Diagnosis of endocrine disease: Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer: a clinical position paper

Luca Giovanella, Penelope M. Clark, Luca Chiovato, Leonidas Duntas, Rossella Elisei, Ulla Feldt-Rasmussen, Laurence Leenhardt, Markus Luster, Camilla Schalin-Jan̈tti, Matthias Schott, Ettore Seregni, Herald Rimmele, Jan Smit, Frederik A. Verburg

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Abstract

Differentiated thyroid cancer (DTC) is the most common endocrine cancer and its incidence has increased in recent decades. Initial treatment usually consists of total thyroidectomy followed by ablation of thyroid remnants by iodine-131. As thyroid cells are assumed to be the only source of thyroglobulin (Tg) in the human body, circulating Tg serves as a biochemical marker of persistent or recurrent disease in DTC follow-up. Currently, standard follow-up for DTC comprises Tg measurement and neck ultrasound combined, when indicated, with an additional radioiodine scan. Measurement of Tg after stimulation by endogenous or exogenous TSH is recommended by current clinical guidelines to detect occult disease with a maximum sensitivity due to the suboptimal sensitivity of older Tg assays. However, the development of new highly sensitive Tg assays with improved analytical sensitivity and precision at low concentrations now allows detection of very low Tg concentrations reflecting minimal amounts of thyroid tissue without the need for TSH stimulation. Use of these highly sensitive Tg assays has not yet been incorporated into clinical guidelines but they will, we believe, be used by physicians caring for patients with DTC. The aim of this clinical position paper is, therefore, to offer advice on the various aspects and implications of using these highly sensitive Tg assays in the clinical care of patients with DTC.

Original languageEnglish
JournalEuropean Journal of Endocrinology
Volume171
Issue number2
DOIs
Publication statusPublished - 2014

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ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Giovanella, L., Clark, P. M., Chiovato, L., Duntas, L., Elisei, R., Feldt-Rasmussen, U., Leenhardt, L., Luster, M., Schalin-Jan̈tti, C., Schott, M., Seregni, E., Rimmele, H., Smit, J., & Verburg, F. A. (2014). Diagnosis of endocrine disease: Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer: a clinical position paper. European Journal of Endocrinology, 171(2). https://doi.org/10.1530/EJE-14-0148