Application of post‐surgical stimulated thyroglobulin for radioiodine remnant ablation selection in low‐risk papillary thyroid carcinoma

Background We present our ongoing experience in the use of postsurgical stimulated serum thyroglobulin (Stim‐Tg) to assist in radioiodine remnant ablation (RRA) decision‐making. Methods Patients with low‐risk well‐differentiated thyroid carcinoma (WDTC) with undetectable anti‐Tg antibodies were prospectively followed after total thyroidectomy and therapeutic central compartment neck dissection, when indicated.Stim‐Tg was performed 3 months postoperatively and used to base RRA selection. Results Of 104 patients, 59 patients (56.7%) had an undetectable Stim‐Tg after thyroidectomy, 35 (33.7%) had Stim‐Tg values of 1–5 μg/L, and 10 (9.6%) had Stim‐Tg values >5 μg/L. RRA was administered to 1 patient (1.7%) with undetectable Stim‐Tg, 6 patients (17.1%) with Stim‐Tg1–5 μg/L, and 9 patients (90%) with Stim‐Tg >5 μg/L, for a total of 16 patients (15.4%) receiving RRA. When compared to current RRA selection guidelines, the proposed protocol achieved a significantly lower RRA administration rate. Conclusion Stim‐Tg measurement performed several months after total thyroidectomy is a useful objective parameter in assisting RRA decision‐making for patients with low‐risk WDTC.