THE ROLE OF NECK ULTRASONOGRAPHY IN THE FOLLOW-UP OF PATIENTS WITH DIFFERENTIATED THYROID CANCER AFTER TOTAL THYROIDECTOMY AND I131-ABLATION AND LOW OR UNDETECTABLE THYROGLOBULIN LEVELS (Thyroid 2018, 28 [6])

After total thyroidectomy and 131I ablation, neck ultrasonography should in general be reserved for patients with a Tg level of ≥1 μg/L in anti-Tg antibody negative patients, regardless of initial risk. Patients with a Tg <1 μg/L have an extremely low rate of true-positive neck ultrasonography, but they have a considerable rate of false-positive findings (ranging from 45 to 67 % in the literature). In contrast, patients with a Tg level ≥1 μg/L may benefit from neck ultrasonography evaluations, given a much better balance between true- and false-positive findings. False-positive results of neck ultrasonography in these patients may result in a large number of additional follow-up visits, increasing patient’s anxiety, and causing more invasive investigations or interventions as a result of these findings. In contrast, in patients with low (< 1μg/L) or undetectable Tg levels, true positive results are observed in 1.6 % of patients


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