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The early detection of recurent diferentiated thyroid carcinoma (DTC) cels in the post sur-gery DTC patients relies on the sensitivity of and 131-Iodine distribution by Whole Body Scan (WBS). Undetectable level of Tg asociated with negative WBS or elevated levels of Tg assoc-iated with positive WBS ("concordant") is ordi-narily indicative of either absence or presence of disease. At times, elevated level of Tg with negative WBS or low levels of Tg with positive WBS ("discordant") could also occur. In the pre-sent study, we retrospectively reviewed series of 573 patients with DTC folowed in the Diag-nostic Imaging and Radiotherapy of the Uni-1997. We focused on 9 out of 573 patients (1.56%) who had a discordant patern with low level of Tg/positive WBS in the post-surgical folow-up. Four patients were metastatic at pre-sentation while 5 patients with metastasis dur-ing follow-up still remained in persistently low levels of Tg (<5 ng/mL). This result does point to some flaw in the evaluation of "discordant" cases. Reviewing data previously described ser-ies by reseting cut-off values of Tg <1 ng/ml as undetectable changed the apparent "discor-dant" subgroup of patients into "concordant". Recent introduction of recombinant human TSH (rhTSH) to enhance the expression level of Tg brought significant increase in the sensitivity of diagnostic evaluation of thyroid cancer patients. The role of burdensome WBS in the follow up evaluation of DTC patients is significantly re-duced over time especialy in low-risk patients while the relevance of Tg assay is steadily in-creased. Sensitive Tg assays, significantly im-follow-up of DTC. Given the posibility of late disease relapses, the need for long-term fol-low-up, and reduced delay in treatment of persistent disease, there is stil need for greater sensitive diagnostic tols for DTC.

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