Biomarkers and Molecular Imaging in Postoperative DTC Management

Abstract

The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine [iodine-131 (131I)] therapy, individualized thyroid hormone therapy, and follow-up for detection of patients with recurrent or persistent disease. Recently, several international associations like ATA, EANM, and SNMMI developed specific guidelines for the management of these patients. They shared that an individualized risk-adapted approach should be suggested considering the main clinical, epidemiological, and histopathological features. The postoperative management of DTC is a challenge because several biomarkers and molecular imaging tools are available. The choice of execution and the timing of neck ultrasound, serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin, the 131I/123I diagnostic whole-body scans integrated by single photon emission computed tomography/computed tomography (SPECT/CT) if indicated, and 18F-fluorodeoxyglucose ([18F]-FDG) positron emission tomography/CT (PET/CT) is directly related to the patients’ characteristics. In this chapter, we summarize the role of the main biomarker and molecular imaging examinations in the management of DTC patients in postoperative setting.