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Circulating 131I thyroxine and thyroid cancer

M T Hays1, I R McDougall

  • 1Research and Development Office, Palo Alto DVA Medical Center, CA.

Thyroid : Official Journal of the American Thyroid Association
|January 1, 1994
PubMed
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Estimation of total body iodine content in normal young men.

Thyroid : official journal of the American Thyroid Association·2001

A new blood test detects radioactive thyroxine (T4) in circulation, indicating the presence of thyroactive tissues. This sensitive test aids in evaluating patients for radioactive iodine therapy for differentiated thyroid cancer.

Area of Science:

  • Endocrinology
  • Nuclear Medicine
  • Oncology

Background:

  • Differentiated thyroid carcinomas (DTCs) often require ablative therapy using radioactive iodine (131I).
  • Accurate detection of residual or metastatic thyroactive tissue is crucial for effective treatment planning.
  • Current methods may not always precisely identify all functional thyroid tissue.

Purpose of the Study:

  • To develop and validate a blood test for detecting circulating radioactive thyroxine (131I-T4).
  • To assess the test's ability to identify the presence of thyroactive tissues in patients undergoing evaluation for 131I therapy.
  • To correlate blood test results with total body 131I scans and thyroglobulin levels.

Main Methods:

  • Serum samples from 19 patients evaluated for 131I therapy were analyzed.

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  • Chromatographic techniques (Sep-Pak and HPLC) were used to isolate 131I-T4 from serum, removing radioiodide.
  • Samples were tested for the presence of 131I-labeled T4 using an internal 125I-T4 marker.

    • Main Results:

    • All 12 patients (16 studies) with positive total body 131I scans showed detectable circulating 131I-T4.
    • Seven patients with negative whole body scans were negative for 131I-T4.
    • The test identified thyroactive tissue in some cases with negative thyroglobulin assays or discordant scan results.

    Conclusions:

    • Measurement of circulating 131I-T4 is a sensitive indicator of functional normal or malignant thyroactive tissue.
    • This blood test can help identify patients likely to benefit from 131I ablation therapy.
    • The test offers a valuable adjunct to conventional imaging and tumor marker assessments in thyroid cancer management.