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Differentiated thyroid cancer: Ongoing monitoring

Differentiated thyroid cancer: Ongoing monitoring
  Response to therapy
Excellent Biochemical incomplete Structural incomplete Indeterminate
Nonstimulated Tg Every one to two years Every six months Every six months 6 to 12 months
Stimulated Tg Not needed May be repeated at two- to three-year intervals if needed to establish an excellent response to therapy Not needed May be repeated at two- to three-year intervals if needed to establish an excellent response to therapy
Neck ultrasound Consider at three- to five-year intervals Yearly for five years Yearly for five years 6- to 12-month intervals for five years
Diagnostic WBS Not indicated Not usually done* To evaluate RAI avidity of structural disease Not usually done*
MRI, CT Not indicated Not indicated* 6- to 12-month intervals depending on rate of progression Not indicated*
FDG-PET Not indicated Not indicated* To identify additional sites of disease and for prognostic purposes Not indicated*
Serum TSH 0.5 to 2 mU/L 0.1 to 0.5 mU/L <0.1 mU/L 0.1 to 0.5 mU/L
Tg: thyroglobulin; WBS: whole-body scan; RAI: radioiodine; MRI: magnetic resonance imaging; CT: computed tomography; FDG-PET: fludeoxyglucose-positron emission tomography; TSH: thyroid-stimulating hormone.
* Consider if nonstimulated Tg is greater than 10 ng/mL or Tg is rising.
¶ TSH goals are modified based on concurrent medical conditions that increase the risk of TSH suppression.
Data from: Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26:1.
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