People living with thyroid cancer across NSW now have access to a highly specialised diagnostic test available through NSW Health Pathology, providing clinicians with a new option for monitoring patients where conventional testing may be less reliable.

The new high-sen­si­tiv­i­ty serum thy­roglob­u­lin (TgMS) test offers clin­i­cians an addi­tion­al option for mon­i­tor­ing select­ed patients with dif­fer­en­ti­at­ed thy­roid can­cer when con­ven­tion­al immunoas­say results may be affect­ed by anti­body interference.

This new ser­vice, devel­oped by NSW Health Pathology’s Clin­i­cal Chem­istry team based at Roy­al North Shore Hos­pi­tal, is the first clin­i­cal assay of its kind avail­able in Aus­trala­sia and expands access to advanced mass spec­trom­e­try-based diag­nos­tics for patients across NSW and beyond.

How is the test different?

Thy­roglob­u­lin is an impor­tant tumour mark­er used to mon­i­tor patients fol­low­ing treat­ment for dif­fer­en­ti­at­ed thy­roid can­cer. How­ev­er, con­ven­tion­al lab­o­ra­to­ry test­ing can be affect­ed by anti-thy­roglob­u­lin anti­bod­ies (TgAb) and het­erophile anti­body inter­fer­ence, mak­ing results dif­fi­cult to inter­pret in some patients.

The new LC-MS/MS assay over­comes these lim­i­ta­tions by pro­vid­ing thy­roglob­u­lin mea­sure­ment that is unaf­fect­ed by these inter­fer­ences, help­ing clin­i­cians make more informed deci­sions about ongo­ing patient care.

Dr Mag­da Bolek and Dr Lucy Ding (pic­tured above) led the devel­op­ment of the new assay.

Dr Bolek said the test fills an impor­tant need for clin­i­cians man­ag­ing patients with dif­fer­en­ti­at­ed thy­roid cancer.

“This is a sig­nif­i­cant advance­ment in thy­roid can­cer mon­i­tor­ing and pro­vides clin­i­cians with access to a high­ly spe­cialised test, not pre­vi­ous­ly avail­able any­where else in Aus­tralia,” she said.

“The assay may be par­tic­u­lar­ly valu­able for patients with per­sis­tent anti-thy­roglob­u­lin anti­bod­ies, where stan­dard test­ing results do not align with the clin­i­cal pic­ture, or where anti­body inter­fer­ence is suspected.”

Dr Ding says the assay fills an impor­tant clin­i­cal gap.

“For some thy­roid can­cer patients, con­ven­tion­al thy­roglob­u­lin test­ing can be chal­leng­ing to inter­pret due to anti­body inter­fer­ence,” she said.

“This new LC-MS/MS assay elim­i­nates the anti­body inter­fer­ence but still has a sen­si­tiv­i­ty down to 0.1 ug/L which is equiv­a­lent to the best thy­roglob­u­lin immunoas­says on the market.”

NSW Health Pathol­o­gy Chief Exec­u­tive Vanes­sa Janis­sen said the ser­vice demon­strates the exper­tise and inno­va­tion of pub­lic pathol­o­gy ser­vices in NSW.

“Our teams con­tin­ue to devel­op and deliv­er sophis­ti­cat­ed diag­nos­tic ser­vices that sup­port clin­i­cians and improve health out­comes for patients across the state,” Ms Janis­sen said.

“This new assay strength­ens NSW Health Pathol­o­gy’s capa­bil­i­ties in pre­ci­sion diag­nos­tics and ensures patients have access to world-class test­ing clos­er to home.”

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