Prognostic value of an increase in the serum thyroglobulin level at the time of the first ablative radioiodine treatment in patients with differentiated thyroid cancer.

PURPOSE: The aim of this study was to assess the prognostic factors for treatment efficacy, and in particular the increase in serum thyroglobulin (Tg) level at the time of the first ablative radioiodine treatment, in patients with differentiated thyroid carcinoma (DTC). METHODS: A retrospective chart review was performed on 407 patients treated for DTC by total thyroidectomy and (131)I ablation between 1995 and 2002, and examined 5-12 months later with diagnostic (131)I whole-body scan and serum Tg measurement after thyroid hormone treatment withdrawal. At the time of the ablative radioiodine treatment, serum Tg level was determined just before (131)I administration (TgD0) and 5 days later (TgD5); Tg variation was expressed as the ratio TgD5/TgD0. At the first post-ablation follow-up examination, unsuccessful ablation was defined by a Tg level > or =2 ng/ml and/or abnormal (131)I uptake. RESULTS: Ablation was unsuccessful in 51 patients. Univariate analysis showed high TgD0 level, low TgD5/TgD0 ratio extrathyroidal invasion, (131)I uptake in the neck (excluding the thyroid bed) during the ablative treatment and distant metastases to be significantly associated with unsuccessful ablation. On logistic multivariate analysis, TgD0 level <5 ng/ml and TgD5/TgD0 ratio > or =20 were independently associated with successful ablation. A receiver operating characteristic curve analysis determined that a TgD5/TgD0 ratio greater than 20 had a 97% positive predictive value for successful ablation. When both TgD0 and TgD5/TgD0 ratio were considered, that is, TgD0 <5 ng/ml or TgD0 > or =5 ng/ml but TgD5/TgD0 ratio >20, ablation was unsuccessful in only 12/301 patients. CONCLUSION: Our data show that the TgD5/TgD0 ratio may be used as a new prognostic indicator of (131)I treatment efficacy in patients with DTC.

Nonpolymeric Coatings of Iron Oxide Colloids for Biological Use as Magnetic Resonance Imaging Contrast Agents.

Iron oxide nanoparticles are used in vivo as contrast agents in magnetic resonance imaging. Their widely used polymer coatings are directly involved in their biocompatibility and avoid magnetic aggregation. As these polymer brushes also limit their tissular diffusion due to important hydrodynamic sizes, this work looks to obtain particles coated with thin layers of organic biocompatible molecules. Coating molecules were chosen depending on their fixation site on iron cores; carboxylates, sulfonates, phosphates, and phosphonates, and, among them, analogs of the phosphorylcholine. Two coating procedures (dialysis and exchange resins purification) were evaluated for hydrodynamic size, total iron concentration, electrophoretic mobility, and colloidal stability. Furthermore, a complementary test on stainless steel plates evaluated the contamination by competition of phosphonates as a rough estimation of the biocompatibility of the particles. Coating with bisphosphonates, the more interesting fixation moiety, leads to small (less than 15 nm) and stable objects in a wide range of pH including the neutrality. From stability data, the coating density was evaluated at around 1.6 molecules per nm(2). Including a quaternary ammonium salt to the coating molecule lowers their electrophoretic mobility. Moreover, this type of coating protects steel plates against contamination without significant desorption. All these properties allow further developments of these nanoparticles for biomedical applications. Copyright 2001 Academic Press.