A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer

Bryan R. Haugen, Furio Pacini, Christoph Reiners, Martin Schlumberger, Paul W. Ladenson, Steven I. Sherman, David S. Cooper, Kathryn E. Graham, Lewis E. Braverman, Monica C. Skarulis, Terry F. Davies, Leslie J. Degroot, Ernest L. Mazzaferri, Gilbert H. Daniels, Douglas S. Ross, Markus Luster, Mary Samuels, David V. Becker, Harry R. Maxon, Ralph R. CavalieriCarole A. Spencer, Kevin McEllin, Bruce D. Weintraub, E. Chester Ridgway

Research output: Contribution to journalArticle

501 Citations (Scopus)

Abstract

Recombinant human TSH has been developed to facilitate monitoring for thyroid carcinoma recurrence or persistence without the attendant morbidity of hypothyroidism seen after thyroid hormone withdrawal. The objectives of this study were to compare the effect of administered recombinant human TSH with thyroid hormone withdrawal on the resalts of radioiodine whole body scanning (WBS) and serum thyroglobalin (Tg) levels. Two hundred and twenty-nine adult patients with differentiated thyroid cancer requiring radioiodine WBS were studied. Radioiodine WBS and serum Tg measurements were performed after administration of recombinant human TSH and again after thyroid hormone withdrawal in each patient. Radioiodine whole body scans were concordant between the recombinant TSH-stimalated and thyroid hormone withdrawal phases in 195 of 220 (89%) patients. Of the discordant scans, 8 (4%) had superior scans after recombinant human TSH administration, and 17 (8%) had superior scans after thyroid hormone withdrawal (P = 0.108). Based on a serum Tg level of 2 ng/mL or more, thyroid tissue or cancer was detected during thyroid hormone therapy in 22%, after recombinant human TSH stimulation in 52%, and after thyroid hormone withdrawal in 56% of patients with disease or tissue limited to the thyroid bed and in 80%, 100%, and 100% of patients, respectively, with metastatic disease. A combination of radioiodine WBS and serum Tg after recombinant human TSH stimulation detected thyroid tissue or cancer in 93% of patients with disease or tissue limited to the thyroid bed and 100% of patients with metastatic disease. In conclusion, recombinant human TSH administration is a safe and effective means of stimulating radioiodine uptake and serum Tg levels in patients undergoing evaluation for thyroid cancer persistence and recurrence.

Original languageEnglish (US)
Pages (from-to)3877-3885
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume84
Issue number11
StatePublished - 1999

Fingerprint

Thyrotropin Alfa
Thyrotropin
Thyroid Hormones
Thyroid Gland
Whole Body Imaging
Neoplasms
Tissue
Hospital beds
Scanning
Thyroid Neoplasms
Serum
Recurrence
Hypothyroidism
Morbidity
Monitoring

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Haugen, B. R., Pacini, F., Reiners, C., Schlumberger, M., Ladenson, P. W., Sherman, S. I., ... Ridgway, E. C. (1999). A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer. Journal of Clinical Endocrinology and Metabolism, 84(11), 3877-3885.

A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer. / Haugen, Bryan R.; Pacini, Furio; Reiners, Christoph; Schlumberger, Martin; Ladenson, Paul W.; Sherman, Steven I.; Cooper, David S.; Graham, Kathryn E.; Braverman, Lewis E.; Skarulis, Monica C.; Davies, Terry F.; Degroot, Leslie J.; Mazzaferri, Ernest L.; Daniels, Gilbert H.; Ross, Douglas S.; Luster, Markus; Samuels, Mary; Becker, David V.; Maxon, Harry R.; Cavalieri, Ralph R.; Spencer, Carole A.; McEllin, Kevin; Weintraub, Bruce D.; Ridgway, E. Chester.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 84, No. 11, 1999, p. 3877-3885.

Research output: Contribution to journalArticle

Haugen, BR, Pacini, F, Reiners, C, Schlumberger, M, Ladenson, PW, Sherman, SI, Cooper, DS, Graham, KE, Braverman, LE, Skarulis, MC, Davies, TF, Degroot, LJ, Mazzaferri, EL, Daniels, GH, Ross, DS, Luster, M, Samuels, M, Becker, DV, Maxon, HR, Cavalieri, RR, Spencer, CA, McEllin, K, Weintraub, BD & Ridgway, EC 1999, 'A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer', Journal of Clinical Endocrinology and Metabolism, vol. 84, no. 11, pp. 3877-3885.
Haugen, Bryan R. ; Pacini, Furio ; Reiners, Christoph ; Schlumberger, Martin ; Ladenson, Paul W. ; Sherman, Steven I. ; Cooper, David S. ; Graham, Kathryn E. ; Braverman, Lewis E. ; Skarulis, Monica C. ; Davies, Terry F. ; Degroot, Leslie J. ; Mazzaferri, Ernest L. ; Daniels, Gilbert H. ; Ross, Douglas S. ; Luster, Markus ; Samuels, Mary ; Becker, David V. ; Maxon, Harry R. ; Cavalieri, Ralph R. ; Spencer, Carole A. ; McEllin, Kevin ; Weintraub, Bruce D. ; Ridgway, E. Chester. / A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer. In: Journal of Clinical Endocrinology and Metabolism. 1999 ; Vol. 84, No. 11. pp. 3877-3885.
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abstract = "Recombinant human TSH has been developed to facilitate monitoring for thyroid carcinoma recurrence or persistence without the attendant morbidity of hypothyroidism seen after thyroid hormone withdrawal. The objectives of this study were to compare the effect of administered recombinant human TSH with thyroid hormone withdrawal on the resalts of radioiodine whole body scanning (WBS) and serum thyroglobalin (Tg) levels. Two hundred and twenty-nine adult patients with differentiated thyroid cancer requiring radioiodine WBS were studied. Radioiodine WBS and serum Tg measurements were performed after administration of recombinant human TSH and again after thyroid hormone withdrawal in each patient. Radioiodine whole body scans were concordant between the recombinant TSH-stimalated and thyroid hormone withdrawal phases in 195 of 220 (89{\%}) patients. Of the discordant scans, 8 (4{\%}) had superior scans after recombinant human TSH administration, and 17 (8{\%}) had superior scans after thyroid hormone withdrawal (P = 0.108). Based on a serum Tg level of 2 ng/mL or more, thyroid tissue or cancer was detected during thyroid hormone therapy in 22{\%}, after recombinant human TSH stimulation in 52{\%}, and after thyroid hormone withdrawal in 56{\%} of patients with disease or tissue limited to the thyroid bed and in 80{\%}, 100{\%}, and 100{\%} of patients, respectively, with metastatic disease. A combination of radioiodine WBS and serum Tg after recombinant human TSH stimulation detected thyroid tissue or cancer in 93{\%} of patients with disease or tissue limited to the thyroid bed and 100{\%} of patients with metastatic disease. In conclusion, recombinant human TSH administration is a safe and effective means of stimulating radioiodine uptake and serum Tg levels in patients undergoing evaluation for thyroid cancer persistence and recurrence.",
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AU - Ladenson, Paul W.

AU - Sherman, Steven I.

AU - Cooper, David S.

AU - Graham, Kathryn E.

AU - Braverman, Lewis E.

AU - Skarulis, Monica C.

AU - Davies, Terry F.

AU - Degroot, Leslie J.

AU - Mazzaferri, Ernest L.

AU - Daniels, Gilbert H.

AU - Ross, Douglas S.

AU - Luster, Markus

AU - Samuels, Mary

AU - Becker, David V.

AU - Maxon, Harry R.

AU - Cavalieri, Ralph R.

AU - Spencer, Carole A.

AU - McEllin, Kevin

AU - Weintraub, Bruce D.

AU - Ridgway, E. Chester

PY - 1999

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N2 - Recombinant human TSH has been developed to facilitate monitoring for thyroid carcinoma recurrence or persistence without the attendant morbidity of hypothyroidism seen after thyroid hormone withdrawal. The objectives of this study were to compare the effect of administered recombinant human TSH with thyroid hormone withdrawal on the resalts of radioiodine whole body scanning (WBS) and serum thyroglobalin (Tg) levels. Two hundred and twenty-nine adult patients with differentiated thyroid cancer requiring radioiodine WBS were studied. Radioiodine WBS and serum Tg measurements were performed after administration of recombinant human TSH and again after thyroid hormone withdrawal in each patient. Radioiodine whole body scans were concordant between the recombinant TSH-stimalated and thyroid hormone withdrawal phases in 195 of 220 (89%) patients. Of the discordant scans, 8 (4%) had superior scans after recombinant human TSH administration, and 17 (8%) had superior scans after thyroid hormone withdrawal (P = 0.108). Based on a serum Tg level of 2 ng/mL or more, thyroid tissue or cancer was detected during thyroid hormone therapy in 22%, after recombinant human TSH stimulation in 52%, and after thyroid hormone withdrawal in 56% of patients with disease or tissue limited to the thyroid bed and in 80%, 100%, and 100% of patients, respectively, with metastatic disease. A combination of radioiodine WBS and serum Tg after recombinant human TSH stimulation detected thyroid tissue or cancer in 93% of patients with disease or tissue limited to the thyroid bed and 100% of patients with metastatic disease. In conclusion, recombinant human TSH administration is a safe and effective means of stimulating radioiodine uptake and serum Tg levels in patients undergoing evaluation for thyroid cancer persistence and recurrence.

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