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Abstract
The effectiveness of diagnostic scanning, which is carried out after receiving radioactive iodine in minimal doses, remains debatable. Some authors also deny the value of performing a diagnostic scan before thyroid ablation taking into account that a «stunning» effect may occur. Thus, continuing research in this
direction is an urgent problem in the management of patients with well differentiated thyroid cancers. The aim. Determination of the level of information content of radioiodine diagnostics (RaID) in comparison with ultrasound and laboratory parameters of thyroglobulin (TG), antithyroglobulin antibodies (AbTg) for the diagnosis of relapses of well-differentiated thyroid cancer in the postoperative period. Material and methods. The study group of patient was selected from the electronic register of the clinic of the State Institute «V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine» (12 659 RaID researches in 6589 people). The main group for studying the efficiency of RaID consisted of 35 cases, in which the accumulation of the isotope was determined in areas of the jugular lymphatic drainage collectors. Radiological (scanning), laboratory (determination of hormones and antibodies) and statistical research methods were used. Results. In a group of 35 cases of RaID with accumulation in scintigraphy in the jugular collectors of lymph drainage of the neck with zero TG and AbTG values did not reveal a single case (0%). With TG up to 1 ng/mL and AbTG up to 10 U/mL, 2 cases (5.7%) were identified. If we include both TG (<1 ng/mL) and AgTG (<10 U/mL) and ultrasound diagnostic data in the risk factors, then the absence of any risk signs was recorded in only one case (2.9%). The independent effectiveness of ultrasound for detecting metastatic lesions in the studied group was 37.1%, that is, low. Conclusion: the use of RaID at zero levels of TG and AbTG does not have independent diagnostic efficiency (0% according to our data) and may not be used in these cases. At TG levels <1 ng/mL simultaneously with AgTG levels <10 U/mL, the independent efficiency of RaID in detecting metastatic lesions is extremely low, which allows limiting its use with a minimal risk of information loss. The independent effectiveness of ultrasound in the studied group is not enough to use it as an independent factor when deciding on the advisability of performing RaID.
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