Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin

Radioiodine ablation (RA) of normal thyroid remnants after thyroidectomy fo r differentiated thyroid carcinoma improves the sensitivity of subsequent r adioiodine scans and serum thyroglobulin measurements for detection of resi dual thyroid carcinoma. Local cancer recurrences are also lower after RA. O ne standard preparation for RA involves rendering the patient hypothyroid i n order to stimulate endogenous thyrotropin (TSH) secretion and sodium iodi de symporter (NIS) activity. An alternative approach is to prescribe thyrox ine after thyroidectomy and to stimulate NIS with exogenous recombinant hum an thyrotropin (rhTSH). This latter approach was used in 10 patients at our medical center. Complete resolution of all visible I-131 thyroid bed uptak e was achieved in all when follow-up scans were performed 5 to 13 months la ter. This approach has the potential to successfully ablate thyroid remnant s without the need to induce hypothyroidism.