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47

NCCN Guidelines for Patients

®

:

Thyroid Cancer, Version 1.2017

5

Treatment guide

Papillary, follicular, and

Hürthle cell

Guide 13

(continued)

. Consider RAI therapy for papillary, follicular, or Hürthle cell

6 to 12 weeks after thyroidectomy

RAI therapy

Test results Further testing Next steps of care

Based on

pathology, RAI

therapy may be

recommended

ª

• No or minor

radioiodine uptake

on thyroid bed

• Unstimulated Tg

less than 1 ng/mL

and negative anti-

Tg antibodies

ª

• Follow without

RAI therapy

ª

• See surveillance

and maintenance

(Guides 15 and 16)

and

• Levothyroxine

• Suspected or

proven radioiodine

uptake on thyroid

bed

ª

• Follow without

RAI therapy

or

• Smaller dose

of RAI for

smaller area

of disease

or

• Adjuvant

therapy (RAI);

imaging after

treatment

ª

ª

• Suspected or

proven radioiodine

uptake in

metastases

ª

• RAI therapy;

imaging after

treatment