19
D. Measurement of serum Tg on thyroid hormone in patients after
lobectomy during initial follow-up is not recommended routinely
(see Recommendation 30). (C-VL)
E. In patients with circulating anti-Tg antibodies, trends of serial TgAb
levels using the same assay may be useful to monitor disease.
Current Tg immunometric assays (IMA) and radioimmunoassays
(RIA) are often affected by TgAb, and Tg liquid chromatography-
tandem mass spectrometry (LC/MSMS) has low sensitivity. These
should not be solely relied upon to monitor patients with circulating
TgAb levels. Imaging is the primary modality for monitoring in this
population. (C-L)
Recommendation 48
A. For patients with low-risk DTC treated with total thyroidectomy
and RAI and a sustained excellent response 5–8 years after initial
therapy, routine ultrasound can be discontinued, and patients can
be followed subsequently with biochemical markers alone every 1–2
years. (C-L)
B. Patients with low-risk DTC treated with total thyroidectomy and RAI
and sustained excellent response for 10–15 years do not require
continued routine biochemical monitoring for thyroid cancer and
should be considered to have achieved a complete remission. (GPS)
C. For patients with low-risk DTC treated with a total thyroidectomy
alone and a sustained excellent response 5–8 years after initial
therapy, routine ultrasound can be discontinued, and patients can
be followed subsequently with biochemical markers alone every 1–2
years. (C-L)
D. Patients with low-risk DTC treated with total thyroidectomy alone
and sustained excellent response for 10–15 years do not require
continued routine biochemical monitoring for thyroid cancer and
have achieved a complete remission. (GPS)
E. For patients with low-risk DTC treated with lobectomy, if initial
ultrasound is negative, subsequent ultrasounds should be performed
every 1–3 years for 5–8 years after initial therapy. Nodules in
the residual lobe should be monitored as per ATA thyroid nodule
guidelines. (GPS)
F. For patients with low-risk DTC treated with lobectomy, if
postoperative Tg is not markedly elevated (see Recommendation 30),
additional Tg testing is not recommended routinely. (GPS)
