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C.-O. Sahlmann, I. Schreivogel, C. Angerstein, U. Siefker, K. Lehmann, G. Altenvoerde, M. Hfner, J. Meller
Clinical evaluation of a new thyroglobulin immunoradiometric assay in the follow-up of differentiated thyroid carcinoma
Keywords: Thyroid cancer, thyroglobulin, IRMA, immunoradiometric assay
AIM: Formal and clinical comparison of a new 3 rd -generation-Tg-IRMA (3-G-IRMA; Dynotest Tg-plus) with a conventional Tg-IRMA (3-G-IRMA; SELco Tg-assay) for patients with differentiated thyroid carcinoma. In addition we evaluated, if thyroglobulin (Tg) levels above a specific threshold concentration indicate the need for further investigations for residual disease. PATIENTS, METHODS: Tg concentration of 105 sera of 93 consecutive patients with a differentiated thyroid cancer was determined with both assays and compared at different cut-off values (Dynotest Tg-plus: 0.2, 1, 2 ng/ml; SELco Tg-assay: 0.5, 1, 2 ng/ml) with the clinical results in respect to the corresponding TSH concentration. RESULTS: Tg concentration did not show any significant difference (SELco Tg-assay 0.5 ng/ml, Dynotest Tg-plus 0.2 ng/ml). The Tg-values of both assays correlated with 97%. However, correlation of recovery in both assays was small (40%). The sensitivities and specificities of both assays at different cut-offs and TSH values did not reveal significant differences. In patients with TSH concentration > 30 U/ml the functional assay sensitivity was superior to arbitrary cut-offs in the decision to start further evaluations. CONCLUSIONS: In our study neither formal nor clinical significant differences between two Tg-assays were found. In a hypothyroid patient (TSH > 30 U/ml, Tg concentration exceeding the functional assay sensitivity) further investigations for residual disease are warranted. Higher thresholds are of limited value, due to a inacceptable high rate of false negative results.
Nuklearmedizin, Schattauer
Print ISSN: 0029-5566
Volume: 42, 01/2003
Pages: 71 - 77