Post-Treatment Monitoring
A diagnosis of thyroid cancer requires life-long monitoring for possible recurrence. A regular monitoring program is important and can be reassuring. Monitoring may include regular neck examination (including palpating the thyroid area), neck ultrasound and blood tests. Follow-up may periodically include chest X-ray, RAI scan, CT scans of neck and/or chest, or PET/CT scans.
If a follow-up scanning dose or treatment dose of RAI is scheduled, the patient follows the same procedure for becoming hypothyroid and following the LID as described above. In the case of RAI scanning (WBS), the dose is usually in the range of .15 to .30 kBq (4-8 mCi). However, the American Thyroid Association now recommends that the follow-up scan not be used in most cases for follow-up because the combination of Thyroglobulin monitoring and neck ultrasound is more sensitive.
Thyroglobulin (Tg) testing is more accurate when the TSH is elevated. This is called a stimulated Tg reading. The patient may prepare for the test by stopping thyroid hormone replacement to become hypothyroid. Alternatively, Thyrogen® can be used to elevate the TSH. Stimulated Tg testing can be done as part of a RAI scanning protocol, or it can be done as a separate test without a whole body scan (WBS).
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