Advertisement

The optimal TSH level necessary for successful radioiodine ablation of differentiated thyroid carcinoma, as well as the time to reach this level, is a work in progress

  • Ismaheel O. Lawal
  • Mariza Vorster
  • Alfred O. Ankrah
  • Mike M. Sathekge
Letter to the Editor
  • 404 Downloads

Dear Editor,

We read with great interest the article by Piccardo et al. titled “Could short thyroid hormone withdrawal be an effective strategy for radioiodine remnant ablation in differentiated thyroid cancer patients?” [1]. The authors retrospectively reviewed the data of two groups of patients who had radioactive iodine (RAI) ablation post-total thyroidectomy for differentiated thyroid cancer. Group A (n = 85) patients had thyroid hormone withdrawal (THW) for 2 weeks, while group B patients (n= 137) had THW for 3–4 weeks. All patients in the two groups had sufficiently elevated thyroid-stimulating hormone (TSH) levels at the time of RAI ablation. The authors found no statistical significant difference between the groups regarding their age, gender, histological variant of thyroid carcinoma, tumor size, nodal status, or tumor aggressiveness. The serum TSH level at the time of ablation was significantly higher in group B patients compared with group A. This, however, did not have a...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no financial or non-financial competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

References

  1. 1.
    Piccardo A, Puntoni M, Ferrarazzo G, Foppiani L, Bottoni G, Altrinetti V, et al. Could short thyroid hormone withdrawal be an effective strategy for radioiodine remnant ablation in differentiated thyroid cancer patients? Eur J Nucl Med Mol Imaging. 2018;  https://doi.org/10.1007/s00259-018-3955-x.
  2. 2.
    Edmonds CJ, Hayes S, Kermode JC, Thompson BD. Measurement of serum TSH and thyroid hormones in the management of treatment of thyroid carcinoma with radioiodine. Br J Radiol. 1977;50:799–807.CrossRefPubMedGoogle Scholar
  3. 3.
    Vrachimis A, Rirmann B, Mäder U, Reiners C, Verburg FA. Endogenous TSH levels at the time of 131I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality. Eur J Nucl Med Mil Imaging. 2016;43:224–31.CrossRefGoogle Scholar
  4. 4.
    Hasbek Z, Turgut B. Is very high thyroid stimulating hormone level required in differentiated thyroid cancer for ablation success? Mol Imaging Radionucl Ther. 2016;25:79–84.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Zhao T, Liang J, Guo Z, Li T, Lin Y. In patients with low- to intermediate-risk thyroid cancer, a preablative thyrotropin level of 30 μIU/mL is not adequate to achieve better response to 133I therapy. Clin Nucl Med. 2016;41:454–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Lawal IO, Nyakale NE, Harry LM, Lengana T, Mokgoro NP, Vorster M, et al. Higher preablative serum thyroid-stimulating hormone level predicts radioiodine ablation effectiveness in patients with differentiated thyroid carcinoma. Nucl Med Commun. 2017;38:222–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Verburg FA, Mäder U, Grille I, Visser TJ, Peeters RP, Smit JW, et al. The thyroid axis ‘setpoint’ are significantly altered after long-term suppressive LT4 therapy. Horm Metab Res. 2014;46:794–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Hoermann R, Midgley JE, Giacobino A, Eckl WA, Wahl HG, Dietrich JW, et al. Homeostatic equilibria between free thyroid hormones and pituitary thyrotropin are modulated by various influences including age, body mass index and treatment.Google Scholar
  9. 9.
    Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Nuclear MedicineUniversity of Pretoria and Steve Biko Academic HospitalPretoriaSouth Africa
  2. 2.Department of Nuclear Medicine and Molecular ImagingUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands

Personalised recommendations