Tables and Figures
34
Table 9. Response Criteria After Initial Therapy Based on
Type of Intervention
Response to
therapy
Post total
thyroidectomy
and/or neck
dissection with
RAI ablation or
therapy
Post total
thyroidectomy
and/or neck
dissection
without RAI
ablation
Post
hemithyroidectomy TSH goal
Excellent Non-stimulated
Tg <0.2 or
stimulated Tg
<1 and negative
imaging
Non-stimulated
Tg <2.5
Normal or low
risk nodules in the
contralateral lobe,
or contralateral lobe
nodules with benign
biopsy AND no
abnormal lymph
nodes on imaging
TSH
within
normal
reference
range
Indeterminate Nonspecific
findings
on imaging
studies or
non-stimulated
Tg 0.2–1 or
stimulated Tg
1–10, or stable/
declining TgAb
levels
Nonspecific
findings
on imaging
studies or
non-stimulated
Tg 2.5–5, or
stable/declining
TgAb levels
N/A
a
TSH
within
normal
reference
range
b
Biochemically
Incomplete
Non-stimulated
Tg >1 or
stimulated
Tg >10 or
increasing
TgAb levels and
negative imaging
Non-stimulated
Tg >5 or
increasing
TgAb levels
and negative
imaging
N/A
a
TSH
below
normal
reference
range
c
Structurally
Incomplete
Structural
evidence
of disease
(suspicious
imaging or
biopsy proven
local or distant
metastatic
disease)
Structural
evidence
of disease
(suspicious
imaging or
biopsy proven
local or distant
metastatic
disease)
Structural evidence
of disease (suspicious
imaging or biopsy
proven local or
distant metastatic
disease)
TSH
below
normal
reference
range
c
a
See Recommendation 48 for specific comments regarding Tg levels (ng/ml) in patients treated with
hemithyroidectomy.
b
Data on optimal TSH target range are inconclusive.
c
Data on optimal TSH target range are inconclusive and/or conflicting. If there is progression of
residual disease or development of new recurrence, targeting a TSH below normal reference range
may be reasonable. However, comorbidities such as atrial fibrillation and osteoporosis should be
factored into the decision making process.
