3. CLINICAL PRESENTATION
4.6. Conclusions
Measurement of serum Tg is of limited value in the diagnosis of primary thyroid tumour but is very useful in post-operative management of differentiated thyroid carcinoma. The sensitivity and the specificity of Tg determination is comparable to that obtained with WBS, however, both are complimentary. Hypothyroid and euthyroid rhTSH-stimulated serum Tg levels (measured 72 h after the last dose of rhTSH) are comparable in detecting metastases when a cut-off of 2 µg/litre is used. Serum Tg measurements during thyroid hormone suppression are sufficiently sensitive to forgo further testing in a low-risk patient who is clinically free of disease and has had an undetectable (<1 µg/litre) serum Tg level during THST and after rhTSH or THW. In patients with metastatic disease of primary unknown origin, high levels of Tg in circulation or demonstration of Tg in metastatic tissue specimen by immunohistochemistry is indicative of involvement of thyroid as a primary organ.
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