患者的研究不支持在Tg检测不到后使用重复的诊断性¹³¹I-WBS,因为在对¹³¹I-WBS阴性的患者进行24个月的随访并连续测量Tg及左旋甲状腺素抑制情况后,我们未发现Tg反弹。