ATA Background
The 2015 ATA Guidelines do not recommend routine RAI ablation in
What is low and select intermediate risk patients?
Post operative disease status should be considered in deciding whether additional treatment is needed
What is 50 A?
Patients with PTC tumors equal to or greater than 1cm (T1-T3) were followed after
What is a total thyroidectomy and selective therapeutic central compartment neck dissection?
number of patients
What is 129?
A follow up including long term THST with repeat neck ultrasound, suppressed and stimulated Tg measurements, and imaging biopsy studies every
What is 6-12 months?
Recommendations for RAI administration is broad and provide no objective criteria to assist
What is HCP decision-making?
(B) Post operative serum thyroglobulin (Tg) (on THT or after TSH stimulation) can help in assessing the persistence of disease or thyroid remnant and predicting potential future
What is disease recurrence?
Stim Tg and neck ultrasound were performed 3 months post thyroidectomy in patients with a Tg less than or equal to 1ug/L while on THST in three groups
What is 5 days after rhTSH, 9 days after withdrawal from tri-iodothyronine, and 22 days after withdrawal from L-thyroxine?
this percent of patients was able to avoid unnecessary RAI using a personalized risk stratification and RAI selection protocol (PRSP)
What is 90%?
a post treatment WBS seven days after treatment for patients receiving
What is RAI?
Difficult for HCP's to decide who should as well as which patients should, and which patients should not be safely
What is ablated?
Postoperatively, in most patients Tg should reach its lowest
What is 3-4 weeks?
Stim Tg and neck US 3months post surgery, <1, 1-5, and >5 determined
What is RAI recommendation?
What is 6.2 years?
Although Orlov et al proposed Stim-Tg cutoffs, other studies are needed to determine whether these are optimal
What are cutoff values?
The use of rhTSH in this setting falls within the scope of the
What is diagnostic indication?
(C) The optimal cutoff value for post operative serum Tg or state in which it is measured to guide decision making regarding RAI administration is
What is not known?
Orlov et al 2015 provides an example of how the 2015 ATA guidelines and this fit into clinical practice
What is Recommendation 50?
In low and intermediate risk patients, the overall risk for residual/recurrent PTC was
What is <1%?
Methods for evaluating postoperative disease status
What are Serum Tg, Neck US, and Iodine radioisotope scanning?
Provides an important opportunity to help HCP's
What is stratify a patients risk?
When the extent of the thyroid remnant or residual disease cannot be accurately ascertained from the surgical report or neck US, or when the results may alter the decision to treat or the activity of RAI that is to be administered, this may ne useful
What is postoperative diagnostic RAI WBS?
can help stratify risk and guide decision-making
What is serum Tg?
Orlov et al propose using stim Tg and neck US findings, in low and intermediate risk PTC patients, as initial criteria for risk stratification and RAI selection how many months post total thyroidectomy
What is 3 months?
When performed, pretherapy doagnostic scans should utilize 123I or a low activity of 131I, with the theraputic activity optimally administered within this many hours
What is 72?