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Luca Giovanella,Gaetano Paone,Teresa Ruberto,Luca Ceriani,Pierpaolo Trimboli 대한내분비학회 2019 Endocrinology and metabolism Vol.34 No.1
Background: Postoperative routine radioiodine (RAI) treatment is currently debated for patients with low-risk differentiated thyroidcarcinoma (DTC) patients. If performed, a low 131I activity (i.e., 1 to 2 GBq) is recommended with the aim to ablate thyroid remnantand facilitate subsequent follow-up by thyroglobulin measurement. The purpose of this study was to evaluate the relationship between postsurgical technetium-99m (99mTc)-pertechnetate scintigraphy and the rate of successful remnant ablation after low activityradioiodine ablation in patients with DTC. Methods: Enrolled were 193 patients with low risk DTC who underwent total thyroidectomy and RAI ablation with a fixed 1.1 GBqactivity of 131I. 99mTc-pertechnetate scans were done and thyrotropin stimulated thyroglobulin (sTg) levels measured just before ablation. Ablation effectiveness was assessed 6 to 12 months later by sTg measurement, neck ultrasound and diagnostic whole body scan. Results: A negative 99mTc-perthecnetate scans was the best predictor of successful ablation (P<0.001) followed by preablative sTglevels <0.8 ng/mL (P=0.008) and 99mTc-pertechnetate uptake rate values <0.9% (P=0.065). Neither sex nor age of the patient at thetime of ablation or tumor histology and size showed a significant association with the rate of successful ablation. Conclusion: The 99mTc-pertechnetate scintigraphy is a simple and feasible tool to predict effectiveness of low activity 131I thyroid toablate thyroid remnants in patients with DTC.