Usefulness of isotope diagnosis, ultrasound neck investigation and thyroglobulin assays in quantification of patients operated on for differentiated thyroid cancer and prepared for radioiodine treatment]

The aim of the study was to assess the efficacy of surgical treatment of patients operated on differentiated thyroid carcinoma, using Tg serum assays and 131-I whole body scintigraphy. We investigated 208 patients aged from 15 to 78 yr. (mean 43.52, S.S. 16.37) including 182 females and 26 males. 183 cases of papillary cancer and 25 cases of follicular cancer were confirmed by pathologist. All the patients were investigated 6-8 weeks after thyreoidectomy. The following procedures were performed in all the patients: 1. ultrasound imaging. 2. 131 iodine uptake test, 24 hours after administration. 3. 131-I whole body scintigraphy (dose per patient 3 mCi, device Varicam). 4. TSH and Tg serum assay using FIA method. Moreover, all the tissue fragments obtained during surgery underwent histopathological assessment.The mean volume of the post-surgery thyroid tissue remains was 2.91 cc varying from 0 to 40. Volume was counted with Gutekunt's formula. Oncologically suspected lymph nodes were found in 8 cases. The mean TSH serum level was 79.31 (SD 59.59). The mean Tg serum level was 51.73 (SD 179). The mean value of an iodine uptake test was 6.96% (SD 6.69). Whole body scintigraphy discovered solitary thyroid site iodine uptake areas in 199 patients (95.7%). Additional uptake areas were observed in 4.3% 2 (0.9%) cases in cervical lymph nodes, 4 (1.9%) cases in lungs, 3 (1.5%) in bones. The correlation between investigations both laboratory and isotopic, and clinical state was observed in 207 cases (99.5%). The presence of high Tg serum level despite of absence of extracervical iodine uptake areas was observed in one case. We presume that the situation can be caused by the presence of multiple lung metastases not having possibility of iodine uptake. Ultrasound imaging, 131-I scintigraphy and Tg serum assays are essential methods in diagnosing and treatment process in the patients with differentiated thyroid carcinoma.