Controversies in the Management and Followup of Differentiated Thyroid Cancer: Beyond the Guidelines
Table 2
Follow-up strategy based on risk groups (adapted from [4]).
Initial estimate of risk of recurrence first 2 years of followup incomplete response
Suppressed Tg
Low risk Q 6 months
Intermediate risk Q 6 months
High risk Q 6 months
Stimulated Tg
Not required
<10 ng/mL
>10 ng/mL
Neck ultrasound
Q year 2
Q year 2
Q year 2
Diagnostic RAI WBS
Not required
1-2 years
1-2 years
Cross-sectional imaging (MRI, CT)
Not required
Not required
If Tg elevated or high clinical suspicion
Secondary risk stratification response to therapy assessment
Ongoing followup
Yearly physical examination, yearly suppressed Tg
Yearly physical examination, yearly suppressed Tg, stimulated Tg to document undetectable Tg on suppression, continued observation/assessment of indeterminate structural abnormalities for at least another 2-3 years
Consider additional cross-sectional imaging, possibly FDG PET scan and the need for additional therapy
