Abstract
To discuss the role and limitations of serum thyroglobulin (Tg) assay in management of differentiated thyroid cancer (DTC) from the perspective of nuclear medicine (NM) physicians. We performed a literature search in electronic databases PubMed, Embase, and the Cochrane Library up to January 2019 using the following key words: thyroid, cancer/carcinoma/neoplasm, and thyroglobulin. We included prospective and retrospective original and recent studies written in English regarding Tg in DTC. Serum Tg level can reflect disease status. It is a tumor marker of DTC. Many studies have confirmed the clinical roles of Tg in monitoring thyroid remnant, locoregional, and distant metastatic disease, tailoring radioactive iodine (RAI) therapy, and predicting persistence or recurrence as well as response to treatment. Most NM physicians in Asia are actively involved in the management of DTC. They are actively using serologic markers such as Tg, anti-Tg antibody, and thyroid stimulating hormone as well as imaging studies including neck ultrasound and RAI whole body scan. Authors suggest an algorithm for the use of serum Tg assay as an indicator of RAI therapy. Pitfalls of interpretation and complementary roles of Tg and imaging studies are discussed. Serum Tg is a useful biomarker for risk stratification and decision-making in the management of DTC. It is expected to be used more widely in NM practice.
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