/sup 99m/Tc pertechnetate uptake in the thyroid measured with a scintillation camera: a parameter of thyroid function. [/sup 131/I

Energy Technology Data Exchange (ETDEWEB)

Sokole, E.B.; van der Schoot, J.B.; Alberts, C.

1975-01-01

A /sup 99m/Tc pertechnetate thyroid uptake procedure, using a scintillation camera and a data storage system, is described. After comparison of extrathyroidal activity in several regions below the thyroid, activity in the clavicular regions was preferred for correction of the thyroid uptake measurement. No pertechnetate uptake curve obtained over the initial 15 min after injection was found to be representative of a specific thyroid function, and regional thyroid uptake curves gave only quantitative differences. The 15-min pertechnetate thyroid uptake measurement, with correction for clavicular extrathyroidal activity, correlates well with /sup 131/I uptake and is a good parameter of thyroid function, especially in the distinction of euthyroidism and hyperthyroidism.

Change of 99mtechnetium-pertechnetate-thyroid uptake under suppression (TcTUs) induced by optimization of iodine supply in Germany

International Nuclear Information System (INIS)

Reinhardt, M.J.; Trupkovic, T.; Schumacher, T.; Krause, T.M.; Oexle, C.; Moser, E.

1998-01-01

The present study deals with the change of the 99m Technetium-pertechnetate thyroid uptake under suppression (TcTU s ) in dependence on the urinary iodine excretion. The study collective comprises 510 patients with euthyroid goiter (N=91), with functional thyroid autonomy (N=361) and with Graves' disease (N=58), who were examined in the now thyroid ambulance between January 1995 and February 1997 and who presented with endogeneous or exogeneous TSH-supression. All patients received a quantitative thyroid scintigraphy with 99m Technetium-pertechnetate and a measurement of the urinary iodine excretion. The TcTU s from the whole collective shows an inverse correlation to the urinary iodine excretion for the range of 0 to 500 μg iodine/g creatinine. The TcTU s remains constant on a low basal level for iodine excretion values over 500 μg iodine/g creatinine. Significant differences occur in dependence on the underlying disease. TcTU s is constantly low in patients with euthyroid goiter, independent of the iodine excretion value. The TcTU s is significantly increased in patients with functional thyroid autonomy or Graves' disease when iodine excretion is below 100 or 50 μg iodine/g creatinine respectively, but shows only minor changes when iodine excretion rises up to 500 μg iodine/g creatinine. When iodine excretion exceeds 500 μg iodine/g creatinine, the TcTU s of patients with thyroid autonomy drops down to a low basal level. (orig.) [de

Evaluation of thyroid nodules with technetium-99m tetrofosmin dual-phase scintigraphy

International Nuclear Information System (INIS)

Kresnik, E.; Gallowitsch, H.J.; Mikosch, P.; Molnar, M.; Pipam, W.; Gomez, I.; Lind, P.

1997-01-01

Technetium-99m tetrofosmin, a lipophilic cationic complex molecule, was introduced for myocardial imaging. In some biodistribution studies it has also been reported to accumulate in the thyroid gland. Our objectives were to determine which thyroid nodules retain tetrofosmin and whether preoperative evaluation of malignancy is possible. Tetrofosmin scintigraphy was performed in 57 patients with a cold thyroid nodule on previously performed pertechnetate scintigraphy. All patients had undergone ultrasonography and sonographically guided fine-needle aspiration biopsy. The tetrofosmin scintigrams were obtained 5 min (early image) and 1 h (late image) after intravenous injection of 370 MBq. Only nodules that showed clear tracer retention after 1 h in comparison with retention at 5 min were classified as TETRO positive. Nodules without late retention were classified as TETRO negative. All patients underwent surgery and the histological results were compared with the results of tetrofosmin scintigraphy. Ten out of 11 patients with thyroid carcinoma (two pT1, three pT2, five pT4) were TETRO negative. One patient with papillary carcinoma (pT2) was TETRO positive. The mean nodular to thyroid tissue (N/T) ratio for the late scan was 1.0±0.20. There were 21 patients with thyroid adenomas (seven follicular, seven microfollicular and seven oxyphilic); 15 of these patients were TETRO positive and six TETRO negative. The mean N/T ratio for the late images was 1.34±0.41. All patients with degenerative goitre (24 cases) and the one patient with Hashimoto's disease were TETRO negative after 1 h and the N/T ratio was 0.92±0.12 on the late scan. Our results indicate that 99m Tc-tetrofosmin scanning is of little value preoperatively in distinguishing thyroid carcinoma from other thyroid nodules. Tetrofosmin tends to demonstrate thyroid adenomas but does not have a routine role in the assessment of thyroid nodules. (orig.). With 2 figs., 4 tabs

Twenty cases of ectopic thyroid gland detected by thyroid scintigraphy

International Nuclear Information System (INIS)

Hashimoto, Teisuke; Kubo, Atsushi; Hashimoto, Shozo

1988-01-01

20 cases of ectopic thyroid gland were detected out of 5,261 thyroid scintigraphy from 1973. Except for 1 case, all cases were female. Considering of thyroid function, 11 cases were euthyroid and rest of 9 cases were hypothyroid function. Clinical symptom of hypothyroid cases were mainly retarded linear growth and high value of serum TSH and in case of euthyroid cases were sublingual tumor and fullness or tightness in throat. Thyroid scintigraphy is very useful to diagnose the sublingual tumor whether it is ectopic thyroid gland or not. In case of congenital hypothyroidism children, ectopic thyroid gland causing hypothyroidism is definitely diagnosed by thyroid scintigraphy. (author)

MIBI-SPECT in hypofunctioning thyroid nodules for detection of thyroid carcinoma; MIBI-SPECT bei kalten Knoten zur Schilddruesenkarzinomdetektion

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Schmidt, M.; Schicha, H. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin

2010-12-15

The clinical usefulness of Tc-99m-MIBI in hypofunctioning thyroid nodules for detection of thyroid carcinoma is presented. Tc-99m-MIBI is a lipophilic cation and a non-specific radiopharmaceutical for tumour imaging. It has become an important imaging technique for the assessment of hypofunctioning thyroid nodules because of its high negative predictive value excluding malignant thyroid tumours. After injection of Tc-99m-MIBI either a single-phase protocol with late planar and SPECT images about 1-2 h post injection or a double-phase protocol with early (about 15-30 min p.i.) and late images (about 2 h p.i.) were reported. Findings include a reduced, an isointense or an increased Tc-99m-MIBI accumulation in the thyroid nodule in comparison to the paranodular thyroid tissue and in comparison to pertechnetate thyroid scintigraphy. A 'Match' between pertechnetate and Tc-99m-MIBI scintigraphy is a concordantly decreased uptake in the thyroid nodule in comparison to the normal thyroid gland. This finding has a negative predictive value of >97% to exclude differentiated thyroid cancer. A definite 'Mismatch' means a cold thyroid nodule on pertechnetate scintigraphy and an increased uptake of Tc-99m-MIBI in comparison to the MIBI-uptake of the paranodular thyroid tissue. The positive predictive value of this finding for malignancy varies between studies and is in the range of <10-65% (Cologne data: 19%) depending on the prevalence of malignant thyroid tumours in the patient population studied. An isointense uptake was not associated with thyroid malignancy according to 'Cologne' data. Further studies are desirable for better characterization of the method. (orig.)

Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy

International Nuclear Information System (INIS)

Baehre, M.; Lindemann, C.; Emrich, D.; Hilgers, R.

1988-01-01

This study is concerned with 236 euthyroid individuals living in an area of iodine deficiency, 227 of whom had endemic goitres. In these subjects, autonomy could be suspected owing to an inhomogeneous activity distribution on the thyroid scintigram or a subnormal TSH response to TRH. They complete a total number of 426 investigated individuals. Previously, in 190 separated controls without evidence of autonomy, the reference ranges for the thyroid 99m Tc pertechnetate uptake under suppression (TcU s ), a measure for the non-suppressible thyroid iodide clearance, and for suppressibility of circumscribed thyroid regions, had been determined. These two parameters obtained by highresolution quantified scintigraphy were used for an accurate detection of thyroid autonomy among the 236 individuals. Suppression scintigraphy revealed autonomy in 171 patients. ΔTSH after TRH was subnormal in 40% of the subjects with abnormal thyroid suppressibility. Prevalence of abnormal suppression was dependent on three factors: patient age, goitre type and estimated thyroid weight. In the total investigated collective, the prevalence of autonomy was 77% in patients with a goitre weight above 50 g. The individuals with abnormal suppression were grouped into four classes of TcU s . I these classes, free thyroxie index (FT 4 I) and total triiodothyronine (TT 3 ) icreased with increasing TcU s , whereas ΔTSH decreased. This finding indicates a continuum of different extents of autonomous thyroid function, whereas in the individual patient, the extent can be determined using the pertechnetate uptake under suppression. In addition, FT 4 I, TT 3 and ΔTSH in each of the TcU s classes depended on the individual iodine supply. It is concluded that, in patients with thyroid autonomy, actual thyroid hormone concentrations and TSH stimulation are determined by two major factors: the extent of autonomy and the individual iodine supply. Therefore, in iodine deficiency, the TRH test may be normal

Cutoff value of thyroid uptake of (99m)Tc-pertechnetate to discriminate between Graves' disease and painless thyroiditis: a single center retrospective study.

Science.gov (United States)

Uchida, Toyoyoshi; Suzuki, Ruriko; Kasai, Takatoshi; Onose, Hiroyuki; Komiya, Koji; Goto, Hiromasa; Takeno, Kageumi; Ishii, Shinya; Sato, Junko; Honda, Akira; Kawano, Yui; Himuro, Miwa; Yamada, Emiko; Yamada, Tetsu; Watada, Hirotaka

2016-01-01

Thyroid uptake of (99m)Tc-pertechnetate is a useful way to determine the cause of thyrotoxicosis. In daily clinical practice, (99m)Tc-pertechnetate uptake is used to discriminate between Graves' disease and painless thyroiditis when clinical information is not enough to make the distinction. However, since the optimal cutoff value of (99m)Tc-pertechnetate uptake has not yet been elucidated, our aim was to determine this value. We recruited patients with thyrotoxicosis in whom (99m)Tc-pertechnetate uptake was measured in clinical settings between 2009 and 2013. Three experienced endocrinologists (who were blinded to the value of (99m)Tc-pertechnetate uptake and initial treatment) diagnosed the cause of thyrotoxicosis based on thyrotropin, free triiodothyronine, free thyroxine, and thyrotropin receptor antibody levels, and by ultrasound findings and using images of thyroid uptake of (99m)Tc-pertechnetate without the actual values. Ninety-four patients diagnosed as having Graves' disease or painless thyroiditis were finally included. According to the diagnosis, the optimal cutoff value of (99m)Tc-pertechnetate uptake was determined by receiver operating characteristics analysis. A cutoff value of 1.0% provided optimal sensitivity and specificity of 96.6% and 97.1%, respectively. Then, its validity was confirmed in 78 patients with confirmed Graves' disease or painless thyroiditis diagnosed at another institute. Applying this cutoff value to the patients with thyrotoxicosis revealed positive and negative predictive values for Graves' disease of 100% and 88.9%, respectively. In conclusion, a cutoff value for (99m)Tc-pertechnetate uptake of 1.0% was useful to discriminate between Graves' disease and painless thyroiditis.

The role of technetium-99m methoxyisobutylisonitrile scintigraphy in the differential diagnosis of cold thyroid nodules

Energy Technology Data Exchange (ETDEWEB)

Mezosi, E.; Bajnok, L.; Sztojka, I.; Szabo, J.; Leovey, A.; Kakuk, G.; Nagy, E. [Department of Medicine, University Medical School, Debrecen (Hungary); Gyory, F. [Department of Surgery, University Medical School, Debrecen (Hungary); Varga, J.; Galuska, L. [Nuclear Medicine Centre, University Medical School, Debrecen (Hungary)

1999-08-01

Various diagnostic techniques have been successfully used in the clinical management of cold nodules; however, the decision on whether to employ surgery or a conservative treatment is not always easy. This study was designed to appraise the diagnostic value of technetium-99m methoxyisobutylisonitrile (MIBI) scintigraphy in the assessment of cold nodules detected using {sup 99m}Tc-pertechnetate. Fifty-two patients were included in the study. All had already been selected for surgery, based on their clinical and laboratory findings, including fine-needle aspiration biopsy. The total number of cold nodules on {sup 99m}Tc-pertechnetate scans was 59. The thyroid scan was performed 20-40 min after i.v. injection of 400 MBq of {sup 99m}Tc-MIBI. Uptake of MIBI in thyroid nodules was compared with that in the surrounding normal thyroid tissue, and a score of between 0 and 3 was assigned to each nodule as follows: 0, cold; 1, decreased; 2, equal; 3, hot. Definitive histology revealed nodular goitre in 24 cases, adenoma in 19, thyroiditis in 1, differentiated cancer in 12, medullary cancer in 2, and anaplastic cancer in 1. None of the degenerative nodules were hot on MIBI scan, while the adenomas showed a variety of MIBI imaging patterns, most frequently the score 3 pattern. In the diagnosis of differentiated thyroid cancer the sensitivities of score 3 and score 2+3 MIBI uptake patterns were 83% (10/12) and 100%, respectively. The score 3 MIBI uptake pattern had a specificity of 100% and a positive predictive value of 100% with respect to thyroid (benign and malignant) neoplastic diseases, whereas a specificity of 72% and a positive predictive value of 43% were observed in the detection of differentiated cancer. After a cold nodule had been detected using {sup 99m}Tc-pertechnetate, a second scan with high MIBI uptake increased by 7.8 times the probability that this nodule would be a differentiated cancer. In conclusion, {sup 99m}Tc-MIBI scintigraphy is a useful method in the

Role of /sup 99/mTc pertechnetate uptake in the evaluation of thyroid function

Energy Technology Data Exchange (ETDEWEB)

Sucupira, M.S.; Camargo, E.E.; Nickoloff, E.L.; Alderson, P.O.; Wagner, H.N. Jr.

1983-01-01

To investigate the usefulness of the 20 min /sup 99/mTc-pertechnetate uptake test, the records of 246 consecutive patients were reviewed. Of these, 192 patients (151 females, 41 males; 10 weeks to 78 years) had at least one year clinical follow-up or a confirmed diagnosis by biopsy or surgery and were included in our study. In these patients, the /sup 99/mTc pertechnetate uptake and hormonal values (T3 resin uptake, T4 RIA, T-index) were obtained. These results were then compared to the clinical diagnosis at the time of the uptake and one year later. All patients received an i.v. injection of 5 mCi of /sup 99/mTc pertechnetate. Imaging was performed using a pinhole collimator and a scintillation camera interfaced to a computer. Regions of interest for the thyroid and the background were used to calculate the 20 min /sup 99/mTc pertechnetate uptake as a percentage of the injected dose. /sup 99/mTc uptake and hormonal values were confirmatory in 158 patients (82.3%): 138 were euthyroid, 18 were hyperthyroid and 2 were hypothyroid. In 29 other patients (15.1%) the pertechnetate uptake provided useful additional information and helped to identify Hashimoto's thyroiditis (8 patients); thyroid suppression by exogenous iodide, steroids or T4 (7 patients); overtreated hyperthyroidism (1 patient); persistent hyperthyroidism (5 patients); different stages of Grave's disease (4 patients); and toxic nodular goiter (4 patients). The /sup 99/mTc uptake was misleading in 5 euthyroid patients (2.6%). We have found the /sup 99/mTc pertechnetate uptake a useful adjunct to measurement of hormonal levels in patients with suspected thyroid disease.

Clinical evaluation of gastric scintigraphy with sup(99m)Tc-pertechnetate

Energy Technology Data Exchange (ETDEWEB)

Kaneko, T; Tsuchigame, T; Katayama, K [Kumamoto Univ. (Japan). School of Medicine; Matsumoto, M

1979-12-01

Gastric scintigraphy with sup(99m)Tc-pertechnetate has been clinically evaluated. After an overnight fast, 3 mCi sup(99m)Tc-pertechnetate was injected intravenously and serial gastric images were obtained by the use of a gamma camera and a data processing system. The appropriate term available for observation of the gastric image widely ranged from within 3 min to more than 15 min after injection. A total of 84 cases were investigated. In 19 out of 20 cases of gastric cancer, the size of cold spots was influenced by the presence of intestinal metaplasia accompanying the cancer. Similar results were observed in cases of gastric ulcer (16 cases) and gastritis (12 cases). It is useful, though of less clinical significance for the detection of gastric cancer and ulcer, to study the condition of gastric mucosa clinically.

Clinical evaluation of gastric scintigraphy with sup(99m)Tc-pertechnetate

International Nuclear Information System (INIS)

Kaneko, Teruo; Tsuchigame, Tadatoshi; Katayama, Kenshi; Matsumoto, Masanori.

1979-01-01

Gastric scintigraphy with sup(99m)Tc-pertechnetate has been clinically evaluated. After an overnight fast, 3 mCi sup(99m)Tc-pertechnetate was injected intravenously and serial gastric images were obtained by the use of a gamma camera and a data processing system. The appropriate term available for observation of the gastric image widely ranged from within 3 min to more than 15 min after injection. A total of 84 cases were investigated. In 19 out of 20 cases of gastric cancer, the size of cold spots was influenced by the presence of intestinal metaplasia accompanying the cancer. Similar results were observed in cases of gastric ulcer (16 cases) and gastritis (12 cases). It is useful, though of less clinical significance for the detection of gastric cancer and ulcer, to study the condition of gastric mucosa clinically. (author)

Somatostatin receptor scintigraphy on thyroid carcinoma

International Nuclear Information System (INIS)

Pan Weimin; Tan Tianzhi

2004-01-01

Purpose: To study the diagnostic value and clinical method of somatostatin receptor scintigraphy on thyroid carcinoma using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent; Methods: Somatostatin receptor scintigraphy (SRS) were performed on 25 patients with thyroid carcinoma, using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent, controlling with 131 I- whole- body- imaging(1312 -WBI). Results: Of 4 patients with MTC (medullary thyroid carcinoma), positive metastasis and primary tumour were detected on 3 patients by SRS, negative results were obtained by 131 I-WBI, the positive detective rate by SRS is 3/4; of 12 patients with PTC (papillary thyroid carcinoma), positive metastasis and primary tumour were detected on 2 patients by SRS or 131 I-WBI,1 of which only by SRS, while negative results were obtained by 131 I- WBI, the positive detective rate by SRS is 3/12; of 8 patients with FTC(follicular thyroid carcinoma), positive metastasis and primary tumour were detected on 1 patients by SRS or 131 I-WBI, and 2 positive results were obtained only by SRS, while negative by 131 I-WBI, the positive detective rate by SRS is 3/8; of 1 patients with HCC (hurthle cell carcinoma ), positive metastasis and primary tumour were detected by SRS, while negative by 131 I-WBI; Conclusions: SRS using 99 Tc m -RC-160 labeled with direct method as scintigraphy reagent has high diagnostic value on thyroid carcinoma, especially on MTC and HCC. (authors)

Correlation between 5-Minute {sup 99m}Tc-Pertechnetate Uptake and 24-Hour {sup 131}I Uptake in Patients with Thyroid Disease

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Lee, Chan Woo; Won, Kyu Chang; Yoon, Hyun Dae; Cho, In Ho; Kim, Tae Nyeun; Shin, Dong Gu; Lee, Hyoung Woo; Shim, Bong Sup; Lee, Hyun Woo [Yeungnam University School of Medicine, Daegu (Korea, Republic of)

1992-07-15

The 20-minute {sup 99m}Tc-pertechnetate uptake became readily available for routine use and it replaced {sup 131}I for thyroid imaging. However measuring thyroid uptake during a 5-minute minimizes pertechnetate uptake by the salivary glands and presence of contaminated saliva from those glands in to the pharynx and esophagus. A study was carried out to determine the suitability of the utility of a 5-minute and 20-minute interval from administration of {sup 99m}Tc-pertechnetate to imaging and uptake measurement as a replacement for the 24 hour standard originally established with {sup 131}I, and to evaluate the relationship between 5-minute {sup 99m}Tc-pertechnetate uptake and other thyroid functions. A 5-minute and 20-minute uptake of {sup 99m}Tc-pertechnetate were measured in 70 patients with thyroid disease at Yeungnam University Hospital from March 1, 1991 to Feb. 29, 1992. The results were as follows. 1) The 5-minute {sup 99m}Tc-pertechnetate uptake in Graves' disease, Hashimoto's thyroiditis, simple goiter non toxic nodular goiter, subacute thyroiditis and euthyroid were 18.2%, 14.6%, 2.8%, 3.2%, 1.2% and 1.1%, respectively. There was a significant difference between the mean of the euthyroid group and the mean of the Graves' disease. So differentiation between them can be easily made. 2) The 5 minute {sup 99m}Tc- pertechnetate thyroid uptake was well correlated with 24 hour {sup 131}I thyroid uptake (r=0.75, p<0.001). These data provided an equation for estimating the 24 hour uptake of iodide given the 5 minute pertechnetate uptake: Estimated 24-hour '1{sup 31}I thyroid Uptake = 7.188{sup *}In (5 minute {sup 99m}Tc-Pertechnetate uptake)+16.94 3) The 20-minute {sup 99m}Tc-pertechnetate thyroid uptake was well correlated with 24-hour {sup 131}I uptake (r=0.72, p<0.001) and 5-minute {sup 99m}Tc-pertechnetate thyroid uptake (r=0.96, p<0.001). 4) In the Graves' disease, The 5-minute {sup 99m}Tc-pertechnetate thyroid uptake was well

Experience in thyroid scintigraphy with Ethiopian patients

International Nuclear Information System (INIS)

Demena, Solomon

1993-01-01

One thousand and thirty seven thyroid scintigraphy examinations done in the Nuclear Medicine Unit of Tikur Anbesma Hospital, Addis Abeba, Ethiopia between December 1984 and September 1989 were analyzed to assess their diagnostic value. Thirty one percent of the referrals were to investigate clinically detectable solitary nodules, and of these fifty-six percent had ''cold'' nodules and twenty-three percent ''hot'' nodules. Fifty-five percent of the referrals for evaluation of goitre were for multi nodular goitres and twelve percent for diffuse. Thirteen of fifty-three cases with suspected ectopic thyroid tissue were positive. Little useful information was obtained in the evaluation of goitre. It is concluded that thyroid scintigraphy was an unnecessary investigation in the evaluation of goitres in euthyroid patients. Its primary role was in the investigation of the solitary nodule, ectopic thyroid tissue and the retresternal goitre. Therefore, only selected patients should be investigated with thyroid scintigraphy

Diagnosis of primary and metastatic cancer of the thyroid using 201-thallium chloride

International Nuclear Information System (INIS)

Kasatkin, Yu.N.; Purizhanskij, I.I.; Vidyukov, V.I.; Aleshin, A.P.

1995-01-01

Thirty-nine patients with primary bulky formations, relapses, and metastases of thyroid cancer were examined using 201-thallium chloride and 99m Tc-pertechnetate; 13 patients were with benign tumors, 26 with malignant ones and metastases. 201-thallium chloride of 74 to 111 MBq activity was injected intravenously. Scintigraphy was carried out using emission gamma chambers Toshiba-GCA 90B (Japan) and Elscint. Visually the accumulation of 201-thallium chloride was assessed after static scintigraphy of the thyroid and was correlated to the visual pattern of 99m Tc-pertechnetate distribution. A focus of an increased accumulation of the radiopharmaceutical (hot node) was seen in all scintigrams of patients with thyroid cancer which were obtained using 201-thallium chloride, the contrast coefficient (CC) being 1,2 to 1,8. In benign tumors scintigraphy showed either a negligible accumulation of 201-thallium chloride, or none at all, the CC being less than 1 in such cases. 9 refs., 6 figs

The place occupied by early measurement (20th minute) of the thyroid uptake of sup(99m)Tc pertechnetate in thyroid pathology

International Nuclear Information System (INIS)

Guilloteaux, Gerard.

1977-01-01

The place occupied by early measurement (20th minute) of the thyroid uptake of sup(99m)Tc pertechnetate is situated for different types of thyroid condition (hypo-, normo- and hyperthyroidism). The use of technetium is simple in practice because only the cervical and crural radioactivity measurements are required. Like all simplified methods it involves risks of errors but lends itself to systematic routine use. The practical advantages of this isotope, which in view of its short half-life appears with iodine 123 as the nearly ideal tracer for thyroid exploration at present are outlined. The thyroid gland can be studied both functionally and scintigraphically at the cost of minimum irradiation, which is a great advantage. The fact that a number of data may be obtained in less than an hour (including scintigraphy) is a particularly valuable asset. However the method has its limits. For example a diagnosis of hyper or hypothyroidism based on the technetium uptake at the 20th minute alone is out of the question. A zero uptake may be observed in the presence of Basedow's disease or conversely a high uptake in hypo- or euthyroid cases. Discrimination is satisfactory between hyper and euthyroid but not between eu- and hypothyroid subjects. Technological progress however promises a routine use of 123 I and 99mTc together, the two isotopes serving to explore two different phases of the thyroid metabolism [fr

Tc99m-pertechnetate thyroid scintigraphy in newborns with neonatal TSH levels > 20uUI/ml, detected in the national program of newborn screening of congenital hypothyroidism (CH)

International Nuclear Information System (INIS)

Lobo, G.; Ladron de Guevara, D.; Perez, A.; Donoso, G.; Jimenez, C.; Arnello, F.; Vivanco, X.

2002-01-01

The aim of this study was to analyse the thyroid scintigraphy (TS) findings in 279 newborn with neonatal TSH (TSHnn) levels above 20 uUI/ml, detected in the national program of newborn screening of CH and phenylketonuria, and to compare them with: 1) final diagnosis, estimating its positive (PPV) and negative predictive value (NPV) and 2) TSHnn levels. Materials and Method: Thyroid scintigraphy of 279 newborn (57.3% girls) who presented TSHnn levels > 20 uUI/ml were revised, classifying them in eutopic gland (EuG), ectopic gland (EcG) and absence of contrast (AC). EuG was classified by visual and quantitative criteria in: normal contrast and size, goiter, and decreased contrast (DC). Tc99m-pertechnetate TS was performed average at 19th life's day (SD:11 days) with a gammacamera- computer system. The patients were separated according to hormonal confirmatory levels in: CH, hyperthyrotropinaemia (HT) and euthyroid. We compared TS results with final diagnosis and also with TSHnn levels (>= or 50 uUI/ml group (p<0.001). Moreover, the former group presented bigger proportion of CH newborns and of EcG scans than < 50uUI/ml patients (p<0.001). EcG and goiter condition had a PPV for CH of 100% and 79.6%, respectively. The NPV of normal TS was 86.7%. Conclusion: 1) Newborns with TSHnn levels larger than 20 uUI/ml show a high frequency of abnormal TS. 2) The EcG is highly predictive of CH. 3) Goiter and AC associated to TSHnn levels above 50 uUI/ml support strongly CH diagnosis. 4) Normal TS correspond very likely to euthyroid newborn, specially when TSHnn is lower than 50 uUI/ml

Interferin with thyroid scintigraphy: the effects of interferon alpha induced thyroid gland autoimmunity and dysfunction upon thyroid scintigraphy in patients with the hepatitis C virus

International Nuclear Information System (INIS)

Rome, S.P.; Karamoskos, P.; Schlicht, S.M.

2003-01-01

Full text: The incidence of hepatitis C virus (HCV) infection is increasing. Interferon alpha therapy is often used to treat patients who are HCV positive. Thyroid gland autoimmunity and dysfunction has been reported to occur with variable frequency during INF-alpha therapy in patients with the HCV. This study reviews the scintigraphic findings of thyroid scans in such patients in order to assess for the effects on thyroid scintigraphy. To our knowledge, there has been no comprehensive study of this important occurrence to date. There were a number of patients with the HCV being treated at our institution between 23/09/1996 and 09/08/2000. Some of them received INF-alpha therapy, certain were subsequently diagnosed with thyroid gland autoimmunity and/or dysfunction. Eight were imaged with thyroid scintigraphy and reviewed. The scintigraphic findings in the 8 patients fell into two broad categories; 4 demonstrated changes of Graves' disease, and 3 changes of thyroiditis (1 of these was sub-acute). One hypothyroid patient with anti-thyroglobulin antibodies had normal thyroid scintigraphy. Six patients were found to have antithyroid antibodies. One patient with thyroiditis tested negative to antithyroid antibodies. One patient was not tested for antithyroid antibodies. Interferon alpha induced thyroid gland autoimmunity and/or dysfunction can markedly affect the thyroid scintigraphic findings of patients with the hepatitis C virus. This hitherto undescribed occurrence on thyroid scintigraphy has important practical implications of which Nuclear Medicine Specialists need to be aware in order to correctly interpret thyroid scintigraphy studies in such patients. The clinical presentation and effects on imaging appearances are varied. The Nuclear Medicine Specialist can play a central role in establishing the causal link. Awareness of this occurrence enables the Nuclear Medicine Specialist to add value to the referral. This occurrence will become an increasingly common

Scintigraphy and ultrasonography of various thyroid diseases

International Nuclear Information System (INIS)

Ban, Yoshio; Nagakura, Hozumi; Kawauchi, Akihiro; Fukunari, Nobuhiro; Itoh, Kunihiko; Higashi, Tomomitsu.

1987-01-01

We reported the usefulness of scintigraphy and ultrasonography of various thyroid diseases. The scintigraphy were useful information in the determination of functioning adenoma, location of ectopic thyroid glands and appearance of lang and bone metastasis of thyroid carcinoma. As ultrasonography were able to be observation of internal structure of thyroid gland, that maight be used to determined associated nodular lesions in diffuse goiter and differentiation between benign and malignant tumor in nodular goiter. In observation of calcifications of goiter, soft X rays apparatus were usefull tool. US, as initial diagnostic test before scintiscanning, provided useful information and minimized radiation exposure. (author)

A kinetic compartment model for evaluating salivary gland scintigraphies

DEFF Research Database (Denmark)

Afzelius, Pia; Fuglsang, Stefan

2014-01-01

referred for (99m) Tc-pertechnetate thyroid scintigraphy were studied. Dynamic imaging of the head in a fixed anterior projection was performed after an intravenous bolus injection of 150 MBq (99m) Tc-pertechnetate using a gamma scintillation camera. After 30 min, lemon juice was orally administered...... through a syringe. Time activity curves were generated for each of the four major salivary glands (i.e. the right and left submandibular and right and left parotid glands). Excretion fractions (the fraction of mobilizable radioactivity after administering lemon juice) and the gland activity...

Scintigraphy of the articular caps of a patient with rheumatoid arthritis using sup(99m)Tc-pertechnetate

International Nuclear Information System (INIS)

Weel, F.A. van der

1981-01-01

A method is presented for the diagnosis of rheumatoid arthritis, which is also used to control the effectiveness of treatment. It involves scintigraphy using sup(99m)Tc-pertechnetate. The uptake of this substance by bone joints enables full documentation of any inflammation activity in the joints. (C.F.)

Diagnosis of thyroid lymphoma and follow-up evaluation using Ga-67 scintigraphy

International Nuclear Information System (INIS)

Nishiyama, Yoshihiro; Yamamoto, Yuka; Yokoe, Koiku; Satoh, Katashi; Ohkawa, Motoomi

2003-01-01

A strong association between malignant lymphoma and Hashimoto's thyroiditis has frequently been reported. However, it is difficult to detect the lymphomatous transformation of Hashimoto's thyroiditis in the early stage. The purpose of the present study was to examine the usefulness of 67 Ga scintigraphy in the diagnosis and evaluation of the therapeutic effects during follow-up, in patients with a suspected diagnosis of primary thyroid lymphoma. Twenty-five patients who were suspected of having primary thyroid lymphoma and had undergone 67 Ga scintigraphy were studied. 67 Ga planar scintigraphy was performed 72 hours after injection of 67 Ga-citrate. The degree and pattern of 67 Ga accumulation were graded visually. Histopathology on biopsy examination revealed thyroid lymphoma in 17 and Hashimoto's thyroiditis in 8 patients. Abnormal accumulation of 67 Ga in the thyroid was seen in all of the 17 thyroid lymphoma cases with additional mediastinal and abdominal involvement in one. Fifteen of 17 thyroid lymphoma patients also underwent 67 Ga scintigraphy 2-4 weeks after chemotherapy and/or radiotherapy. All 15 patients showed diminishing 67 Ga accumulation and a good clinical course. In one patient with local recurrence, abnormal accumulation could be depicted by follow-up scintigraphy. However, diffuse or enlarged accumulation in the thyroid was seen in all of the 8 Hashimoto's thyroiditis cases. The degree of abnormal accumulation in the thyroid in clinically active phase thyroiditis was more intense than that in the chronic phase thyroiditis. 67 Ga scintigraphy was helpful to confirm the diagnosis of thyroid lymphoma and to evaluate the therapeutic effects during follow-up. However, 67 Ga scintigraphy may not always distinguish thyroid lymphoma from Hashimoto's thyroiditis, especially the active phase of the disease. (author)

Procedure guideline for thyroid scintigraphy (version 3)

International Nuclear Information System (INIS)

Dietlein, M.; Schicha, H.; Eschner, W.; Deutsche Gesellschaft fuer Medizinische Physik; Koeln Univ.; Leisner, B.; Allgemeines Krankenhaus St. Georg, Hamburg; Reiners, C.; Wuerzburg Univ.

2007-01-01

The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the 99m Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)

Intrathoracic toxic thyroid nodule causing hyperthyroidism with a multinodular normal functional cervical thyroid gland

International Nuclear Information System (INIS)

Serim, Burcu Dirlik; Korkmaz, Ulku; Can, Unal; Altun, Gulay Durmus

2016-01-01

Radionuclide scintigraphy with I-131 and Tc-99m pertechnetate ( 99 mTc0 4 ) has been widely used in detecting toxic nodules. Intrathoracic goiter usually presents as an anterior mediastinal mass. Mostly the connection between intrathoracic mass and the cervical thyroid gland is clearly and easily identified occurring as a result of inferior extension of thyroid tissue in the neck, which is called as secondary intrathoracic goiter. Completely separated, aberrant or in other words primary intrathoracic goiters arise as a result of abnormal embryologic migration of ectopic thyroid closely associated with aortic sac and descend into the mediastinum. Intrathoracic goiters are generally nontoxic nodules existing with mass effect without causing hyperthyroidism. However, mostly reported cases had enlarged thyroid glands in the neck. This report demonstrates the usefulness of I-131 and 99 mTc0 4 scintigraphy for detecting intrathoracic goiter causing hyperthyroidism with a normal functioned cervical thyroid gland

Possibilities of 99mTc-MIBI for imaging of the thyroid parenchyma

International Nuclear Information System (INIS)

Mluchkov, N.; Mluchkov, Kh.

1998-01-01

Thyroid parenchyma imaging is very important as an evidence of residual part of the gland in case of thyroidectomy. The determination of the mass of this part and its function is crucial at the substituting hormonal therapy. Also at cases of thyroid carcinomas the differential diagnosis of recurrences of radiation and/or postoperative fibrosis is difficult. The thyroid imaging by 131 I and by 99m Tc-pertechnetates is not always possible because of gland blockage from medicines, thyroid hormones and foods with high iodine content. The aim of this study was to establish if 99m Tc-MIBI could depict the thyroid parenchyma without being influenced by gland blockage giving a real image of it. A comparative scintigraphic study has been carried out at 58 patients with different thyroid diseases using 99m Tc-pertechnetate, 131 I and 99m Tc-MIBI. There were 17 patients with diffuse goiter, 27 with nodules (23 of normal activity and 4 with cold nodules), 3 patients with retrosternal goiter and 11 with thyroid carcinoma after surgery intervention. The visualization of the thyroid parenchyma with 99m Tc-MIBI was better than that with 99 0 m Tc-pertechnetate and no dependent on suppression of the gland. All nodules showed 99m Tc-MIBI uptake with the same intensity as the surrounding normal gland tissue. The scintigraphy with 99m Tc-MIBI was of no value for differential diagnosis of nodules. 99m Tc-MIBI scintigraphy could be successfully applied at patients with retrosternal thyroid goiter and for detecting a thyroid rest at patients with thyroid cancer after surgery intervention. (author)

Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

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Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo

1993-06-01

This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

Scintigraphy in benign thyroid disorders

International Nuclear Information System (INIS)

Mahlstedt, J.

2004-01-01

For diagnosis, therapy and prognosis of benign thyroidal disorders thyroidal scintigraphy has to be seen in full strength in relation to thyroid hormone metabolism and regulation. Thyroidal iodine avidity can easily be assessed by TcTU ( 99m Tc-thyroid-up-take 20 min p.inj.), as the well known standard measure for the service of goiter patients. TcTU and TSH show concordance, i.e. direct correlation, when thyroid regulation is intact, however there is no correlation, i.e. discordance, in disorders such as destruction, autonomy oder immunogenic stimulation. The strategy to evaluate concordance/discordance of TcTU and TSH in outpatient routine work (''one stop shop'') is demonstrated in a variety of clinical situations being not always conform to current guide lines and recommendations. (orig.)

Role of color Doppler in differentiation of Graves' disease and thyroiditis in thyrotoxicosis

Science.gov (United States)

Donkol, Ragab Hani; Nada, Aml Mohamed; Boughattas, Sami

2013-01-01

AIM: To evaluate the role of thyroid blood flow assessment by color-flow Doppler ultrasonography in the differential diagnosis of thyrotoxicosis and compare it to technetium pertechnetate thyroid scanning. METHODS: Twenty-six patients with thyrotoxicosis were included in the study. Clinical history was taken and physical examination and thyroid function tests were performed for all patients. Thyroid autoantibodies were measured. The thyroid glands of all patients were evaluated by gray scale ultrasonography for size, shape and echotexture. Color-flow Doppler ultrasonography of the thyroid tissue was performed and spectral flow analysis of both inferior thyroid arteries was assessed. Technetium99 pertechnetate scanning of the thyroid gland was done for all patients. According to thyroid scintigraphy, the patients were divided into two groups: 18 cases with Graves’ disease and 8 cases with Hashimoto’s thyroiditis. All patients had suppressed thyrotropin. The diagnosis of Graves’ disease and Hashimoto’s thyroiditis was supported by the clinical picture and follow up of patients. RESULTS: Peak systolic velocities of the inferior thyroid arteries were significantly higher in patients with Graves’ disease than in patients with thyroiditis (P = 0.004 in the right inferior thyroid artery and P = 0.001 in left inferior thyroid artery). Color-flow Doppler ultrasonography parameters demonstrated a sensitivity of 88.9% and a specificity of 87.5% in the differential diagnosis of thyrotoxicosis. CONCLUSION: Color Doppler flow of the inferior thyroid artery can be used in the differential diagnosis of thyrotoxicosis, especially when there is a contraindication of thyroid scintigraphy by radioactive material in some patients. PMID:23671754

EVALUATION OF QUANTITATIVE THYROID SCINTIGRAPHY FOR DIAGNOSIS AND STAGING OF DISEASE SEVERITY IN CATS WITH HYPERTHYROIDISM: COMPARISON OF THE PERCENT THYROIDAL UPTAKE OF PERTECHNETATE TO THYROID-TO-SALIVARY RATIO AND THYROID-TO-BACKGROUND RATIOS.

Science.gov (United States)

Peterson, Mark E; Guterl, Jade N; Rishniw, Mark; Broome, Michael R

2016-07-01

Thyroid scintigraphy is commonly used for evaluation of cats with hyperthyroidism, with the thyroid-to-salivary ratio (T/S) being the most common method to quantify the degree of thyroid activity and disease. Calculation of thyroid-to-background ratios (T/B) or percent thyroidal uptake of (99m) TcO(-) 4 (TcTU) has only been reported in a few studies. The purpose of this prospective, cross-sectional study was to evaluate a number of quantitative scintigraphic indices as diagnostic tests for hyperthyroidism, including the T/S, three different T/B, TcTU, and estimated thyroid volume. Of 524 cats referred to our clinic for evaluation of suspected hyperthyroidism, the diagnosis was confirmed (n = 504) or excluded (n = 20) based on results of a serum thyroid panel consisting of thyroxine (T4 ), triiodothyronine (T3 ), free T4 (fT4 ), and thyroid-stimulating hormone (TSH) concentrations. In the hyperthyroid cats, median values for TcTU, T/S, and three T/B ratios were all significantly higher (P hyperthyroidism, but the T/S ratio had the highest test accuracy. The T/S ratio correlated strongly with the TcTU (r = 0.85). However, the TcTU had a higher and more significant correlation (P metabolic activity of the feline adenomatous thyroid gland. © 2016 American College of Veterinary Radiology.

Detection and localization of enlarged parathyroid glands in patients with hyperparathyroidism using 99mTc-methoxyisobutylisonitrile (MIBI). A study of subtraction scintigraphy with 99mTc-pertechnetate

International Nuclear Information System (INIS)

Katagiri, Makoto; Ohtawa, Takahiro; Otsuka, Nobuaki; Morita, Koichi; Sone, Teruki; Mimura, Hiroaki; Yanagimoto, Shinichi; Fukunaga, Masao; Harada, Tanekazu

1995-01-01

In this study we investigated the detectability of abnormal parathyroid gland(s) by 99m Tc-methoxy-isobutylisonitrile (MIBI) scintigraphy in patients with hyperparathyroidism. The subjects were 6 patients with primary hyperparathyroidism (PHP) with a single adenoma and 13 patients with renal hyperparathyroidism (RHP) on chronic maintenance hemodialysis. The imaging data of 99m Tc-pertechnetate were subtracted from those of 99m Tc-MIBI (MIBI-Tc), and number and location of the positive images on scintigrams were compared with those obtained by conventional scintigraphy using 201 Tl-Cl and 99m Tc-pertechnetate (Tl-Tc). All of the patients underwent surgery, and the number and location of the abnormal parathyroid glands were confirmed. The number of resected parathyroid glands were 6 in PHP and 52 in RHP. The detectability of MIBI-Tc was 83.3% in PHP and 51.9% in RHP, while that of Tl-Tc was 100% and 44.2%, respectively. Although no statistically significant difference in the detectability was found between MIBI-Tc and Tl-Tc, the number of false positives with MIBI-Tc was less than that with Tl-Tc. The detectability of MIBI-Tc depended on the size of the parathyroid gland. The maximal diameter and weight of the smallest parathyroid gland detected were 15 mm and 290 mg in PHP, and 9 mm and 50 mg in RHP. The existence of the thyroid gland did not reduce the detectability of MIBI-Tc. In conclusion, MIBI-Tc was clinically very useful for the detection of abnormal parathyroid glands in patients with hyperparathyroidism. (author)

A Study on 99mTc-pertechnetate thyroid uptake in various thyroid disease

International Nuclear Information System (INIS)

Choi, Sung Jae; Min, Hae Sook; Koh, Chang Soon; Lee, Mun Ho

1974-01-01

The 99m Tc-pertechnetate thyroid uptake rates(20 min) were measured in 24 healthy normal subjects, 140 patients with nontoxic goiter and 98 patients with thyrotoxicosis who were treated at the Thyroid Clinic, Seoul National University Hospital, from August 1972 to August 1973. Diagnostic reliabilities and correlations between 99m TcO 4 -thyroid uptake rate (20 min) and other thyroid function tests were evaluated. The observed results were as follows:1) The 99m TcO 4 - thyroid uptake rates (20 min) in normal subjects, euthyroid group and hyperthyroid group were 4.1±0.9%, 5.2±1.8% and 29.7±10.6%. There was a significant difference between the mean of the euthyroid group and the mean of the hyperthyroid group and so differentiation between them can be easy. 2) In the diagnosis of hyperthyroidism, the reliabilities of 99m TcO 4 - thyroid uptake rate(20 min), 131 I thyroid uptake rate (24 hrs), serum T 3 resin uptake rate, serum T 4 and T 7 were 87.9-97.9%, 81.2-94.4%, 87.9-97.9%, 90.5-99.3% and 93.7-100%. 99m TcO 4 -thyroid uptake rate (20 min) is more accurate than 131 I thyroid uptake rate (24 hrs) in the diagnosis of hyperthyroidism. 3) 99m TcO 4 -thyroid uptake rate (20 min) was well correlated with 131 I thyroid uptake rate (24 hrs), serum T 3 resin uptake rate, serum T 4 and T 7 . Points in favor of 99m Tc are that it gives a small radiation dose to the thyroid, that tests can be repeated at the short interval, the study can be completed at a single patient visit and it is particularly well suited for the assessment of thyroid function in patients being treated with an antithyroid drug.

Usefulness of Technetium 99 m- Sestamibi (MIBI) scintigraphy in the detection of parathyroid adenoma and hyperplasia

International Nuclear Information System (INIS)

Markarian, Maria F.; Yelin, Enrique G.; Aparicio, Rocio; Marino, Juan M.

2005-01-01

Purpose: To evaluate parathyroid substration scintigraphy with Tc99m-pertechnetate-Tc99m-MIBI, for detection of parathyroid adenomas or hyperplasia in patients with hyperparathyroidism. Materials and methods: Thirty patients were studied by Tc99m-pertechnetate-Tc99m-MIBI scintigraphy, 24 with primary hyperparathyroidism, 2 with hypo echogenic nodular image behind the thyroid gland, 1 with bone fracture history, 1 with hypophosphataemia and 2 with secondary hyperparathyroidism. The initial image was made with pertechnetate, the next one and the late (2-3 hs) with Tc99m-MIBI, making digital substration with the first image. Six patients were excluded (difficult follow-up n=5, death n=1). Results: The final 24 patients series showed: 10 positive and 12 negative for adenomas; 1 positive and 1 negative for hyperplasia. The correlation between the scintigraphic study and the clinical, biochemical and anatomicopathological data, showed a high sensitivity (90%), and specificity (92%), for parathyroid adenomas and/or hyperplasia. Conclusions: The Tc99m-pertechnetate-Tc99m-MIBI shows high sensitivity and high specificity for the detection of adenomas and hyperplasia in patient with hyperparathyroidism. (author)

Treatment of thyroid carcinoma as a problem of internal medicine

International Nuclear Information System (INIS)

Roos, J.

1975-01-01

The usefulness of gallium-67 as a radiopharmaceutical for the detection of carcinoma of the thyroid gland is investigated. Gallium-67 does not accumulate in a benign goitre. In combination with iodide and pertechnetate scintigraphy of the thyroid, the application of gallium-67 is important for the detection of malignancy in large goitres. To increase the efficiency of iodine-131 therapy, a low-iodine diet and intensive diuresis during four days preceding administration of radioactive iodide is recommended

Iodine-123 scintigraphy in the evaluation of pediatric thyroid disorders: a ten year experience

International Nuclear Information System (INIS)

Paltiel, H.J.; Summerville, D.A.; Treves, S.T.

1992-01-01

Between 1978 and 1987, we studied 280 children with iodine-123 ( 123 I) scintigraphy. Indications for scintigraphy included hypothyroidism, neck masses, hyperthyroidism, and miscellaneous reasons. Scintigraphy was helpful in distinguishing anatomic from functional causes of hyothyroidism. It reliably identified the location of the thyroid gland in patients with neck masses. The functional status of thyroid nodules was readily assessed and was important in directing further treatment. Scintigraphy added little to the management of children with post-irradiation hypothyroidism without a palpable nodule, patients with Hashimoto thyroiditis or Graves disease when the clinical diagnosis was straightforward. (orig./GDG)

Iodine-123 scintigraphy in the evaluation of pediatric thyroid disorders: a ten year experience

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Paltiel, H.J.; Summerville, D.A.; Treves, S.T. (Children' s Hospital, Boston, MA (United States). Div. of Nuclear Medicine Harvard Medical School, Boston, MA (United States))

1992-08-01

Between 1978 and 1987, we studied 280 children with iodine-123 ([sup 123]I) scintigraphy. Indications for scintigraphy included hypothyroidism, neck masses, hyperthyroidism, and miscellaneous reasons. Scintigraphy was helpful in distinguishing anatomic from functional causes of hyothyroidism. It reliably identified the location of the thyroid gland in patients with neck masses. The functional status of thyroid nodules was readily assessed and was important in directing further treatment. Scintigraphy added little to the management of children with post-irradiation hypothyroidism without a palpable nodule, patients with Hashimoto thyroiditis or Graves disease when the clinical diagnosis was straightforward. (orig./GDG).

Thyroid carcinoma presenting as a pertechnetate ''Hot'' nodule, but with 131I uptake: case report

International Nuclear Information System (INIS)

Turner, J.W.; Spencer, R.P.

1976-01-01

A 24-year-old woman presented with a mass on the right side of the neck; this proved to be a hyperfunctioning or hot nodule on /sup 99m/Tc-scan. Because of the firmness of the area, the study was repeated with 131 I, but the region did not accumulate radioiodide. The tissue showing this discrepant handling of pertechnetate and radioiodide was surgically removed and identified as a follicular carcinoma with papillary foci. A brief review of the literature data on the disassociation of thyroid trapping and organification functions, and hence of possible discrepancies between pertechnetate and radioiodide uptake, is given

Clinical usefulness of Tc-99M pertechnetate per-rectal portal scintigraphy in evaluation the severity of portal hypertension in cirrhotic patients

International Nuclear Information System (INIS)

Namwongprom, S.; Ekmahachai, M.; Boonyaprapa, S.; Vilasdechanon, N.; Taya, P.; Chankaew, N.; Chitapanarux, T.

2004-01-01

Objectives: Variceal hemorrhage is a potentially life-threatening complication in cirrhotic patients. Identification of patients at high risk for bleeding is particularly important. The aim of this study was to determine the clinical usefulness of per-rectal portal scintigraphy in evaluation the severity of portal hypertension in cirrhotic patients in terms of correlation between cirrhosis and classic indicators of hepatic functional reserve and identifying the difference of the portal shunt index (PSI) of the bleeding esophageal varices group and non-bleeding esophageal varices group. Material and methods: Portal circulations in 15 healthy volunteer's and in 67 patients with cirrhosis were evaluated by Tc-99m pertechnetate per-rectal p. ortal scintigraphy. Tc-99m pertechnetate (550 MBq) was instilled into the upper rectum, and dynamic images were taken. Radioactivity curves of the liver and the heart were generated sequentially. Through the analysis of these curves, the PSI was determined by calculating the ratio of counts of the liver to counts of the heart integrated for 24 seconds immediately after the appearance of the liver time-activity curve. Results: The results, expressed as PSI were: 13.63 +/- 6.28 % in healthy subjects and 66.32+/-22.80 % in cirrhotic patients. Of these, the PSIs were 56036 +/- 27.14 % in 31 cirrhotic patients without esophageal varices, and 74.89 +/- 13.62 % in 36 cirrhotic patients with esophageal varices. The PSI was significantly lower in cirrhotic patients without bleeding esophageal vances (BEV) than those with BEV (p=0.001). The PSI calculated with this method was correlated with the serum albumin, the serum bilirubin and the Child-Pugh's score. Conclusion: The Tc-99m pertechnetate per-rectal portal scintigraphy has clinical usefulness as a relatively non-invasive method of choice for quantitative evaluating the severity of portal hypertension in cirrhotic patients. (authors)

The role of Tl-201 total body scintigraphy in follow up of thyroid carcinoma

International Nuclear Information System (INIS)

Hoefnagel, C.A.; Delprat, C.C.; Marcuse, H.R.

1985-01-01

To evaluate the reliability of the procedure T1-201 total body scintigraphy was performed in 294 patients (449 studies) after total thyroidectomy for thyroid carcinoma. Results were correlated with I-131-scintigraphy and tumor-marker levels (Tgb or Calcitonin/CEA). T1-201 total body scintigraphy was negative in 196 patients with no evidence of disease. T1-201-scintigraphy correctly detected tumor localizations in 24 of 30 patients with I-131-positive metastases. In 28 patients T2-201 total body scintigraphy revealed metastases which did not concentrate I-131. Histology/cytology confirmed thyroid carcinoma metastases in 16 patients and other pathology in 5 cases. 9 of 18 patients with medullary thyroid carcinoma (I-131-negative) had elevated Calcitonin/CEA-levels. The T1-201 scintigram was positive in 8 of these patients. Comparison of T1-201, I-131 and tumor markers showed that only combined use of these parameters provide complete reliability. The authors conclude that T1-201 total body scintigraphy is useful in follow up of thyroid carcinoma, especially when a discrepancy of the other parameters exists and particularly in medullary carcinoma. In long term follow up of patients who are unsuspected of disease after successful therapy for thyroid carcinoma one can rely on T1-201 total body scintigraphy in combination with tumor marker assays

Thyroglobulin Gene Mutation with Cold Nodule on Thyroid Scintigraphy

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Toshio Kahara

2012-01-01

Full Text Available Thyroglobulin gene mutation is a rare cause of congenital hypothyroidism, but thyroglobulin gene mutations are thought to be associated with thyroid cancer development. A 21-year-old Japanese man treated with levothyroxine for congenital hypothyroidism had an enlarged thyroid gland with undetectable serum thyroglobulin despite elevated serum TSH level. The patient was diagnosed with thyroglobulin gene mutation, with compound heterozygosity for Gly304Cys missense mutation and Arg432X nonsense mutation. Ultrasonography showed a hypovascular large tumor in the left lobe that appeared as a cold nodule on thyroid scintigraphy. He underwent total thyroidectomy, but pathological study did not reveal findings of thyroid carcinoma, but rather a hyperplastic nodule with hemorrhage. Strong cytoplasmic thyroglobulin immunostaining was observed, but sodium iodide symporter immunostaining was hardly detected in the hyperplastic nodule. The clinical characteristics of patients with thyroglobulin gene mutations are diverse, and some patients are diagnosed by chance on examination of goiter in adults. The presence of thyroid tumors that appear as cold nodules on thyroid scintigraphy should consider the potential for thyroid carcinoma, if the patient has relatively low serum thyroglobulin concentration in relation to the degree of TSH without thyroglobulin autoantibody.

Value of thyroid scintigraphy using thallium 201

International Nuclear Information System (INIS)

Hermans, J.; Parmentier, S.; Beauduin, M.; Schmitz, A.; Therasse, G.

1986-01-01

The value of thallium-201 scintigraphy in the differential diagnosis of cold thyroid nodules demonstrated on the thyroid scan with technetium-99m was emphasized. From the clinical results it can be deduced that if a cold nodule is positive with thallium-201 the lesion has a high percentage of being a high risk of malignancy. This information might be quite valuable in selecting patients for operation [fr

Non-visualized Thyroid Gland by Tc-{sup 99m} MIBI Scan with Normal Thyroid Scan

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Koca, Gokhan; Atilgan, Hasan Ikbal; Baskin, Aylin; Demirel, Koray; Korkmaz, Meliha [Ankara Training and Research Hospital, Ankara (Turkmenistan)

2013-09-15

We present the case of a 21-year-old man who was referred to us for parathyroid scintigraphy with high blood levels of intact parathormone and osteoporosis. Several methods and radiopharmaceuticals, e.g., Tc-99m MIBI and Tl-201 chloride/Tc-99m pertechnetate (Tl-201/TcPO{sup -4}) subtraction, are commonly used for this purpose. We present the case of a thyroid gland that demonstrates quite normal Tc-99m pertechnetate uptake, no accumulation of Tc-99m MIBI, and very low grade Tl-201 uptake. To the best of our knowledge, no similar case has been reported previously. A 21-year-old male with osteoporosis and growth-development retardation was referred for MIBI parathyroid scan because of high blood levels of intact parathormone and bone-specific alkaline-phosphatase, which were 219.4 (15-88 pg/ml) and 355 (21-58 U/L), respectively. In his Tc-99m pertechnetate (TcPO{sup -4}) pinhole scintigraphy, bilateral clearly visualized radioactivity accumulation in the thyroid gland was seen. In both early or late images of the Tc-99m MIBI parathyroid scan, the thyroid gland was not visualized. Therefore, a Tl-201/TcPO{sub -4} subtraction scan method was used. However, the Tl-201 accumulation level in the thyroid gland was not sufficient for the subtraction method. In his thyroid ultrasonography, the thyroid gland echo was homogenous, and there was neither any solid nor cystic lesion. The physical examination of his neck was normal. Other laboratory findings were all normal as follows. TSH: 3.03 (0.35-5.6 IU/mL), free T3: 3.66 (2.5-3.9 pg/mL), free T4: 0.90 (0.59-1.3 ng/dL), Anti-TPO:0.3 (0.40 IU/mL), Anti-TG-Ab: <2.2 (0-+u/L), TSH receptor Ab: 1.0 (0.14 U/L), osteocalcine: 9.13 (1.5-15 ng/dL), growth hormone: 1.3 (0.014-5.21), calcitonin:17 (0.150 ng/mL), sedimentation:6 (0.15 mm/h). There were no significant symptoms of acute or chronic thyroiditis. The cause for discordant uptake in the thyroid gland with T1-201 and Tc-99m MIBI scan could not be provided through clinical or

Salivary gland scintigraphy with 99mTc-pertechnetate in Sjoegren's syndro Relationship to clinicopathologic features of salivary and lacrimal glands

International Nuclear Information System (INIS)

Saito, Tohru; Fukuda, Hiroshi; Horikawa, Masa-aki; Ohmori, Kei-ichi; Shindoh, Masanobu; Amemiya, Akira

1997-01-01

Salivary gland scintigraphy was performed on 52 patients who were suspected of having Sjoegren's syndrome (SS), and the results were compared with clinicopathologic features of the salivary and lacrimal glands. The time-activity curves which were obtained from computer-assisted analysis of 99m Tc-pertechnetate ( 99m Tc) scintigraphy were classified into four types (normal, median, flat and sloped types). The stimulated parotid flow rate decreased and the incidence of SS-related sialographic and histopathologic findings increased significantly as the scintigraphic abnormality advanced. In addition, the lacrimal gland function decreased and the proportion of patients diagnosed as having keratoconjunctivitis sicca (KCS) increased significantly as the scintigraphic abnormality advanced. These results indicate that the results of scintigraphy are related not only to the clinicopathologic features of the salivary glands but also to the lacrimal gland functions in SS. (au) 25 refs

Brain Tumour Scintigraphy with {sup 99m}Tc-Pertechnetate, {sup 99m}Tc-Fe(II) Complex and {sup 131}I-Labelled Macroaggregated Albumin - Comparison of Results; La Scintigraphie des Tumeurs Cerebrales a l'Aide de Pertechnetate Marque au {sup 99m}Tc, de Complexe {sup 99m}Tc-Fe-II et de Macroagregats d'Albumine Marques au {sup 131}I. Comparaison des Resultats

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Haas, J. P.; Dietz, H.; Schmidt, K. J.; Doerr, F.; Brod, K. H.; Wolf, R. [Institut de Radiologie Clinique et Clinique de Neurochirurgie, Universite de Mayence, Federal Republic of Germany (Germany)

1969-05-15

{sup 99m}Tc, in the form of pertechnetate, has now gained its place in brain scintigraphy. The present authors and many others have found its diagnostic value equal to that of substances labelled with mercury or iodine. Using {sup 99m}Tc-pertechnetate as the basis of their work, the authors attempted to extend isotopic diagnosis by two methods, namely: intra-arterial introduction of macroaggregated albumin; and intravenous injection of a new substance, the {sup 99m}Tc-Fe(II) complex. Following their publication in 1966 of the results obtained with the first method, the authors now present an account of their experiments carried out on over 100 patients with brain tumours. Compared with scintigraphy involving intravenous injection of {sup 99m}Tc-pertechnetate, this new method gives supplementary information which is often of considerable help in clinical neuroradiological diagnosis of these patients. The findings in a majority of cases were confirmed by operation or by autopsy. The method made it possible for the first time to use scintigraphy to visualize the arterial network of the brain. In view of the ease with which brain scintigraphy can be performed after intravenous injection, and also of our experience with the {sup 99m}Tc-Fe(II) complex in kidney scintigraphy and the evidence of a brief report in the United States literature, the authors decided to try out this substance in the detection of brain tumours. Their first results showed it to be incontestably superior to all others previously applied intravenously. It has the indubitable advantages of {sup 99m}Tc as regards the irradiation dose to the patient and gives an exceptionally precise delineation of the invasive cerebral processes due to a rapid fall in blood concentration. A combination of these two new scintigraphic methods would thus seem to open up new possibilities and greatly enhance the field of application of radioisotopes in the clinical study of brain diseases. The paper contains material

Incidence rate of symptomatic painless thyroiditis presenting with thyrotoxicosis in Denmark as evaluated by consecutive thyroid scintigraphies

DEFF Research Database (Denmark)

Schwartz, Frederik; Bergmann, Natasha; Zerahn, Bo

2013-01-01

Painless thyroiditis (PT) is a transient kind of thyrotoxicosis, with lack of uptake on a thyroid scintigraphy in a non-tender thyroid gland, elevated anti-TPO antibodies, no fever, no history of increased iodine intake, and a normal sedimentation rate. The prevalence of PT varies hugely...

Performances of scintigraphy in the primitive hyperparathyroidism and the associated thyroid pathologies

International Nuclear Information System (INIS)

Monteil, J.; Mathonnet, M.; Chianea, T.; Cubertafond, P.; Piquet, L.; Rince, C.; Bournaud, E.; Verbeke, S.; Perdrisot, R.; Vandroux, J.C.

1997-01-01

The data from scintigraphic and echographic exploration were compared to the surgery results in 32 patients (29 F and 3 M) presenting a primitive hyperparathyroidism, biologically proved, associated to a thyroid pathology. The scintigraphies were achieved with a collimator placed anteriorly and oblique-anteriorly, 4 h after injection by iodine 123 (7 MBq) and 30 min and 2 h after injection of 99m Tc-MIBI (555 MBq). The cervical echography and scintigraphy are independently interpreted. The results are given in a table containing the sensitivity, specificity, V.P.P. and V.P.N. for scintigraphy and echography, respectively. The association of a primary hyperparathyroidism and of a thyroid pathology (with a prevalence of 70% in our region) appears to affect less the performances of scintigraphy imaging than those of morphologic imaging

Dual ectopic thyroid associated with thyroid hemiagenesis.

Science.gov (United States)

Nakamura, Shigenori; Masuda, Teruyuki; Ishimori, Masatoshi

2018-01-01

We report a case of a 15-year-old girl with a midline neck mass that was first noted 2 or 3 years previously. She had been treated with levothyroxine (L-T4) for congenital hypothyroidism until 11 years of age. Ultrasonography revealed an atrophic right thyroid (1.0 × 1.6 × 2.6 cm in size) and a mass (2.3 × 1.0 × 3.5 cm in size) in the upper part of the neck. No left lobe of the thyroid was detected. On further evaluation, Tc-99m pertechnetate thyroid scintigraphy and CT showed ectopic thyroid tissue in the lingual region and infrahyoid region. Thus, she was diagnosed as having dual ectopic thyroid and thyroid hemiagenesis. The atrophic right thyroid was thought be non-functional. Treatment with L-T4 was started to reduce the size of the dual ectopic thyroid tissue. This may be the first reported case of dual ectopic thyroid associated with hemiagenesis detected only by ultrasonography. Ultrasonography can confirm the presence or absence of orthotopic thyroid tissue in patients with ectopic thyroid.The cause of congenital hypothyroidism should be examined.Clinical manifestation of ectopic thyroid may appear when the treatment with L-T4 is discontinued.Annual follow-up is needed in all children when their thyroid hormone replacement is stopped.

Evaluation of Salivary Gland Dysfunction Using Salivary Gland Scintigraphy in Sjoegren's Syndrome Patients and in Thyroid Cancer Patients after Radioactive Iodine Therapy

International Nuclear Information System (INIS)

Kang, Ji Yeon; Jang, Su Jin; Lee, Won Woo; Jang, Sung June; Lee, Yun Jong; Kim, Sang Eun

2011-01-01

Salivary gland scintigraphy (SGS) provides an objective means of diagnosing salivary gland dysfunction in Sjogren's syndrome (SS) patients and in thyroid cancer patients after radioactive iodine (RAI) therapy. In the present study, SGS was performed in SS patients and in thyroid cancer patients post RAI, and scintigraphic parameters were compared. Twenty eight SS patients (males:females=1:27, age 53.3±11.9 years), 28 controls (males:females=3.25, age 54.1±10.1 years), and 92 thyroid cancer patients (males:females=28:64, age 46.2±12.9) who had undergone a session of high dose RAI therapy (mean dose, 5.2±1.5 GBq) were included. SGS was performed using Tc 99m pertechnetate (925MBq). Scintigraphic parameters (parotid uptake ratio PU, submandibular uptake ratio SU, percent age parotid excretion %PE, and percentage submandibular excretion %SE) were measured and compared for SS, thyroid cancer post RAI, and control patients. PU, SU, %SE, and %PE were all significantly lower in SS than in post RAI thyroid cancer of control patients (p<0.05), whereas only %PE was significantly lower in post RAI thyroid cancer patients than in controls (P<0.05). SU and %SE were found to be correlated with the unstimulated whole salivary flow rate. Scintigraphic parameters derived from SGS can play a crucial role in the detection of salivary gland dysfunction in SS patients and in post RAI thyroid cancer patients.

The Basedow disease on ectopic thyroid: a cause of hyperthyroidism with 'white' thyroid scintigraphy; Maladie de Basedow sur thyroide ectopique: une cause d'hyperthyroidie avec scintigraphie thyroidienne 'blanche'

Energy Technology Data Exchange (ETDEWEB)

Tessonnier, L.; Taieb, D.; Mundler, O. [Service central de medecine nucleaire, CHU La Timone, Marseille, (France); Imbert-Joscht, I. [servicede medecine nucleaire, hopital Nord, Marseille, (France)

2009-05-15

We report the case of a 55 years old patient sent for a scintigraphy exploration of a biological hyperthyroidism, for which has been enlightened an ectopic thyroid in lingual position. The hyperthyroidism is a rare circumstance of finding a thyroid ectopy. (N.C.)

Clinical application of 201Tl scintigraphy in patients with cold thyroid nodules

International Nuclear Information System (INIS)

Tonami, N.; Bunko, H.; Michigishi, T.; Kuwajima, A.; Hisada, K.

1978-01-01

201 Tl-chloride scintigraphy was performed in 45 patients with cold thyroid nodules. The 201 Tl scintigram was positive in 17 of 18 thyroid patients with cancer (94.4%), 8 of 20 patients with an adenoma (40.0%), 1 of 2 adenomatous goiter patients (50.5%), and all of 5 cases of chronic thyroiditis (100.0%). When the cold nodule was demonstrated to be positive with 201 Tl, the statistical chance of the lesion being a cellular one was 100.0% and a risk of its malignancy was 54.8%. On the other hand, the nodule with negative 201 Tl concentration had a 14.3% chance of cellularity and a 7.1% risk of malignancy. Thus, 201 Tl scintigraphy is of use in the differential diagnosis of the cold thyroid nodule

Procedure guideline for thyroid scintigraphy (version 3); Verfahrensanweisung fuer die Schilddruesenszintigraphie (Version 3)

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Dietlein, M.; Schicha, H. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Eschner, W. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Allgemeines Krankenhaus St. Georg, Hamburg (Germany). Abt. fuer Nuklearmedizin; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

2007-07-01

The version 3 of the procedure guideline for thyroid scintigraphy is an update of the procedure guideline previously published in 2003. The interpretation of the scintigraphy requires the knowledge of the patients' history, the palpation of the neck, the laboratory parameters and of the sonography. The interpretation of the technetium-99m uptake requires the knowledge of the TSH-level. As a consequence of the improved alimentary iodine supply the {sup 99m}Tc-uptake has decreased; 100 000 counts per scintigraphy should be acquired. For this, an imaging time of 10 minutes is generally needed using a high resolution collimator for thyroid imaging. (orig.)

Thyrotoxic Graves' disease with normal thyroidal technetium-99m pertechnetate uptake

Energy Technology Data Exchange (ETDEWEB)

Ikekubo, Katsuji; Hino, Megumu; Ito, Hidetomi; Koh, Toshikiyo; Ishihara, Takashi; Kurahachi, Hiroyuki (Kobe City General Hospital (Japan)); Kasagi, Kanji; Hidaka, Akinari; Mori, Toru

1990-07-01

We saw 24 thyrotoxic Graves' patients with normal thyroidal uptake of technetium-99m pertechnetate ({sup 99m}Tc) out of 201 untreated thyrotoxic Graves' patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analyzed. Thyroid uptake and scintigraphic examinations by means of {sup 99m}Tc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands. These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high {sup 99m}Tc uptake groups with Graves' disease, and their condition could be easily controlled with small amounts of antithyroid drugs. Our study indicates that thyrotoxic Graves' disease with normal {sup 99m}Tc uptake exists and {sup 99m}Tc uptake study and TBII activity measurement is very useful for the diagnosis. The normal {sup 99m}Tc uptake thyrotoxic Graves' patient might be early stage patients with general Graves' disease and their early discrimination from general Graves' patients is very advantageous for treatment and prognosis. (author).

[Application scintigraphy in evaluation of salivary gland function].

Science.gov (United States)

Mojsak, Małgorzata Natalia; Rogowski, Franciszek

2010-03-01

The salivary glands belong to the exocrine glands. There are tree main pairs of salivary glands: parotid, submandibular, sublingual. Several modalities are used for salivary gland imaging, such as sonography, computer tomography and magnetic resonance imaging. The aim of these methods is mainly to present morphological impairment. Parenchymal function and excretion function of all salivary glands can be quantified by scintigraphy. After single intravenous injection of 99mTc-pertechnetate sequential images are acquired up to 25-40 minutes. Usually about fifteen minutes postinjection 3 ml of lemon juice are administered intraorally as sialogogue. Salivary scintigraphy can estimate the severity of salivary gland involvement and function disorders, which may not be accurately reflected by the morphological damage. The clinical impact of scintigraphy has been reported in multiple salivary glands diseases, such as Sjogren's syndrome, sialolithiasis with or without parenchymal damage, iatrogenic irradiation of the salivary glands for therapy of head and neck tumors or radioiodine treatment of thyroid cancer. No other method can give so much information about function of salivary glands. Scintigraphy is noninvasive examination, easy to perform, reproducible and well-tolerated by the patient.

Evaluation of Salivary Gland Dysfunction Using Salivary Gland Scintigraphy in Sjoegren's Syndrome Patients and in Thyroid Cancer Patients after Radioactive Iodine Therapy

Energy Technology Data Exchange (ETDEWEB)

Kang, Ji Yeon; Jang, Su Jin; Lee, Won Woo; Jang, Sung June; Lee, Yun Jong; Kim, Sang Eun [Seoul National Univ., Seoul (Korea, Republic of)

2011-09-15

Salivary gland scintigraphy (SGS) provides an objective means of diagnosing salivary gland dysfunction in Sjogren's syndrome (SS) patients and in thyroid cancer patients after radioactive iodine (RAI) therapy. In the present study, SGS was performed in SS patients and in thyroid cancer patients post RAI, and scintigraphic parameters were compared. Twenty eight SS patients (males:females=1:27, age 53.3{+-}11.9 years), 28 controls (males:females=3.25, age 54.1{+-}10.1 years), and 92 thyroid cancer patients (males:females=28:64, age 46.2{+-}12.9) who had undergone a session of high dose RAI therapy (mean dose, 5.2{+-}1.5 GBq) were included. SGS was performed using Tc 99m pertechnetate (925MBq). Scintigraphic parameters (parotid uptake ratio PU, submandibular uptake ratio SU, percent age parotid excretion %PE, and percentage submandibular excretion %SE) were measured and compared for SS, thyroid cancer post RAI, and control patients. PU, SU, %SE, and %PE were all significantly lower in SS than in post RAI thyroid cancer of control patients (p<0.05), whereas only %PE was significantly lower in post RAI thyroid cancer patients than in controls (P<0.05). SU and %SE were found to be correlated with the unstimulated whole salivary flow rate. Scintigraphic parameters derived from SGS can play a crucial role in the detection of salivary gland dysfunction in SS patients and in post RAI thyroid cancer patients.

{sup 99m}Tc-sestamibi thyroid uptake in euthyroid individuals and in patients with autoimmune thyroid disease

Energy Technology Data Exchange (ETDEWEB)

Santos, Allan O. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil); Avenida Independencia, Piracicaba, Sao Paulo (Brazil); Zantut-Wittmann, D.E.; Tambascia, M.A. [Campinas State University, Division of Endocrinology, Department of Internal Medicine, School of Medical Sciences, Campinas (Brazil); Nogueira, R.O.; Etchebehere, E.C.S.C.; Lima, M.C.L.; Camargo, E.E.; Ramos, C.D. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil)

2005-06-01

We investigated the biokinetics of {sup 99m}Tc-sestamibi in the thyroid of euthyroid volunteers (EVs) and in patients with autoimmune thyroid diseases and determined the best time interval between {sup 99m}Tc-sestamibi injection and calculation of uptake. Forty EVs, 30 patients with Graves' disease (GD), 15 patients with atrophic Hashimoto's thyroiditis (AHT) and 15 patients with hypertrophic Hashimoto's thyroiditis (HHT) underwent {sup 99m}Tc-sestamibi thyroid scintigraphy. Dynamic images were acquired for 20 min, and static images were obtained 20 min, 60 min and 120 min post injection. Five-, 20-, 60- and 120-min uptake, time to maximal uptake (T{sub max}) and T{sub 1/2} of tracer clearance were calculated. Thyroid hormones and antibodies were measured. {sup 99m}Tc-pertechnetate uptake was investigated in GD patients. T{sub max} was approximately 5 min in all four groups. The mean T{sub 1/2} value for EVs was similar to the GD value and lower than the HHT and AHT values. The mean ({+-}SD) 5-min uptake was 0.13% ({+-}0.05%) for EVs. The 5-min uptake in GD was higher than that in EVs(P<0.001) and correlated with free thyroxine (r=0.54) and with {sup 99m}Tc-pertechnetate uptake (r=0.68). Uptake in HHT was higher than that in AHT (P=0.0003) and EVs (P=0.002). Uptake in AHT was lower than uptake in EVs (P=0.0001). Five minutes is the optimal time interval between {sup 99m}Tc-sestamibi injection and calculation of thyroid uptake. Five-minute uptake differentiates euthyroid individuals from GD patients. There is a high correlation between {sup 99m}Tc-sestamibi and {sup 99m}Tc-pertechnetate uptake in GD. The reduced {sup 99m}Tc-sestamibi uptake in AHT patients is probably due to glandular destruction and fibrosis. Inflammatory infiltrate and high mitochondrial density in thyrocytes possibly explain the increased uptake in GD and HHT. (orig.)

Causes of appearance of scintigraphic hot areas on thyroid scintigraphy analyzed with clinical features and comparative ultrasonographic findings

Energy Technology Data Exchange (ETDEWEB)

Iwata, Masahiro [Hikone Municipal Hospital, Shiga (Japan); Kasagi, Kanji [Takamatsu Red Cross Hospital, Kagawa (Japan); Hatabu, Hiroto [Univ. of Pennsylvania Medical Center, PA (United States); Misaki, Takashi; Iida, Yasuhiro; Fujita, Toru; Konishi, Junji [Kyoto Univ. (Japan). Graduate School of Medicine

2002-06-01

This study was done retrospectively to analyze the ultrasonographic (US) findings in thyroid scintigraphic hot areas (HA). Three-thousand, eight-hundred and thirty-nine consecutive patients who underwent {sup 99m}Tc-pertechnetate (n=3435) or {sup 123}I (n=457) scintigraphy were analyzed. HA were regarded as present when the tracer concentration was greater than the remaining thyroid tissue, or when hemilobar uptake was observed. High-resolution US examinations were performed with a real-time electronic linear scanner with a 7.5 or 10 MHz transducer. One hundred and four (2.7%) were found to be scintigraphic HA (n=120). US revealed a nodular lesion or well-demarcated thyroid tissue corresponding to the HA in 94 areas (78.4%, Category 1), an ill-defined region with different echogenicity in 13 areas (10.8%, Category 2), and no correlating lesion in 13 areas (10.8%, Category 3). These 104 patients included 43 with adenomatous goiter (59 areas), 33 with adenoma, 11 with Hashimoto's thyroiditis, 5 with primary thyroid cancer, 4 with euthyroid ophthalmic Graves' disease (EOG), 3 with hemilobar atrophy or hypogenesis, 2 with hemilobar agenesis, 2 with hypothyroidism with blocking-type TSH-receptor antibodies (TSHRAb), 1 with acute suppurative thyroiditis. Among the 59 adenomatous nodules and 33 adenomas, 51 (86.4%) and 32 (97.0%), respectively, belonged to Category 1. A solitary toxic nodule was significantly larger and occurs more often in older patients than in younger patients. On the other hand, all 17 patients with known autoimmune thyroid diseases including Hashimoto's thyroiditis, EOG and hypothyroidism with blocking TSHRAb belonged to Category 2 or 3. Possible underlying mechanisms are hyperfunctioning tumors or nodules, localized functioning thyroid tissue freed from autoimmune destruction, inflammation or tumor invasion, congenital abnormality, clusters of hyperactive follicular cells caused by long-term TSH and/or TSHRAb stimulation, asymmetry

Causes of appearance of scintigraphic hot areas on thyroid scintigraphy analyzed with clinical features and comparative ultrasonographic findings

International Nuclear Information System (INIS)

Iwata, Masahiro; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Fujita, Toru; Konishi, Junji

2002-01-01

This study was done retrospectively to analyze the ultrasonographic (US) findings in thyroid scintigraphic hot areas (HA). Three-thousand, eight-hundred and thirty-nine consecutive patients who underwent 99m Tc-pertechnetate (n=3435) or 123 I (n=457) scintigraphy were analyzed. HA were regarded as present when the tracer concentration was greater than the remaining thyroid tissue, or when hemilobar uptake was observed. High-resolution US examinations were performed with a real-time electronic linear scanner with a 7.5 or 10 MHz transducer. One hundred and four (2.7%) were found to be scintigraphic HA (n=120). US revealed a nodular lesion or well-demarcated thyroid tissue corresponding to the HA in 94 areas (78.4%, Category 1), an ill-defined region with different echogenicity in 13 areas (10.8%, Category 2), and no correlating lesion in 13 areas (10.8%, Category 3). These 104 patients included 43 with adenomatous goiter (59 areas), 33 with adenoma, 11 with Hashimoto's thyroiditis, 5 with primary thyroid cancer, 4 with euthyroid ophthalmic Graves' disease (EOG), 3 with hemilobar atrophy or hypogenesis, 2 with hemilobar agenesis, 2 with hypothyroidism with blocking-type TSH-receptor antibodies (TSHRAb), 1 with acute suppurative thyroiditis. Among the 59 adenomatous nodules and 33 adenomas, 51 (86.4%) and 32 (97.0%), respectively, belonged to Category 1. A solitary toxic nodule was significantly larger and occurs more often in older patients than in younger patients. On the other hand, all 17 patients with known autoimmune thyroid diseases including Hashimoto's thyroiditis, EOG and hypothyroidism with blocking TSHRAb belonged to Category 2 or 3. Possible underlying mechanisms are hyperfunctioning tumors or nodules, localized functioning thyroid tissue freed from autoimmune destruction, inflammation or tumor invasion, congenital abnormality, clusters of hyperactive follicular cells caused by long-term TSH and/or TSHRAb stimulation, asymmetry, etc. Scintigraphic HA are

Causes of appearance of scintigraphic hot areas on thyroid scintigraphy analyzed with clinical features and comparative ultrasonographic findings.

Science.gov (United States)

Iwata, Masahiro; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Fujita, Toru; Konishi, Junji

2002-06-01

This study was done retrospectively to analyze the ultrasonographic (US) findings in thyroid scintigraphic hot areas (HA). Three-thousand, eight-hundred and thirty-nine consecutive patients who underwent 99mTc-pertechnetate (n = 3435) or 123I (n = 457) scintigraphy were analyzed. HA were regarded as present when the tracer concentration was greater than the remaining thyroid tissue, or when hemilobar uptake was observed. High-resolution US examinations were performed with a real-time electronic linear scanner with a 7.5 or 10 MHz transducer. One hundred and four (2.7%) were found to be scintigraphic HA (n = 120). US revealed a nodular lesion or well-demarcated thyroid tissue corresponding to the HA in 94 areas (78.4%, Category 1), an ill-defined region with different echogenicity in 13 areas (10.8%, Category 2), and no correlating lesion in 13 areas (10.8%, Category 3). These 104 patients included 43 with adenomatous goiter (59 areas), 33 with adenoma, 11 with Hashimoto's thyroiditis, 5 with primary thyroid cancer, 4 with euthyroid ophthalmic Graves' disease (EOG), 3 with hemilobar atrophy or hypogenesis, 2 with hemilobar agenesis, 2 with hypothyroidism with blocking-type TSH-receptor antibodies (TSHRAb), I with acute suppurative thyroiditis. Among the 59 adenomatous nodules and 33 adenomas, 51 (86.4%) and 32 (97.0%), respectively, belonged to Category 1. A solitary toxic nodule was significantly larger and occurs more often in older patients than in younger patients. On the other hand, all 17 patients with known autoimmune thyroid diseases including Hashimoto's thyroiditis, EOG and hypothyroidism with blocking TSHRAb belonged to Category 2 or 3. Possible underlying mechanisms are 1) hyperfunctioning tumors or nodules, 2) localized functioning thyroid tissue freed from autoimmune destruction, inflammation or tumor invasion, 3) congenital abnormality, 4) clusters of hyperactive follicular cells caused by long-term TSH and/or TSHRAb stimulation, 5) asymmetry, etc

Evaluation of thyroid nodules by 123I thyroid scintigraphy and computed tomography

International Nuclear Information System (INIS)

Kurihara, Yoshiko; Imanishi, Yoshimasa; Ehara, Norishige

1991-01-01

We have already reported that computed tomography (CT) could be used to quantify iodine concentration in the thyroid. Correlation between CT value and iodine concentration in thyroid tissues was represented by the following formula (n=31, r=0.96): iodine concentration=(CT value-65)/104 (mg/g). In this study, we evaluated thyroid nodules by 123 I thyroid scintigraphy and histograms of CT values in the nodules. Radioiodine accumulation and the histograms on CT of the thyroid nodules were correlated with the histopathology of 35 thyroid nodules (22 benign nodules, 13 malignant nodules) of 27 patients. Results showed no definite correlation between radioiodine accumulation in the thyroid nodule and the pattern on CT reflecting iodine concentration in the nodule. Some nodules with little radioiodine accumulation had considerable iodine concentration. Benign thyroid nodules tended to have lower iodine concentration than malignant nodules. Fifteen (94%) of 16 nodules showing only minimal iodine concentration were benign. We conclude that the function and/or differentiation of tumor cells in the thyroid nodule must be evaluated not only radioiodine accumulation in the nodule but also by iodine concentration in the nodule and that thyroid nodules with only minimal iodine concentration are most likely benign. (author)

Imaging of the thyroid in benign and malignant disease.

Science.gov (United States)

Intenzo, Charles M; Dam, Hung Q; Manzone, Timothy A; Kim, Sung M

2012-01-01

The thyroid gland was one of the first organs imaged in nuclear medicine, beginning in the 1940s. Thyroid scintigraphy is based on a specific phase or prelude to thyroid hormone synthesis, namely trapping of iodide or iodide analogues (ie, Tc99m pertechnetate), and in the case of radioactive iodine, eventual incorporation into thyroid hormone synthesis within the thyroid follicle. Moreover, thyroid scintigraphy is a reflection of the functional state of the gland, as well as the physiological state of any structure (ie, nodule) within the gland. Scintigraphy, therefore, provides information that anatomical imaging (ie, ultrasound, computed tomography [CT], magnetic resonance imaging) lacks. Thyroid scintigraphy plays an essential role in the management of patients with benign or malignant thyroid disease. In the former, the structure or architecture of the gland is best demonstrated by anatomical or cross-sectional imaging, such as ultrasound, CT, or even magnetic resonance imaging. The role of scintigraphy, however, is to display the functional state of the thyroid gland or that of a clinically palpable nodule within the gland. Such information is most useful in (1) patients with thyrotoxicosis, and (2) those patients whose thyroid nodules would not require tissue sampling if their nodules are hyperfunctioning. In neoplastic thyroid disease, thyroid scintigraphy is often standard of care for postthyroidectomy remnant evaluation and in subsequent thyroid cancer surveillance. Planar radioiodine imaging, in the form of the whole-body scan (WBS) and posttherapy scan (PTS), is a fundamental tool in differentiated thyroid cancer management. Continued controversy remains over the utility of WBS in a variety of patient risk groups and clinical scenarios. Proponents on both sides of the arguments compare WBS with PTS, thyroglobulin, and other imaging modalities with differing results. The paucity of large, randomized, prospective studies results in dependence on consensus

An Experimental Comparison of Two Different Technetium Source Activities Which Can Imitate Thyroid Scintigraphy in Case of Thyroid Toxic Nodule

OpenAIRE

Miftari, Ramë; Fejza, Ferki; Bicaj, Xhavit; Nura, Adem; Topciu, Valdete; Bajrami, Ismet

2014-01-01

Purpose: In cases of thyroid toxic autonomous nodule, anterior projection of Tc-99m pertechnetate image shows a hot nodule that occupies most, or the entire thyroid lobe with near-total or total suppression of the contra lateral lobe. In this case is very difficult to distinguish toxic nodule from lobe agenesis. Our interest was to estimate and determinate the rate of radioactivity when the source with high activity can make total suppression of the second source with low activity in same con...

Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie

Energy Technology Data Exchange (ETDEWEB)

Brandt-Mainz, K.; Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin Radionuk, Essen (Germany)

2008-09-15

Thyroid hypofunctional ('scintigraphic cool or cold') nodules are detected frequently. Dependent on the clinical situation, on morbidity and on economic aspects it is necessary to select patients for surgery and to avoid unnecessary surgical treatment. Therefore it is necessary to develop appropriate diagnostic algorithm to manage hypofunctional thyroid nodules. The ultrasound guided fine-needle aspiration cytology (FNA) is on the one hand side a useful diagnostic tool, but on the other hand side there exist certain limitations. It is questionable if the nodule is correctly reached. In case of heterogeneous larger mixed nodules or multiple hypofunctional nodules, it is difficult to choose the correct location of punctation. Furthermore a certain number of FNA's is not diagnostic without any result or due to 'follicular neoplasia'. {sup 99m}Tc-MIBI-sctintigraphy (MIBI) and {sup 18}F-FDG-positron-emission-tomography (FDG-PET) are established methods in the follow-up of differentiated thyroid cancer after thyroidectomy with elevated thyroglobulin-levels without adequate 131-Iodine-uptake. Moreover in case of parafollicular medullary thyroid carcinomas after thyroidectomy with elevated calcitonin-concentrations the FDG-PET is a valuable diagnostic method in localizing tumor. However these tracers gain in importance in differentiating malignant from benign preoperative hypofunctional nodules. In conclusion MIBI-scintigraphy should be used routinely to plan the correct guide of FNA. The application of both methods (MIBI and FNA) improves the differentiation of dignity, whereas a negative MIBI-examination and a negative FNA is able to exclude malignancy nearly. In this way the number of unnecessary numbers of surgical treatments can be reduced. FDG-PET is not definitely superior compared to MIBI-scintigraphy. From the cost perspective MIBI is more attractive than FDG-PET. (orig.)

Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study

International Nuclear Information System (INIS)

Bhatnagar, Aseem; Sawroop, Krishan; Chopra, M.K.; Sinha, Noaline; Kashyap, Ravi; Sarker, B.B.

2002-01-01

In the present study, we performed early blood pool scintigraphy with technetium-99m pertechnetate in 20 patients (10-180 days after frostbite injury; 71 clinical lesions) referred for a topical treatment protocol for mild to moderately severe frostbite, and in 22 asymptomatic controls. The aims of the study were to define the ''normal'' microcirculation of the hands and feet, to characterise the appearances of frostbite lesions on scintigraphy and correlate these with the clinical presentation, and to evaluate the usefulness of scintigraphy for assessing the treatment response. Six patients were ''fresh'', 12 had been undergoing conservative treatment (topical homeopathic) for several weeks and two had permanent fibrotic hand phalanges. Nine patients on treatment underwent serial scintigraphy a total of 22 times. Eleven patients were imaged only once, including the two with permanent fixed defects. Three distinct physiological microcirculation patterns were evident in control hands or feet: right- or left-handedness (seven subjects), subclinical inflammatory foci correlating with callosity or pressure points (36 lesions) and distinctly increased pooling of radiotracer at the thenar or hypothenar region (eight subjects). In frostbite patients, 128 lesions (48 inflammatory, 80 ischaemic) were seen on the scan. This number included all 71 lesions identified clinically, the rest being subclinical. Subclinical frostbite lesion as an entity has not been described previously. Microvasculature of normal muscle groups (in the hands, elbow or feet) was shown on scintigraphy to improve after topical treatment. The treatment resulted in improved or normalised perfusion scan in 25 of 45 ischaemic segments with matching clinical improvement, and reduction or normalisation of uptake in inflammatory lesions (n=30). The data confirm the vasodilator and anti-inflammatory action of the topical preparation, and the sensitivity of the radionuclide method in monitoring treatment

Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of 99mTc-pertechnetate: applicability to unifocal thyroid autonomy?

International Nuclear Information System (INIS)

Reinhardt, Michael J.; Joe, Alexius Y.; Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer; Wissmeyer, Michael; Juengling, Freimut D.; Krause, Thomas M.

2006-01-01

The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on 99m Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU s ) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1±10.3 years) with unifocal thyroid autonomy were treated at three different centres with 131 I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU s (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36±19% and 38±20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28±16%; p s can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study

Energy Technology Data Exchange (ETDEWEB)

Bhatnagar, Aseem; Sawroop, Krishan; Chopra, M.K.; Sinha, Noaline; Kashyap, Ravi [Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Delhi (India); Sarker, B.B. [Defence Institute of Physiology and Allied Sciences, Delhi (India)

2002-02-01

In the present study, we performed early blood pool scintigraphy with technetium-99m pertechnetate in 20 patients (10-180 days after frostbite injury; 71 clinical lesions) referred for a topical treatment protocol for mild to moderately severe frostbite, and in 22 asymptomatic controls. The aims of the study were to define the ''normal'' microcirculation of the hands and feet, to characterise the appearances of frostbite lesions on scintigraphy and correlate these with the clinical presentation, and to evaluate the usefulness of scintigraphy for assessing the treatment response. Six patients were ''fresh'', 12 had been undergoing conservative treatment (topical homeopathic) for several weeks and two had permanent fibrotic hand phalanges. Nine patients on treatment underwent serial scintigraphy a total of 22 times. Eleven patients were imaged only once, including the two with permanent fixed defects. Three distinct physiological microcirculation patterns were evident in control hands or feet: right- or left-handedness (seven subjects), subclinical inflammatory foci correlating with callosity or pressure points (36 lesions) and distinctly increased pooling of radiotracer at the thenar or hypothenar region (eight subjects). In frostbite patients, 128 lesions (48 inflammatory, 80 ischaemic) were seen on the scan. This number included all 71 lesions identified clinically, the rest being subclinical. Subclinical frostbite lesion as an entity has not been described previously. Microvasculature of normal muscle groups (in the hands, elbow or feet) was shown on scintigraphy to improve after topical treatment. The treatment resulted in improved or normalised perfusion scan in 25 of 45 ischaemic segments with matching clinical improvement, and reduction or normalisation of uptake in inflammatory lesions (n=30). The data confirm the vasodilator and anti-inflammatory action of the topical preparation, and the sensitivity of the

Positive thyroid cancer scintigraphy using technetium-99m methoxyisobutylisonitrile

International Nuclear Information System (INIS)

Nemec, J.; Nyvltova, O.; Blazek, T.; Vlcek, P.; Racek, P.; Novak, Z.; Preiningerova, M.; Hubackova, M.; Krizova, M.; Zimak, J.; Bilek, R.

1996-01-01

The aim of the study was to evaluate the possibility of detecting thyroid cancer recurrences without the need for withdrawal of thyroid suppressive treatment. Upper-body or whole-body scintigraphy was performed in a group of 200 patients evaluated for differentiated thyroid cancers in 1993 and 1994 using technetium-99m sestamibi. Scans were performed 20-30 min following i.v. administration of 500 MBq of 99m Tc-methoxyisobutylisonitrile (MIBI). Bone and lung metastases were detected with very high sensitivity and specificity, with a very high predictive value of negative results and a somewhat lower predictive value of positive results. The sensitivity and specificity of findings in the neck were lower but the predictive value of negative results was high. Whole-body scans with 99m Tc-MIBI are a useful tool in the follow-up of patients with differentiated thyroid cancer, for the detection of distant metastatic lesions. (orig.)

Preoperative localization of parathyroid adenomas by technetium and thallium double-labeling scintigraphy. Difficulties linked to associated thyroid lesions

International Nuclear Information System (INIS)

Valensi, P.; Attali, J.R.; Sebaoun, J.; Bedig, G.; Paycha, F.; Tellier, P.; Vulpillat, M.; Sarfati, E.; Dubost, C.

1989-01-01

Technetium and thallium double-labeling scintigraphy with image subtraction was carried out on 63 patients suspected of having primary hyperparathyroidism, with or without thyroid involvement. Forty-four patients had a normal thyroid image with technetium. The positive foci located by double-labeling in patients who were to undergo surgery always coincided with parathyroid adenoma. In the 16 cases where the initial diagnosis of hyperparathyroidism was not substantiated, the double-labeling test was normal. Thus for these 44 patients, scintigraphy sensitivity was 75% and specificity was 100%. Nineteen patients had an abnormal thyroid image with technetium. In 7 cases, image subtraction following double-labeling yielded uninterpretable data. In 12 other patients, the positive foci located outside the thyroid by double-labeling coincided with a parathyroid adenoma, whereas this was true for only one patient whose positive foci were located inside the thyroid; a parathyroid adenoma was not detected preoperatively in 4 patients. This double-labeling test is thus useful in locating parathyroid adenomas when technetium scintigraphy of the thyroid is normal; when it is abnormal, double-labeling is advantageous only in cases of extrathyroid foci [fr

Quantitative comparison of technetium-99m tetrofosmin and thallium-201 images of the thyroid and abnormal parathyroid glands

International Nuclear Information System (INIS)

Giordano, A.; Meduri, G.; Calcagni, M.L.; Marozzi, P.; Ficola, U.; Vaccaro, A.; Rubini, G.; Attard, M.; Li Puma, M.; Ricci, R.; Corsello, S.

1999-01-01

The aim of the study was to quantitatively compare the scintigraphic images of the thyroid and abnormal parathyroid glands obtained with technetium-99m tetrofosmin and thallium-201 in patients with hyperparathyroidism. Forty-six patients with hyperparathyroidism underwent 201 Tl (74 MBq), 99m Tc-pertechnetate (74 MBq) and 99m Tc-tetrofosmin (555-740 MBq) scintigraphy in a single session. Image analysis included the computation of the thyroid/background ratio in the whole study population and the parathyroid/background ratio, parathyroid/thyroid ratio and diagnostic sensitivity in 17 patients who underwent parathyroid surgery. The pertechnetate subtraction technique was used. 201 Tl and 99m Tc-tetrofosmin showed a similar thyroid/background ratio (1.79±0.41 and 1.81±0.47, respectively, P=NS); however, 99m Tc-tetrofosmin showed a higher parathyroid/background ratio than 201 Tl (2.06±0.54 vs 1.79± 0.50, P=0.007). Despite the superior quality of 99m Tc-tetrofosmin images, both tracers showed identical sensitivity in detecting enlarged parathyroid glands in patients with primary hyperparathyroidism (89%) and in those with secondary hyperparathyroidism (50%). (orig.)

Radioiodine therapy for Plummer's disease based on the thyroid uptake of technetium-99m pertechnetate

International Nuclear Information System (INIS)

Meller, J.; Wisheu, S.; Behe, M.; Gratz, S.; Becker, W.

2000-01-01

The aim of this retrospective study was the evaluation of a TcTUs (global technetium-99m pertechnetate thyroid uptake under suppression)-based approach in 370 patients with thyroid autonomy (Plummer's disease) treated by radioiodine therapy (RIT) under standardised conditions. The analysis included 370 patients (309 females, 61 males; mean age 64±11.6 years) treated for thyroid autonomy [unifocal (UFA), 36.8%; multifocal (MFA), 55.7%; disseminated (DISA), 7.6%]. During RIT all patients were under thyroid suppression (TSH 0.5 μU/l and/or TcTUs 4 μU/ml). A dose of 350-450 Gy to the autonomous tissue resulted in a success rate of 97% in the UFA group and 81% in the MFA/DISA group. Decrease in total thyroid volume and TcTUs did not differ significantly between successfully treated patients and patients with persistent autonomy. Multivariate analysis of all 370 patients identified four independent factors that negatively influenced the therapeutic success: high pretherapeutic thyroid volume (P=0.0001; odds ratio: 1.017), high pretherapeutic TcTUs values (P=0.0001; odds ratio: 1.378), multifocal/disseminated autonomy (P=0.0056; odds ratio: 3.245) and low target dose (P=0.017; odds ratio: 0.997). It is concluded that the high success rate in the treatment of UFA indicates the concept of TcTUs-based RIT to be valid, but that in the therapy of MFA/DISA the target se has to be corrected if the total thyroid volume exceeds a critical threshold. (orig.)

Accurately localizing the thyroid tissue in mature cystic teratoma of ovary by single-photon emission computerized tomography/computerized tomography

International Nuclear Information System (INIS)

Demir, Yusuf; Üçler, Rıfkı; Alkiş, İsmet; Bulut, Gülay

2015-01-01

A 30-year-old woman with hyperthyroidism was admitted to hospital. Although increased thyroid function was found, the gland was normal in ultrasonography (USG). Additionally, thyroid iodine uptake and Tc-99m pertechnetate scintigraphy was normal. Abdomen USG detected a cystic pelvic mass in left ovary. A whole-body scan was performed 48 hours after oral ingestion of 29.6 MBq (0.8 mCi) I-131 (iodine-131) revealed a round structure located to the left lower abdomen. Iodine uptake was detected in this cyst which was compatible with functional thyroid tissue demonstrated by SPECT/CT. The patient was underwent surgical operation and histopathology confirmed mature cystic teratoma. Accurate localization and depiction of thyroid tissue in ovary mass was provided with SPECT/CT

Dose selection for radioiodine therapy of borderline hyperthyroid patients according to thyroid uptake of {sup 99m}Tc-pertechnetate: applicability to unifocal thyroid autonomy?

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, Michael J.; Joe, Alexius Y. [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Biermann, Kim; Brockmann, Holger; Mallek, Dirk von; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Wissmeyer, Michael [Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland); Juengling, Freimut D.; Krause, Thomas M. [University Hospital Freiburg, Department of Nuclear Medicine, Hugstetter Str. 55, 79106 Freiburg (Germany); Inselspital Bern, Department of Nuclear Medicine, 3010 Bern (Switzerland)

2006-05-15

The aim of this study was to evaluate the feasibility of applying a previously described dose strategy based on {sup 99m}Tc-pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}) to radioiodine therapy for unifocal thyroid autonomy. A total of 425 consecutive patients (302 females, 123 males; age 63.1{+-}10.3 years) with unifocal thyroid autonomy were treated at three different centres with {sup 131}I, using Marinelli's formula for calculation of three different absorbed dose schedules: 100-300 Gy to the total thyroid volume according to the pre-treatment TcTU{sub s} (n=146), 300 Gy to the nodule volume (n=137) and 400 Gy to the nodule volume (n=142). Successful elimination of functional thyroid autonomy with either euthyroidism or hypothyroidism occurred at a mean of 12 months after radioiodine therapy in 94.5% of patients receiving 100-300 Gy to the thyroid volume, in 89.8% of patients receiving 300 Gy to the nodule volume and in 94.4% receiving 400 Gy to the nodule volume. Reduction in thyroid volume was highest for the 100-300 Gy per thyroid and 400 Gy per nodule strategies (36{+-}19% and 38{+-}20%, respectively) and significantly lower for the 300 Gy per nodule strategy (28{+-}16%; p<0.01). A dose strategy based on the TcTU{sub s} can be used independently of the scintigraphic pattern of functional autonomous tissue in the thyroid. (orig.)

Discordant Tl-201 and Tc-99m imaging in a patient with thyroid carcinoma and Hashimoto's disease

International Nuclear Information System (INIS)

Morita, S.; Ishibashi, M.; Hirayama, T.; Kumabe, T.; Ohtake, H.

1990-01-01

In a case of Hashimoto's disease complicated by thyroid gland cancer, the primary site of the cancer was visualized as a cold nodule on Tc-99m pertechnetate scintigraphy, as a warm nodule on Tl-201 early imaging, and as a hot nodule on Tl-201 delayed imaging. Generally, Tl-201 shows markedly diffuse accumulation in the lesions of Hashimoto's disease. The warm nodules observed on early scans suggested similar accumulation at the sites of Hashimoto's disease and thyroid cancer. The hot nodules on delayed imaging may be due to the difference in Tl-201 washout time between the sites of Hashimoto's disease and thyroid cancer. There was markedly increased Tl-201 accumulation in bilateral cervical metastatic lymph nodes on both early and delayed images

Clinical evaluation of joint scintigraphy in rheumatoid arthritis

International Nuclear Information System (INIS)

Shimabukuro, Kunisada; Sakata, Hiromichi; Shirono, Kazuo; Nakajo, Masataka; Shinohara, Shinji

1983-01-01

Pertechnetate (sup(99m)TcO 4 - ) joint scintigraphy was performed on 45 patients with rheumatoid arthritis, 3 with nonspecific arthritis and 6 normal subjects. 1) The sites of radioisotopic accumulation were generally in agreement with those of clinical involvement in rheumatoid arthritis. 2) By analysis of build-up curves in the wrist joint, tracer was found to be concentrated more rapidly in rheumatoid arthritis (T 1/2 = 0.67 min.) than in nonspecific arthritis (T 1/2 = 2.66 min.) 3) The degree of radioisotopic accumulation correlated well with the value of CRP and erythrocyte sedimentation rate. It could be cosidered that pertechnetate joint scintigraphy is useful for clinical evaluation of rheumatoid arthritis. (author)

Brain scintigraphy with Tc99-pertechnetate in the evaluation of patients with cerebrovascular lesions. The diagnostic value related to age of the lesion and to the size, type and localisation revealed by CT-scan

DEFF Research Database (Denmark)

Olsen, T S; Christensen, J; Skriver, E B

1983-01-01

Brain scintigraphy with Tc99-pertechnetate (Tc99-scan) was performed 4 times in 95 consecutive stroke patients: on average 5 days, 18 days, 103 days and 194 days after the stroke. The type (infarct, hematoma), size and localisation of the lesion was evaluated by CT-scan performed 3 times in all...

Papillært thyroideakarcinom med kraftig farvning for tyroperoxidase

DEFF Research Database (Denmark)

Nygaard, Birte; Frisch, T.; Kiss, K.

2008-01-01

Immunostaining for TPO (MoAb47) has been used to predict the risk of thyroid cancer in thyroid adenomas without uptake in thyroid 99m pertechnetate scintigraphy. This case describes a 16-year-old girl with thyroid papillary cancer staining 95% positive using TPO staining. The case indicates that ...

Selenomethionine scintigraphy in the diagnosis of cold thyroid nodules

International Nuclear Information System (INIS)

Rinaldi, Chantal.

1976-01-01

This work attempts to establish the value of a tumoral radiotracer for thyroid exploration: 75 Se-labelled methionine. The purpose of such a radioelement for US in scintigraphy is to allow the cold thyroid nodule diagnosis to be established before surgery, the extent of which depends on whether the nodule is benign or malignant. After a survey of present thyroid cancer diagnosis methods the different tumoral radiotracers are reviewed especially those used to diagnose thyroid neoformations. Selenomethionine appears as one of the most universal of these radiotracers since methionine is an essential amino acid involved in protein synthesis, which is accelerated inside tumour cells, while selenium itself in the form of certain salts possesses a known tropism for neoplastic tissues. The original feature of our study is the use of a method attempting to optimise the results by a more objective reading of the images. To this end we employed a scintillation camera for image acquisition and a data processing system to perform an electronic subtraction, on the thyroid image obtained with selenomethionine, of the thyroid image supplied by radioiodine. The method is nevertheless limited by the properties of the radiotracer used: its long physical and biological half-life is a contra-indication in patients under forty, the dose received by the gonads being relatively large [fr

A comparison of radionuclide thyroid angiography, 99mTc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules

International Nuclear Information System (INIS)

Demirel, Koray; Kapucu, Oezlem; Yuecel, Cem; Oezdemir, Hakan; Ayvaz, Goeksun; Taneri, Ferit

2003-01-01

We prospectively studied 43 patients with solitary cold thyroid nodules greater than 1.5 cm in diameter to determine the comparative diagnostic value of radionuclide thyroid angiography (RTA), technetium-99m methoxyisobutylisonitrile ( 99m Tc-MIBI) scintigraphy and power Doppler ultrasonography (PDUS) in the differentiation of benign and malignant thyroid nodules. Perfusion of the nodules in RTA was compared with the perfusion in the surrounding normal thyroid tissue and classified as follows: 0, avascular; 1, hypovascular; 2, isovascular; 3, hypervascular. 99m Tc-MIBI uptake in the nodules compared with that in surrounding thyroid tissue was scored for both early and delayed images as follows: 0, cold; 1, decreased; 2, equal; 3, increased. PDUS patterns were classified as nodule vascularisation patterns. The malignancy criteria were set as follows: hypervascular nodule with rapid washout in RTA; complex ring sign with anarchic structure or delta sign in PDUS, and positive retention and increased uptake in the nodule in the early and delayed 99m Tc-MIBI images. These data were compared with the histopathological results. Histology revealed thyroid carcinoma in nine patients (five cases of papillary carcinoma, three of follicular carcinoma and one of medullary carcinoma) and benign conditions in 34 patients (30 cases of nodular goitre, three of lymphocytic thyroiditis and one of follicular adenoma). Sensitivity, specificity and accuracy were, respectively, 0.89, 1.00 and 0.97 for RTA, 1.00, 0.76 and 0.81 for PDUS, and 0.67, 0.91 and 0.86 for 99m Tc-MIBI scintigraphy (when nodules with increased uptake in both the early and the delayed images and a positive retention index were considered as malignant). RTA, 99m Tc-MIBI scintigraphy and PDUS could be helpful in the preoperative assessment of solitary cold thyroid nodules. In this study, RTA was found to be the most accurate and specific method for differentiation of malignant from benign thyroid nodules. (orig.)

Morphological and dynamic studies of the accumulation of 123I and 99Tc sup (m) in the thyroid

International Nuclear Information System (INIS)

Cederquist, E.; Naversten, Y.; Persson, R.B.R.; Strand, S.E.

1975-05-01

This investigation was undertaken to compare the use of 131 I, 123 I and 99 Tc sup (m) for scintigraphic studies of the thyroid. 123 I has the most ideal physical and biological characteristics for this purpose. The detectability of 123 I with scintillation camera was found to be more than 200 times better than of 131 I in consideration of the absorbed dose to the patient. We have found that an activity of about 200μCi 123 I is enough for thyroid scintigraphy. This activity will give about the same count rate with the scintillation camera as when 2 mCi 99 Tc sup (m)-pertechnetate is used. Oblique scintillation camera views, which have been found to be of value especially when cold areas were present in the thyroid, can be performed with both 123 I and sup 99Tc sup (m). But when sup 99Tc sup (m) is used, a greater fraction of circulating activity is registered. After i.v. administration of 123 I or 99 Tc sup (m) -pertechnetate sequential scintigrams were registered over the thyroid and the aortic region with a scintillation camera. The activity time curves were analyzed and uptake parameters were evaluated with a computer. The initial trapping curve could thus be studied in patients with different thyroid disorders. (author)

Differential diagnosis of thyroid diseases with 131I and 201TlCl scintigraphy

International Nuclear Information System (INIS)

Kumano, Machiko; Ishida, Osamu

1979-01-01

Scintigraphic study with 131 I and 201 TlCl was performed on the differential diagnosis of various kinds of thyroid disease. When thyroid nodules are cold by scintigraphy with 131 I and hot with 201 TlCl, the lesions were proved to be solid tumor, that is, mostly follicular adenoma and carcinoma, and also most probably chronic thyroiditis. Accumulation of 201 TlCl, however, is not observed in cystic lesions, and is very high with high frequency in metastatic lesion of the lymph nodes as well as the thyroid cancer, especially in well differentiated follicular carcinoma. Therefore 201 TlCl was very useful to confirm the metastatic tumors from the thyroid cancer. These features in accumulation of 131 I and 201 TlCl in thyroid disease suggest the imaging technique with 201 TlCl combined with 131 I seem to provide more pathological information on the thyroid and metastatic lesions. (author)

Salivary gland scintigraphy using technetium-99m-pertechnetate after autotransplantation of the submandibular salivary gland in the correction of dry eye

International Nuclear Information System (INIS)

Lauer, I.; Baehre, M.; Richter, E.; Sieg, P.

1998-01-01

The aim of the study was to determine whether salivary gland scintigraphy using technetium-99m pertechnetate is suitable for checking the vitality and function after autotransplantation of the submandibular salivary gland in patients with dry eye syndrome. To this end, 56 scintigraphic studies in 20 patients have so far been performed. In addition, these scans were evaluated by a region of interest (ROI) technique in order to examine tracer uptake in the early and late stages after surgery. We have been able to prove that in this special respect, too, the salivary gland scintigraphy is suitable for assessing reliably the vitality and function of the transplanted gland. The secretion into the eye and thus the patency of the efferent duct can also be displayed. This proved to be particularly valuable in those cases in which at first no secretion could be seen in the clinical examination. In patients with uncertain excretory function, we were able to distinguish between non-vitality and lack of patency of the secretory duct. Using ROI evaluation, no significant decrease in the salivary function has been detected in long-term follow-up, now extending to 1 year after surgery. (orig.)

Performance of thyroid scintigraphy in the thyrotoxicosis etiological diagnosis: about 210 cases; Performance de la scintigraphie thyroidienne dans le diagnostic etiologique des thyrotoxicoses: a propos de 210 cas

Energy Technology Data Exchange (ETDEWEB)

Chatti, K.; Nouira, M.; Guezguez, M.; Sfar, R.; Essabbah, H. [CHU Sahloul, Service de medecine nucleaire, Sousse (Tunisia); Zantour, B. [CHU Mahdia, service d' endocrinologie (Tunisia)

2010-07-01

Purpose: The thyrotoxicosis is a syndrome linked to thyroid hormones excess grouping any causes leading to a overload in circulating hormones, including these ones linked to an inflammatory process (thyroiditis) or an exogenous contribution. The etiologic diagnosis is based on complementary examinations. The objective of our work is to elucidate the performance of scintigraphy in the etiologic diagnosis and the therapy approach of thyrotoxicosis through the experience of our service. Conclusions: Scintigraphy has a place in the etiologic diagnosis of thyrotoxicosis. it brings functional and morphological information and allows to guide the diagnostic and therapeutic approach. (N.C.)

A comparison of radionuclide thyroid angiography, {sup 99m}Tc-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules

Energy Technology Data Exchange (ETDEWEB)

Demirel, Koray; Kapucu, Oezlem [Department of Nuclear Medicine, Gazi University School of Medicine, Ankara (Turkey); Yuecel, Cem; Oezdemir, Hakan [Department of Radiology, Gazi University School of Medicine, Ankara (Turkey); Ayvaz, Goeksun [Department of Endocrinology and Metabolic Diseases, Gazi University School of Medicine, Ankara (Turkey); Taneri, Ferit [Department of Surgery, Gazi University School of Medicine, Ankara (Turkey)

2003-05-01

We prospectively studied 43 patients with solitary cold thyroid nodules greater than 1.5 cm in diameter to determine the comparative diagnostic value of radionuclide thyroid angiography (RTA), technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc-MIBI) scintigraphy and power Doppler ultrasonography (PDUS) in the differentiation of benign and malignant thyroid nodules. Perfusion of the nodules in RTA was compared with the perfusion in the surrounding normal thyroid tissue and classified as follows: 0, avascular; 1, hypovascular; 2, isovascular; 3, hypervascular. {sup 99m}Tc-MIBI uptake in the nodules compared with that in surrounding thyroid tissue was scored for both early and delayed images as follows: 0, cold; 1, decreased; 2, equal; 3, increased. PDUS patterns were classified as nodule vascularisation patterns. The malignancy criteria were set as follows: hypervascular nodule with rapid washout in RTA; complex ring sign with anarchic structure or delta sign in PDUS, and positive retention and increased uptake in the nodule in the early and delayed {sup 99m}Tc-MIBI images. These data were compared with the histopathological results. Histology revealed thyroid carcinoma in nine patients (five cases of papillary carcinoma, three of follicular carcinoma and one of medullary carcinoma) and benign conditions in 34 patients (30 cases of nodular goitre, three of lymphocytic thyroiditis and one of follicular adenoma). Sensitivity, specificity and accuracy were, respectively, 0.89, 1.00 and 0.97 for RTA, 1.00, 0.76 and 0.81 for PDUS, and 0.67, 0.91 and 0.86 for {sup 99m}Tc-MIBI scintigraphy (when nodules with increased uptake in both the early and the delayed images and a positive retention index were considered as malignant). RTA, {sup 99m}Tc-MIBI scintigraphy and PDUS could be helpful in the preoperative assessment of solitary cold thyroid nodules. In this study, RTA was found to be the most accurate and specific method for differentiation of malignant from benign

Comparison of radionuclide thyroid angiography, Tc-99m-MIBI scintigraphy and power Doppler ultrasonography in the differential diagnosis of solitary cold thyroid nodules

International Nuclear Information System (INIS)

Kapucu, L.O.; Demirel, K.; Unlu, M.; Yucel, C.; Ozdemir, H.; Ayvaz, G.; Taneri, F.

2002-01-01

.55, PD pattern B2 and/or C and MIBI score 3 (for both early and delayed images) with positive retention index value were 100%, 78% and 91%, respectively. The sensitivities of RTA, PD, MIBI were 89%, 100%, 63%, respectively. Accuracy of RTA was significantly higher than that of the other modalities (RTA; kappa=0.933, PD; kappa=0.517, MIBI; kappa=0.539). Conclusion: RTA was found to be superior to MIBI scintigraphy and PD in differentiating benign from malignant thyroid nodules. We suggest a combination of dynamic perfusion imaging and Tc-99m-pertechnetate scan as a routine diagnostic approach to cold thyroid nodules

Hürthle cell tumor dwelling in hot thyroid nodules: preoperative detection with technetium-99m-MIBI dual-phase scintigraphy.

Science.gov (United States)

Vattimo, A; Bertelli, P; Cintorino, M; Burroni, L; Volterrani, D; Vella, A; Lazzi, S

1998-05-01

Single injection dual-phase scintigraphy (early and late acquisitions) with 99mTc-MIBI was used to differentiate benign and malignant hot thyroid nodules. Thirteen euthyroid and two hyperthyroid patients displaying a hot thyroid nodule on the 99mTc scan due to an autonomously functioning thyroid nodule (AFTN) underwent early (15-30 min) and late (3-4 hr) thyroid scintigraphy after the administration of 740-1000 MBq 99mTc-MIBI. Visual scoring was done to assess nodular tracer uptake and retention. In addition, the nodular-to-thyroid (N/T) uptake ratio in the early and late image and the washout rates (WO) from the nodule and thyroidal tissue were measured. All patients underwent thyroid surgery. Histopathology revealed a Hürthle cell tumor in three nodules, a benign adenoma with oxyphilic metaplasia in two nodules and a benign adenoma without oxyphilic cells in the remaining 10 nodules. The Hürthle cell tumor nodules displayed intense and persistent uptake of 99mTc-MIBI (N/T was 2.81 +/- 0.52 and 5.53 +/- 1.06 in early and late images, respectively; WO from the nodule was 12.33 +/- 0.47, WO from the thyroidal tissue was 22.00 +/- 3.56). The benign nodules showed intense uptake in the early image and intense uptake to absent retention in the late image (N/T was 2.94 +/- 1.31 and 1.62 +/- 0.50 in the early and late images, respectively; WO from the nodule was 20.25 +/- 2.92, WO from the thyroidal tissue was 20.33 +/- 2.92). Single injection dual-phase 99mTc-MIBI scintigraphy of the thyroid with AFTN can identify nodules as a result of the activity of a Hürthle cell tumor, since these tumors cause intense and persistent tracer uptake in contrast with a benign AFTN.

Radionuclide method for functional and structural examination of the thyroid gland

International Nuclear Information System (INIS)

Mladenov, K.

2009-01-01

Full text: The aim of this study is development and routine daily practice of the radionuclide method for tracking of the thyroid gland functional status and structure. 168 patients with various thyroid diseases were examined. Nuclear medicine examination is held by gamma camera (Siemens and ADAK). 74 MBq 99m Tc-pertechnetate is injected intravenous. The activity of full and empty syringe is measured. Static scintigrams of full and empty syringes and injection place and duration 10 seconds are carried out. On 20 th minute a static scintigraphy of the thyroid gland with a duration of 300 seconds in front position is held. The individual dose calibration factor is calculated. The functional status of thyroid gland as well as its structural changes is determined. In addition, the relationships between the accumulation of radiopharmaceutical in the salivary glands and thyroid are determined. 168 patients are studied, 97 of them are with euthyroidism, 71 with hyperthyroidism and 19 - with hypothyroidism. The nuclear medicine diagnostic method provides information about functional and structural condition of the thyroid gland. The study is determining for decision to conduct the metabolic brachytherapy of hyperthyroid conditions

Graves' disease in an adolescent with dual congenital ectopia and no orthotopic thyroid gland identified by Tc-99m-pertechnetate SPET/CT imaging.

Science.gov (United States)

Qiu, Zhong-Ling; Xue, Yan-Li; Shen, Chen-Tian; Zhu, Rui-Sen; Luo, Quan-Yong

2013-01-01

This is the first case of Graves' disease in an adolescent with lingual and prelaryngeal dual congenital ectopia and no orthotopic thyroid gland identified by technetium-99m-pertechnetate (99mTcO-4) SPET/CT imaging in a 15 years old boy. After 8 weeks treatment with methimazole, Graves' disease subsided. Fine needle aspiration cytology of the mass revealed the normal colloid and normal follicular cells without an atypia or lymphoid elements, suggesting a benign ectopic thyroid gland. In conclusion, there is no report in the literature with DETT lingual and prelaryngeal absence of orthotopic thyroid tissue and Graves' disease as in our case. This case also highlights the potential ascendancy of 99mTcO-4 SPET/CT in diagnosing the DETT.

Salivary scintigraphy

International Nuclear Information System (INIS)

Sabri, P.J.

1988-01-01

Salivary gland scintigraphy with technetium 99m ( 99m Tc) in the form pertechnetate ion is a relatively simple procedure, which can provide a unique and sensitive means for investigating salivary gland physiologic function and its derangements. However, salivary scintigraphy is poorly suited for the detection and characterization of masses in and around the salivary glands. Computed tomography (CT) has, therefore, largely supplanted scintigraphy for the evaluation of masses and is the method of choice because it can provide exquisite anatomic detail. Consequently, CT is more sensitive for mass detection and can also provide useful information as to whether a mass has arisen from within or from outside of a salivary gland or whether a mass is circumscribed or invasive. It also can disclose the relationship of the mass to the facial nerve and occasionally can provide histologic characterization of such masses as cysts, lipomas, and masseter muscle hypertrophy

Contribution of scintigraphy for somatostatin receptors in case of non-iodine-fixating metastases of thyroid epithelioma

International Nuclear Information System (INIS)

Couty, H.; Andrieu, J.M.; Baudet, L.; Faurous, P.; Artus, J.C.; Jaffiol, C.

1997-01-01

The objective of this work was to evaluate the sensitivity and importance of scintigraphy of somatostatin receptors (SSR) in the detection of non iodine-fixating metastases of thyroid epithelioma. We have studied retrospectively 7 patients with a detectable thyroglobulin under hormonal hindrance, amounting after cessation of treatment up to 72 - 1500 μ g/l and a normal post-irradiation therapy (3.7 GBq of 131 I) scintigraphy. These patients (4 F / 3 M), aged from 27 to 74 years (average age, 54 years), were treated by total and ganglionic curettage for papillary cancer of thyroid. Their evolutive surveillance extended from 1 to 24 years (on average, 8.4 years) and they received curative cumulated 131 I activities of 13 to 26 GBq. Each of them benefited by an osseous scintigraphy, of a cervico-thoraco-abdominal TDM and of a 111 In Pentetreotide SSR. The SSR was positive for 4/7 patients showing cervico-mediastinal fixations, the localizations being not detected by TDM. The osseous scintigraphy revealed once to be positive showing a costal lesion already detected by SSR. Cervical non-palpable adenopathies were detected by TDM for one patient. The anatomical-pathological analysis confirmed their thyroid origin. For other two patients the TDM showed suspect pulmonary nodules. These cervical and pulmonary localization were not detected by SSR. The SSR + TDM couple was positive for 6/7 patients. In conclusion, in this series the sensitivity of SSR was estimated to be 57%. Besides, the results obtained showed a net complementarity between the detection performances of SSR and TDM

Comparison of 99Tcm(V)-DMSA and 99Tcm-MIBI scintigraphy in medullary thyroid carcinoma

International Nuclear Information System (INIS)

Deng Bo; Xiao Huan; Chen Xiaofeng; Chen Huaming

2004-01-01

SPECT scintigraphy is used in 62 patients with medullary thyroid carcinoma (MTC), which are divided into two groups: 32 patients by 99 Tc m (V)-DMSA and 30 patients by 99 Tc m -MIBI. The qualitative analysis and half quantitative analysis are performed to the early and delayed images. Comparing the results with two groups, there is no difference in the masculine rate of MTC primary focus, but the results of 99 Tc m (V)-DMSA scintigraphy is obviously larger than 99 Tc m -MIBI by half quantitative analysis. The results show that the 99 Tc m (V)-DMSA scintigraphy is more predominant than the 99 Tc m -(V)-DMSA scintigraphy may be superior to 99 Tc m -MIBI in MTC primary focus and metastasis focus before surging for MTC patients. (authors)

Technetium 99m pertechnetate scans in congenital hypothyroidism

International Nuclear Information System (INIS)

Bauman, R.A.; Bode, H.H.; Hayek, A.; Crawford, J.D.

1976-01-01

Goiters are rarely palpable in infants with congenital hypothyroidism except in the case of maternal ingestion of iodide. The presence or absence of glandular tissue is, however, important for genetic and prognostic counseling and for acceleration of diagnosis in other affected siblings. The detection of thyroid tissue by /sup 99m/Tc pertechnetate scans in a significant number of our patients heretofore considered athyreotic establishes that physical findings and traditional laboratory data are not adequate to determine whether or not thyroid tissue is present

Somatostatin receptor scintigraphy to predict the clinical evolution and therapeutic response of thyroid-associated ophthalmopathy

Energy Technology Data Exchange (ETDEWEB)

Nocaudie, M.; Bailliez, A.; Itti, E. [Centre Hospitalier Regional et Universitaire, Lille (France). Service Central de Medecine Nucleaire et Imagerie Fonctionnelle; Bauters, C.; Wemeau, J.L. [Clinique d`Endocrinologie, Centre Hospitalier Regional et Universitaire de Lille (France); Marchandise, X.

1999-05-01

Management of thyroid-associated ophthalmopathy remains a topic of controversy. Immunosuppressive treatments have to be applied at peak disease activity and before criteria of severity develop. Expression of somatostatin receptors on activated lymphocytes allows scintigraphic imaging with indium-111 pentetreotide. We conducted a prospective study with 17 patients who presented severe ophthalmopathy (11 Graves` disease, four Hashimoto`s thyroiditis, two isolated in appearance: Means` syndrome). Each patient underwent hormonal (free T{sub 3} and TSH) and immunological (TBII) assessment, an orbital computed tomography scan or magnetic resonance imaging, a visual functional examination and {sup 111}In-pentetreotide orbital scintigraphy before undergoing treatment by steroids and/or radiotherapy, independently of scintigraphic results. At 4 and 24 h after the intravenous injection of 111 MBq of {sup 111}In-pentetreotide, planar imaging centred on the head and neck (anterior and both lateral views) was carried out. Retrobulbar uptake was assessed by visual semi-quantitative analysis (score given by two independent trained observers) and by quantitative analyses (regions of interest, orbit/brain uptake indices). Patients were ophthalmologically followed up for 6 months and then classified as improved or not. Visual semi-quantitative analysis of 4-h/24-h planar images was correlated with the ophthalmological evolution ({chi}{sup 2} test, P<0.01). All ten patients in whom scintigraphy was considered positive were clinically improved at 6 months, and of the seven patients in whom scintigraphy was negative, six were not improved. Nevertheless, objective quantitative analysis did not succeed in confirming these results. We conclude that {sup 111}In-pentetreotide scintigraphy requires further developments, including quantitative single-photon emission tomographic acquisition, if its role as a guide to therapeutic strategy in thyroid-associated ophthalmopathy is to be confirmed

Interest of the thyroid scintigraphy in the hypothyroidism of children affected by Downs Syndrome; Interet de la scintigraphie thyroidienne dans l'hypothyroidie des enfants atteints de trisomie 21

Energy Technology Data Exchange (ETDEWEB)

Krimi, S.; Slim, I.; Yeddes, I.; El Ajmi, W.; Rmadi, S.; Ltaief, B.; Mhiri, A.; Ben Slimene, M.F. [Service de medecine nucleaire, institut Salah Azeiz, Tunis, (Tunisia)

2009-05-15

The corrected hypothyroidism for the trisomic children can have diverse etiologies. the thyroid scintigraphy allows to precise the stage of the thyroiditis in case of auto-immune disease and to comfort the hypothesis of the hypothalamus-hypophysis axis immaturity in the case of negative immunological evaluation. (N.C.)

The potential value of somatostatin receptor scintigraphy in medullary thyroid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Doerr, U.; Bihl, H. (Katharinenhospital, Stuttgart (Germany). Dept. of Nuclear Medicine); Frank-Raue, K.; Raue, F. (Heidelberg Univ. (Germany). Dept. of Internal Medicine); Sautter-Bihl, M.L.; Buhr, H.J. (Staedt. Klinikum, Karlsruhe (Germany). Dept. of Radiooncology and Nuclear Medicine); Guzman, G. (Katherinenhospital, Stuttgart (Germany). Dept. of Nuclear Medicine Inst. de Neurocirugia, Investigationes Cerebrales ' Dr Asenjo' Santiago (Chile). Dept. de Medicina Nuclear)

1993-06-01

In a prospective study, ten patients with recurrent medullary thyroid carcinoma (markedly elevated calcitonin levels) were investigated by means of somatostatin receptor scintigraphy (SRS) with [sup 111]In-pentetreotide. Scintigraphically, 30 sites of pathological uptake were found, mostly located in the neck and upper mediastinum. So far, 18 suspected tumour sites underwent histological examination and 14 of them could be verified as metastases of medullary thyroid carcinoma (MTC). The remaining four putative tumour lesions turned out to be false positive scintigraphic findings caused by chronic inflammation and somatostatin receptor positive tumours other than MTC. We conclude that SRS is a promising imaging modality for localization of MTC recurrence and may thus make a contribution to better management of this patient group. (Author).

The potential value of somatostatin receptor scintigraphy in medullary thyroid carcinoma

International Nuclear Information System (INIS)

Doerr, U.; Bihl, H.; Frank-Raue, K.; Raue, F.; Sautter-Bihl, M.L.; Buhr, H.J.; Guzman, G.; Inst. de Neurocirugia, Investigationes Cerebrales 'Dr Asenjo' Santiago

1993-01-01

In a prospective study, ten patients with recurrent medullary thyroid carcinoma (markedly elevated calcitonin levels) were investigated by means of somatostatin receptor scintigraphy (SRS) with 111 In-pentetreotide. Scintigraphically, 30 sites of pathological uptake were found, mostly located in the neck and upper mediastinum. So far, 18 suspected tumour sites underwent histological examination and 14 of them could be verified as metastases of medullary thyroid carcinoma (MTC). The remaining four putative tumour lesions turned out to be false positive scintigraphic findings caused by chronic inflammation and somatostatin receptor positive tumours other than MTC. We conclude that SRS is a promising imaging modality for localization of MTC recurrence and may thus make a contribution to better management of this patient group. (Author)

Achalasia diagnosed by 99mTc pertechnetate scintigraphy

International Nuclear Information System (INIS)

Mikosch, P.; Gallowitsch, H.J.; Kresnik, E.; Lind, P.

1997-01-01

A 73-year-old patient presented a 99m Tc scintiscan with a focal tracer accumulation left and caudal of the thyroid gland. Further investigations with sonography, CT, esophagoscopy and barium swallow provided the diagnosis of achalasia as the reason for focal 99m Tc retention caudal of the thyroid gland. Explanation for 99m Tc accumulation within the esophagus may be the nonspecific accumulation of 99m Tc not only in the thyroid gland but also in the salivary glands. Excretion of the tracer follows with the saliva. Structural and motor disorders of the esophagus can thus lead to focal tracer retention within the esophagus simulating thyroid tissue. (orig.) [de

Clinical need for both scintigraphy with technetium-99m GSA and per-rectal portal scintigraphy in some patients with chronic liver disease

Energy Technology Data Exchange (ETDEWEB)

Shiomi, Susumu; Iwata, Yoshinori; Sasaki, Nobumitsu [Osaka City Univ. (Japan). Medical School] (and others)

1999-08-01

Scintigraphy with {sup 99m}Tc-diethylenetriaminepentaacetate with galactosyl human serum albumin ({sup 99m}Tc-GSA) and per-rectal portal scintigraphy are useful for evaluating hepatic functional reserve and portal circulation, respectively. We did the procedures simultaneously in some patients to examine the relationship between hepatic functional reserve and portal circulation in chronic liver disease. Scintigraphy with {sup 99m}Tc-GSA was done in 10 healthy subjects, 45 patients with chronic hepatitis, and 165 patients with cirrhosis. Fifty-seven patients (13 with hepatitis and 44 with cirrhosis) also underwent per-rectal portal scintigraphy with {sup 99m}Tc-pertechnetate within two weeks. A receptor index was calculated by dividing the radioactivity of the liver region of interest (ROI) by that of the liver-plus-heart ROI at 15 min after the injection of {sup 99m}Tc-GSA. The index of blood clearance was calculated by dividing the radioactivity of the heart ROI at 15 min by that of the heart ROI at 3 min. A solution containing {sup 99m}Tc-pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. A per-rectal portal shunt index was determined by calculating the ratio of counts for the liver to counts for the heart integrated for 24 seconds immediately after the appearance of the liver time-activity curve. The median receptor index was lower for more severe liver disorders, increasing in the order of chronic hepatitis, compensated cirrhosis and decompensated cirrhosis, and the median index of blood clearance was higher. The median receptor index was significantly lower when a complication (varices, ascites, or encephalopathy) was present, and the median index of blood clearance was higher. The shunt index was correlated significantly with the two other indices, but these values for some one-third of the patients disagreed in either indices. Scintigraphy with {sup 99m

Radiopharmaceuticals for thyroid imaging: a review

International Nuclear Information System (INIS)

Nishiyama, H.

1979-01-01

A review of radiopharmaceuticals which have been used for thyroid imaging was made with special emphasis on palpable thyroid nodules. An attempt was made to evaluate cold nodules derived from imaging methods using radioiodine or Tc-99m pertechnetate, followed by a successive application of another radiopharmaceutical. An attempt was also made to understand the patho-physiology of various thyroid disorders. The latter was based on the accumulated cases with discordant images between radioiodine and Tc-99m pertechnetate, and also on the iodine content within the gland by means of fluorescent techniques. Better radiopharmaceuticals are anxiously awaited in order to realize the distinction between benign and malignant thyroid disorders at the preoperative decision-making stage

Follicular thyroid carcinoma masquerading as subacute thyroiditis diagnosis using ultrasonography and radionuclide thyroid angiography

International Nuclear Information System (INIS)

Prakash, R.; Jayaram, G.

1991-01-01

The rare presentation of a follicular thyroid carcinoma mimicking the clinical and radionuclide features of subacute thyroiditis is described. Granulomatous thyroiditis was initially suspected on the clinical basis. Repeat fine needle aspiration cytology was suggestive of acinar proliferation with hyperfunction. Ultrasonography revealed a solid nodule with a peripheral sonolucent halo. Radionuclide angiography showed intense arterial flow of Tc-99m pertechnetate through the right lobe thyroid enlargement suggestive of malignant thyroid pathology. Surgical excision and histopathological examination revealed a follicular carcinoma involving the right lobe. 31 refs., 4 figs

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

Science.gov (United States)

Lumachi, F; Marzola, M C; Zucchetta, P; Tregnaghi, A; Cecchin, D; Bui, F

2003-09-01

A series of 112 consecutive patients with primary hyperparathyroidism who underwent both high-resolution neck ultrasonography (US) and 99mTc-sestamibi/99mTc-pertechnetate subtraction scintigraphy (SS) prior to successful parathyroidectomy was reviewed. There were 29 (25.9%) men and 83 (74.1%) women, with a median age of 58 years (range 13-78 years). Patients were divided into two groups, according to the preoperative US findings: group A (87 patients, 77.7%) without thyroid diseases, and group B (25 patients, 22.3%) with either multinodular goitre or a solitary nontoxic thyroid nodule. In group B patients partial or total thyroidectomy was also performed, according to the intraoperative findings and frozen-section examination results. Final histopathology showed 99 (88.4%) solitary parathyroid (PT) adenomas and 3 (2.7%) PT carcinomas, while 10 (8.9%) patients had a multiglandular disease. The sensitivity and positive predictive value (PPV) were (group A vs group B) 79.8% vs 70.8% (P=0.25) and 95.7% vs 94.4% (P=0.58) for US, and 83.3% vs 87.0% (P=0.47) and 95.9% vs 90.9% (P=0.32) for SS respectively. Better but similar (P=not significant) results were obtained in patients with solitary PT tumours: 81.5% vs 77.8% (US) and 85.0 vs 94.1% (SS) sensitivity; 97.1% vs 93.3% (US) and 95.8% vs 88.9% (SS) PPV. Overall, the combination of US and SS was 92.9% sensitive (group A=93.1%, group B=92.0%; P=0.55), and the PPV reached 100% in each group. In conclusion, in patients with primary hyperparathyroidism the results of both US and SS are independent of coexistent thyroid disease, especially in patients with solitary PT tumours.

Usefulness of per-rectal portal scintigraphy with Tc-99m pertechnetate for galactosemia in infants

Energy Technology Data Exchange (ETDEWEB)

Shiomi, Susumu; Sasaki, Nobumitsu; Ikeoka, Naoko; Kuroki, Tetsuo; Okano, Yoshiyuki; Kawabe, Joji; Ochi, Hironobu [Osaka City Univ. (Japan). Medical School

1998-12-01

Galactosemia discovered by newborn screening is rarely caused by enzyme deficiency. It has recently been reported that among patients without enzyme deficiency portosystemic shunting may be a cause of galactosemia in some patients. We did per-rectal portal scintigraphy in patients with such galactosemia detected during screening of newborns to examine the usefulness of this method for the diagnosis of portosystemic shunts via the inferior mesenteric vein. The subjects were eight neonates with galactosemia without enzyme deficiency detected during screening. A solution containing technetium-99m pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. The per-rectal portal shunt index was determined by calculating the ratio for counts of the liver to counts for the heart integrated for 24 seconds immediately after the appearance of the liver time-activity curve. A portosystemic shunt was detected in both of the patients with a shunt index of 30% or more, but not in the six patients with a shunt index less than 30%. The blood galactose levels of these six patients later entered the reference range. This method is noninvasive and there is little exposure to the radionuclide. It seemed to be useful for the diagnosis of portosystemic shunt in newborns with galactosemia without enzyme deficiency. (author)

Quantitative thyroid scintigraphy for the differentiation of Graves' disease and hyperthyroid autoimmune thyroiditis

Energy Technology Data Exchange (ETDEWEB)

Sahlmann, C.O.; Siefker, U.; Lehmann, K.; Harms, E.; Conrad, M.; Meller, J. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

2004-08-01

The purpose of this study is the evaluation of the TCTUs in the differentiation between AIT and GD in patients with hyperthyroidism. Methods: We determined the TCTUs in 59 patients with untreated hyperthyroid GD and in 51 patients with AIT who had subclinical or manifest hyperthyroidism without medication. Patients with GD were characterized by the presence of hyperthyroidism, decreased echogenicity of the thyroid, elevation of TSH-receptor autoantibodies (TRAb). AIT was defined by a decreased echogenicity of the thyroid, absence of elevated TSH-receptor autoantibodies (TRAb), autoantibodies against the thyroid peroxidase (anti-TPO) and spontaneous remission or development of subclinical hypothyroidism within 3 months. Results: Thyroid volumes of patients with AIT were significantly lower than those of patients with GD (p<0.05). TRAb levels were significantly higher in GD-patients (median: 19.5 U/ml; range: 15.3-35 U/ml) than in AIT-patients (median: 1.3 U/ml; range: 0-4.1 U/ml). 73% (38/59) of patients with GD had elevated anti-TPO levels. In these patients anti-TPO levels (median: 768 U/l; range: 83-6397 U/l) were not significantly different from anti-TPO levels of patients with AIT (median: 834 U/l; range: 107-8675 U/l; p=0.17). TCTUs values of patients with AIT were significantly lower (p<0.05; median: 0.9%; range: 0.1-3.2%) than those of patients with GD (median: 5.7%; range: 1.9-28.3%). Conclusion: In our patients quantitative thyroid scintigraphy with {sup 99m}TcO{sub 4}{sup -} offered rapid and reliable differentiation between hyperthyroid GD and AIT. (orig.)

Somatostatin receptor scintigraphy using (99m)Tc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma

NARCIS (Netherlands)

Czepczynski, Rafal; Parisella, Maria Gemma; Kosowicz, Jerzy; Mikolajczak, Renata; Ziemnicka, Katarzyna; Gryczynska, Maria; Sowinski, Jerzy; Signore, Alberto

2007-01-01

Purpose Several new somatostatin analogues have been developed for the diagnosis and therapy of different tumours. Since somatostatin receptors are often over-expressed in medullary thyroid carcinoma (MTC), the aim of our study was to evaluate the utility of scintigraphy with the somatostatin

Analysis of the factors associated with Tc-99m pertechnetate uptake in thyrotoxicosis and Graves' disease

International Nuclear Information System (INIS)

Kidokoro-kunii, Yo; Emoto, Naoya; Cho, Keiichi; Oikawa, Shinichi

2006-01-01

To determine the factors associated with 20 minute Tc-99m pertechnetate thyroid uptake, we examined all patients in whom thyrotoxicosis was diagnosed at Chiba-Hokusoh Hospital, Nippon Medical School from 2001 April through 2003 March. Patients with thyrotoxicosis diagnosed during this period were 57 with Graves' disease (76%), 11 with transient hyperthyroxinemia (TH) (14.7%), and 7 with subacute thyroiditis (SAT) (9.3%). The uptake of Tc-99m ranged from 0.97% to 40.1% in Graves' disease and from 0.15% to 0.8% in TH. Although TH may include spontaneous resolution of Graves' disease as well as painless thyroiditis, no treatment was necessary for these patients. Uptake in all patients with SAT was less than 0.5%. There were significant correlations between the level of Tc-99m uptake and the levels of free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH)-binding inhibitory immunoglobulin (TBII), and thyroid stimulating antibody (TSAb) in patients with Graves' disease. Older patients with Graves' disease showed lower uptake than did younger patients. Both Tc-99m pertechnetate uptake and TBII levels, but not fT3, fT4 or TSAb levels, at the beginning of antithyroid drug treatment correlated significantly with the duration of treatment until the daily dose of methimazole reached 5 mg. These data suggest that Tc-99m pertechnetate uptake reflects the severity of Graves' disease and its response to the medical treatment and that antithyroid drug therapy is not necessary when the uptake is less than 0.9%. (author)

Excretory function of salivary gland during static salivary scintigraphy using technetium-99m pertechnetate: a correlation study with salivary flow rate in sjogrens syndrome

International Nuclear Information System (INIS)

Jang, S. J.; Lee, W. W.; Lee, Y. J.; So, Y.; Jeong, J. G.; Lee, M. C.; Kim, S. E.

2005-01-01

Salivary scintigraphy is useful in the evaluation of xerostomia. To identify the relevant and clinically applicable parameter for the evaluation of xerostomia, we performed static salivary scintigraphy using Tc-99m and compared it with salivary flow rate in patients with xerostomia. Twenty-three female patients (age 51.2±10.4 years) who suffered from xerostomia were investigated. Nine patients were classified as Sjogrens syndrome (SS) by clinical criteria, and 14 patients were classified as non-Sjogrens syndrome. Un-stimulated salivary flow rate and simulated salivary flow rate were checked. Salivary scintigraphy was performed with injection of 25 mCi Tc-99m pertechnetate after injection anterior static image was obtained over face as basal uptake. ROIs were drawn over each salivary gland with background subtraction by square ROI drawn over skull. We used the mean data of right and left salivary glands for analysis. Percent excretion of salivary gland was calculated. Un-stimulated salivary flow rates(SFR) were different between groups (p 0.05): 5.88±4.07 ml/15 min in SS, and 10.31±6.49 ml/15 min in non-SS. The uptake value in submandibular gland revealed significant difference between the groups. The percent excretion of submandibular gland had positive correlation with un-stimulated salivary flow rate (r=0.534, p=0.009), and that of parotid gland was also positive correlation (r=0.437, p=0.037). The result of multiple regression analysis revealed only percent excretion of submandibular gland was single determinant of unstimulated SFR. Percent excretion of submandibular gland had positive correlation with un-stimulated SFR. Thus, excretory function of submandibular gland assessed by salivary scintigraphy appears more related with xerostomia than parotid gland

Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma.

Science.gov (United States)

Czepczyński, Rafał; Parisella, Maria Gemma; Kosowicz, Jerzy; Mikołajczak, Renata; Ziemnicka, Katarzyna; Gryczyńska, Maria; Sowiński, Jerzy; Signore, Alberto

2007-10-01

Several new somatostatin analogues have been developed for the diagnosis and therapy of different tumours. Since somatostatin receptors are often over-expressed in medullary thyroid carcinoma (MTC), the aim of our study was to evaluate the utility of scintigraphy with the somatostatin analogue (99m)Tc-EDDA/HYNIC-TOC in MTC in comparison with other diagnostic techniques. Forty-five patients with MTC, aged 14-83 years, were investigated. Scintigraphy using (99m)Tc-EDDA/HYNIC-TOC (Tektrotyd) was performed 2 and 4 h post injection of 740 MBq (20 mCi) of the tracer. Other imaging techniques were also applied and analysed in individual cases (ultrasonography, computed tomography, (99m)Tc(V)-DMSA, (131)I-MIBG, (99m)Tc-MDP, (111)In-DTPA-octreotide and (18)F-FDG-PET) and compared with (99m)Tc-EDDA/HYNIC-TOC. In group 1 (eight patients before thyroidectomy), uptake of the tracer was found in the primary tumours. In group 2 (six patients with remission), a false positive result was found in one patient; in the remaining five patients, no pathological foci were visualised. In group 3 (31 patients with post-surgical hypercalcitoninaemia), scintigraphy was true positive in 23 patients (74.2%): uptake in the thyroid bed was found in five patients, in the lymph nodes in 18 and in bone metastases in four. Using (99m)Tc-EDDA/HYNIC-TOC scintigraphy, the overall sensitivity was 79.5%, specificity 83.3%, accuracy 80.0%, positive predictive value 96.9% and negative predictive value 38.5%. (99m)Tc-EDDA/HYNIC-TOC is clinically useful for scintigraphy in the follow-up of patients with MTC. It can be used in clinical practice for preoperative evaluation, for localisation of local recurrence or distant metastases and particularly for therapy decision making.

Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma

International Nuclear Information System (INIS)

Czepczynski, Rafal; Kosowicz, Jerzy; Ziemnicka, Katarzyna; Gryczynska, Maria; Sowinski, Jerzy; Parisella, Maria G.; Mikolajczak, Renata; Signore, Alberto

2007-01-01

Several new somatostatin analogues have been developed for the diagnosis and therapy of different tumours. Since somatostatin receptors are often over-expressed in medullary thyroid carcinoma (MTC), the aim of our study was to evaluate the utility of scintigraphy with the somatostatin analogue 99m Tc-EDDA/HYNIC-TOC in MTC in comparison with other diagnostic techniques. Forty-five patients with MTC, aged 14-83 years, were investigated. Scintigraphy using 99m Tc-EDDA/HYNIC-TOC (Tektrotyd) was performed 2 and 4 h post injection of 740 MBq (20 mCi) of the tracer. Other imaging techniques were also applied and analysed in individual cases (ultrasonography, computed tomography, 99m Tc(V)-DMSA, 131 I-MIBG, 99m Tc-MDP, 111 In-DTPA-octreotide and 18 F-FDG-PET) and compared with 99m Tc-EDDA/HYNIC-TOC. In group 1 (eight patients before thyroidectomy), uptake of the tracer was found in the primary tumours. In group 2 (six patients with remission), a false positive result was found in one patient; in the remaining five patients, no pathological foci were visualised. In group 3 (31 patients with post-surgical hypercalcitoninaemia), scintigraphy was true positive in 23 patients (74.2%): uptake in the thyroid bed was found in five patients, in the lymph nodes in 18 and in bone metastases in four. Using 99m Tc-EDDA/HYNIC-TOC scintigraphy, the overall sensitivity was 79.5%, specificity 83.3%, accuracy 80.0%, positive predictive value 96.9% and negative predictive value 38.5%. 99m Tc-EDDA/HYNIC-TOC is clinically useful for scintigraphy in the follow-up of patients with MTC. It can be used in clinical practice for preoperative evaluation, for localisation of local recurrence or distant metastases and particularly for therapy decision making. (orig.)

F-18 Sodium Fluoride Positron Emission Tomography/Computed Tomography for Detection of Thyroid Cancer Bone Metastasis Compared with Bone Scintigraphy.

Science.gov (United States)

Lee, Hyunjong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun

2016-01-01

The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism

DEFF Research Database (Denmark)

Øgard, Christina G; Vestergaard, Henrik; Thomsen, Jørn B

2005-01-01

.3%. Then 700 MBq (99m)Tc-sestamibi was injected and another scintigram of the neck was obtained. Perchlorate was given at the end of the sestamibi scintigram to increase the wash-out of (99m)Tc-pertechnetate from the thyroid gland, and after 2 h a delayed scintigram was obtained. A subtraction of the thyroid...

Brain scintigraphy in patients with hydrocephalus

International Nuclear Information System (INIS)

Kadowaki, Hirotaka; Imanaga, Hirohisa; Kitamura, Koichi

1975-01-01

Brain scintigraphy is a simple, innocuous and valuable diagnostic method. Particulary in children, in order to minimize damage by examination, brain scintigraphy should be the first examination for patients, before other diagnostic methods such as cerebral angiography and pneumoencephalography. In the 3 years between Jan. 1970 and Dec. 1972, 235 children under the age of 15 years had brain scintigraphy with sup(99m)Tc pertechnetate at the Tokyo Women's Medical College Hospital. The authors especially attended to the findings of scintigrams in children with hydrocephalus. 29 children with non-neoplastic hydrocephalus were scanned with sup(99m)Tc pertechnetate: noncommunicating hydrocephalus; 9; hydroencephalodysplasia; 4; Chiari Arnold malformation; 1; cranium bifidum; 2; communicating hydrocephalis; 13. In noncommunicating hydrocephalus, the midline structure on the scintigram appeared thicker than the normal, because activity in the superior sagittal sinus was relatively high compared to the reduction of activity in the enlarged ventricles. In cases of very severe hydrocephalus, the basal ganglia was shown as a clear hot spot on the scintigram, because R. I. activity in the basal ganglia was relatively high compared to the reduction of R. I. activity in the enlarged ventricles. In cases of hydroencephalodysplasia, the midline structure on the scintigram shifted to the side opposite the dysplasia, as the result of pressure from a large CSF collection. In cases of cranium bifidum, the scintigram showed an elevation of the transverse sinus and the confluent sinus. (auth.)

Correlation of single image Tc-99m MIBI scan and ultrasonography with fine needle aspiration cytology (FNAC) to assess neoplasia in solitary 'cold' thyroid nodules

International Nuclear Information System (INIS)

Sohaib, M.; Saeed, S.; Naseeb, H.K.; Hyder, S.W.

2007-01-01

Category-1 and 2 as true positive results sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scanning were found to be 100, 90, 71 and 100% respectively. Ultrasonography also had a sensitivity of 100% considering solid and cystic lesions as test positive. But specificity of US was found to be only 13%. The sensitivity and specificity of the combined results of Tc-99m MIBI scintigraphy and ultrasonography were also not found to be significantly different from those of Tc-99m MIBI scan alone (100% and 91% respectively). Hence in patients with solitary cold thyroid nodules on Tc-99m Pertechnetate study, a single Tc-99m MIBI scan can be used reliably to assess neoplastic nature of the nodule with high degree of sensitivity and specificity. (author)

Use of thyroid scintigraphy and pituitary immunohistochemistry in the diagnosis of spontaneous hypothyroidism in a mature cat.

Science.gov (United States)

Blois, Shauna L; Abrams-Ogg, Anthony C G; Mitchell, Colleen; Yu, Anthony; Stoewen, Debbie; Lillie, Brandon N; Kiupel, Matti

2010-02-01

A 12-year old, castrated male domestic shorthair cat presented with a 2-year history of poor hair coat, seborrhea, generalized pruritus and otitis externa. Low circulating concentrations of total serum thyroxine (TT(4)) and free thyroxine (fT(4)) and an elevated thyroid stimulating hormone concentration supported a diagnosis of primary hypothyroidism. Thyroid scintigraphy did not show uptake of radioactive technetium in the thyroid area. Treatment with levothyroxine resulted in clinical improvement. Recurrence of dermatitis 8 months after onset of treatment resulted in euthanasia of the cat. On post-mortem examination, thyroid tissue was not identified on gross or histological examination. Pituitary immunohistochemistry identified hyperplasia of chromophobe cells. Copyright 2009 ESFM and AAFP. Published by Elsevier Ltd. All rights reserved.

Early recognition of autonomous thyroid tissue by a combination of quantitative thyroid pertechnetate scintigraphy with the free T4 equivalent

International Nuclear Information System (INIS)

Joseph, K.; Mahlstedt, J.; Welcke, U.

1980-01-01

A suspicion of AFTT can be raised in 80% of still euthyroid patients by a combined evaluation of an equivalent to the free T 4 (FTE) and an equavilant to the clearance using a quantitative evaluation of the thyroid technetium scan (TcTU). The suppression test not only confirms the autonomy in a qualitative manner but also provides an estimate of the volume of autonomous tissue because The TcTU after suppression strictly correlates linearly with the volume of the AFTT. Since after iodine administration FTE increases proportionally to the volume of AFTT, the procedure can be of some prognostic value: those with autonomous tissue in excess of a critical volume will almost certainly develop hyperthyroidism following a certain minimum rate of iodine administration. A prospective study of patients under age 50 whose thyroids contained various amounts of AFTT has shown that prophylactic dietary iodine supplementation will not cause hyperthyroidism to develop provided the additional iodine intake does not exceed 100 μg per day. (orig./MG) [de

Is there still a role for thyroid scintigraphy in the workup of a thyroid nodule in the era of fine needle aspiration cytology and molecular testing? [version 1; referees: 3 approved

Directory of Open Access Journals (Sweden)

Rodrigo Moreno-Reyes

2016-04-01

Full Text Available Thyroid scintigraphy is now rarely used in the work-up of a thyroid nodule except in the presence of a low TSH value. Therefore, autonomously functioning thyroid nodules (AFTNs with a normal TSH value are diagnosed only in the rare medical centers that continue to use thyroid scan systematically in the presence of a thyroid nodule. In this review, we discuss the prevalence of AFTN with a normal TSH level and the possible consequences of performing fine needle aspiration cytology (FNAC in an undiagnosed AFTN. We also discuss the risk of malignant AFTN which may be higher than previously stated.

Radiation dosimetry from breast milk excretion of radioiodine and pertechnetate

International Nuclear Information System (INIS)

Hedrick, W.R.; Di Simone, R.N.; Keen, R.L.

1986-01-01

Measurements were made of the activity in samples of breast milk obtained from a patient with postpartum thyroiditis following administration of [ 123 I]sodium iodide and subsequently [99mTc]pertechnetate 24 hr later. Both 123 I and 99mTc were found to be excreted exponentially with an effective half-life of 5.8 hr and 2.8 hr, respectively. Less than 10% of the activity was incorporated into breast-milk protein. After administration of [ 123 I]sodium iodide breast feeding should be discontinued for 24-36 hr to reduce the absorbed dose to the child's thyroid

The Change of the Salivary Function after the High Dose Radioiodine Treatment in the patients with Differentiated Thyroid Cancer

International Nuclear Information System (INIS)

Lim, S. M.; Hong, S. W.; Lee, J. O.; Kang, T. W.

1989-01-01

The pain, swelling of salivary glands and dry mouth are not infrequent complication of the high dose radioiodine treatment in the patients with differentiated thyroid cancer. The purpose of this study was, by the dynamic salivary scintigraphy, to observe the change of the salivary function after the high dose (150-200 mCi) radioiodine treatment. From May 1987 to April 1988, the dynamic salivary scintigraphy with 5 mCi of 99m Tc-pertechnetate and gamma camera was performed before and 7 days after the radioiodine treatment in 7 patients with differentiated thyroid cancer. Just after the dynamic scintigraphy, the stimulation test with vitamin C solution of pH 3.0 and poststimulation scintigraphy were done, and the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were calculated for each gland. There was positive correlation between the radioactivity uptake index and excretion fraction after the stimulation. The salivary clearance after the stimulation was 18.96 ± 8.95 ml/min in the pretreatment state, and 14.37 ± 7.7 ml/min after the radioiodine treatment. After the radioiodine treatment, the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were significantly reduced in the parotid glands, but only the excretion fraction was reduced in the submandibular glands. The more the pretreatment salivary clearance after the stimulation was, the % change after the treatment was smaller. Further studies on the relation between the radiation dose in the salivary glands and the change of their function, and the long-term observation for the recovery of function are expected.

Can thyroid parotid ratio replace radioactive iodine uptake as a new objective parameter in the evaluation of thyroid function in cases of hyperthyroidism? A comparative study

International Nuclear Information System (INIS)

Malhotra, G.; Seshadri, N.; Gupta, A.; Das, B.K.; Gambhir, S.; Pradhan, P.K.; Bhagat, J.K.

2002-01-01

Aim: Radioactive iodine uptake (RAIU) measurements are used to distinguish other causes of thyrotoxicosis from hyperthyroidism. However it is a cumbersome technique requiring patients' visit for two or more days. Thyroid to parotid ratio (TP ratio) which is a ratio of Technetium-99m pertechnetate counts in thyroid to those in parotid glands is a new objective parameter for evaluation of thyroid function. The aim of present study was to compare TP ratio with RAIU in patients of thyrotoxicosis. Materials and Methods: The study group comprised of 15 patients (13 males and 2 females) who were clinically and biochemically hyperthyroid. All of these patients underwent Tc-99m pertechnetate thyroid scintigraphy followed by RAIU on two separate occasions. The technetium thyroid scan was done 20 minutes after intravenous application of 185 MBq (5 mCi) of the radiotracer. Both anterior and oblique views of the neck region were acquired under a standard large field of view gamma camera with LEAP collimation. The TP ratio was calculated from anterior view by drawing the region of interest over the thyroid and two regions of interest over each parotid gland. The counts of thyroid region were compared with each parotid and average of two sides was taken as TP ratio. The radioactive iodine uptake was estimated at 2,4,24, and 48 hours after oral administration of 925 KBq (25 microcuries) of I-131 in all patients with a thyroid probe by the standard technique. Apart from this 10 controls (5 males and 5 females) who were clinically and biochemically euthyroid were also included in the study and they underwent same studies as the cases. All patients with nodular disease of thyroid, past history of thyroiditis and parotitis were excluded from the study. Results: The scintigraphic findings in all patients revealed a diffusely concentrating thyroid gland with no evidence of hot or cold areas. The RAIU and TP ratio in both cases and controls is presented.: S.E: Standard error. There was a

Thallium-201 chloride dynamic analysis using thallium-201 chloride and sodium iodide-131 thyroid subtraction scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Morimoto, Setsuo; Hiraki, Yoshio; Togami, Izumi [Okayama Univ. (Japan). School of Medicine

1984-10-01

The mechanism of /sup 201/Tl chloride accumulation is unclear in thyroid gland and thyroid tumor. This report examines 108 patients that received thyroid scintigraphy examinations with both /sup 201/Tl chloride and sodium /sup 131/I. The patients were diagnosed clinically and histologically whenever possible. The ROI were obtained by subtraction imaging with both isotopes and by subtraction positive and negative areas of imaging. Dynamic curves were obtained for /sup 201/Tl chloride per square unit of each ROI. The dynamic curve in the radioiodide-accumulated area was examined. The data indicate that the clearance rate of /sup 201/Tl chloride (T/sub 15/) was correlated with the sodium /sup 131/I uptake rate at 24 h (r=0.70).

Biodistribution of the radiopharmaceutical sodium pertechnetate after biliopancreatic bypass with a duodenal switch

International Nuclear Information System (INIS)

Araujo-Filho, Irami; Rego, Amalia Cinthia Meneses; Brandao-Neto, Jose; Villarim-Neto, Arthur; Egito, Eryvaldo Socrates Tabosa; Azevedo, Italo Medeiros; Medeiros, Aldo Cunha

2007-01-01

Study with the purpose to examine the effects of duodenal switch (DS), regularly performed in morbidly obese patients, on biodistribution of sodium pertechnetate in several organs of rats. There was no early or late mortality in either rats groups. The values of percent radioactivity per gram of tissue (%ATI/g), showed no significant difference in liver, stomach, small bowel, duodenum, kidney, heart, bladder, bone and brain, when compared the DS rats with sham and controls rats. A postoperative significant increase (p<0.05) in mean %ATI/g levels was observed in spleen, pancreas and muscle in group DS rats, as compared to group S and C rats. In the lung there was an increase and in thyroid a decrease in mean %ATI/g of DS rats, when compared to sham rats (p<0.05). In conclusion, the biliopancreatic diversion with duodenal switch in rats modified the biodistribution of sodium pertechnetate in thyroid, lung, pancreas, spleen and muscle. (author)

Biodistribution of the radiopharmaceutical sodium pertechnetate after biliopancreatic bypass with a duodenal switch

Energy Technology Data Exchange (ETDEWEB)

Araujo-Filho, Irami; Rego, Amalia Cinthia Meneses; Brandao-Neto, Jose; Villarim-Neto, Arthur; Egito, Eryvaldo Socrates Tabosa; Azevedo, Italo Medeiros; Medeiros, Aldo Cunha [Universidade Federal do Rio Grande do Norte, Natal, RN (Brazil). Programa de Pos-graduacao em Ciencias da Saude]. E-mail: aldo@ufrnet.br

2007-09-15

Study with the purpose to examine the effects of duodenal switch (DS), regularly performed in morbidly obese patients, on biodistribution of sodium pertechnetate in several organs of rats. There was no early or late mortality in either rats groups. The values of percent radioactivity per gram of tissue (%ATI/g), showed no significant difference in liver, stomach, small bowel, duodenum, kidney, heart, bladder, bone and brain, when compared the DS rats with sham and controls rats. A postoperative significant increase (p<0.05) in mean %ATI/g levels was observed in spleen, pancreas and muscle in group DS rats, as compared to group S and C rats. In the lung there was an increase and in thyroid a decrease in mean %ATI/g of DS rats, when compared to sham rats (p<0.05). In conclusion, the biliopancreatic diversion with duodenal switch in rats modified the biodistribution of sodium pertechnetate in thyroid, lung, pancreas, spleen and muscle. (author)

Somatostatin receptor scintigraphy to predict the clinical evolution and therapeutic response of thyroid-associated ophthalmopathy

International Nuclear Information System (INIS)

Nocaudie, M.; Bailliez, A.; Itti, E.; Marchandise, X.

1999-01-01

Management of thyroid-associated ophthalmopathy remains a topic of controversy. Immunosuppressive treatments have to be applied at peak disease activity and before criteria of severity develop. Expression of somatostatin receptors on activated lymphocytes allows scintigraphic imaging with indium-111 pentetreotide. We conducted a prospective study with 17 patients who presented severe ophthalmopathy (11 Graves' disease, four Hashimoto's thyroiditis, two isolated in appearance: Means' syndrome). Each patient underwent hormonal (free T 3 and TSH) and immunological (TBII) assessment, an orbital computed tomography scan or magnetic resonance imaging, a visual functional examination and 111 In-pentetreotide orbital scintigraphy before undergoing treatment by steroids and/or radiotherapy, independently of scintigraphic results. At 4 and 24 h after the intravenous injection of 111 MBq of 111 In-pentetreotide, planar imaging centred on the head and neck (anterior and both lateral views) was carried out. Retrobulbar uptake was assessed by visual semi-quantitative analysis (score given by two independent trained observers) and by quantitative analyses (regions of interest, orbit/brain uptake indices). Patients were ophthalmologically followed up for 6 months and then classified as improved or not. Visual semi-quantitative analysis of 4-h/24-h planar images was correlated with the ophthalmological evolution (χ 2 test, P 111 In-pentetreotide scintigraphy requires further developments, including quantitative single-photon emission tomographic acquisition, if its role as a guide to therapeutic strategy in thyroid-associated ophthalmopathy is to be confirmed. (orig.)

Contribution of sup(99m)Tc pertechnetate brain scintigraphy in the diagnosis of tumours of posterior fossa

International Nuclear Information System (INIS)

Sergent, Aline.

1976-01-01

The present work concerns 38 posterior cranial fossa tumour cases subjected to sup(99m)Tc pertechnetate brain scintigraphy between May 1974 and June 1976. 33 of these patients have undergone an anatomical check while for the remaining 5, the existence of a posterior fossa tumour is established from the conjunction of clinical signs and other paraclinical examinations. The procedure was the same for all these 38 patients: after a 300 μC/kg injection of tracer, an immediate angioscintigraphic period, an early set of pictures (half an hour after the tracer injection) then delayed set (4 to 5 hours later) taken from 4 angles: front, back and two profiles. The examination was performed with an OHIO NUCLEAR SIEMENS gamma camera and sometimes a conventional scanner as well (the latter giving no better a diagnosis than the former). In 75% of the cases a hyperfixation of the injected tracer was observed and its site located quite accurately in the posterior fossa tumour. The etiology of the lesion could be diagnosed in 'most probable' or 'least probable' terms. Examination of work by other authors, who obtained similar results, leads to the conclusion that this method is very helpful in the diagnosis of posterior fossa tumours when used as a means of early detection, before the undertaking of more complex neuroradiological explorations [fr

[111In-DTPA-D-Phe1] octreotide scintigraphy in thyroidal and orbital Graves' disease: a parameter for disease activity?

NARCIS (Netherlands)

Postema, P. T.; Krenning, E. P.; Wijngaarde, R.; Kooy, P. P.; Oei, H. Y.; van den Bosch, W. A.; Reubi, J. C.; Wiersinga, W. M.; Hooijkaas, H.; van der Loos, T.

1994-01-01

Visualization of malignant lymphomas and granulomatous disease is possible by [111In-DTPA-D-Phe1]octreotide scintigraphy through binding of the radioligand to somatostatin receptors on activated leukocytes. Because thyroidal and orbital tissues are infiltrated by activated leukocytes in Graves'

Combined {sup 99m}Tc-methoxyisobutylisonitrile scintigraphy and fine-needle aspiration cytology offers an accurate and potentially cost-effective investigative strategy for the assessment of solitary or dominant thyroid nodules

Energy Technology Data Exchange (ETDEWEB)

Wale, Anita [Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Brighton (United Kingdom); Royal Sussex County Hospital, Department of Nuclear Medicine, Brighton (United Kingdom); Miles, Kenneth A. [University College London, London (United Kingdom); Young, Barnaby [Tan Tock Seng Hospital, Novena (Singapore); Zammit, Charles [Brighton and Sussex University Hospitals NHS Trust, Department of Surgery, Brighton (United Kingdom); Williams, Anthony [Brighton and Sussex University Hospitals NHS Trust, Department of Pathology, Brighton (United Kingdom); Quin, John [Brighton and Sussex University Hospitals NHS Trust, Department of Endocrinology and Diabetes, Brighton (United Kingdom); Dizdarevic, Sabina [Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Brighton (United Kingdom)

2014-01-15

Fine-needle aspiration (FNA) has revolutionised the care of patients with thyroid nodules and is the initial investigation of choice. However, as a result of nondiagnostic (Thy1) and nonneoplastic (Thy2) specimens, it remains an imperfect sole solution with a range of sensitivities and a high inadequate ratio. Therefore the British Thyroid Association (BTA) guidelines recommend a second FNA immediately for Thy1 specimens and 3-6 months later for Thy2 specimens. Patients must be followed up to exclude malignancy. In this study we assessed the performance of MIBI scintigraphy for diagnosing thyroid malignancy and the cost-effectiveness of a combined FNA/MIBI investigative strategy for the management of thyroid nodules. The diagnostic performance of MIBI scintigraphy was calculated from a retrospective review of local data combined with a meta-analysis of the published literature. Decision tree analysis was used to calculate the cost-effectiveness of a combined FNA/MIBI investigative strategy compared to the BTA guidelines. From 712 patients, the sensitivity, specificity, PPV and NPV of MIBI scintigraphy for the diagnosis of malignancy were 96 %, 46 %, 34 % and 97 %, respectively. MIBI-based strategies were more accurate and associated with lower cost per patient (pound 1,855/EUR2,125 vs. pound 2,445/EUR2,801) and lower cost per cancer diagnosed (pound 1,902/EUR2,179 vs. pound 2,469/EUR2,828) with negligible change in life expectancy. Due to its high NPV, MIBI scintigraphy can usefully exclude malignancy for Thy1 and Thy2 lesions. Its low specificity means MIBI scintigraphy cannot be recommended as a first-line investigation, but as a second-line investigation MIBI scintigraphy may lead to a lower rate of unnecessary thyroidectomies. Combined FNA/MIBI strategies are potentially cost-effective in the management of solitary or dominant thyroid nodules. (orig.)

High prevalence of thyroid disease and role of salivary gland scintigraphy in patients with xerostomia

Energy Technology Data Exchange (ETDEWEB)

Jung, Ji Hoon; Lee, Chang Hee; Son, Seung Hyun; Jeong, Ju Hye; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae; Ahn, Byeong Cheol [Dept. of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu (Korea, Republic of)

2017-06-15

Although Sjös syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS. We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests. Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses. More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease.

High prevalence of thyroid disease and role of salivary gland scintigraphy in patients with xerostomia

International Nuclear Information System (INIS)

Jung, Ji Hoon; Lee, Chang Hee; Son, Seung Hyun; Jeong, Ju Hye; Jeong, Shin Young; Lee, Sang Woo; Lee, Jae Tae; Ahn, Byeong Cheol

2017-01-01

Although Sjös syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS. We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests. Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses. More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease

F-8 sodium fluoride position emission tomography/computed tomography for detection of thyroid cancer bone metastasis compared with bone scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyun Jong; Lee, Won Woo; Park, So Yeon; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

2016-04-15

The aim of the study was to compare the diagnostic performances of F-18 sodium fluoride positron emission tomography/computed tomography (bone PET/CT) and bone scintigraphy (BS) for the detection of thyroid cancer bone metastasis. We retrospectively enrolled 6 thyroid cancer patients (age = 44.7 ± 9.8 years, M:F = 1:5, papillary:follicular = 2:4) with suspected bone metastatic lesions in the whole body iodine scintigraphy or BS, who subsequently underwent bone PET/CT. Pathologic diagnosis was conducted for 4 lesions of 4 patients. Of the 17 suspected bone lesions, 10 were metastatic and 7 benign. Compared to BS, bone PET/CT exhibited superior sensitivity (10/10 = 100% vs. 2/10 = 20%, p = 0.008), and accuracy (14/17 = 82.4% vs. 7/17 = 41.2%, p < 0.025). The specificity (4/7 = 57.1%) of bone PET/CT was not significantly different from that of BS (5/7 = 71.4%, p > 0.05). Bone PET/CT may be more sensitive and accurate than BS for the detection of thyroid cancer bone metastasis.

TIRADS for sonographic assessment of hypofunctioning and indifferent thyroid nodules.

Science.gov (United States)

Schenke, Simone; Rink, T; Zimny, M

2015-01-01

To test the feasibility of the Thyroid Imaging Reporting And Data System (TIRADS) according to Horvath and Kwak for the assessment of thyroid nodules. Retrospective analysis of patients with thyroid nodules applying the following inclusion criteria: B-mode-ultrasound, surgery and histological results. Thyroid nodules were classified as TIRADS 2, 3, 4A, 4B, 4C, 5 and 6. A total of 172 patients were included (133 women, 48 ± 13 years, 39 men, 49 ± 11 years) with 222 thyroid nodules (24.9 ± 11.5 mm). Final histological diagnosis revealed 203 benign nodules (91%) and 19 malignant nodules (9%; 18 papillary thyroid carcinoma, PTC, and one medullary thyroid carcinoma, MTC). One hundred and sixty thyroid nodules were hypofunctioning in 99mTc-pertechnetate-scintigraphy, 14 nodules were hyperfunctioning and 46 nodules were classified as indifferent. In two cases with small carcinoma nodules (39%) were not clearly classifiable, including 3 carcinoma (4.1%). According to Kwak, the prevalence of malignancy was 6.9% in TIRADS 2, 0% in 3, 2% in 4A, 4.1% in 4B, 23.1% in 4C, and 100% in 5 and 6, respectively. Notably, in the subgroup of hot nodules, 11 (79%) were graded as TIRADS 4A or higher, and thus advisable for fine-needle aspiration biopsy in both TIRADS. The TIRADS described by Horvath is not practicable due to numerous unclassifiable nodules. The revised TIRADS published by Kwak is feasible and suitable to assess the prevalence of malignancy, but it cannot replace scintigraphic imaging. Fine-needle-biopsy is not necessary in nodules categorized as (K)TIRADS 3, 4A and 5.

Accuracy of preoperative diagnosis for primary hyperparathyroidism by CT, US and scintigraphy

International Nuclear Information System (INIS)

Imada, Masanobu; Nonaka, Satoshi; Hayashi, Tatsuya; Kunibe, Isamu; Harabuchi, Yasuaki

2003-01-01

We determined the usefulness of computed tomography (CT), ultrasonography (US) and Tc-Tl subtraction scintigraphy for preoperative diagnosis in 12 patients with primary hyperparathyroidism, all of which were solitary adenoma. Seven (63.6%) of 11 tumors were detected by CT, 7 (58.3%) of 12 tumors were detected by US, and 7 (63.6%) of 11 tumors were detected by Tc-Tl subtraction scintigraphy. Of 7 tumors with size>10 mm, 6 (85.7%) were detected by CT, 5 (71.4%) were detected by US, and 6 (85.7%) were detected by Tc-Tl subtraction scintigraphy, whereas only 1 (25%) with a diameter of 10 mm was detected by each of CT or Tc-Tl subtraction scintigraphy and 2 (40%) with diameters 10 mm were detected by US. Of 6 tumors situated behind the thyroid gland or intra thyroid gland, 5 (83.3%) were detected by CT and all 6 (100%) were detected by US, Tl-Tc subtraction scintigraphy, which was employed for 5 tumors, detected all 5 (100%). However, in the tumors situated beneath the thyroid gland only 2 (40%) of 5, 1 (16.7%) of 6 and 2 (33.3%) of 6 were detected by CT, US and Tc-Tl subtraction scintigraphy respectively. In 5 tumors without thyroid disease, 4 (80%) of 5 were detected by both CT and US, 3 (75%) of 4 were detected by Tc-Tl subtraction scintigraphy. However, in 7 tumors with thyroid diseases (papillary carcinoma, follicular carcinoma, follicular adenoma, chronic thyroiditis, and adenomatous goiter), 3 (50%) of 6 were detected by CT, 3 (42.9%) of 7 were detected by US and 4 (57.1%) of 7 were detected by Tc-Tl subtraction scintigraphy. Location of tumor was the factor most likely to make appropriate diagnosis difficult for primary hyperparathyroidism by any assessment method. (author)

Technetium-99m thyroid scan; does it have a diagnostic aid in sub-clinical auto-immune thyroid disease in systemic lupus erythematosus patients?

Science.gov (United States)

Amin, A; Alkemary, A; Abdo, M; Salama, M

2016-02-01

Technetium-99m (Tc-99m) thyroid scintigraphy is a well known diagnostic tool that shows the entire gland in a single image. We aimed to evaluate its additive diagnostic value in subclinical autoimmune thyroid disease (S-AITD) in systemic lupus erythematosus (SLE) patients. We investigated 100 systemic lupus erythematosus (SLE) patients without overt thyroid involvement (eight men and 92 women; mean age 40±6.5 years) and 50 age and sex matched controls. All were subjected to thyroid evaluation using anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies; hormones (FT3; FT4 and TSH) and Tc-99m thyroid scintigraphy. 14/100 (14%) and none (0%) were positive for S-AITD in SLE and control groups, respectively (P = 0.0001). They were classified by thyroid scintigraphy and hormonal profile into 2/14 Hashimoto; 10/14 atrophic thyroiditis and 2/14 Graves' disease. Anti-TPO was elevated in 12 SLE cases, while anti-TG was elevated in only 2/14 (P = 0.0001). Thyroid scintigraphy showed statistically significant associations with FT4, TSH and anti-TPO. Tc-99m thyroid scintigraphy may have an additional diagnostic role in S-AITD among SLE patients, with an impact on patient management. This potential needs to be further evaluated in a larger series on a multicenter basis. © The Author(s) 2015.

Lung perfusion scintigraphy by SPECT

International Nuclear Information System (INIS)

Hirayama, Takanobu

1990-01-01

The initial study reports the characteristic performance using lung segmental phantom filled in Tc-99m pertechnetate. To evaluate the segmental defect in lung perfusion scintigraphy, we applied Bull's-eye analysis in addition to planar image set. Bull's-eye analysis especially facilitated the interpretation in both middle and lower lobes. Subsequently, to evolute the clinical application of Bull's-eye analysis, pulmonary scintigraphy was performed on 10 normal subjects and 60 patients with several pulmonary diseases. Of interest, Bull's-eye analysis, however, encouraged the interpretation in both lower lobes. To calculate the extention and severity of perfusion defect, the present study describes Bull's-eye analysis. Quantitative scoring showed higher in patients with lung cancer than those with pulmonary tuberculosis. The present study focus that Bull's-eye analysis can be useful for evaluating perfusion in patients with a couple of pulmonary diseases. (author)

Graves' disease: thyroid function and immunologic activity

International Nuclear Information System (INIS)

Gossage, A.A.; Crawley, J.C.; Copping, S.; Hinge, D.; Himsworth, R.L.

1982-01-01

Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [/sup 99m/Tc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity--TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p less than 0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

Graves' disease: thyroid function and immunologic activity

International Nuclear Information System (INIS)

Gossage, A.A.R.; Crawley, J.C.W.; Copping, S.; Hinge, D.; Himsworth, R.L.

1982-01-01

Patients with Graves' disease were studied for two years during and after a twelve-month course of treatment. Disease activity was determined by repeated measurements of thyroidal uptake of [ 9 -9μTc]pertechnetate during tri-iodothyronine administration. These in-vivo measurements of thyroid stimulation were compared with the results of in-vitro assays of Graves, immunoglobulin (TSH binding inhibitory activity - TBIA). There was no correlation between the thyroid uptake and TBIA on diagnosis. Pertechnetate uptake and TBIA both declined during the twelve months of antithyroid therapy. TBIA was detectable in sera from 19 of the 27 patients at diagnosis; in 11 of these 19 patients there was a good correlation (p<0.05) throughout the course of their disease between the laboratory assay of the Graves, immunoglobulin and the thyroid uptake. Probability of recurrence can be assessed but sustained remission of Graves' disease after treatment cannot be predicted from either measurement alone or in combination

Brain scintigraphy with Tc99-pertechnetate in the evaluation of patients with cerebrovascular lesions. The diagnostic value related to age of the lesion and to the size, type and localisation revealed by CT-scan

DEFF Research Database (Denmark)

Olsen, T S; Christensen, J; Skriver, E B

1983-01-01

Brain scintigraphy with Tc99-pertechnetate (Tc99-scan) was performed 4 times in 95 consecutive stroke patients: on average 5 days, 18 days, 103 days and 194 days after the stroke. The type (infarct, hematoma), size and localisation of the lesion was evaluated by CT-scan performed 3 times in all...... identified (90%) while infarcts localised deep in the hemisphere were identified in only 20% of the patients; (ii) the size of the lesion, i.e. large deep infarcts were seen with a much higher frequency than small deep infarcts. The detection rate of the CT-scan was practically not dependent upon the time...

Association of parathyroid adenoma and autonomous nodule of the thyroid. Diagnostic efficacy of 201thallium-sup(99m)technetium scintigraphy

International Nuclear Information System (INIS)

Talbot, J.N.; Kiffel, T.; Duron, F.; Nordlinger, B.

1986-01-01

The thallium-technetium subtraction technique, proposed originally by Ferlin and co-workers, is now widely used to localize parathyroid adenoma. We report here the case of a hypercalcemic women, referred to our ward with the biologically assessed diagnosis of primary hyperparathyroidism. Thallium-technetium substraction scintigraphy not only successfully localized the parathyroid adenoma but alsorevealed the existence of an autonomous nodule of the thyroid, which was not suspected. It has previously been shown that this method can localize parathyroid adenoma in cases of cold thyroid nodule. This report shows that this is also true in the case of hot thyroid nodule. No observations of concomitant parathyroid adenoma and autonomous nodule of the thyroid have been reported (at least during the two past decades). Is this association casual or has it never been raticed. Further examinations can be performed with thallium when a hot thyroid is found in a hypercalcemic patient. (orig.)

Process for reducing the pertechnetate anion

International Nuclear Information System (INIS)

Ruddock, C.F.

1980-01-01

Process for reducing the 'pertechnetate' ion TcO 4 - , whereby an aqueous solution of 'pertechnetate' is mixed with tin metal or a tin alloy as 'pertechnetate' reducing agent, and a soluble salt of a metal below tin in the electro-chemical tension scale, as activator for the reducing tin. This reduced 'pertechnetate' is used for forming usable complexes in medical diagnosis exploration [fr

Effect of tripanossomicide benznidazole (Rochagan) on the biodistribution of sodium pertechnetate (Na{sup 99m}TcO4) in Wistar rats

Energy Technology Data Exchange (ETDEWEB)

Barbosa, Vanessa Santos de Arruda; Holanda, Cecilia Maria de Carvalho Xavier; Silva, Roseane Pereira da; Medeiros, Aldo Cunha [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Centro de Ciencias da Saude]. E-mail: vambio@oi.com.br; Oliveira, Daniel Pereira de; Silva Junior, Mauricio Ferreira da; Oliveira, Elias Herculano de [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Centro de Biociencias. Dept. de Microbiologia e Parasitologia; Spyrides, Maria Helena Constantino [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Dept. de Estatistica

2008-12-15

Benznidazole, a drug with specific anti-Trypanosoma cruzi activity, is used in the treatment of Chagas' disease. The radiopharmaceutical sodium pertechnetate (Na{sup 99m}TcO{sub 4}) is used to obtain diagnostic images of the stomach, thyroid, parathyroids, salivary glands, brain and in the study of esophageal reflux and blood flow. This study aimed at evaluating in vivo the influence of benznidazole treatment on the sodium pertechnetate biodistribution in Wistar rats. The percentage of radioactivity per gram (%ATI/g) of various organs (brain, heart, esophagus, stomach, small intestine, large intestine, spleen, liver, muscle and blood) was determined. Comparing the treated rats with the controls, we observed that sodium pertechnetate biodistribution did not change when administered to rats treated for thirty days with benznidazole. (author)

MIBI scintigraphy in hypofunctioning thyroid nodules. Can it predict the dignity of the lesion?

Energy Technology Data Exchange (ETDEWEB)

Theissen, P.; Schmidt, M.; Ivanova, T.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

2009-07-01

Aim: Several authors have investigated the value of technetium-MIBI scanning to predict the dignity of hypofunctioning, cold thyroid nodules (HTN) in regions with differing levels of iodine supply. They concluded that an MIBI scan can exclude thyroid malignancy, although comparisons between the studies are of limited value owing to differences in methodology and wide variations in patient selection criteria. The present study investigates whether the above claim is also valid in Germany, a country with a long-standing and persistent, mild iodine deficiency and a high incidence of nodules in large goiters with a low prevalence of malignancy. Patients, methods: The study compares the results of {sup 99m}Tc-MIBI scintigraphy (incl. SPECT and planar images) in HTN (MIBI) with those of fine-needle aspiration biopsy (FNAB) and histology. Of 154 consecutive patients (121 women, 33 men; mean age 56 {+-} 12 years), 73 underwent thyroid surgery from which the results of FNAB and MIBI were assessed. Selection criteria were risk estimation or conditions limiting the feasibility of FNAB. The mean thyroid volume was 42 {+-} 25 ml, with 2.1 {+-} 1.4 nodules per patient. Results: Histology revealed thyroid malignancies in 8 out of 73 patients (11.0%). The negative predictive value for MIBI was 97%, which is comparable to FNAB (94%). However, in 19.5% of patients FNAB was indeterminate. Lower specificity (54%) and low positive predictive value (19%) showed that MIBI accumulation cannot differentiate between malignant and benign thyroid nodules. However, comparison with cytological and/or histological findings indicated that it could distinguish between lesions with differing rates of mitochondrial metabolism. Conclusion: Even in areas of former or mild iodine deficiency MIBI forms a basis for choosing between wait-and-see and surgical strategies if FNAB is unfeasible or not representative. However, even for pathological MIBI results, the prevalence of malignancy is not very high

Real-time elastography in autonomously functioning thyroid nodules: relationship with TSH levels, scintigraphy, and ultrasound patterns.

Science.gov (United States)

Trimboli, Pierpaolo; Paone, Gaetano; Zatelli, Maria Chiara; Ceriani, Luca; Giovanella, Luca

2017-12-01

Real-time elastography has been proposed to increase the sensitivity of ultrasound and improve the detection of thyroid nodules at risk of malignancy. To date sparse data on real-time elastography assessment of autonomously functioning thyroid nodules exist. Here, we investigated the potential role of real-time elastography in autonomously functioning thyroid nodule assessment. Specifically, the correlation between serum hormones and real-time elastography score, as well as other clinical and ultrasound features, was analyzed. Patients with autonomously functioning thyroid nodule identified by I-123 scintigraphy from September 2015 to July 2016 and undergoing ultrasound, real-time elastography, and thyroid function evaluation were selected. All autonomously functioning thyroid nodule were classified as RTE I (prevalence of red or green color with blue in up to 25% of the nodule area), RTE II (blue in 25-75%), or RTE III (blue in more than 75%). The association between suppressed thyroid stimulating hormone and patient's age, nodule's size, ultrasound presentation, and real-time elastography scoring was analyzed by Odds Ratio in univariate fashion and multivariate model. A number of 47 subjects with single autonomously functioning thyroid nodule were enrolled. Median age of 63 years, median size of 2.0 cm, and suppressed thyroid stimulating hormone levels in 32% of cases were found. Those nodules classified by ultrasound at high risk underwent fine-needle aspiration cytology and cancer was excluded. At real-time elastography evaluation, a 45% of autonomously functioning thyroid nodule had a hard appearance (RTE III) and had thyroid stimulating hormone significantly lower than the other (p < 0.0001). A model of multivariate logistic regression including nodule's size, ultrasound characteristics, and elastographic presentation showed that only RTE III was significantly associated with suppressed thyroid stimulating hormone (Odds Ratio of 50). Autonomously

In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

Energy Technology Data Exchange (ETDEWEB)

Spesshardt, K. (Sankt-Vincentius-Krankenhaeuser, Karlsruhe (Germany, F.R.). Radiologische Abt. mit Strahlentherapie und Nuklearmedizin)

1980-10-15

In-vivo diagnoses of thyroid diseases can be carried out using /sup 123/I, /sup 131/I, and /sup 99/sup(m)Tc-pertechnetate. For the thyroid scintiscan, /sup 99/sup(m)Tc-pertechnetate or /sup 123/I are used. Some functional parameters can be determined using /sup 99/sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with /sup 123/I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using /sup 131/I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited.

In-vivo isotope diagnosis and radioiodine therapy of benign thyroid diseases

International Nuclear Information System (INIS)

Spesshardt, K.

1980-01-01

In-vivo diagnoses of thyroid diseases can be carried out using 123 I, 131 I, and 99 sup(m)Tc-pertechnetate. For the thyroid scintiscan, 99 sup(m)Tc-pertechnetate or 123 I are used. Some functional parameters can be determined using 99 sup(m)Tc-pertechnetate, but iodine is more accurate, so that thyroid clearance examinations with 123 I are rapidly gaining importance. However, the iodine turnover in the thyroid can only be determined by a several-days' test using 131 I. The available techniques of diagnosis are employed in several steps. Most thyroid diseases can already be diagnosed on the basis of the hormone parameters and a thyroid scan; otherwise, a TRH test and suppression and functional studies will be necessary. Treatment of enthyroid struma is limited to inoperable cases with functional blockage or compression of the trachea. In the treatment of diffuse hyperthyroidism, doses should be exact enough to counteract the hyperthyroid metabolism without inducing hypothyroidism. With exact doses, a second radioiodine therapy will only be necessary in about 40% of all cases. High doses should not be applied in the treatment of hyperthyroidism unless it is a case of excessive clinical hyperthyroid somatics as the risk of hypothyroidism is high. The diagnostic problem of autonomous adenoma is the highly varying hormone activity. The intention of radioiodine therapy here is a functional elimination of the autonomous adenoma. Radioiodine resection is indicated in cases where there are several small autonomous adenomas or where the operability of the patient is limited. (orig./MG) [de

Clinical evaluation of echography in diagnosis of thyroid disease

International Nuclear Information System (INIS)

Fritzsche, H.; Braendle, J.

1983-01-01

In 63 patients echography of thyroid was performed additionally to case history, palpation, scintigraphy and hormone tests for evaluating clinical significance of this method. The benefit of this technique is rapid measurement of thyroid size, demonstration of nodules in palpable diffuse goiters and differentiating of solid or cystic nodules of the thyroid. For diagnosis of autonomous areas in the thyroid scintigrahy remains the method of choice. Also there is no correlation of ultrasound findings and thyroid function. In routine diagnostic procedure of thyroid disease echography may replace scintigraphy only in diffuse goiter and if radionuclide imaging is not possible. Nevertheless ultrasonic evaluation of the thyroid is an important additional method in diagnostic of thyroid diseases. (Author)

Thallium-201 and technetium-99m pertechnetate subtraction scintigraphy in patients with hyperparathyroidism

International Nuclear Information System (INIS)

Kuwashima, Shigeko; Koizumi, Mitsuru; Goto, Masafumi; Nomura, Toshiharu; Fujioka, Mutsuhisa; Watari, Tsutomu

1992-01-01

A reliable technique for detecting and localizing abnormal parathyroid tissue has been a persistent problem. We evaluated thallium-technetium (Tl/Tc) subtraction scintigraphy in 16 patients with clinical biochemical evidence of hyperparathyroidism prior to other diagnostic methods and surgery. Seven patients had surgery and were confirmed to have parathyroid adenoma or hyperplasia. The other methods included ultrasonography (US) in 6 patients, computed tomography (CT) in 10 patients, magnetic resonance imaging (MRI) in 8 patients, and bone scintigraphy in 7 patients. In patients who had several imaging modalities, the detection rate was significantly better for Tl/Tc subtraction scan than for US, CT or MRI. Bote scintigraphy, though not so sensitive as Tl/Tc subtraction studies, was an important tool for evaluating metabolic bone disorder including hyperparathyroidism and renal osteodystrophy. Thus, Tl/Tc subtraction scan is more useful for diagnosis when hyperparathyroidism is suspected if both Tl/Tc subtraction scan and bone scan are performed. The detectability depended on the mass size, and detection of abnormal glands was greater for adenoma than for hyperplasia. The results suggest that Tl/Tc subtraction scan is a simple, non-invasive and useful tool for locating parathyroid abnormality even when compared with MRI. (author)

Extensive heterotopic gastric mucosa of the small intestine: imaging with {sup 99m}Tc-sodium pertechnetate SPECT/CT enterography

Energy Technology Data Exchange (ETDEWEB)

Schapiro, Andrew H.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology and Medical Imaging, Cincinnati, OH (United States); Lin, Tom K. [Cincinnati Children' s Hospital Medical Center, Division of Gastroenterology, Cincinnati, OH (United States); Frischer, Jason S. [Cincinnati Children' s Hospital Medical Center, Department of Surgery, Cincinnati, OH (United States); Silverman, Ayaka [Cincinnati Children' s Hospital Medical Center, Department of Pathology, Cincinnati, OH (United States)

2016-12-15

Extensive heterotopic gastric mucosa of the small intestine is a rare, but potentially life-threatening condition characterized by multifocal or long-segment heterotopic gastric mucosa within the bowel lumen that is often associated with other anomalies including malrotation and annular pancreas. Although the imaging findings are characteristic, this entity may be unrecognized due to its unusual imaging appearance and rarity. CT or MR enterography and {sup 99m}Tc-sodium pertechnetate scintigraphy can provide complementary information that enables specific diagnosis and accurate assessment of disease extent. We present a case of extensive heterotopic gastric mucosa of the small intestine imaged by simultaneous, combined {sup 99m}Tc-sodium pertechnetate single photon-emission computed tomography (SPECT)/CT enterography to both familiarize the reader with the condition and describe an imaging strategy that enables specific diagnosis and assists with treatment planning. (orig.)

Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of 99mTc-pertechnetate thyroid uptake

International Nuclear Information System (INIS)

Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger; Joe, Alexius; Zimmerlin, Martina; Krause, Thomas M.

2002-01-01

The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTU s ). The TcTU s value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70±9 years, and the mean thyroid volume was 54±26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTU s : 150 Gy for a TcTU s of 1.5%-2.49%, 200 Gy for a TcTU s of 2.5%-3.49%, 250 Gy for a TcTU s of 3.5%-4.49% and 300 Gy for a TcTU s of ≥4.5%. Normalisation of TcTU s and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTU s in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54±26 before treatment to 34±20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTU s can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

A Case of Painful Hashimoto Thyroiditis that Mimicked Subacute Thyroiditis

Science.gov (United States)

Seo, Hye Mi; Kim, Miyeon; Bae, Jaeseok; Kim, Jo-Heon; Lee, Jeong Won; Lee, Sang Ah; Koh, Gwanpyo

2012-01-01

Hashimoto thyroiditis (HT) is an autoimmune thyroid disorder that usually presents as a diffuse, nontender goiter, whereas subacute thyroiditis (SAT) is an uncommon disease that is characterized by tender thyroid enlargement, transient thyrotoxicosis, and an elevated erythrocyte sedimentation rate (ESR). Very rarely, patients with HT can present with painful, tender goiter or fever, a mimic of SAT. We report a case of painful HT in a 68-year-old woman who presented with pain and tenderness in a chronic goiter. Her ESR was definitely elevated and her thyroid laboratory tests suggested subclinical hypothyroidism of autoimmune origin. 99mTc pertechnetate uptake was markedly decreased. Fine needle aspiration biopsy revealed reactive and polymorphous lymphoid cells and occasional epithelial cells with Hürthle cell changes. Her clinical symptoms showed a dramatic response to glucocorticoid treatment. She became hypothyroid finally and is now on levothyroxine therapy. PMID:22570820

Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

OpenAIRE

Luca Giovanella; Fabrizio Fasolini; Sergio Suriano; Luca Mazzucchelli

2010-01-01

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the 9 9 m T c -pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissu...

Parathyroid scintigraphy in chronic renal failure

International Nuclear Information System (INIS)

Baulieu, J.L.; Houlier, S.; Baulieu, F.; Rousseau, C.

1995-01-01

The performances of the scintigraphic localization of parathyroid adenoma have improved with the use of technetium-99m radiolabeled tracers and the development of thyroid subtraction methods. By using methoxy--isobutyl-isonitrile (MIB) alone in two phases, sensitivity and specificity are respectively O.85 and 0.92. The interest of scintigraphy compared with ultrasonography is specially marked in the situations encountered in patients with renal failure: hyperplasia, multiple or ectopic adenoma, association with thyroid nodules. However, the localisation of adenoma remains more difficult in renal failure than in primary hyperthyroidism. Scintigraphy seems to be essential for localizing adenoma and eventually hyperplasia, before surgery in patients in bad conditions or before a second operation. (authors). 26 refs., 3 figs., 2 tabs

Reconsideration of the indication of Ga-67 scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Takanashi, Toshiyasu; Komatani, Akio; Yamaguchi, Koichi (Yamagata Univ. (Japan))

1984-11-01

In order to establish proper indication of Ga-67 scintigraphy, its actual utilization in our hospital was reviewed. Although a large number of Ga-67 scintigraphy over 500 cases a year had been done, the clinical efficacy was found in limited conditions such as small cell carcinoma of the lung, malignant lymphoma, anaplastic carcinoma of the thyroid and abscess. In the other conditions, Ga-67 scintigraphy had little significance clinically and was not effective for seeking metastasis. Based on such situations, we emphasized that the indication of Ga-67 scintigraphy should be more limited under the better understanding of its characteristics.

Per-rectal portal scintigraphy in chronic liver diseases

International Nuclear Information System (INIS)

Frusciante, V.; Barbano, F.; Btuno, M.; Facciorusso, D.; Tonti, P.; Giacobbe, A.; Andriulli, A.; Vettori, P.G.P.

1993-01-01

Portal circulation has been evaluated by per-rectal portal scintigraphy in 21 controls and in 30 pts affected by chronic liver diseases. Tc99m-pertechnetate (10 mci) was given through a Nelaton's catheter in the upper rectum; a per-rectal portal shunt index (SI) was calculated. A relevant overlap is evident between controls and CHP pts; no overlap exists between controls and B or C graded cirrhosis. We conclude that the technique may be suggested to monitor the course of chronic liver diseases and different therapeutic regimens. (orig.) [de

TSH alone is not sufficient to exclude all patients with a functioning thyroid nodule from undergoing testing to exclude thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Hurtado-Lopez, Luis-Mauricio; Monroy-Lozano, Blanca-Estela [General Hospital of Mexico, Mexico City (Mexico); Martinez-Duncker, Carlos [Hospital Infantil de Mexico Federico Gomez, Medicina Nuclear Molecular, Mexico City, DF (Mexico)

2008-06-15

The purpose of the study was to analyze whether the thyroid-stimulating hormone (TSH) alone avoids tests to exclude malignancy in all patients with functional thyroid nodules (FTN). Sixty-nine patients with FTN on {sup 99m}Tc scintigraphy, radioiodine uptake test (RIU), {sup 99m}Tc thyroid uptake, TSH assay, T3, and T4 obtained within 48 h were retrospectively identified out of 2,356 thyroid scans performed from January 2000 to April 2007. FTNs were classified as causing total, partial, or no inhibition of the thyroid as group 1, 2, or 3, respectively. TSH was subnormal in 21 of 69 (30.43%) patients. In group 1 (N = 23, 33.3%), TSH was subnormal, normal, and high in eight, nine, and six patients; in group 2 (N = 17, 24.6%), TSH was subnormal, normal, and high in four, six, and seven patients, and in group 3 (N = 29, 42%), TSH was subnormal, normal, and high in 9, 13, and 7 patients, respectively. TSH was significantly lower in group 1. In T3, T4, {sup 99m}Tc thyroid uptake, and RIU, there were no differences between the three groups. Only 30.43% of patients had subnormal TSH. TSH alone cannot avoid tests to exclude malignancy in all patients with FTN. FTN existence can only be accurately assessed by thyroid scintigraphy. The current incidence of FTN may be unknown because scintigraphy is not routinely performed in all patients with thyroid nodules. Thyroid scintigraphy of patients with high TSH can detect diseases such as Hashimoto's thyroiditis and identify patients with FTN in whom no further diagnostic procedures would be needed in patients with normal TSH levels with nondiagnostic fine-needle aspiration results. (orig.)

Detecting thyroid cancer: utopia or reality? or Possibilities for thallium 201 in thyroid oncopathology

International Nuclear Information System (INIS)

Hermans, J.; Beauduin, M.; Gigot, J.F.; Schmitz, A.; Pluygers, E.

1985-01-01

201 Tl uptake by cold thyroid nodules, as evidenced by routine scintigraphy, was investigated in 119 patients. Results show strong correlation (89.5%) of existence of thyroid tumors (benign follicular adenoma and carcinoma) with 202 Tl uptake. (Auth.)

Dose selection for radioiodine therapy of borderline hyperthyroid patients with multifocal and disseminated autonomy on the basis of {sup 99m}Tc-pertechnetate thyroid uptake

Energy Technology Data Exchange (ETDEWEB)

Reinhardt, Michael J.; Mallek, Dirk von; Manka-Waluch, Agnieszka; Palmedo, Holger [Department of Nuclear Medicine, University Hospital Bonn (Germany); Joe, Alexius; Zimmerlin, Martina [Department of Nuclear Medicine, University Hospital Freiburg (Germany); Krause, Thomas M. [Department of Nuclear Medicine, Inselspital Bern (Switzerland)

2002-04-01

The aim of this study was to optimise radioiodine therapy of diffuse and nodular toxic goitre by calculation of the radiation dose delivered to the thyroid on the basis of the pretreatment technetium-99m pertechnetate thyroid uptake under thyrotropin suppression (TcTU{sub s}). The TcTU{sub s} value serves as a substitute for the non-suppressible iodine turnover and the functional autonomous mass. Marinelli's formula was used to calculate tissue absorbed doses of 150 Gy, 200 Gy, 250 Gy and 300 Gy to the thyroids of 438 patients with multifocal and disseminated autonomy. The mean age of patients was 70{+-}9 years, and the mean thyroid volume was 54{+-}26 ml. Two hundred and sixty-one of the patients had at least one documented previous episode of overt hyperthyroidism. Tissue absorbed doses were adapted to the pretreatment TcTU{sub s}: 150 Gy for a TcTU{sub s} of 1.5%-2.49%, 200 Gy for a TcTU{sub s} of 2.5%-3.49%, 250 Gy for a TcTU{sub s} of 3.5%-4.49% and 300 Gy for a TcTU{sub s} of {>=}4.5%. Normalisation of TcTU{sub s} and thyrotropin (TSH), thyroid volume reduction and frequency of hypothyroidism and recurrent hyperthyroidism were evaluated 1 year after a single radioiodine therapy. The presented dose strategy resulted in normalisation of TcTU{sub s} in 96% and an increase in TSH to the normal range in 92%. Recurrent hyperthyroidism was observed in only five patients. Thyroid volume decreased from 54{+-}26 before treatment to 34{+-}20 ml, a mean reduction of 37%. The frequency of hypothyroidism, at 0.9%, was encouragingly low. Dose selection in accordance with pretreatment TcTU{sub s} can be recommended for elimination of functional autonomous tissue with a single radioiodine therapy in patients of advanced age with enlarged thyroid glands and relevant autonomous masses who are at risk of developing iodine-induced hyperthyroidism. (orig.)

Comparison of 99mTc-HYNIC-TOC and HYNIC-TATE octreotide scintigraphy with FDG PET and 99mTc-MIBI in local recurrent or distant metastatic thyroid cancers.

Science.gov (United States)

Sager, Sait; Kabasakal, Levent; Halac, Metin; Maecke, Helmut; Uslu, Lebriz; Önsel, Çetin; Kanmaz, Bedii

2013-05-01

There have been various studies for early diagnosis of local recurrent or distant metastatic thyroid cancers. The aim of this study is to evaluate the clinical utility of 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE, octreotide derivatives, to detect recurrences or distant metastases in 131I-negative thyroglobulin positive thyroid cancer patients and to compare the lesions with FDG PET and 99mTc-MIBI studies in the same patient group. Twenty differentiated thyroid cancer patients, 7 male and 13 female, mean age 54.6 ± 15.3 (range 13-78 years), were included in this study. Eighteen patients had papillary thyroid cancer and 2 had follicular thyroid cancer. Fifteen patients received HYNIC-TOC and 5 patients received HYNIC-TATE as a radiopharmaceutical. All patients underwent whole-body scan 1 and 4 hours after injection of octreotide derivatives and SPECT imagings were performed from the suspicious sites. The lesions that were seen in 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE studies were compared with 99mTc-MIBI and FDG-PET studies. Among 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE scintigraphies, 15 patient studies were evaluated as true positive (75%) and 5 were false negative (25%). The total number of lesions in octreotide scintigraphy was 48 in 20 patients. Of 20 patients, 19 had FDG-PET study, 15 of them were evaluated as true positive (78.9%), and 4 them were evaluated as false negative (21.1%). Total number of lesions in FDG PET was 74. 99mTc-MIBI study was positive in 11 patients (55%) and negative in 9 patients (45%). Total number of lesions in 99mTc-MIBI was 25. Technetium-labeled somatostatin receptor scintigraphy analogues HYNIC-TOC and HYNIC-TATE are useful imaging alternatives in somatostatin receptor expressing thyroid cancer patients. Radiolabeling is easy and they are readily available for routine use.

The role of scintigraphy with the use of 99mTc-HYNIC-TOC in the diagnosis of medullary thyroid carcinoma

International Nuclear Information System (INIS)

Czepczynski, R.; Kosowicz, J.; Ziemnicka, K.; Gryczynska, M.; Sowinski, J.; Mikolajczak, R.

2006-01-01

Introduction: Recently a new somatostatin analogue labelled with 99mT c ( 99mT c-HYNIC-TOC) has been synthetized. Aim of this study was to evaluate the utility of 99mT c-HYNIC--TOC in the radionuclide imaging in patients with medullary thyroid carcinoma (MTC). Material and methods: 30 patients with MTC aged 22.83 years in different stages of the disease were investigated. In 6 patients (group 1) scintigraphy was performed before surgery directly after diagnosis of MTC. Four patients (group 2) were qualified to the study in the phase of remission after surgical treatment that had been confirmed by low concentrations of calcitonin. Twenty patients (group 3) were investigated due to stagnation or recurrence confirmed by persistent hypercalcitoninemia. The scintigraphy using 99mT c- HYNIC-TOC (Tektrotyd, POLATOM) was performed 2 and 4 hours post injection of 20 mCi (740 MBq) of the tracer. Other imaging techniques were also employed and analysed in individual cases (US, CT, 99mT c(V)-DMSA, 131I -MIBG, 99mT c-MDP, 111I n-octreotide and FDG-PET). Results: Images obtained 2 and 4 hours p.i. were similar. In group 1, uptake of the tracer was found in the primary tumour of MTC in all patients. In group 2, a false positive result was found in 1 of 6 patients. In the remaining 5 of 6 cases no pathological foci were visualised. In group 3, uptake in the thyroid bed was found in 3 of 20 cases and in the lymph nodes in 14 of 20 patients. In 3 of 20 cases uptake in the bone metastases was found. Globally, sensitivity of the scintigraphy using 99mT c-HYNIC-TOC was 86.4%, specificity 75.0%, and accuracy . 84.6%. Conclusion: The scintigraphy using 99mT c-HYNIC-TOC showed high utility in the diagnosis of MTC. Confirmation of the presence of somatostatin receptors with this method may be used for treatment planning: surgery or radionuclide therapy. (author)

Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism

International Nuclear Information System (INIS)

Sohn, Myung Hee; Jeong, Hwan Jeong; Kim, Dong Wook; Lim, Seok Tae

2009-01-01

A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism

Scintigraphic discrimination of infections from cancer with 67Ga citrate and sup(99m)Tc pertechnetate

International Nuclear Information System (INIS)

Okuyama, Shinichi; Ito, Yasuhiko; Sato, Tachio

1977-01-01

A paralleled study was carried out on lung cancer and infectious lesions by scintigraphy with 67 Ga citrate and sup(99m)Tc pertechnetate. Malignancies were Ga-positive but Tc-negative whilest infective lesions were positive with both radioisotopes. The technic is simple and yet unique in that it employs radioisotopic uptake ratios which were computed by recording radioactivity over such lesions and over appropriate control sites. This technic may offer a prompt and prospective means of making a differential diagnosis of lung cancer and active lung abscesses. Confirmative value of lesion to control region counting ratio was also emphasized. (auth.)

Hyperthyroidism due to struma ovarii: Diagnostic pitfalls and preventing thyroid storm

OpenAIRE

Koichi Nagai; Hiroshi Yoshida; Kayo Katayama; Yumi Ishidera; Yuka Oi; Noriko Ando; Hiroyuki Shigeta

2017-01-01

We report struma ovarii in a case that had hyperthyroidism and was treated with laparoscopic tumor resection. A 40-year-old Japanese woman presented with tachycardia, finger tremor, and weight loss. Although blood examination showed hyperthyroidism, test results for thyroid stimulating hormone receptor antibody and thyroid stimulating antibody were negative, and thyroid scintigraphy showed no abnormal findings. Because she was diagnosed with an ovarian tumor, and whole-body scintigraphy showe...

Method and container for reducing pertechnetate

International Nuclear Information System (INIS)

Ruddock, C.F.

1980-01-01

A method of reducing the pertechnetate in TcO 4 - comprises mixing together an aqueous solution of pertechnetate, e.g. the eluant from a technetium generator, metallic tin or an alloy thereof as a reducing agent for the pertechnetate, and a soluble salt of a metal below tin in the electrochemical series, e.g. copper, as an activator for the tin metal reducing agent. A complexing agent for the reduced technetium or a colloid stabiliser may also be included. The pH is preferably 3 to 12. Also claimed is a closed container containing the tin reducing agent, the activator, and the complexant or colloid stabiliser if used, preferably in a freeze-dried sterile state, to which the pertechnetate solution may be added. (author)

Transient thyrotoxicosis from thyroiditis induced by sibutramine overdose: a case report.

Science.gov (United States)

Kim, S K; Lee, S M; Yoo, S S; Hahm, J R; Jung, J H; Kim, H S; Kim, S; Chung, S I; Jung, T S

2013-08-01

Sibutramine is an antiobesity drug that inhibits the reuptake of serotonin and noradrenalin in the hypothalamus. A 37-year-old Korean man presented to the emergency room for the oral intake of 280 mg of sibutramine. The patient was in thyrotoxic state. The (99m)Technetium-pertechnetate thyroid scan showed irregular uptake of radioisotope and thyroid-stimulating hormone receptor antibody and thyroperoxidase antibody were negative. Thyroid function normalized after that. The patient had transient thyrotoxicosis with thyroiditis. We report a case of thyrotoxicosis accompanied by thyroiditis resulting from the intentional overdose of sibutramine.

Detecting thyroid cancer: utopia or reality; possibilities for thallium 201

International Nuclear Information System (INIS)

Hermans, J.; Beauduin, M.; Gigot, J.F.; Schmitz, A.

1986-01-01

Faced with a diagnosis of cold thyroid nodule as evidenced by routine scintigraphy, the clinician has to determine whether this nodule is malignant or not. This is a serious problem since, according to literature, 7-20 per cent of cold thyroid nodules are malignant. In 1982 some Japanese authors demonstrated the possibility of using 201 T1 in diagnosing thyroid tumors. This study refers to 120 patients who underwent an operation for thyroid disorders characterized by the presence of one or several cold nodules (as evaluated with conventional scintigraphy) and enables a comparison between a thorough evaluation of the thyroidal status and the 201 T1 scintigrams. These were obtained with a gamma-camera using a pinhole collimator. If a cold nodule is positive with 201 T1, surgery is incontestably indicated, as such a finding correlates with the existence of a thyroid tumor (benign follicular adenoma or carcinoma) in 89.5 per cent of the observed cases. In the cancer group the sensibility of the Thallium test is of 85 per cent and its specificity 80 per cent. We may assert that there is a very low risk of Thallium negative (old) nodules being malignant. The pre-operative 201 T1 scintigraphy is easy to perform in any Nuclear Medicine department. Nowadays, the combination of aspiration cytology and 201 T1 scintigraphy should make it possible to make an accurate diagnosis in the vast majority of differentiated and undifferentiated thyroid cancers [fr

Comparison of sup(99m)Tc-MDP to sup(99m)Tc-pertechnetate by computerized quantitative joint scintigraphy

International Nuclear Information System (INIS)

Rekonen, A.; Moettoenen, T.; Oka, M.

1982-01-01

99mTc-pertechnetate was compared to 99mTc-MDP in joint pairs with asymmetric arthritis. Markedly elevated joint activity ratios (inflamed/uninflamed joint) were measured in all the joint pairs studied. In the joints affected by reactive arthritis and without roentgenologic changes the mean joint activity was the same with both tracers. A very high activity ratio with 99mTc-MDP was found in septic arthritis. In rheumatoid arthritis the sensitivity of 99mTc-MDP as an indicator of active arthritis seemed to be better than that of 99mTc-pertechnetate. Even in joints without erosions in roentgenograms the joint activity ratios were markedly elevated with 99mTc-MDP. This suggests, that high activity in 99mTc-MDP scanning might be prognostic of erosive joint changes. In this work a profile curve was used for quantitation differences between joints

Double thyroid ectopia (with incidental papillary thyroid microcarcinoma) (2010: 8b)

Energy Technology Data Exchange (ETDEWEB)

Borges, Alexandra [Instituto Portugues de Oncologia de Francisco Gentil-Centro de Lisboa, Department of Radiology, Lisbon (Portugal); Martins, Mariluz [Instituto Portugues de Oncologia de Francisco Gentil-Centro de Lisboa, Department of Head and Neck Surgery, Lisbon (Portugal); Andre, Saudade [Instituto Portugues de Oncologia de Francisco Gentil-Centro de Lisboa, Department of Pathology, Lisbon (Portugal)

2010-11-15

We present the case of a 45-year-old man with a long-standing history of a slow-growing left submandibular mass. Imaging was diagnostic as it disclosed an absent orthotopic thyroid gland and heterogeneous masses, with both solid and cystic components, as well as calcifications in the left sublingual/submandibular space and in the left paramedian aspect of the tongue base, consistent with double thyroid ectopia, originating from central and lateral thyroid anlages, respectively. Pathology confirmed an ectopic thyroid goiter in the left submandibular space with an incidental papillary microcarcinoma. Scintigraphy also demonstrated ectopic thyroid tissue in the left tongue base. (orig.)

Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism

Energy Technology Data Exchange (ETDEWEB)

Sohn, Myung Hee; Jeong, Hwan Jeong; Kim, Dong Wook; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

2009-04-15

A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism

Scintigraphic evaluation of congenital anomalies of the thyroid gland

International Nuclear Information System (INIS)

Paul, A. K.; Hassan, M.A.; Miah, M.S.R.

2001-01-01

Total 2287 patients who undergone thyroid scintigraphy in Nuclear Medicine Centre, Khulna from January 1998 to December 2000 were retrospectively studied to evaluate the congenital anomalies of the thyroid gland. Scintigraphy showed thyroid anomalies in 11 patients (0.48%). The presenting features and thyroid function tests were analyzed and a detailed study was performed. Of these 11 cases, 7 patients (63.6%) had ectopic thyroid gland and site of ectopic was found to be lingual in 4 cases, sublingual in 2 cases and pre laryngeal in 1 case, 3 patients (27.3%) with hemi agenesis of thyroid and 1 patient (9.1%) with athyreosis. Biochemically 3 cases were hypothyroid of which 2 had ectopic thyroid and 1 with athyreosis. 1 patient was hyperthyroid with hemi agenesis of thyroid and 7 were euthyroid. Females were more affected than males, the ratio being 4.5:1. (authors) 2 tabs. 12 refs

Thyroid profiles in a patient with resistance to thyroid hormone and episodes of thyrotoxicosis, including repeated painless thyroiditis.

Science.gov (United States)

Taniyama, Matsuo; Otsuka, Fumiko; Tozaki, Teruaki; Ban, Yoshiyuki

2013-07-01

Thyrotoxic disease can be difficult to recognize in patients with resistance to thyroid hormone (RTH) because the clinical symptoms of thyrotoxicosis cannot be observed, and thyrotropin (TSH) may not be suppressed because of hormone resistance. Painless thyroiditis is a relatively common cause of thyrotoxicosis, but its occurrence in RTH has not been reported. We assessed the thyroid profile in a patient with RTH and episodes of thyrotoxicosis who experienced repeated painless thyroiditis. A 44-year-old Japanese woman with RTH, which was confirmed by the presence of a P453A mutation in the thyroid hormone receptor β (TRβ) gene, showed a slight elevation of the basal levels of thyroid hormones, which indicated that her pituitary RTH was mild. She experienced a slight exacerbation of hyperthyroxinemia concomitant with TSH suppression. A diagnosis of painless thyroiditis was made because of the absence of TSH receptor antibodies, low Tc-99m pertechnetate uptake by the thyroid gland, and transient suppression followed by a slight elevation of TSH following the elevation of thyroid hormones. The patient's complaints of general malaise and occasional palpitations did not change throughout the course of painless thyroiditis. Three years later, painless thyroiditis occurred again without any deterioration of the clinical manifestations. Mild pituitary RTH can be overcome by slight exacerbation of hyperthyroxinemia during mild thyrotoxicosis. When pituitary resistance is severe and TSH is not suppressed, thyrotoxicosis may be overlooked.

A comparison between the secretion of Tc-99m pertechnetate and I-131 iodide through the stomach of the chacma monkey

International Nuclear Information System (INIS)

Ellmann, A.

1985-03-01

The way in which pertechnetate is excreted by the stomach is a continuing controversy in the nuclear medicine literature. The question arises: Does the stomach, unlike the thyroid handle pertechnetate and iodide by different mechanisms? The excretion of pertechnetate and iodide by the stomach in the Chacma baboon was compared. In this way an attempt was made to obtain more information on the way in which the stomach handles pertechnetate. The study was performed on young adult Chacma baboons. Pertechnetate and iodide were administeed simultaneously via the intravenous route. 6 Baboons were studied after pharmacological interventions, namely the administration of pentagastrin, cimetidine and perchlorate. Nine other baboons were studied after surgical interventions. Three groups of 3 each were studied after selective vagotomy, Billroth I gastrectomy and proximal gastrectomy respectively. In the surgical group post-operative studies were also done before and after pentagastrin stimulation. Tissue samples of the stomachs of 4 baboons were studied. The various types of surgery all resulted in a decrease in the volume of gastric juice. The excretion of pertechnetate and iodide was related to the volume of gastric juice except after the administration of perchlorate. In spite of marked changes of up to 60 times in the amount of pertechnetate and iodide excretion after the pharmacological and surgical interventions, the Tc : I - ratio remained almost constant. The Tc : I - ratio in the blood samples showed a gradual increase as could be expected. The Tc : I - ratios in the tissue samples were similar to those in the blood samples. It is indicated that, like iodide, pertechnetrat is probably excreted by the mucus cells of the stomach and not by the parietal cells. 28 figs., 164 refs., 6 tabs

Scintigraphic And Ultrasonic Determinations of Thyroid Volume

International Nuclear Information System (INIS)

Sarsono; Ismanto; Kunto, W; Hayati, N; Irma, S H

1996-01-01

A study has been done on the determination of thyroid volume by scintigraphic method in comparison to ultrasonographic technique, which involved a healthy woman volunteer, 5 women patients and a man patient with thyroid diseases. Scintigraphic examination upon the patient's thyroid was performed using a gamma camera 20 minutes following the injection of 55.5 Mbq (1.5 mCi) Tc-99m pertechnetate. A computer, with a dedicated program, coupled to the gamma camera was employed in the calculation of thyroid volume based on the scintigraphic data. Subsequent to the scintigraphic study, ultrasonographic determination of thyroid volume was then carried out. Correlation test that was applied to the outcome of the two methods of thyroid volume determination resulted in an excellent coefficient of correlation, R, which was 0.99. This showed a very good correlation between these two different techniques of thyroid volume determination

Hyperthyroidism caused by a toxic intrathoracic goiter with a normal-sized cervical thyroid gland

International Nuclear Information System (INIS)

Prakash, R.; Lakshmipathi, N.; Jena, A.; Behari, V.; Chopra, M.K.

1986-01-01

The rare presentation of hyperthyroidism caused by an intrathoracic goiter with a normal-sized cervical thyroid gland is described. The toxic intrathoracic goiter demonstrated avid uptake of [ 131 I] and [99mTc]pertechnetate, with comparatively faint isotopic accumulation seen in the cervical thyroid. A chest roentgenogram and radioisotope scan should be mandatory in cases of hyperthyroidism having no cervical thyroid enlargement to explore the possibility of a toxic intrathoracic goiter

Sup(99m)Tc compounds for diagnostic purposes

International Nuclear Information System (INIS)

Cifka, J.; Budsky, F.

1980-01-01

The applications of sup(99m)Tc in nuclear medicine are discussed, such as sodium pertechnetate in thyroid and brain scintigraphy, complex compounds in lungs and liver diao.nosis. Technetium generators are classified according to the method of separating sup(99m)Tc from 99 Mo. Adsorption generators are used, molybdate-99 is adsorbed on an Al 2 O 3 -packed column while pertechnetate-99m is eluted with 0.9% NaCl solution. Also used is continuous pertechnetate-99m extraction with methyl ethyl ketone from 0.5 M potassium molybdate and 2.5 M of potassium carbonate. The manufacture is described of kits for sup(99m)Tc radiopharmaceuticals preparation, eg., Diagos I, a gluconate complex, a lyophilisate for sup(99m)Tc-sodium pyrophosphate injections, a diagnostic kit for lung scintiscanning. (H.S.)

Kinetics of the human thyroid trap: experience in normal subjects and in thyroid disease

Energy Technology Data Exchange (ETDEWEB)

Hays, M.T.

1979-03-01

Kinetics of the thyroid pertechnetate trap were assessed in 39 normal subjects, five untreated patients with Graves' disease (two before and after treatment), two hypothyroid patients, and in one patient each with Hashimoto's thyroiditis of recent onset, subacute thyroiditis, and massive anaplastic carcinoma. In normal subjects, the effects of sex, time of day, and order of experimental sessions were studied. A three-compartment model was assumed for all studies. Data on thyroidal and neck-background pertechnetate were collected with a multicrystal camera during 40 min after iv injection. The two thyroidal compartments in the model - the follicular cell, v/sub 2/, and the colloidal plasma-equivalent space, V/sub 3/ - is a multi-exponential function of plasma radioactivity, V/sub 1/. None of the model parameters was systematically affected by sex and order of session did not consistently alter any parameter, except for V/sub 3/, which was greater in session 2 than in session 1. That increase was not consistent and is believed to be spurious. Time of day affected only the exit rate constant from the colloid ..lambda../sub 23/, which was increased later in the day (P < 0.02). Distribution of the normal parameters was more log-normal than normal. After 5% were excluded at the high end and at the low end, the range for a parameter, p, was found empirically to be: antiln (mean ln p - 1.7 s.d. ln p), and antiln (mean ln p + 1.5 s.d. ln p). In Graves' disease, V/sub 2/ is increased (P < 0.02), but the increases in V/sub 3/ and in ..lambda../sub 21/ (the clearance into the thyroid from serum) are more dramatic (P < 10/sup -8/). After treatment, V/sub 3/ and ..lambda../sub 21/ fell toward normal. The hypothyroid patients showed no trap activity, and the trap was normal in the patient with early Hashimoto's thyroiditis. The patients with subacute thyroiditis and anaplastic carcinoma had increases in V/sub 2/, V/sub 3/, and ..lambda../sub 21/, but the

Quaternary alkylammonium and alkylphosphonium pertechnetates. Application to pertechnetate ion-selective electrodes

International Nuclear Information System (INIS)

German, K.E.; Dorokhov, A.V.; Tarasov, A.V.; Baulin, V.E.; Peretroukhine, V.; Tsivadze, A.Yu.; Kopytin, A.V.; Politov, Yu.; Pyatova, E.N.

2005-01-01

Pertechnetate ion-selective PVC membrane electrodes based on quaternary alkylammonium and phosphonium salts (bromides and pertechnetates) were examined. The most favorable ionophore was tetradecyltrimethylammonium bromide. The response function was linear within the concentration range 10 -2 -10 -6 mol/L and the slope was 52 mV/pTcO 4 . The detection limit remained at 5x10 -7 mol/L. The selectivity and response time of the electrodes was studied and it was found that the electrodes exhibited high selectivity to TcO 4 - -anion against the main inorganic components of radioactive waste solutions and environmental waters (nitrate, sulfate, chloride and others). The electrodes response was stable over a wide pH range. (author)

Role of Nuclear Medicine in the Diagnosis of Benign Thyroid Diseases.

Science.gov (United States)

Garberoglio, Sara; Testori, Ornella

2016-01-01

A deep understanding of thyroid pathophysiology is the basis for diagnosing and treating benign thyroid diseases with radioactive materials, known as radiopharmaceuticals, which are introduced into the body by injection or orally. After the radiotracer administration, the patient becomes the emitting source, and several devices have been studied to detect and capture these emissions (gamma or beta-negative) and transform them into photons, parametric images, numbers and molecular information. Thyroid scintigraphy is the only technique that allows the assessment of thyroid regional function and, therefore, the detection of areas of autonomously functioning thyroid nodules. Scintigraphy visualizes the distribution of active thyroid tissue and displays the differential accumulation of radionuclides in the investigated cells, thus providing a functional map. Moreover, this technique is a fundamental tool in the clinical and surgical management of thyroid diseases, including: single thyroid nodules with a suppressed thyroid-stimulating hormone level, for which fine-needle aspiration biopsy (FNAB) is used to identify hot nodules; multinodular goiters, especially larger ones, to identify cold or indeterminate areas requiring FNAB and hot areas that do not need cytologic evaluation, and to evaluate mediastinal extension; the diagnosis of ectopic thyroid tissue; subclinical hyperthyroidism to identify occult hyperfunctioning tissue; follicular lesions to identify a functioning cellular adenoma that could be benign, although such nodules are mostly cold on scintigraphy; to distinguish low-uptake from high-uptake thyrotoxicosis, and to determine eligibility for radioiodine therapy. © 2016 S. Karger AG, Basel.

Biodistribution of technetium-99m pertechnetate after Roux-en-Y gastric bypass (Capella technique) in rats

International Nuclear Information System (INIS)

Rego, Amalia Cinthia Meneses do; Jacome, Daniel Torres; Ramalho, Rachel de Alcantara Oliveira; Araujo-Filho, Irami; Azevedo, Italo Medeiros; Medeiros, Aldo Cunha

2010-01-01

Purpose: The biodistribution of sodium pertechnetate, the most used radiopharmaceutical in nuclear medicine, has not been studied in details after bariatric surgery. The objective was to investigate the effect of Roux-en-Y gastric bypass (RYGB) on biodistribution of sodium pertechnetate (Na 99m Tc-) in organs and tissues of rats. Methods: Twelve rats were randomly divided into two groups of 6 animals each. The RYGB group rats were submitted to the Roux-en-Y gastric bypass and the control group rats were not operated. After 15 days, all rats were injected with 0.1mL of Na 99m Tc- via orbital plexus with average radioactivity of 0.66 MBq. After 30 minutes, liver, stomach, thyroid, heart, lung, kidney and femur samples were harvested, weighed and percentage of radioactivity per gram (%ATI/g) of each organ was determined by gamma counter Wizard Perkin-Elmer. We applied the Student t test for statistical analysis, considering p 99m Tc - . (author)

The additional diagnostic value of a single-session combined scintigraphic and ultrasonographic examination in patients with thyroid and parathyroid diseases.

Science.gov (United States)

Gedik, G K; Bozkurt, F M; Ugur, O; Grassetto, G; Rubello, D

2008-09-01

The aim of this study was to investigate the diagnostic efficacy and the clinical impact of scintigraphy combined with ultrasonography (USG) in the management of thyroid and parathyroid disorders in a large series of patients. A total of 387 consecutive patients referred to the Nuclear Medicine Department of Hacettepe University in the period from January to September 2007 for investigating a thyroid (N. 339 patients: 232 females and 107 males, mean age+/-SD=48.9+/-13.6 years) or a parathyroid disease (N. 48 patients: 34 females and 14 males, mean age+/-SD=47.4+/-9.6 years) were prospectively evaluated, systematically performing both scintigraphy and USG in a single-day session. All the examinations were independently reviewed by two nuclear medicine physicians; in cases of discrepancy (3%) a final diagnosis was reached by consensus. For thyroid pathologies, USG results were considered to provide additional diagnostic information over scintigraphy: 1) if more nodules were identified; 2) if an irregular hyperactive area at scintigraphy suspicious for the presence of a nodule was clearly characterized at USG; 3) if a nodule missed at scintigraphy because of small size (thyroid diseases, scintigraphy was considered to provide additional diagnostic information over USG, if the functional status of a diffuse or uni- or multi-nodular goiter were clearly defined at scintigraphy. In parathyroid diseases, scintigraphy was considered to provide additional diagnostic information over USG, if the differential diagnosis between a lymph node or a muscle or a vessel depicted at USG was clearly defined as a parathyroid enlargement at scintigraphy. Lastly, the clinical impact of the single-day combined scintigraphic/USG protocol was evaluated. USG. In the thyroid diseases group, USG was particularly useful: 1) to detect additional nodules in glands with suppressed thyroid tissue; 2) to disclose small thyroid nodules (thyroid diseases group, scintigraphy was particularly useful: 1

Hyperfunctioning solid/trabecular follicular carcinoma of the thyroid gland.

Science.gov (United States)

Giovanella, Luca; Fasolini, Fabrizio; Suriano, Sergio; Mazzucchelli, Luca

2010-01-01

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the (99m)Tc-pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

Hyperthyroidism due to struma ovarii: Diagnostic pitfalls and preventing thyroid storm

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Koichi Nagai

2017-02-01

Full Text Available We report struma ovarii in a case that had hyperthyroidism and was treated with laparoscopic tumor resection. A 40-year-old Japanese woman presented with tachycardia, finger tremor, and weight loss. Although blood examination showed hyperthyroidism, test results for thyroid stimulating hormone receptor antibody and thyroid stimulating antibody were negative, and thyroid scintigraphy showed no abnormal findings. Because she was diagnosed with an ovarian tumor, and whole-body scintigraphy showed that iodine uptake was detected in the pelvic space, we diagnosed her with an ovarian tumor, which caused excessive thyroid hormone secretion. After controlling the thyroid hormone level, we resected the ovarian tumor laparoscopically. The thyroid hormone level was within the normal range postoperatively without any medications. Based on our experience, physicians need to remember that ovarian tumors can cause hyperthyroidism. Controlling the thyroid hormone level preoperatively by using antithyroid drugs and performing minimally invasive laparoscopic surgery is considered useful for preventing thyroid storm.

Preliminary Tests For Development Of A Non-Pertechnetate Analysis Method

Energy Technology Data Exchange (ETDEWEB)

Diprete, D. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); McCabe, D. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2016-09-28

The objective of this task was to develop a non-pertechnetate analysis method that 222-S lab could easily implement. The initial scope involved working with 222-S laboratory personnel to adapt the existing Tc analytical method to fractionate the non-pertechnetate and pertechnetate. SRNL then developed and tested a method using commercial sorbents containing Aliquat^® 336 to extract the pertechnetate (thereby separating it from non-pertechnetate), followed by oxidation, extraction, and stripping steps, and finally analysis by beta counting and Mass Spectroscopy. Several additional items were partially investigated, including impacts of a ¹³⁷Cs removal step. The method was initially tested on SRS tank waste samples to determine its viability. Although SRS tank waste does not contain non-pertechnetate, testing with it was useful to investigate the compatibility, separation efficiency, interference removal efficacy, and method sensitivity.

Sorption and pertechnetate by salts of molybdophosphoric acid

International Nuclear Information System (INIS)

Suess, M.; Pfrepper, G.

1983-01-01

The sorption of pertechnetate on salts of molybdophosphoric acid from nitric acid and in the presence of electrolytes was investigated. Distribution coefficients from 10 to 100 ml/g were found. The sorption of pertechnetate can be increased by the addition of K + , NH 4 + , Rb + and Cs + salts. A saturation capacity of proportional 0,19 mmol/g ammonium phosphomolybdate was found from the adsorption isotherms. The formation of alkali metal pertechnetate associates in the sorbent phase is supposed. (orig.)

Identification of Hürthle cell tumor by single-injection, double-phase scintigraphy with technetium-99m-sestamibi.

Science.gov (United States)

Vattimo, A; Bertelli, P; Cintorino, M; Burroni, L; Volterrani, D; Vella, A

1995-05-01

Early and late (double-phase) scintigraphy with 99mTc-MIBI was used in a comparative study of the scintigraphic aspects of Hürthle cell tumors and other thyroid tumors. Single-injection, dual-phase (15-30 min and 3-4 hr) thyroid scintigraphy with 99mTc-sestamibi (MIBI) was performed on 41 patients who displayed a cold nodule on previous 99mTc scintigraphy. Visual scoring of nodular uptake was done to compare thyroidal and background tracer uptake. In addition, the nodular-to-thyroid (N/T) uptake ratio in the early and late images and the washout rate from the nodule (WON) and thyroidal tissue (WOT) were measured. Cytologic results were obtained for all patients; histopathologic results were obtained for the 20 patients who had surgery. In eight patients (Group A), the nodule displayed intense and persistent uptake of MIBI (N/T = 1.77 +/- 0.46 and 3.20 +/- 1.37; WON = 17.2% +/- 6.3%; WOT = 24.6% +/- 7.5%); histopathology revealed Hürthle cell tumors (two carcinomas and three adenomas) in five surgical patients. In 15 patients (Group B), the nodule displayed intense uptake in the early image with fading activity in the late image (N/T = 1.45 +/- 0.54 and 0.84 +/- 0.30; WON = 30.0% +/- 7.3%; WOT = 24.5% +/- 6.8%); histopathology revealed a colloid nodule (n = 1), papillary carcinoma (n = 4) and follicular carcinoma (n = 5) in 10 surgical patients. In the remaining 18 patients (Group C), the nodule was cold and late images were not acquired. Histopathology revealed colloid nodules (n = 2) and follicular adenoma (n = 3) in five surgical patients. Single-injection, dual-phase MIBI scintigraphy of the thyroid can identify Hürthle cell tumors because these tumors have intense, persistent tracer uptake in contrast to other thyroid tumors.

Gamma-scintigraphy

International Nuclear Information System (INIS)

Desgrez, H.A.

1960-06-01

Gamma-scintigraphy is a medical technique making it possible to fix the image of certain organs after the concentration in these of emitting radioactive products. It is already widely used in the case of the thyroid gland with iodine-132 by applying the isotope iodine 131. The study of the liver and gall bladder is carried out using colloidal gold 198 and Bengal pink marked with iodine 131. Serum albumin marked with iodine 131 makes it possible to study rachidian blockages. Other applications can already be foreseen in this direction. (author) [fr

Thyroid function study

International Nuclear Information System (INIS)

Rocha, A.F.G. da

1976-01-01

A short revision of thyroid physiology is done. The radioisotopes of common use in thyroid investigation and the choice of the most appropriated ones are discussed. A table showing radioisotopes frequently used in this study, with their main characteristics is presented. Among several isotopic assays in thyroid propaedeutics, those that refer to the function study, topographic studies and tests 'in vitro' are pointed out. Exploration methods 'in vivo' are treated, such as: thyroid uptake; urinary excretion; thyroid scintigraphy, with scintigraphic imagings; stimulation test by TSH; suppression test; pbi; clearance test with perchlorate; iodine deficiency test and thyroid study with technetium. 'In vitro' proofs like triiodothyronine (T 3 ) and thyroxine (T 4 ) assays, as well as free thyroxine index, are treated. At last, the therapeutics by Iodine 131 is commented and emphasis is given to its application on the treatment of hyperthyroidism and thyroid carcinoma [pt

Hyperfunctioning Solid/Trabecular Follicular Carcinoma of the Thyroid Gland

Directory of Open Access Journals (Sweden)

Luca Giovanella

2010-01-01

Full Text Available A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the 99mTc-pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.

Coexistence of Hashimoto's thyroiditis and papillary thyroidal carcinoma with papillary carcinoma of thyreoglossal duct

Directory of Open Access Journals (Sweden)

Čizmić Milica

2007-01-01

Full Text Available Background. Simultaneous presence of Hashimoto's thyroiditis and papillary thyroidal carcinoma in thyroidal gland with papillary carcinoma association in thyroglossal duct is quite rare. The questions like where the original site of primary process, is where metastasis is, what the cause of coexisting of these diseasesis present a diagnostic dilemma. Case report. We presented a case of a 53-year old female patient, with the diagnosis of Hashimoto's thyroiditis and symptoms of subclinical hypothyreosis and nodal changes in the right lobe of thyroidal gland, according to clinical investigation. Morphological examination of thyroidal gland, ultrasound examination and scintigraphy with technetium (Tc confirmed the existence of nonhomogenic tissue with parenchyma nodular changes in the right lobe of thyroidal gland that weakly bonded Tc. Fine needle biopsy in nodal changes, with cytological analyses showed no evidence of atypical thyreocites. Hashimoto's thyroiditis was confirmed on the basis of the increased values of anti-microsomal antibodies, the high levels of thyreogobulin 117 ng/ml and TSH 6.29 μIU/ml. The operation near by the nodular change in the right lobe of thyroidal gland revealed pyramidal lobe spread in the thyroglossal duct. Total thyroidectomia was done with the elimination of thyroglossal duct. Final patohystological findings showed papillary carcinoma in the nodal changes pT2, N0 and in the thyroglossal duct with the presence of Hashimoto's thyroiditis in the residual parenchyme of the thyroid gland. After the surgery the whole body scintigraphy with iodine 131 (131I did not reveal accumulation of 131I in the body, while the fixation in the neck was 1%. After that, the patient was treated with thyroxin with suppressionsubstitution doses. Conclusion. Abnormality in embrional development of thyroidal tissue might be the source of thyroidal carcinoma or the way of spreading of metastasis of primary thyroidal carcinoma from thyroid

Chapter 3. Thyroid

International Nuclear Information System (INIS)

Tubiana, M.; Perez, R.

1975-01-01

In the context of a functional thyroid exploration study the physiopathology of the thyroid was reviewed on the basis of data supplied by the use of radioisotopes, especially radioiodine. It was pointed out in this respect that the functional activity of the thyroid is closely bound up with the iodine metabolism. The different stages of the iodine metabolism were therefore described in relation to the methods used for their exploration: study of iodine intake to the thyroid and uptake measurement; hormonogenesis and secretion of hormone iodine; transport and circulation of thyroid hormones; exploration of the hypothalamus-pituitary gland-thyroid axis. It was pointed out in addition that the morphological examination often complements the thyroid function exploration and is carried out whenever thyroid palpation reveals an anomaly. Data obtained by scintigraphy are given in this repect. Furthermore the remarkable capacity of hyperthyroid tissues to concentrate radioactive iodine may be used therapeutically to perform an endogenous irradiation of the thyroid. The treatment of both hyperthyroidism and thyroid cancers with radioactive iodine was studied [fr

Radioprotection of salivary glands by S-2-(3-aminopropylamino)-ethylphosphorothioic (amifostine) obtained in a rabbit animal model

International Nuclear Information System (INIS)

Bohuslavizki, Karl H.; Klutmann, Susanne; Jenicke, Lars; Brenner, Winfried; Feyerabend, Bernd; Henze, Eberhard; Clausen, Malte

1999-01-01

Background: Impairment of salivary gland function following high-dose radioiodine treatment (HDRIT) is a well-recognized side effect of the treatment. Because differentiated thyroid cancer has an excellent prognosis, reduction of long-term side-effects is mandatory. Therefore, the aim of this study was to investigate the radioprotective effect of amifostine in a rabbit animal model. Methods: Salivary gland scintigraphy was performed in a total of 16 New Zealand White rabbits. Uptake of 99m Tc-pertechnetate was calculated in percentage of injected activity as a quantitative measure of both salivary gland and thyroid function. Reproducibility of salivary gland scintigraphy was evaluated in one rabbit without any intervention. Fifteen rabbits were studied prior to and up to 6 months after high-dose radioiodine treatment applying 2 GBq 131 I. Ten animals received 200 mg/kg amifostine prior to high-dose radioiodine therapy, and 5 served as controls. Salivary glands were examined histopathologically. Results: Variation coefficient of parenchymal function was less than 3.8% in salivary glands. Prior to HDRIT, thyroid uptake was 0.417 ± 0.373% and 0.421 ± 0.241% in control and amifostine-treated rabbits, respectively. Four weeks after HDRIT, complete ablation of the thyroid was achieved in both groups. Prior to HDRIT, uptake of 99m Tc-pertechnetate in salivary glands of five control rabbits was not significantly different from ten amifostine-treated rabbits. In control rabbits 6 months after HDRIT, parenchymal function was reduced significantly (p 0.05) in parotid and submandibular glands, respectively. Histopathologically, marked lipomatosis was observed in control animals but was negligible in amifostine-treated animals. Conclusion: Parenchymal damage in salivary glands induced by high-dose radioiodine treatment can be significantly reduced by amifostine in this rabbit animal model. This corresponds to data obtained in patients with differentiated thyroid cancer

Mechanisms of thallium-201 accumulation to thyroid gland

International Nuclear Information System (INIS)

Kishida, Toshihiro

1987-01-01

In this study 91 patients with goiter were scintigraphed for the duration of 84 minutes after intravenous administration of thallium-201 by digital γ camera lined to computer data system. Regions of interest (ROIs) were assigned for thyroid tumor, normal thyroid and back ground, and time-activity curves (TACs) were generated from these ROIs. Na + , K + -ATPase activity of microsome fraction from thyroid tumor and the normal thyroid glands was determined. The first 15 minutes accumulation of each ROI was determined as the early accumulation of thallium-201 for tumor and the normal thyroid glands. Papillary and follicular carcinomas, showing the high accumulation of thallium-201, had high activity of Na + , K + -ATPase. Microfollicular adenomas had high activity of Na + , K + -ATPase and demonstrated intense accumulation of thallium-201. However, colloid adenoma had a similar level of Na + , K + -ATPase activity to that of the normal thyroid glands and did not demonstrate radionuclide accumulation. Consequently, radionuclide accumulation in thallium-201 thyroid scintigraphy was closely correlated to Na + , K + -ATPase activity of thyroid tumor. Thyroid blood flow was measured by hydrogen gas clearance method. Thyroid blood flow of papillary carcinoma was smaller, as compared with normal thyroid blood flow. TAC of papillary carcinoma showed flattening. Thallium-201 accumulation in early image was also found to correspond to thyroid blood flow. From this study we can conclude that mechanisms of thallium-201 accumulation in a thyroid tumor depends on Na + , K + -ATPase activity and thyroid blood flow. Washout of TAC in thallium-201 scintigraphy appears dependent on blood flow of a thyroid nodule. (author)

Thyroid disease in children and adolescents

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Hong, Hyun Sook; Lee, Ji Ye; Jeong, Sun Hye [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

2017-10-15

Thyroid imaging in pediatric patients is indicated for the evaluation of congenital hypothyroidism (CH) during newborn screening or for a palpable thyroid mass. The primary imaging modalities for newborn screening are ultrasonography (US) and radionuclide scintigraphy. US is useful as a first-line test for the diagnosis of thyroid abnormalities and lymphadenopathy in pediatric patients. In addition, US can be used to guide the aspiration of detected nodules and to support the evaluation of the lymph nodes.

The role of nuclear medicine in diagnosis and treatment of feline hyperthyroidism; Nuklearmedizinische Diagnostik und Therapie der felinen Hyperthyreose

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Puille, Max; Puille, N. [MVZ fuer Diagnostik und Therapie, Regensburg (Germany)

2010-03-15

Feline hyperthyroidism is the most common endocrinological disorder of older cats. Diagnosis is established by assessment of thyroid stimulating hormone (TSH) and free thyroxine (FT4). In hyperthyroidism FT4 is found up to ten times above the normal range. Thyroid scintigraphy using {sup 99m}Tc-pertechnetate shows goiter size, which can reach more than 20 ml, and differentiates between unifocal and multifocal thyroid adenoma. In rare cases, ectopic tracer accumulation may be found, suggesting thyroid carcinoma. Radioiodine is the safest, simplest and most effective treatment for benign thyroid disease in the cat. Normal thyroid function is usually established within two weeks. Practical and legal radiation protection rules are strictly to be observed. Even so, the rapid elimination of {sup 131}I usually allows patient discharge within one week. Internal and external radiation risks are very low for clinic staff and cat owners. (orig.)

Technetium-99 in ''instant'' sup(99m)Tc-pertechnetate

International Nuclear Information System (INIS)

Mattsson, S.

1978-01-01

The 99 Tc-content in sup(99m)Tc-pertechnetate separated from 99 Mo by distillation or extraction has been studied with a plastic scintillation detector. The identification of the measured activity was achieved by beta-spectrometry, chemical separation and half-life studies. The frequency distribution of the sup(99)Tc/sup(99m)Tc-ratios in the different samples was observed to be log-normal. The most likely activity ratio was 0.4x10 -6 , the maximum value being 5x10 -6 . The specific activity of ''instant'' pertechnetate is approximately a factor of 60 lower than that normally recorded in pertechnetate derived from daily eluted column generators. The low specific activity of ''instant'' pertechnetate is primarily explained by the long time between separation and usage and secondly by the low yield of Tc in the distillation and extraction processes. In several of the ''instant'' pertechnetate solutions the carrier concentration exceeded the reductive capacity of the stannous ions in ''kits'' with small amounts of Sn(II) in usable form. (T.G.)

Dynamic gamma camera scintigraphy in primary hypoovarism

International Nuclear Information System (INIS)

Peshev, N.; Mladenov, B.; Topalov, I.; Tsanev, Ts.

1988-01-01

Twenty-seven patients with primary hypoovarism and 10 controls were examined. After intravenous injection of 111 to 175 MBq 99m Tc pertechnetate, dynamic gamma camera scintigraphy for 15 minutes was carried out. In the patients with primary amenorrhea no functioning ovarial tissue was visualized or the ovaries were diminished in size, strongly reduced and non-homogenous accumulation of the radionuclide with unclear and uneven delineation were observed. In the patients with primary infertility, the gamma camera investigation gave information not only about the presence of ovarial parenchyma, but about the extent of the inflammatory process, too. In the patients after surgical intervention, the dynamic radioisotope investigation gave information about the volume and the site of the surgical intervention, as well as about the conditions of the residual parenchyma

Paraganglioma of the thyroid gland: A case report

Directory of Open Access Journals (Sweden)

Filipović Aleksandar

2014-01-01

Full Text Available Introduction. Thyroid paraganglioma is a very rare malignant neuroendocrine tumor. Immunohistochemical features of thyroid paraganglioma are helpful for the diagnosis. Case report. A 69-year-old female came to hospital with the presence of a growing thyroid nodule of the left lobe. Ultrasonic neck examination showed 5 cm hypoechoic nodule in the left thyroid lobe. Thyroid scintigraphy showed a big cold nodule in the left lobe. Computed tomography (CT scan showed left lobe thyroid tumor with tracheal deviation on the right site. Extended total thyroidectomy was done. Intraoperative consultation with the pathologist confirmed thyroid cancer. The pathologist diagnosed thyroid paraganglioma on the base of immuohistochemical investigation. This thyroid paraganglioma was positive for neuron-specific enolase, chomogranin A, synaptophysin, and S-100 protein highlighted the sustentacular cells. Tumor cells were nega-tive for thyroglobulin, epithelial membrane antigen, cytokeratin, calcitonin, and carcinoembryonic. After the surgery the patient was treated with chemotherapy, peptide receptor radionuclide therapy, and permanent TSH suppressive therapy. The patient was followed with measurements of thyroid hormone and serum neuron-specific enolase, chromogranin A level, every 6 months. Gastroscopy, colonoscopy, chest and abdomen CT scan as well as further tests (chest x-ray, ultrasound of the neck, and whole body octreotide scintigraphy were done. No primary neuroendocrine tumor in digestive sistem or in the chest was found. After more than 3 years the patient has no evidence of the recurrent disease. Conclusion. Radical resection of thyroid paraganglioma, followed by chemotherapy and peptide receptor radionuclide therapy, should be considered the treatment of choice in patients with thyroid gland paraganglioma.

Radioguided surgery of primary hyperparathyroidism in a population with a high prevalence of thyroid pathology

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Garcia-Talavera, Paloma [University Hospital of Valladolid, Department of Nuclear Medicine, Valladolid (Spain); Gonzalez, Carmen; Gomez, Alberto [University Hospital of Salamanca, Department of Surgery, Salamanca (Spain); Garcia-Talavera, Jose Ramon; Martin, Esther; Martin, Mariano [University Hospital of Salamanca, Department of Nuclear Medicine, Salamanca (Spain)

2010-11-15

Patients with concomitant thyroid pathology are usually excluded from minimally invasive radioguided parathyroidectomy (MIRP). We assessed the value in these patients of the gamma probe, alone or in combination with other techniques, in MIRP and unilateral or bilateral approaches. We evaluated its performance in association with intraoperative determination of intact parathyroid hormone (ioPTHi) and preoperative {sup 99m}Tc-MIBI dual phase scintigraphy. Included in the study were 87 patients with a diagnosis of primary hyperparathyroidism who underwent radioguided surgery. They were divided into two groups depending on the presence of concomitant thyroid pathology (TP group, 33 patients) or absence of concomitant thyroid pathology (NTP group, 54 patients). In the TP group, ioPTHi achieved the highest accuracy (90.9%), followed by the gamma probe (81.8%) and scintigraphy (69.7%). In the NTP group, the probe (94.4%) performed better than ioPTH and scintigraphy (both 85.2%). In the TP group, scintigraphy in combination with the gamma probe had a success rate of 90.9%, and 94% in combination with ioPTHi. The three techniques are applied together had a success rate of 97%. For all patients undergoing MIRP, the probe alone worked well, irrespective of the presence or absence of concomitant thyroid pathology. Patients with concomitant thyroid pathology should not be a priori excluded from a MIRP, as long as other adjuvant techniques (scintigraphy or ioPTHi) are used in conjunction with the gamma probe. In these patients, the probe can also be helpful in unilateral or bilateral surgery. (orig.)

Radioguided surgery of primary hyperparathyroidism in a population with a high prevalence of thyroid pathology

International Nuclear Information System (INIS)

Garcia-Talavera, Paloma; Gonzalez, Carmen; Gomez, Alberto; Garcia-Talavera, Jose Ramon; Martin, Esther; Martin, Mariano

2010-01-01

Patients with concomitant thyroid pathology are usually excluded from minimally invasive radioguided parathyroidectomy (MIRP). We assessed the value in these patients of the gamma probe, alone or in combination with other techniques, in MIRP and unilateral or bilateral approaches. We evaluated its performance in association with intraoperative determination of intact parathyroid hormone (ioPTHi) and preoperative 99m Tc-MIBI dual phase scintigraphy. Included in the study were 87 patients with a diagnosis of primary hyperparathyroidism who underwent radioguided surgery. They were divided into two groups depending on the presence of concomitant thyroid pathology (TP group, 33 patients) or absence of concomitant thyroid pathology (NTP group, 54 patients). In the TP group, ioPTHi achieved the highest accuracy (90.9%), followed by the gamma probe (81.8%) and scintigraphy (69.7%). In the NTP group, the probe (94.4%) performed better than ioPTH and scintigraphy (both 85.2%). In the TP group, scintigraphy in combination with the gamma probe had a success rate of 90.9%, and 94% in combination with ioPTHi. The three techniques are applied together had a success rate of 97%. For all patients undergoing MIRP, the probe alone worked well, irrespective of the presence or absence of concomitant thyroid pathology. Patients with concomitant thyroid pathology should not be a priori excluded from a MIRP, as long as other adjuvant techniques (scintigraphy or ioPTHi) are used in conjunction with the gamma probe. In these patients, the probe can also be helpful in unilateral or bilateral surgery. (orig.)

An analysis of preoperative localization of parathyroid glands in hyperparathyroidism associated with thyroid diseases

International Nuclear Information System (INIS)

Komatsu, Makoto; Inoue, Kazuaki; Itoh, Atsuko.

1996-01-01

Recently hyperparathyroidism associated with some thyroid diseases, especially nonmedually thyroid carcinoma has been payed attention to. In this study we analyzed 12 cases of hyperparathyroidism (6 cases independent of thyroid diseases and 6 cases associated with thyroid diseases) and estimated the affect of association with thyroid diseases on the preoperative localization of the parathyroid glands. The results of preoperative localization of the parathyroid glands in cases independent of thyroid diseases were relatively satisfactory. On the other hand, the preoperative localization in cases associated with thyroid diseases came to false result in about half of them. It was far from satisfactory. Association of thyroid diseases strongly affected the preoperative localization of the parathyroid glands in hyperparathyroidism. Conventional imaging such as ultrasonography, CT, MRI and 201 Tl- 99m TC subtraction scintigraphy alone were not satisfactory. Now 99m Tc-MIBI scintigraphy is expected to be one of reliable imaging methods for progress in the preoperative localization. (author)

Utility of Quantitative Parameters from Single-Photon Emission Computed Tomography/Computed Tomography in Patients with Destructive Thyroiditis

Science.gov (United States)

Kim, Ji-Young; Kim, Ji Hyun; Moon, Jae Hoon; Kim, Kyoung Min; Oh, Tae Jung; Lee, Dong-Hwa; So, Young

2018-01-01

Objective Quantitative parameters from Tc-99m pertechnetate single-photon emission computed tomography/computed tomography (SPECT/CT) are emerging as novel diagnostic markers for functional thyroid diseases. We intended to assess the utility of SPECT/CT parameters in patients with destructive thyroiditis. Materials and Methods Thirty-five destructive thyroiditis patients (7 males and 28 females; mean age, 47.3 ± 13.0 years) and 20 euthyroid patients (6 males and 14 females; mean age, 45.0 ± 14.8 years) who underwent Tc-99m pertechnetate quantitative SPECT/CT were retrospectively enrolled. Quantitative parameters from the SPECT/CT (%uptake, standardized uptake value [SUV], thyroid volume, and functional thyroid mass [SUVmean × thyroid volume]) and thyroid hormone levels were investigated to assess correlations and predict the prognosis for destructive thyroiditis. The occurrence of hypothyroidism was the outcome for prognosis. Results All the SPECT/CT quantitative parameters were significantly lower in the 35 destructive thyroiditis patients compared to the 20 euthyroid patients using the same SPECT/CT scanner and protocol (p thyroid-stimulating hormone (TSH) significantly correlated with %uptake (p = 0.004), SUVmean (p thyroid mass (p thyroiditis patients, 16 progressed to hypothyroidism. On univariate and multivariate analyses, only T3 levels were associated with the later occurrence of hypothyroidism (p = 0.002, exp(β) = 1.022, 95% confidence interval: 1.008 – 1.035). Conclusion Novel quantitative SPECT/CT parameters could discriminate patients with destructive thyroiditis from euthyroid patients, suggesting the robustness of the quantitative SPECT/CT approach. However, disease progression of destructive thyroiditis could not be predicted using the parameters, as these only correlated with TSH, but not with T3, the sole predictor of the later occurrence of hypothyroidism. PMID:29713225

A rare cause of hyperthyroidism: functioning thyroid metastases.

Science.gov (United States)

Gardner, Daphne; Ho, Su Chin

2014-10-09

Hyperthyroidism is a common medical problem that is readily treated with antithyroid medications. However, attributing the correct aetiology of hyperthyroidism alters management and outcome. We present a case of a 66-year-old woman with a seemingly common problem of hyperthyroidism associated with a goitre, which was initially attributed to a toxic nodule. However, Tc-99m pertechnetate uptake scan and thyroid-stimulating hormone receptor antibody were negative, inconsistent with a toxic nodule or Grave's disease. Her thyroid function tests proved difficult to control over the next few months. She eventually proceeded to a total thyroidectomy and histology revealed follicular variant papillary thyroid carcinoma. She was started on levothyroxine postoperatively but developed severe hyperthyroidism, revealing the cause of hyperthyroidism to be autonomously functioning thyroid metastases. Although functioning thyroid metastases are very rare, they need to be considered among the differential diagnoses of hyperthyroidism, as there are nuances in management that could alter the eventual outcome. 2014 BMJ Publishing Group Ltd.

The Role of Salivary Gland Scintigraphy in the Evaluation of Salivary Gland Dysfunction in Uncontrolled Type II Diabetic Patients

OpenAIRE

Senthilkumar, B.; Sathasivasubramanian, S.

2013-01-01

The aim of the present study was to evaluate the salivary gland dysfunction in patients with uncontrolled type II diabetes using salivary gland scintigraphy and then to compare these ratios with quantitative whole salivary secretion rates. Using a gamma camera (siemens-diacam) equipped with a low energy all-purpose collimator, 32 uncontrolled type II diabetic patients and 30 normal healthy patients were studied by injecting a radio isotope (technetium 99m pertechnetate) about 5 mCi was inject...

Non-pertechnetate Technetium Sensor Research and Development

Energy Technology Data Exchange (ETDEWEB)

Bryan, Samuel A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rapko, Brian M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Branch, Shirmir D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Univ. of Cincinnati, OH (United States); Lines, Amanda M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Heineman, William R. [Univ. of Cincinnati, OH (United States); Soderquist, Chuck Z. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2017-03-24

Several significant uncertainties remain regarding the understanding and modeling of the fate and speciation of technicium-99 (⁹⁹Tc) in Hanford waste tanks, glass, and low-temperature waste forms. A significant (2% to 25%) fraction of the 99Tc in the water-soluble portion of the tank waste may be present as one or more non pertechnetate species that have not been identified and to date, cannot be effectively separated from the wastes. This task will provide a sensor specifically tuned to detect the Tc(I)-carbonyl species believed to constitute the main fraction of the non-pertechnetate form of technetium. By direct measurement of the non-pertechnetate species, such a sensor will help reduce the uncertainties in the modeling of the fate and speciation of ⁹⁹Tc in Hanford tanks and waste forms. This report summarizes work performed in FY2016 that was sponsored by the Department of Energy’s Office of Environmental Management and demonstrates the protocol for using fluorescent Tc(I)-tricarbonyl complex as a means to detect the non-pertechnetate species within tank waste solutions. The protocol was optimized with respect to ligand concentration, solvent choice, reaction temperature and time. This work culminated in the quantitation of Tc(I)-tricarbonyl within a waste simulant, using a standard addition method for measurement. This report also summarizes the synthesis and high-yield preparation of the low-valence technetium species, [Tc(CO)₃(H₂O)₃]⁺, which will be used as the technetium standard material for the demonstration of the non-pertechnetate species in actual wastes.

The reduction of pertechnetate-99 by stannous chloride

International Nuclear Information System (INIS)

Steigman, J.; Meinken, G.; Richards, P.

1975-01-01

The reduction of pertechnetate-99 by excess stannous chloride in several media was investigated as a possible model for radiopharmaceutical preparations which are based on the reduction of pertechnetate-99m by the same reagent. Polarographic and iodimetric techniques were used to analyze for unreacted stannous ion. It was found that pertechnetate is reduced to the +4 state in a citrate buffer at pH7, to the +3 state in a DTPA buffer at pH4, and possibly to the +4 state in HCl. The reaction in DTPA solution was found to be complete within several minutes. The reduction in the citrate buffer proceeded rapidly to the +5 state, and much more slowly to the +4 state. The implications of these rate studies for the radiopharmaceutical preparations were discussed. Direct potentiometric titrations of pertechnetate-99 with stannous chloride showed that the technetium was in the +4 state in HCl, in the +5 state in citrate solution, and in both the +3 and +4 states in DTPA. (author)

Relative quantification of indium-111 pentetreotide and gallium-68 DOTATOC uptake in the thyroid gland and association with thyroid pathologies.

Science.gov (United States)

Lincke, Thomas; Singer, Joerg; Kluge, Regine; Sabri, Osama; Paschke, Ralf

2009-04-01

Recent data suggest that increased somatostatin receptor (SSTR) expression is detectable in several thyroid diseases. This raises the question as to the specificity and pathophysiologic relevance of these findings. Therefore, we systematically evaluated Indium-111 (In-111) pentetreotide scintigraphies and Gallium-68 (Ga-68) DOTA-Phe(1)-Tyr(3)-Octreotide (DOTATOC) positron emission tomography (PET) scans for thyroid radiotracer uptake. Relative binding of In-111 pentetreotide in the thyroid was measured by region of interest (ROI) technique in 4-hour and 24-hour post-injection (p.i.) planar images of 73 patients undergoing In-111 pentetreotide scintigraphy. Ga-68 DOTATOC PET scans of 77 patients were analyzed by ROI technique applied to coronal slices of 1 cm (0.39 inch) thickness with highest uptake in the thyroid region. A basal indium In-111 and Ga-68 DOTATOC uptake was found in normal thyroid glands. Hot nodules, disseminated thyroid autonomy, and most cases of active Hashimoto's disease as well as goiters and nodular thyroids showed increased In-111 pentetreotide and/or Ga-68 DOTATOC uptake. Higher relative In-111 pentetreotide uptake in the 24-hour p.i. images as compared to the 4-hour p.i. images except for patients after thyroidectomy indicates specific receptor binding in the thyroid. The increased In-111 pentetreotide and Ga-68 DOTATOC uptake in active Hashimoto's disease is most likely related to the lymphocytic infiltration of the thyroid. However, the physiologic or pathophysiologic relevance of the increased In-111 pentetreotide and Ga-68 DOTATOC uptake in normal thyroid glands, hot and cold nodules, and goiters and nodular thyroids remain to be determined.

Thyroid carcinoma in children

International Nuclear Information System (INIS)

Akhzari, F.

2002-01-01

Thyroid cancer is rare in children, with only 3-6% of thyroid malignancies occurring in children, and constitutes but 6% of head and neck tumors. Over 95% thyroid cancer are differentiated, and 10% of these occur in children of adolescents. Any of the histologic types that occur in adults may be in children, but they are most often differentiated thyroid carcinomas. The etiologies of thyroid carcinoma are unknown, but factors considered in pathogenesis include irradiation, sex and age. The incandesce of thyroid carcinoma in a solitary coddle in a child has been described as high as 70%. History and /or physical examination alone are unlikely to advance the diagnosis, and with exception of plasma CT in medullary thyroid carcinoma, blood studies are unhelpful in the diagnosis of thyroid carcinoma. Radiographs and ultrasound imaging are helpful in planning treatment and follow-up, but are unlikely to be needed for initial diagnosis. One of the main indication of thyroid scan in the pediatric group is thyroid nodule. FNAB is established as the most effective method of diagnosis in adults, although in children it may be less reliable. While radionuclide scintigraphy may be considered for initial screening, FNAB is well established and its specificity allows it to negate the need for a substantial number of operation. Treatment of differentiated thyroid carcinoma in children is more controversial. Some authors maintain that modified or subtotal thyroidectomy is appropriation this disease, others maintain that total thyroidectomy is required Nevertheless, radioiodine therapy is considered to be standard in the treatment of iodine-avid thyroid carcinomas for ablation of the thyroid remnant following surgery and for treatment of iodine-avid distant diseases. The front-line treatment of medullary thyroid carcinoma is aggressive surgery. Total thyroidectomy is indicated, In general treatment with chemotherapy, extemal radiation and I-131 are not helpful, however radioactive

Hashimoto's thyroiditis presenting as hot and cold nodules

Energy Technology Data Exchange (ETDEWEB)

Sulimani, R.A.; el-Desouki, M. (King Saud Univ., Riyadh (Saudi Arabia))

1990-05-01

A case of Hashimoto's thyroiditis is presented. I-123 thyroid scintigraphy demonstrated a hot nodule in the left lobe and a cold nodule in the right, which was well visualized by Tl-201 imaging. This unusual scintigraphic appearance is demonstrated, and its possible explanation discussed.

Assessment of the functional validity of hydrocephalus drainages by means of scintigraphy

International Nuclear Information System (INIS)

Mueller, J.; Endert, G.

1980-01-01

The assessment of the functional validity of hydrocephalus drainages is an as yet insolved problem. Several criteria and methods are discussed and a sup(99m)Tc-pertechnetate scintigraphy enabling an evaluation of the drainage function is presented. In case of a stop in the drainage system the surgeon can also obtain certain information about its localization. Out of 30 children, the method showed a sufficient cerebrospinal fluid flow in 14 and an insufficient one in 16 patients, respectively. In 8 children of the latter group the result was confirmed by following operation. 4 children have obviously no longer need of drainage after a period of 5 years or more. (author)

Quantitative thyroid scintigraphy for the differentiation of Graves' disease and hyperthyroid autoimmune thyroiditis

International Nuclear Information System (INIS)

Sahlmann, C.O.; Siefker, U.; Lehmann, K.; Harms, E.; Conrad, M.; Meller, J.

2004-01-01

The purpose of this study is the evaluation of the TCTUs in the differentiation between AIT and GD in patients with hyperthyroidism. Methods: We determined the TCTUs in 59 patients with untreated hyperthyroid GD and in 51 patients with AIT who had subclinical or manifest hyperthyroidism without medication. Patients with GD were characterized by the presence of hyperthyroidism, decreased echogenicity of the thyroid, elevation of TSH-receptor autoantibodies (TRAb). AIT was defined by a decreased echogenicity of the thyroid, absence of elevated TSH-receptor autoantibodies (TRAb), autoantibodies against the thyroid peroxidase (anti-TPO) and spontaneous remission or development of subclinical hypothyroidism within 3 months. Results: Thyroid volumes of patients with AIT were significantly lower than those of patients with GD (p 99m TcO 4 - offered rapid and reliable differentiation between hyperthyroid GD and AIT. (orig.)

First results of radioiodine therapy of multifocal and disseminated functional thyroid autonomy using a TcTUs-adapted dose concept

International Nuclear Information System (INIS)

Oexle, C.; Reinhardt, M.; Moser, E.

1998-01-01

Aim: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99m Tc-pertechnetate thyroid uptake under suppression (TcTU s ) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTU s , which is as a measure for the 'autonomous volume' of the thyroid. Methods: The data of 75 patients (54 female, 21 male; age 71±9 years) with MFA or DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target doses were used: For a TcTU s of 1,5-2,5% 150 Gy, for 2,51-3,5% 200 Gy, for 3,51-4,5% 250 Gy, and for >4,5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful when the basal TSH was above 0,5 mU/l and autonomous areas had disapeared in thyroid scintigraphy or the TcTU was below 1,5%, respectively. The average follow-up period was 8±4 months. Results: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occured. Conclusion: The presented data indicate, that even patients with a marked autonomy (TcTU s >3,5%) can thus expected to be cured by of a onetime therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can alltogether be estimated as very low. (orig.) [de

Diagnostic I-131 scintigraphy in patients with differentiated thyroid cancer. No additional value of higher scan dose

International Nuclear Information System (INIS)

Phan, T.T.H.; Tol, K.M. van; Links, T.P.; Piers, D.A.; Vries, E.G.E. de; Dullaart, R.P.F.; Jager, P.L.

2004-01-01

After initial treatment with total thyroidectomy and radio iodine ablation, most follow-up protocols for patients with differentiated thyroid carcinoma contain cyclic diagnostic I-131 imaging and serum thyroglobulin (Tg) measurements. The applied diagnostic I-131 doses vary between 37 and 370 MBq. The aim of this study was to determine the yield of a diagnostic scan with 370 MBq I-131 in patients with a negative diagnostic scan with 74 MBq I-131. Retrospective evaluation of 158 patients who received a high-dose diagnostic scan with 370 MBq I-131 because of a negative low-dose diagnostic scan with 74 MBq I-131. Special attention was paid to the patients with positive high-dose diagnostic scanning and undetectable serum Tg levels after thyroid hormone withdrawal. In 127 (80%) of patients the 370 MBq I-131 scan was negative, just like the preceding low-dose scan. In 31 (20%) of patients abnormal uptake was present on the 370 MBq diagnostic scan. In 19 of these 31 patients serum Tg was undetectable. In 15/19 the high-dose diagnostic scan proved either false positive or demonstrated clinically irrelevant minor ablation rests. In only four patients (2.5%) did the high-dose diagnostic scans reveal possibly relevant uptake caused by residual differentiated thyroid cancer. In 98% of patients a 370 MBq dose of I-131 for diagnostic whole-body scintigraphy (WBS) had no additional value. The combination of a low-dose diagnostic I-131 scan using only 74 MBq combined with a serum Tg level measurement proved sufficient for correct clinical decision making regarding whether the patient requires additional I-131 therapy. (authors)

Ultrasonography of various thyroid diseases in children and adolescents: A pictorial essay

Energy Technology Data Exchange (ETDEWEB)

Hong, Hyun Sook; Lee, Eun Hye; Jeong, Sun Hye; Park, Ji Sang; Lee, Heon [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

2015-04-15

Thyroid imaging is indicated to evaluate congenital hypothyroidism during newborn screening or in cases of a palpable thyroid mass in children and adolescents. This pictorial essay reviews the ultrasonography (US) of thyroid diseases in children and adolescents, including normal thyroid gland development, imaging features of congenital thyroid disorders (dysgenesis, [aplasia, ectopy, hypoplasia], dyshormonogenesis, transient hypothyroidism, thyroglossal duct cyst), diffuse thyroid disease (Grave's disease, Hashimoto's thyroiditis, and suppurative thyroiditis), and thyroid nodules. The primary imaging modalities for evaluating thyroid diseases are US and radionuclide scintigraphy. Additionally, US can be used to guide aspiration of detected nodules.

Diagnostic value of 99mTc-pertechnetate salivary gland scintigraphy (SGS) in Sjoegren's syndrome (SS). Comparative study with symptomatic non Sjoegren patients and healthy controls

International Nuclear Information System (INIS)

Lobo, G.; Ladron de Guevara, D.; Zerboni, A.; Aguilera, S.

2002-01-01

The aim of this study was to describe SGS findings in patients with SS, and to compare them with non Sjoegren symptomatic and healthy control individual, estimating performance of SGS in SS diagnosis. Materials and Method: Fifty three control individual (average age: 53.7 yr, range: 27-83 yr) and 169 patients with subjective xerostomia underwent 99mTc-pertechnetate scintigraphy. The symptomatic group consisted of: 112 patients with Sjoegren's syndrome (average age: 53.7 yr, range:16-81 yr) according to modifying European Classification Criteria, 42 patients with fibromyalgia (FM)(average age:48.2 yr, range:19-76 yr) who presented non-specific chronic sialadenitis or normal labial biopsy, and 15 patients with keratoconjunctivitis sicca (KS) (average age: 40.9 yr, range:23-57 yr). SGS was performed following i.v. injection of 10 mCi 99mTc-pertechnetate, in dynamic acquisition of 60 15-sec frames, and giving lemon juice orally at 20 min. Irregular regions of interest (ROI) over salivary glands and brain for background assessment were drawn, building time-activity curves. SGS was classified according to visual intensity of gland tracer uptake and excretion before and after lemon and curve evaluation, in: normal (intensity of gland uptake fourfold background activity, ascending curve with fast and profound fall after lemon) , mild alteration (light decrease in gland uptake or excretion, with a normal curve shape), moderate alteration (evident uptake and excretion decrease with a median Mita curve) and severe alteration (very low or absent uptake, flat or slope curve). Scintigraphic findings were compared with diagnosis, calculating positive (PPV) and negative predictive value (NPV) for SS. Results: The results of SGS according to diagnosis are presented. SS group had higher incidence of severe alterations (p<0.001) than each of other clinics groups and lower proportion of mild alterations (p:0.008) and normal scans (p:0.005) than both control and KS patients. The KS

Dosimetric contribution of organs of biokinetics of {sup 99m}Tc and {sup 123}I to estimate radiation doses in thyroids of children of 1 and 5 years; Contribucion dosimetrica de organos de la biocinetica del {sup 99m}Tc y {sup 123}I para estimar dosis en tiroides de ninos de 1 y 5 anos

Energy Technology Data Exchange (ETDEWEB)

Vasquez, M.V.; Castillo, C.E.; Abanto, D.M.; Rocha, D.; Garcia, W.H.; Marin, K., E-mail: marvva@hotmail.com [Universidad Nacional de Trujillo (UNT), Trujillo (Peru); Quispe, R. [Centro de Ciencias Aplicadas y Desarrollo Tecnologico, UNAM, Mexico (Mexico)

2015-07-01

The absorbed doses by thyroids during uptake studies through biokinetics of radiopharmaceuticals containing {sup 123}I (iodine) or {sup 99m}Tc (pertechnetate) are estimated. Using the MIRD scheme and the representation of Cristy-Eckerman for thyroids in children of 1 and 5 years, the objective of the study was to determine whether the dosimetric biokinetic contributions of the organs of {sup 123}I (iodide) and {sup 99m}Tc (pertechnetate) biokinetic are significant in the estimated of the absorbed dose for thyroid uptake studies.

Double-phase parathyroid 99Tcm-MIBI scintigraphy in secondary hyperparathyroidism

International Nuclear Information System (INIS)

Liu Wei; Xu Zhaoqiang; Hu Jianmin; Chang Guojun; Yao Weixuan; Li Yongjun; Chen Jianwei

1999-01-01

Objective: To evaluate the diagnostic value of double-phase parathyroid 99 Tc m -MIBI scintigraphy in secondary hyperparathyroidism (SHP) following chronic renal failure. Methods: 99 Tc m -MIBI parathyroid scintigraphy was performed on 20 SHP patients. All images were analyzed with parathyroid/thyroid ratio (PT/T) and parathyroid index (PTI). 3 patients underwent parathyroidectomy and ectopic autografting. Results: 8 patients were 99 Tc m -MIBI-positive. 9 parathyroid glands removed from 3 patients were histopathologically diagnosed as parathyroid hyperplasia. 8 of the 9 were scintigraphy positive with the sensitivity of 88.9%, the localization of the parathyroids with scanning before operation was accurate. It was found that there were 3 types of MIBI washout in hyperplastic parathyroids. Conclusions: 99 Tc m -MIBI scintigraphy is valuable in localization of parathyroids in SHP, especially of hyperfunctioning glands. Special attention should be paid to the fact that there are different types of MIBI washout in hyperplastic glands, otherwise some abnormal glands might be missed

Visualization of liver on bone scintigraphy during treatment with iron chondroitin sulfate colloid

Energy Technology Data Exchange (ETDEWEB)

Tanaka, Shigeko; Sawa, Hisashi; Fukuda, Teruo

1983-09-01

In order to see its probable cause in the incidental liver delineation on the bone scan with sup(99m)Tc-MDP, patients and experimental rabbits were intravenously injected with Blutal (iron chondroitin sulfate) at various times following the intravenous injection of sup(99m)Tc-MDP. The liver images were obtained during the early periods. An injection of Blutal-sup(99m)Tc pertechnetate mixture did not result in any appreciable hepatic delineation. Stannous chloride in the MDP kit could have enticed formation of radiocolloids in the presence of iron chondroitin sulfate. Diagnostic problems can be avoided by carefully planning the bone scintigraphy in relation to the Blutal administration. (author).

Visualization of liver on bone scintigraphy during treatment with iron chondroitin sulfate colloid

International Nuclear Information System (INIS)

Tanaka, Shigeko; Sawa, Hisashi; Fukuda, Teruo

1983-01-01

In order to see its probable cause in the incidental liver delineation on the bone scan with sup(99m)Tc-MDP, patients and experimental rabbits were intravenously injected with Blutal (iron lhondroitin sulfate) varicus times following the intravenous injection of sup(99m)Tc-MDP. The liver images were obtained during the early periods. An injection of Blutal-sup(99m)Tc pertechnetate mixture did not result in any appreciable hepatic delineation. Stannous chloride in the MDP kit could have enticed formation of radiocolloids in the presence of iron chondroitin sulfate. Diagnostic problems can be evaded by carrefully planning the bone scintigraphy in relation to the Blutal administration. (author)

Detection surgical treatment and its results in children's thyroid gland

International Nuclear Information System (INIS)

Polyakov, V.G.; Lebedev, V.I.; Belkina, B.M.; Shishkov, R.V.; Makarova, I.S.; Durnov, L.A.

1995-01-01

208 patients with thyroid gland cancer were observed in 1975-1993 . The morphological investigations point to an absolute prevalence of highly differentiated forms of thyroid gland cancer in children. The radiation diagnostic techniques included ultrasound investigations of neck organs, chest roentgenography, thyroid gland scintigraphy. It is shown that the surgical method is the basic technique of treating thyroid gland cancer in children. 5-year survival rate of patients depending on the stage of disease development and scope of surgical treatment is analysed

Subacute thyroiditis (de Quervain) presenting as a painless cold nodule

International Nuclear Information System (INIS)

Bartels, P.C.; Boer, R.O.

1987-01-01

A 49-yr-old woman presented with a solid, painless, nontender nodule in the left thyroid lobe. Thyroid scintigraphy revealed a solitary cold area in the left lobe and a slightly decreased 24-hr radioactive iodine thyroid uptake (9%). Although there were no specific clinical or biochemical signs suggesting thyroiditis needle aspiration cytology showed the presence of a subacute thyroiditis. Approximately 1 mo later the entire thyroid gland was affected leading to a completely suppressed thyroid radioiodine uptake and elevated serum thyroid hormone concentrations. This case illustrates that in the early phase of the disease, subacute thyroiditis may present as a solitary, painless, cold nodule and should be considered in the differential diagnosis of such lesions

Absorbed dose in the fetus of a pregnant patient when I"1"3"1 (iodide/Tc"9"9"m (pertechnetate) is administered during thyroid studies

International Nuclear Information System (INIS)

Vasquez A, M.; Murillo C, V.; Arbayza F, J.; Sanchez S, P.; Cabrera S, C.

2016-10-01

The radiation absorbed dose in the fetus of a pregnant woman during thyroid studies is estimated through the analysis of the bio-kinetics of radiopharmaceuticals containing I"1"3"1 (iodide) or Tc"9"9"m (pertechnetate). MIRD formalism and its representation Cristy-Eckerman are used. The results indicate that the absorbed dose by the fetus of a woman of 3, 6 and 9 months of gestation due to Tc"9"9"m emissions is lower than that obtained by I"1"3"1; represent 34.7%, 6% and 3.5% of the dose generate by the iodide. The auto-dose in the fetus of a pregnant woman is mainly due to the local energy deposition of the beta and gamma emissions of I"1"3"1, being greater than the one reported by the gamma emissions and conversion electrons of the Tc"9"9"m, for fetuses of 6 and 9 months. The dose incorporated to the fetus due to the organs of the maternal tissues, which are part of the bio-kinetics, are basically due to the emission of its gamma photons and correspond to 38.50% /60.52% in fetuses of 3 months, 64.71% /12.43% in fetuses of 6 months and 69.79% /10.97% in fetuses of 9 months for the radiopharmaceuticals Tc"9"9"m (pertechnetate) / I"1"3"1 (iodide). The organs of bio-kinetics that contribute to the fetus dose are mainly due to the bladder, followed by the rest, and small intestine (fetuses of 3 months); of the rest, followed by the small intestine and bladder (fetuses of 6 months); of the bladder, followed by the small intestine and stomach (fetuses of 9 months) when using I"1"3"1; while for the Tc"9"9"m the bladder and rest contribute (fetuses of 3 months); of the placenta, followed by the rest and bladder (fetuses of 6 and 9 months). (Author)

Papillary thyroid carcinoma in an autonomous hyperfunctioning thyroid nodule: case report and review of the literature.

Science.gov (United States)

Tfayli, Hala M; Teot, Lisa A; Indyk, Justin A; Witchel, Selma Feldman

2010-09-01

Whereas thyroid nodules are less common among children than among adults, the anxiety generated by the finding of a thyroid nodule is high because 20% of nodules found in children contain thyroid cancer. Discovery of a nodule in the context of hyperthyroidism is usually comforting due to the presumption that the nodule represents a benign toxic adenoma. An 11-year-old girl presented with heavy menses, fatigue, and a right thyroid mass. Laboratory evaluation revealed elevated triiodothyronine and undetectable thyroid-stimulating hormone. Thyroid ultrasonography revealed a 3.5 cm nonhomogenous nodule, and scintigraphy was consistent with an autonomous hyper-functioning nodule. Fine-needle aspiration biopsy could not rule out malignancy, and patient underwent right hemithyroidectomy and isthmusectomy. Pathology was consistent with papillary thyroid carcinoma. We report the discovery of papillary thyroid carcinoma in an autonomously hyperfunctioning nodule in an 11-year-old girl. Detection of an autonomously functioning thyroid nodule in children and adolescents does not exclude the possibility of thyroid carcinoma and warrants careful evaluation and appropriate therapy.

Radioprotection of salivary glands by S-2-(3-aminopropylamino)-ethylphosphorothioic (amifostine) obtained in a rabbit animal model

Energy Technology Data Exchange (ETDEWEB)

Bohuslavizki, Karl H; Klutmann, Susanne; Jenicke, Lars; Brenner, Winfried; Feyerabend, Bernd; Henze, Eberhard; Clausen, Malte

1999-08-01

Background: Impairment of salivary gland function following high-dose radioiodine treatment (HDRIT) is a well-recognized side effect of the treatment. Because differentiated thyroid cancer has an excellent prognosis, reduction of long-term side-effects is mandatory. Therefore, the aim of this study was to investigate the radioprotective effect of amifostine in a rabbit animal model. Methods: Salivary gland scintigraphy was performed in a total of 16 New Zealand White rabbits. Uptake of {sup 99m}Tc-pertechnetate was calculated in percentage of injected activity as a quantitative measure of both salivary gland and thyroid function. Reproducibility of salivary gland scintigraphy was evaluated in one rabbit without any intervention. Fifteen rabbits were studied prior to and up to 6 months after high-dose radioiodine treatment applying 2 GBq {sup 131}I. Ten animals received 200 mg/kg amifostine prior to high-dose radioiodine therapy, and 5 served as controls. Salivary glands were examined histopathologically. Results: Variation coefficient of parenchymal function was less than 3.8% in salivary glands. Prior to HDRIT, thyroid uptake was 0.417 {+-} 0.373% and 0.421 {+-} 0.241% in control and amifostine-treated rabbits, respectively. Four weeks after HDRIT, complete ablation of the thyroid was achieved in both groups. Prior to HDRIT, uptake of {sup 99m}Tc-pertechnetate in salivary glands of five control rabbits was not significantly different from ten amifostine-treated rabbits. In control rabbits 6 months after HDRIT, parenchymal function was reduced significantly (p < 0.0001) by 75.3 {+-} 5.3% and 53.6 {+-} 17.4% in parotid and submandibular glands, respectively. In contrast, in amifostine-treated rabbits, parenchymal function was reduced by 10.6 {+-} 3.4% and 6.5 {+-} 4.3% (p > 0.05) in parotid and submandibular glands, respectively. Histopathologically, marked lipomatosis was observed in control animals but was negligible in amifostine-treated animals. Conclusion

Localization of ectopic gastric mucosa by scintigraphy

International Nuclear Information System (INIS)

D'Alonzo, W.A. Jr.

1988-01-01

When gastric mucosal tissue occurs outside of the confines of the stomach, it is termed ectopic or heterotopic. Ectopic gastric mucosa may be found within Meckel's diverticulum, duplications of the alimentary tract, and Barrett's esophagus. In addition, a surgeon may inadvertently leave behind antral gastric mucosa while performing a partial gastrectomy for peptic ulcer disease (i.e., retained gastric antrum). It is important to detect the presence and location of ectopic mucosa because acid and pepsin secretion may cause ulceration in the adjacent tissue resulting in serious complications. The only currently available specific diagnostic technique for detecting ectopic gastric mucosa is pertechnetate Tc 99m (TcO 4- ) scintigraphy. This chapter reviews the functional anatomy of gastric mucosa, the mechanism of TcO 4 - localization, the various entities containing ectopic gastric mucosa, and the methods and results of TcO 4 - scanning for these disorders

Disappearance of some autonomously functioning thyroid nodules following TSH stimulation: Pathogenetic hypothesis

Energy Technology Data Exchange (ETDEWEB)

Vattimo, A.; Pisani, M.; Martini, G.

1983-04-01

The disappearance of a hot nodule following TSH stimulation has been observed in 6 subjects with autonomously functioning thyroid nodule, in the thyroid scan obtained using sup(99m)Tc-pertechnetate and /sup 131/I. These findings have been related by many workers to the hyperreactivity of the nodular tissue to TSH: the disappearance of the nodule is due to a more rapid turnover of the tracer. In this work a new pathogenetic hypothesis is proposed: the disappearance of hot thyroid nodules might be due to ischaemia induced by the reaction of the healthy tissue, which had previously been inhibited. This hypothesis is confirmed by the scans performed shortly after administration of the tracers.

Disappearance of some autonomously functioning thyroid nodules following TSH stimulation: Pathogenetic hypothesis

International Nuclear Information System (INIS)

Vattimo, A.; Pisani, M.; Martini, G.

1983-01-01

The disappearance of a hot nodule following TSH stimulation has been observed in 6 subjects with autonomously functioning thyroid nodule, in the thyroid scan obtained using sup(99m)Tc-pertechnetate and 131 I. These findings have been related by many workers to the hyperreactivity of the nodular tissue to TSH: the disappearance of the nodule is due to a more rapid turnover of the tracer. In this work a new pathogenetic hypothesis is proposed: the disappearance of hot thyroid nodules might be due to ischaemia induced by the reaction of the healthy tissue, which had previously been inhibited. This hypothesis is confirmed by the scans performed shortly after administration of the tracers. (orig.) [de

Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

Science.gov (United States)

Walfish, P G; Strawbridge, H T; Rosen, I B

1985-12-01

To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered.

Speciation and Oxidative Stability of Alkaline Soluble, Non-Pertechnetate Technetium

Energy Technology Data Exchange (ETDEWEB)

Levitskaia, Tatiana G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rapko, Brian M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Anderson, Amity [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Peterson, James M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chatterjee, Sayandev [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Walter, Eric D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Cho, Herman M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Washton, Nancy M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2014-09-30

The long half-life, complex chemical behavior in tank waste, limited incorporation in mid- to high-temperature immobilization processes, and high mobility in subsurface environments make technetium (Tc) one of the most difficult contaminants to dispose of and/or remediate. Technetium exists predominantly in the liquid tank waste phase as the relatively mobile form of pertechnetate, TcO₄^-. However, based on experimentation to date a significant fraction of the soluble Tc cannot be effectively separated from the wastes and may be present as a non- pertechnetate species. The presence of a non-pertechnetate species significantly complicates disposition of low-activity waste (LAW), and the development of methods to either convert them to pertechnetate or to separate directly is needed. The challenge is the uncertainty regarding the chemical form of the alkaline-soluble low-valent non-pertechnetate species in the liquid tank waste. This report summarizes work done in fiscal year (FY) 2014 exploring the chemistry of a low-valence technetium(I) species, [(CO)₃Tc(H₂O)₃]⁺, a compound of interest due to its implication in the speciation of alkaline-soluble technetium in several Hanford tank waste supernatants.

Diagnostic evaluation of a case of lingual thyroid ectopia

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Valeria Fiaschetti

2016-09-01

Full Text Available Thyroid ectopia can occur when the process of thyroid embryogenesis fails. Here, we present the case of a 30-year-old woman with thyroid ectopia that was discovered during magnetic resonance imaging of cervical spine for referred neck pain. Imaging revealed the presence of an encapsulated mass at the base of her tongue. The patient was not symptomatic for any compression of the airways. Diagnosis of ectopic lingual thyroid was confirmed by 99mTC scintigraphy. Incidental diagnosis of thyroid ectopia in asymptomatic adult patients is rare, and it should be considered on diagnostic imaging in case of an anterior midline cervical mass.

The utility of 99mTc-sestamibi scintigraphy in the localisation of parathyroid adenomas in primary hyperparathyroidism.

LENUS (Irish Health Repository)

Glynn, N

2012-02-01

BACKGROUND: There are conflicting data in the literature about the sensitivity of sestamibi scintigraphy in parathyroid tumour localisation in primary hyperparathyroidism (PHPT). AIM: We aimed to evaluate the overall sensitivity of this modality in parathyroid tumour localisation and to determine clinical and biochemical factors which influence sensitivity of this method. METHODS: We performed a retrospective review of 57 patients with a biochemical diagnosis of PHPT who had sestamibi scintigraphy performed. RESULTS: The sensitivity of sestamibi scanning was 56% in whole group and 63% in those without nodular thyroid disease. Among the patients with confirmed single gland disease (biochemical cure after surgical removal of a single adenoma), sensitivity was 71%. A positive scan was associated with younger age, greater adenoma weight and higher pre-operative serum calcium. Concordance between the sestamibi and neck ultrasonography was 92% accurate in pre-operative tumour localisation. CONCLUSION: Sestamibi scintigraphy was more likely to be positive in younger patients without nodular thyroid disease who have larger parathyroid adenomas with more severe hyperparathyroidism.

Radioiodine-treatment (RIT) of functional thyroidal autonomy

International Nuclear Information System (INIS)

Meller, J.; Sahlmann, C.O.; Becker, W.

2002-01-01

Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

Detection of acute gastrointestinal bleeding by intra-arterial scintigraphy: an experimental study and preliminary clinical experience

Energy Technology Data Exchange (ETDEWEB)

Oh, Joo Hyeong; Kim, Duk Yoon; Yi, Bum Ha; Lee, Dong Ho; Yoon, Yup [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Song, Mi Jin [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

1998-10-01

The purpose of this animal and clinical study was to compare intra-arterial (IA) scintigraphy with angiography in the localization of gastrointestinal (GI) bleeding. After sedation with intramuscularly administered ketamine, lower GI bleeding was induced in ten rabbits. Using inguinal cut-down, an arterial femoral 3F catheter was placed in the proximal mesenteric artery. Following abdominal incision to expose the bowel, lower GI bleeding was caused by incising the antimesenteric border of the small bowel wall. Initial angiography was performed, and this was followede by Tc-99m pertechnetate IA scintigarphy. Tc-99m RBC IA scintigraphy involved two patients who had undergone selective mesenteric arterial catheterizaion for the evaluation of acute lower GI bleeding. Ten rabbits, bleeding at a mean rate of 0.7g/min, were studied. IA scintigraphy was superior to angiography in four cases and equal in six. The sensitivity of angiography was 40%(4/10), and IA scintigraphy 80%(8/10). In one patient, Tc-99m RBC was administered directly into the superior mesenteric artery and ulcer bleeding in the transverse colon was identified. PRior to conventional angiography, the bleeding had been occult. In a second patient, in whom angiography had revealed a hypervascular mass, selective injection of Tc-99m RBC into the superior mesenteric artery revealed tumor(leiomyoma) bleeding in the jejunum. Selective IA scintigraphy was valuable for detecting intestinal bleeding, occult during conventional studies and may be useful for detecting acute bleeding at the time of negative angiography.=20.

Evaluation of the Efficacy of Standardized Uptake Value (SUV-shape Scheme for Thyroid Volume Determination in Graves’ Disease: A Comparison with Ultrasonography

Directory of Open Access Journals (Sweden)

yangchun chen

2017-01-01

Full Text Available Objective(s: In this study, we aimed to evaluate the efficacy of thyroid volume measurement using 99mTc pertechnetate single-photon emission computed tomography (SPECT images, acquired by the standardized uptake value (SUV-shape scheme designed by our expert team.Methods: A total of 18 consecutive patients with Graves’ disease (GD were subjected to both ultrasonographic and 99mTc pertechnetate SPECT examinations of thyroid within a five-day interval. The volume of thyroid lobes and isthmus was measured by ultrasonography (US according to the ellipsoid volume equation. The total thyroid volume, determined as the sum of the volume of both lobes and isthmus, was recorded as TV-US (i.e., thyroid volume measured by US and set as the reference. The thyroid volume was defined according to our SUV-shape scheme and was recorded as TV-SS (i.e., thyroid volume determined by the SUV-shape scheme. The data were analyzed using the Bland-Altman plot, linear regression analysis, Spearman’s rank correlation, and paired t-test, if necessary.Results: The values of TV-SS (40.2±29.4 mL and TV-US (43.0±34.7 mL were not significantly different (t=0.813; P=0.43. The linear regression equation of the two values was determined as TV-US= 1.072 × TV-SS − 0.29(r=0.906; P

Oxidation, characterization, and separation of non-pertechnetate species in Hanford wastes

Energy Technology Data Exchange (ETDEWEB)

Schroeder, N.C. [Los Alamos National Lab., NM (United States)

1997-10-01

Under DOE`s privatization initiative, Lockheed Martin and British Nuclear Fuels Limited are preparing to stabilize the caustic tank waste generated from plutonium production at the Hanford Site. Pretreatment of Hanford tank waste will separate it into low-level waste (LLW) and high-level waste (HLW) fractions. The scope of the technetium problem is indicated by its inventory in the waste: {approximately}2000 kg. Technetium would normally exist as the pertechnetate anion, TcO{sub 4}{sup {minus}}, in aqueous solution. However, evidence obtained at Los Alamos National Laboratory (LANL) indicates that the combination of radiolysis, heat, organic complexants, and time may have reduced and complexed a significant fraction of the technetium in the tank waste. These species are in a form that is not amenable to current separation techniques based on pertechnetate removal. Thus, it is crucial that methods be developed to set technetium to pertechnetate so these technologies can meet the required technetium decontamination factor. If this is not possible, then alternative separation processes will need to be developed to remove these non-pertechnetate species from the waste. The simplest, most cost-effective approach to this problem is to convert the non-pertechnetate species to pertechnetate. Chemical, electrochemical, and photochemical oxidation methods, as well as hydrothermal treatment, are being applied to Hanford waste samples to ensure that the method works on the unknown technetium species in the waste. The degree of oxidation will be measured by determining the technetium distribution coefficient, {sup Tc}K{sub d}, between the waste and Reillex{trademark}-HPQ resin, and comparing it to the true pertechnetate K{sub d} value for the waste matrix. Other species in the waste, including all the organic material, could be oxidized by these methods, thus selective oxidation is desirable to minimize the cost, time, and secondary waste generation.

Study of serum TSH content in functioning thyroid gland adenoma by 'supersensitive' immunoradiometric assay

International Nuclear Information System (INIS)

Foeldes, Janos; Banos, Csaba; Csillag, Jozsef; Lakatos, Peter; Tarjan, Gabor; 2546970HU)

1987-01-01

Determinations of serum TSH levels by immunoradiometric assay (IRMA)-math TSH (Mallinckrodt) kit and of the thyroid function by scintiscanning using 99m Tc-pertechnetate (20-40 MBq) were carried out paralelly in euthyroid and hyperthyroid patients. A comparison of the two tests allowed a better distinction of preclinical hyperthyreosis from toxic adenomas. (L.E.)

Iodine concentration calculated by dual-energy computed tomography (DECT) as a functional parameter to evaluate thyroid metabolism in patients with hyperthyroidism.

Science.gov (United States)

Binh, Duong Duc; Nakajima, Takahito; Otake, Hidenori; Higuchi, Tetsuya; Tsushima, Yoshito

2017-07-19

Thyroid function in patients with Grave's disease is usually evaluated by thyroid scintigraphy with radioactive iodine. Recently, dual-energy computed tomography (DECT) with two different energy X-rays can calculate iodine concentrations and can be applied for iodine measurements in thyroid glands. This study aimed to assess the potential use of DECT for the functional assessment of the thyroid gland. Thirteen patients with Grave's disease treated at our hospital from May to September 2015 were included in this retrospective study. Before treatments, all subjects had undergone both iodine scintigraphy [three and 24 h after oral administration of 123 I (20 μCi)] and non-enhanced DECT. The region of interests (ROIs) were placed in both lobes of the thyroid glands, and CT values (HU: Hounsfield unit) and iodine concentrations (mg/mL) calculated from DECT images were measured. The correlation between CT values and iodine concentrations from DECT in the thyroid gland was evaluated and then the iodine concentrations were compared with radioactive iodine uptake ratios by thyroid scintigraphy. Mean (±SD) 123 I uptake increased from 46.3 (±22.2) % (range, 11.1-80.1) at 3 h, to 66.5 (±15.2) % (range, 40.0-86.1) at 24 h (p hyperthyroid patients.

Effect of Hypericum perforatum extract on in vitro labelling of blood elements with technetium-99m and on bioavailability of sodium pertechnetate in Wistar rats

International Nuclear Information System (INIS)

Santos-Filho, Sebastiao David; Bernardo-Filho, Mario

2005-01-01

Purpose: To evaluate the effect of a hypericum extract (Hypericum perforatum) on the labeling of blood elements with technetium- 99m ( 99m Tc) and in the bioavailability of the radiopharmaceutical sodium pertechnetate in Wistar rats. Methods: Blood (heparinized) withdrawn from Wistar rats is incubated with a hypericum extract, with a stannous chloride and with 99m Tc, as sodium pertechnetate ( 99m TcO Na). Plasma (P) and cells (C) are isolated by centrifugation. Samples of P and C are also precipitated with trichloroacetic acid (TCA 5%) and soluble (FS-P; FS-C) and insoluble (FI-P; FI-C) fractions are separated. In the bioavailability analysis, the extract or NaCl 0.9% solution is administrated into Wistar rats (gavage) during 15 days. Sodium pertechnetate was administered and after 10 min, the animals are sacrificed, the organs were isolated, the radioactivity determined in a well counter, and the percentages of radioactivity per gram (%ATI/g) in the organs are calculated. Results: The hypericum extract decreased significantly (P 99m Tc on the erythrocytes and plasma and cellular proteins. Moreover, it could produce metabolic alterations with influence in the uptake of the radiopharmaceutical 99m TcO 4 Na in bone, muscle, pancreas and thyroid. (author)

Marine-Lenhart syndrome in two adolescents, including one with thyroid cancer: a case series and review of the literature.

Science.gov (United States)

Sharma, Animesh

2017-11-27

The coexistence of functional thyroid nodules and Graves' disease (GD) is a rare condition known as Marine-Lenhart syndrome. Thyroid cancer has been described in several adults, but never in children, with Marine-Lenhart syndrome. This paper discusses the challenges in diagnosis and the unique management of this condition in children, in the context of extant literature. In this case report, two adolescent female patients with Marine-Lenhart syndrome, aged 15 and 16 years, exhibited biochemical evidence of hyperthyroidism, and were found to have unilateral hyperfunctioning thyroid nodules via thyroid scintigraphy. Additionally, both patients showed elevated thyroid-stimulating immunoglobulins (TSI) and increased glandular activity, confirming background GD. Notably, one patient was also diagnosed with intranodular thyroid cancer upon preoperative examination. Both patients were treated via surgical resection. Summary and outlook: Diagnosis of Marine-Lenhart syndrome can be made in patients with functional thyroid nodules and increased glandular activity on thyroid scintigraphy. Standard doses of radioiodine ablation are not effective in the majority of patients and should be avoided due to the increased risk for thyroid cancer, making thyroidectomy the preferred treatment.

High Prevalence of Papillary Thyroid Microcarcinoma in Danish Patients

DEFF Research Database (Denmark)

Rossing, Maria; Nygaard, Birte; Bennedbæk, Finn Noe

2012-01-01

with a cold thyroid nodule undergoing US-guided FNA were prospectively registered. 408 patients underwent thyroid surgery, resulting in 50 cancers and in addition 37 patients had an incidental finding of papillary thyroid microcarcinomas. Based on the diagnostic FNA, we found sensitivity and specificity...... for malignancy. Cancer incidence was 13% among females and 9% among males. The accuracy of a diagnostic set-up based on clinical examination, scintigraphy, US, and US-guided FNA was determined with a 48% rate of histopathological validation in the cohort. The overall thyroid cancer incidence has increased...... worldwide, but our results suggest that the most frequent occurring cancer is an incidental papillary thyroid microcarcinoma of which the clinical significance has yet to be established....

Investigations of the sorption of pertechnetate on salts of molybdophosphoric acid

International Nuclear Information System (INIS)

Suess, M.; Pfrepper, G.

1983-01-01

Studies were made to investigate the sorption of pertechnetate on neutral and acid salts of molybdophosphoric acid from nitric acid and in the presence of electrolytes and non-electrolytes. Particular, distribution coefficients from 10 to 100 were found. The sorption of pertechnetate can be increased by the addition of K + , NH 4 + , Rb + and Cs + salts, by the addition of non-electrolytes the distribution coefficients decrease. A saturation capacity of about 0.19 mmol Tc/g ammonium phosphomolybdate was determined from the adsorption isotherms. The formation of alkali metal pertechnetate associates in the sorbent phase can be supposed. (author)

Dual ectopic thyroid: A case report with review of literature

International Nuclear Information System (INIS)

Sood, A.; Seam, R. K.; Gupta, M.; Raj Sharma, D.; Bhardwaj, P.

2011-01-01

The ectopic thyroid gland is a rare entity which is mostly found along the line of descent of the thyroid gland. Most of the patients present with midline swelling and usually seek medical attention. Dual ectopic thyroid gland is even rarer. The clinical examination and different imaging modalities establish its diagnosis. Radionuclide studies are highly sensitive and specific in demonstrating the functional tissues in patients with ectopic thyroid, thereby guiding further management. The authors reported a case of ectopic thyroid gland in a girl with midline neck swelling initially, subsequently lost to follow-up. She again presented with enlarged swelling after a period of three years with dual ectopic thyroid in the neck region on thyroid scan. Thyroid scintigraphy demonstrated that progression in the size of ectopic glands was due to neglect in treatment.

Thyroid disorders in Chernobyl clean-up workers from Latvia

International Nuclear Information System (INIS)

Kurjane, N.; Orlikovs, G.; Ritenberga, R.; Skudra, M.; Lemane, R.; Lemanis, A.; Curbakova, E.; Groma, V.; Socnevs, A.

1999-01-01

The condition of thyroid was examined in 2188 Chernobyl clean-up workers residing in Latvia and a control group consisting of 1041 employees of the Ministry of International Affairs. Thyroid examinations included palpation, ultrasonography, selective scintigraphy and detection of the level of thyroid hormones in blood serum:L STH (thyroid-stimulating hormone), total T3 (triiodothyronine), and T4 (thyroxine). Thyroid was registered in 394 Chernobyl clean-up workers. Of these cases, 28 patients with suspected thyroid cancer were operated, and morphological examinations revealed papillary adenocarcinoma (in 5 patients), follicular adenocarcinoma (2), nodular colloid goiter (16); toxic diffuse goiter (1), papillary-follicular adenoma (3), and chronic thyroiditis (1). It was determined that the thyroid pathology in the Chernobyl clean-up workers had a tendency to progress (27 cases in 1987 versus 394 cases in 1998 in total; and absence of thyroid cancer in 1987, compared with 7 cases in 1998); thyroid nodules increased twice (64 cases in 1997, compare with 126 cases in 1998). (author)

Sodium pertechnetate (Na99mTcO4) biodistribution in mice exposed to cigarette smoke

International Nuclear Information System (INIS)

Valenca, Samuel S; Lima, Elaine AC; Dire, Gláucio F; Bernardo-Filho, Mário; Porto, Luís Cristóvão

2005-01-01

The biological effects of cigarette smoke are not fully known. To improve our understanding of the action of various chemical agents, we investigated the biodistribution of sodium pertechnetate (Na 99m TcO 4 ) in mice exposed to cigarette smoke. Fifteen BALB/c male mice were exposed to the smoke of nine whole commercial cigarettes per day, 3 times/day, for up to 10 days to whole body exposure in a chamber. A control group of 5 BALB/c male mice was sham-smoked. One day later, the exposed and control groups of mice received (7.4 MBq/0.3 ml) of Na 99m TcO 4 before being killed at 30 min. Bones, brain, heart, intestine, kidney, liver, lungs, muscle, pancreas, spleen, stomach, testis and thyroid were weighed and these organs and blood radioactivity recorded with a gamma counter. The percentage per gram of tissue of injected dose (%ID/g) was determined for each organ. Cigarette smoke significantly decreased (p < 0.05) the %ID/g in red blood cells, bone, kidney, lung, spleen, stomach, testis and thyroid of the exposed mice. The toxic effects of cigarette smoke reduced the Na 99m TcO 4 biodistribution

Gallium-67 uptake by the thyroid associated with progressive systemic sclerosis

International Nuclear Information System (INIS)

Sjoberg, R.J.; Blue, P.W.; Kidd, G.S.

1989-01-01

Although thyroidal uptake of gallium-67 has been described in several thyroid disorders, gallium-67 scanning is not commonly used in the evaluation of thyroid disease. Thyroidal gallium-67 uptake has been reported to occur frequently with subacute thyroiditis, anaplastic thyroid carcinoma, and thyroid lymphoma, and occasionally with Hashimoto's thyroiditis and follicular thyroid carcinoma. A patient is described with progressive systemic sclerosis who, while being scanned for possible active pulmonary involvement, was found incidentally to have abnormal gallium-67 uptake only in the thyroid gland. Fine needle aspiration cytology of the thyroid revealed Hashimoto's thyroiditis. Although Hashimoto's thyroiditis occurs with increased frequency in patients with progressive systemic sclerosis, thyroidal uptake of gallium-67 associated with progressive systemic sclerosis has not, to our knowledge, been previously described. Since aggressive thyroid malignancies frequently are imaged by gallium-67 scintigraphy, fine needle aspiration cytology of the thyroid often is essential in the evaluation of thyroidal gallium-67 uptake

Gallium-67 uptake by the thyroid associated with progressive systemic sclerosis

Energy Technology Data Exchange (ETDEWEB)

Sjoberg, R.J.; Blue, P.W.; Kidd, G.S.

1989-01-01

Although thyroidal uptake of gallium-67 has been described in several thyroid disorders, gallium-67 scanning is not commonly used in the evaluation of thyroid disease. Thyroidal gallium-67 uptake has been reported to occur frequently with subacute thyroiditis, anaplastic thyroid carcinoma, and thyroid lymphoma, and occasionally with Hashimoto's thyroiditis and follicular thyroid carcinoma. A patient is described with progressive systemic sclerosis who, while being scanned for possible active pulmonary involvement, was found incidentally to have abnormal gallium-67 uptake only in the thyroid gland. Fine needle aspiration cytology of the thyroid revealed Hashimoto's thyroiditis. Although Hashimoto's thyroiditis occurs with increased frequency in patients with progressive systemic sclerosis, thyroidal uptake of gallium-67 associated with progressive systemic sclerosis has not, to our knowledge, been previously described. Since aggressive thyroid malignancies frequently are imaged by gallium-67 scintigraphy, fine needle aspiration cytology of the thyroid often is essential in the evaluation of thyroidal gallium-67 uptake.

Somatostatin Receptor Scintigraphy in Medullary Thyroid Cancer

NARCIS (Netherlands)

van der Horst-Schrivers, Anouk N. A.; Brouwers, Adrienne; Links, Thera; Hubalewska‐Dydejczyk, Alicja; Signore, Alberto; de Jong, Marion; Dierckx, Rudi A.; Buscombe, John; Van de Wiele, Christophe

2015-01-01

Medullary thyroid cancer (MTC) is a neuroendocrine tumor originating from the calcitonin‐secreting C cells. Surgery, consisting of a total thyroidectomy and an extensive lymph node dissection, is the only effective treatment in MTC; however, metastases are frequently found in the regional cervical

Lingual thyroid: value of integrated imaging

Energy Technology Data Exchange (ETDEWEB)

Giovagnorio, F. [Sezione di Radiologia e Diagnostica per Immagini, Dipt. di Medicina Sperimentale e Patologia, Univ. `La Sapienza`, Rome (Italy); Cordier, A. [Ist. di Clinica Otorinolaringoiatrica, Univ. `La Sapienza`, Rome (Italy); Romeo, R. [Ist. di Clinica Otorinolaringoiatrica, Univ. `La Sapienza`, Rome (Italy)

1996-02-01

Lingual thyroid is an uncommon cause of oropharyngeal mass, due to a congential anomaly of thyroidal development and migration: It is defined precisely as the presence of thyroid tissue in the midline of the tongue base between circumvallatae papilae and the epiglottis. We report a case of lignual thyroid in which the integration of clinical data, sonography, color-duplex Doppler, MRI and scintigraphy was determinant in demonstrating the disease. A 22-year-old woman presented with a sensation of foreign body in the throat, dysphonia, dyspnoea and dysphagia; we performed sonography (7.5 MHz linear probe), color Doppler (7 MHz Doppler frequeny, PRF 3500 Hz) and MRI (1.5 T, spin-echo T1- and T2-weighted images with administration of Gd-DTPA); a scan with {sup 123}I demonstrated a relevant uptake at the base of the tongue, but no uptake at the typical thyroid location. The gland was removed and partially transplanted in the strap muscles of the neck. (orig.)

Lingual thyroid: value of integrated imaging

International Nuclear Information System (INIS)

Giovagnorio, F.; Cordier, A.; Romeo, R.

1996-01-01

Lingual thyroid is an uncommon cause of oropharyngeal mass, due to a congential anomaly of thyroidal development and migration: It is defined precisely as the presence of thyroid tissue in the midline of the tongue base between circumvallatae papilae and the epiglottis. We report a case of lignual thyroid in which the integration of clinical data, sonography, color-duplex Doppler, MRI and scintigraphy was determinant in demonstrating the disease. A 22-year-old woman presented with a sensation of foreign body in the throat, dysphonia, dyspnoea and dysphagia; we performed sonography (7.5 MHz linear probe), color Doppler (7 MHz Doppler frequeny, PRF 3500 Hz) and MRI (1.5 T, spin-echo T1- and T2-weighted images with administration of Gd-DTPA); a scan with 123 I demonstrated a relevant uptake at the base of the tongue, but no uptake at the typical thyroid location. The gland was removed and partially transplanted in the strap muscles of the neck. (orig.)

Palpation thyroiditis following subtotal parathyroidectomy for hyperparathyroidism

Directory of Open Access Journals (Sweden)

Elizabeth M Madill

2016-07-01

Full Text Available Thyrotoxicosis is an under-recognised but clinically important complication of parathyroidectomy. We report a case of a 37-year-old man with tertiary hyperparathyroidism who initially developed unexplained anxiety, diaphoresis, tachycardia, tremor and hyperreflexia one day after subtotal parathyroidectomy. Thyroid biochemistry revealed suppressed thyroid stimulating hormone and elevated serum free T4 and free T3 levels. Technetium-99m scintigraphy scan confirmed diffusely decreased radiotracer uptake consistent with thyroiditis. The patient was diagnosed with thyrotoxicosis resulting from palpation thyroiditis. Administration of oral beta-adrenergic antagonists alleviated his symptoms and there was biochemical evidence of resolution fourteen days later. This case illustrates the need to counsel patients about thyroiditis as one of the potential risks of parathyroid surgery. It also emphasises the need for biochemical surveillance in patients with unexplained symptoms in the post-operative period and may help to minimise further invasive investigations for diagnostic clarification.

Single-photon emission computed tomography enhanced Tc-99m-pertechnetate disodium-labelled red blood cell scintigraphy in the localization of small intestine bleeding: a single-centre twelve-year study.

Science.gov (United States)

Dolezal, Jiri; Vizda, Jaroslav; Kopacova, Marcela

2011-01-01

To present our experience with the detection of bleeding in the small intestine by means of scintigraphy with in vivo-labelled red blood cells (RBCs) in the period of 1998-2009. A 12-year prospective study was accomplished with 40 patients (23 men, 17 women, aged 12-91, mean 56 years) who had lower gastrointestinal bleeding (obscure-overt bleeding) and underwent scintigraphy with in vivo-labelled RBCs by means of technetium 99m. The scintigraphy was usually performed after other diagnostic tests had failed to locate the bleeding. A total of 26 patients had a positive scintigraphy with in vivo-labelled RBCs and 14 patients had negative scintigraphy. The final diagnosis was confirmed in 20 of 26 patients with a positive scintigraphy by push enteroscopy (6/20), intraoperative enteroscopy (7/20), surgery (4/20), duodenoscopy (1/20), double-balloon enteroscopy (1/20) and X-ray angiography (1/20). The correct location of the bleeding site was identified by RBC scintigraphy in 15 of 20 (75%) patients with the confirmed source. The locations of the bleeding site identified by scintigraphy and enteroscopy (push, intraoperative) and surgical investigations were highly correlated in patients with a positive scintigraphy within the first 3 h. Eleven of the 20 correctly localized studies and none of the incorrectly localized studies were positive in the dynamic phase of imaging. In 5 patients (all erroneously localized), scintigraphy was positive only at a period longer than 18 h. RBC scintigraphy is an effective imaging modality in localizing lower gastrointestinal bleeding in patients for whom other diagnostic tests have failed to locate the bleeding. RBC scintigraphy can be successful in the detection of bleeding sites in the small intestine. Copyright © 2011 S. Karger AG, Basel.

Labelling of red blood cells with 99m pertechnetate

International Nuclear Information System (INIS)

Vyth, A.; Raam, C.F.

1979-07-01

This paper describes a method for labelling red blood cells with 99mTc in vitro, using electrolytically generated stannous ions as the reducing agent for 99mTc-pertechnetate. A labelling of 95% was found. A method for the in vivo labelling of red blood cells is also reported. This involves an injection of a stanno-DTPA-complex followed 20 minutes later by a 99mTc-pertechnetate solution scintillation camera images show more background activity when the in vivo method of labelling is used

Practice, efficacy, and costs of thyroid nodule evaluation: a retrospective study in a Dutch university hospital

NARCIS (Netherlands)

Hooft, Lotty; Hoekstra, Otto S.; Boers, Maarten; van Tulder, Maurits W.; van Diest, Paul; Lips, Paul

2004-01-01

Fine-needle aspiration (FNA) of thyroid nodules has markedly reduced the role of thyroid scintigraphy. This is often limited to nondiagnostic or follicular (tumor) FNA classifications. In this study, we evaluated the efficacy and cost of such a strategy in a university center. From 1992-1998, 995

The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma

Directory of Open Access Journals (Sweden)

Starzinger Matthias

2008-01-01

Full Text Available Abstract Background Thyroid physiology is closely related to oxidative changes. The aim of this controlled study was to evaluate the levels of nutritional anti-oxidants such as vitamin C, zinc (Zn and selenium (Se, and to investigate any association of them with parameters of thyroid function and pathology including benign and malignant thyroid diseases. Methods This controlled evaluation of Se included a total of 1401 subjects (1186 adults and 215 children distributed as follows: control group (n = 687, benign thyroid disease (85 children and 465 adults; malignant thyroid disease (2 children and 79 adults. Clinical evaluation of patients with benign thyroid disease included sonography, scintigraphy, as well as the determination of fT3, fT4, TSH, thyroid antibodies levels, Se, Zn, and vitamin C. Besides the routine oncological parameters (TG, TSH, fT4, ultrasound Se was also determined in the cases of malignant disease. The local control groups for the evaluation of Se levels were taken from a general practice (WOMED as well as from healthy active athletes. Blood samples were collected between 8:00 and 10:30 a.m. All patients lived in Innsbruck. Statistical analysis was done using SPSS 14.0. The Ho stated that there should be no differences in the levels of antioxidants between controls and thyroid disease patients. Results Among the thyroid disease patients neither vitamin C, nor Zn nor Se correlated with any of the following parameters: age, sex, BMI, body weight, thyroid scintigraphy, ultrasound pattern, thyroid function, or thyroid antibodies. The proportion of patients with benign thyroid diseases having analyte concentrations below external reference cut off levels were 8.7% of cases for vitamin C; 7.8% for Zn, and 20.3% for Se. Low Se levels in the control group were found in 12%. Se levels were significantly decreased in cases of sub-acute and silent thyroiditis (66.4 ± 23.1 μg/l and 59.3 ± 20.1 μg/l, respectively as well as in

Identification of Non-Pertechnetate Species In Hanford Tank Waste, Their Synthesis, Characterization, And Fundamental Chemistry

Energy Technology Data Exchange (ETDEWEB)

Kenneth R. Ashely; Norman Schroeder; Jose A. Olivares; Brian Scott

2004-12-10

This proposal had three major goals: (1) develop capillary electrophoresis mass spectrometry as a characterization technique, (2) separate a non-pertechnetate fraction from a waste sample and identify the non-pertechnetate species in it by CEMS, and (3) synthesize and characterize bulk quantities of the identified non-pertechnetate species and study their ligand substitution and redox chemistry.

Identification of Non-Pertechnetate Species In Hanford Tank Waste, Their Synthesis, Characterization, And Fundamental Chemistry

International Nuclear Information System (INIS)

Ashely, Kenneth R.; Schroeder, Norman; Olivares, Jose A.; Scott, Brian

2004-01-01

This proposal had three major goals: (1) develop capillary electrophoresis mass spectrometry as a characterization technique, (2) separate a non-pertechnetate fraction from a waste sample and identify the non-pertechnetate species in it by CEMS, and (3) synthesize and characterize bulk quantities of the identified non-pertechnetate species and study their ligand substitution and redox chemistry

Somatostatin receptor scintigraphy and magnetic resonance imaging in recurrent medullary thyroid carcinoma: A comparative study

International Nuclear Information System (INIS)

Doerr, U.; Wuerstlin, S.; Frank-Raue, K.; Raue, F.; Hehrmann, R.; Iser, G.; Scholz, M.; Guhl, L.; Buhr, H.J.; Bihl, H.

1993-01-01

In a prospective study, 18 patients with recurrent medullary thyroid carcinoma (MTC) underwent magnetic resonance imaging (MRI) of the neck and mediastinum and somatostatin receptor scintigraphy (SRS) with 111 In-labeled pentetreotide. In nine patients with macroscopic MTC, 17 corresponding lesions were found on MRI and SRS; in addition, 13 suspicious lesions were seen on SRS only. Histological confirmation was available for 19 metastatic lesions, showing MRI to be true positive in 13 metastases, SRS in 18. In minimal residual disease (n=10), MRI and SRS were compared with the histological findings in three patients and with selective venous catheterization (SVC) in seven patients. Corresponding findings on MRI and SVC were seen in one of seven, whereas SRS and SVC showed concordant localization of tumor recurrence in five of seven. Histological examination demonstrated MTC tissue in one of three cases; MRI and SRS were false positive in one of three cases, while in the others the interpretation remained uncertain. In conclusion, SRS is a promising imaging modality for localization of MTC recurrence. MRI provides better spatial resolution and thus facilitates the planning of surgery for macroscopic metastases. In minimal residual disease, SRS turned out to be superior in detecting occult MTC recurrence, confirming SVC findings. (orig.)

Computed tomography, conventional X-ray examination, scintigraphy and tumour markers in thyroid carcinomas and suspected metastisation into the thoracic region

International Nuclear Information System (INIS)

Heintz, P.

1986-01-01

In 43 patients suffering from differentiated carcinomas of thyroid, who had previously been subjected to thyroidectomy and curative radioiodine treatment, CT scans of the thorax were used in addition to the usual X-ray examinations in order to exclude the formation of pulmonary metastases. Separate analyses of 45 records on the basis of the stage of the tumour when it was diagnosed and the behaviour of tumour marker hTg under suppression with L-thyroxin and endogenous stimulation during the follow-up permitted patient groups to be defined that are most at risk of metastisation. The results of the three methods of medical imaging were compared to those obtained using tumour marker hTg. The rate of findings revealed by CT, scintigraphy and X-ray examination was calculated with reference to the total number of results suggesting pulmonary metastisation and amounted to 89%, 48% and 44%, respectively. (orig./MG) [de

Non-Pertechnetate Technetium Sensor Research and Development

Energy Technology Data Exchange (ETDEWEB)

Bryan, Samuel A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Crawford, Amanda D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Heineman, William R. [Univ. of Cincinnati, OH (United States); Rapko, Brian M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Branch, Shirmir D. [Univ. of Cincinnati, OH (United States)

2014-09-01

There remain several significant uncertainties in the understanding and modeling of the fate and speciation of ⁹⁹Tc in Hanford waste tanks, glass, and low-temperature waste forms. A significant (2% to 25%) fraction of the ⁹⁹Tc in the water-soluble portion of the tank waste may be present as a non-pertechnetate species that has not been identified and, based on experimentation to date, cannot be effectively separated from the wastes. This task will provide a sensor specifically tuned to detect the Tc(I)-carbonyl species believed to constitute the main fraction of the non-pertechnetate form of technetium. By direct measurement of the non-pertechnetate species, such a sensor will help reduce the uncertainties in the modeling of the fate and speciation of ⁹⁹Tc in Hanford tanks and waste forms. This report summarizes work done in FY 2014 exploring the chemistry of a low-valence technetium species, [Tc(CO)₃(H₂O)₃]⁺, a compound of interest due to its implication in the speciation of alkaline-soluble technetium in several Hanford tank waste supernatants. Progress made in FY 2014 was sponsored by the Department of Energy’s Office of Environmental Management and is summarized in this report.

Percutaneous ethanol injection of large autonomous hyperfunctioning thyroid nodules.

Science.gov (United States)

Tarantino, L; Giorgio, A; Mariniello, N; de Stefano, G; Perrotta, A; Aloisio, V; Tamasi, S; Forestieri, M C; Esposito, F; Esposito, F; Finizia, L; Voza, A

2000-01-01

To verify the effectiveness of percutaneous ethanol injection (PEI) in the treatment of large (>30-mL) hyperfunctioning thyroid nodules. Twelve patients (eight women, four men; age range, 26-76 years) with a large hyperfunctioning thyroid nodule (volume range, 33-90 mL; mean, 46.08 mL) underwent PEI treatment under ultrasonographic (US) guidance. US was used to calculate the volume of the nodules and to assess the diffusion of the ethanol in the lesions during the procedure. When incomplete necrosis of the nodule was depicted at scintigraphy performed 3 months after treatment, additional PEI sessions were performed. Four to 11 PEI sessions (mean, seven) were performed in each patient, with an injection of 3-14 mL of 99.8% ethanol per session (total amount of ethanol per patient, 30-108 mL; mean, 48.5 mL). At scintigraphy after treatment in all patients, recovery of extranodular uptake, absence of uptake in the nodule, and normalization of thyroid-stimulating hormone (thyrotropin) levels were observed. In all patients, US showed volume reductions of 30%-50% after 3 months and 40%-80% after 6-9 months. Side effects were self-limiting in all patients. During the 6-48-month follow-up, no recurrence was observed. PEI is an effective and safe technique for the treatment of large hyperfunctioning thyroid nodules.

Scintigraphic criteria for administration of therapeutic activities of 131I for ablation of residual thyroid tissue in patients with differentiated thyroid cancer

International Nuclear Information System (INIS)

Dzhuzha, D.A.

2003-01-01

With the aim to determinate the optical scintigraphic criteria of radioablation of the small parts of residual thyroid tissue (RTT) after a thyroidectomy the results of postoperative monitoring of 29 women aged 23-60 with differentiated thyroid cancer, who did not get the radioiodine therapy, were analyzed. At the single postoperative scintigraphy with 131 I the optimal scintigraphic criteria for radioablation are the relative level of 131 I accumulation in RTT and the relative specific volume activity in RTT. At the values of these indices below 0.21% and 0.16%/sm 3 , respectively, only suppressive thyroid hormone therapy and standard monitoring are recommended

A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

Directory of Open Access Journals (Sweden)

Hamasaki Hidetaka

2012-12-01

Full Text Available Abstract Background Both thyroid stimulating hormone (TSH and thyroid stimulating antibody (TSAb negative Graves’s disease (GD is extremely rare. Here we present such a patient. Case presentation The patient was a 76-year-old woman who was diagnosed as having schizophrenia forty years ago. She did not show characteristic symptoms for hyperthyroidism, such as swelling of thyroid, exophthalmos, tachycardia and tremor, however, she showed only psychomotor agitation. Serum free triiodothyronine and free thyroxine levels were elevated and TSH level was suppressed, suggesting the existence of hyperthyroidism. However, both the first generation TSH receptor autoantibody (TRAb1 and the thyroid stimulating autoantibody (TSAb were negative. Slightly increased blood flow and swelling was detected by thyroid echography. Thyroid scintigraphy demonstrated diffuse and remarkably elevated uptake of 123I uptake. Finally, we diagnosed her as having GD. She was treated by using methimazole, and hyperthyroidism and her psychiatric symptoms were promptly ameliorated. Discussion We experienced a patient with GD who did not show characteristic symptoms except for psychiatric symptoms, and also showed negativity for both TRAb1 and TSAb. Thyroid autoantibody-negative GD is extremely rare. Thyroid scintigraphy was useful to diagnose such a patient.

Development and gamma scintigraphy evaluation of gastro retentive calcium ion-based oral formulation: an innovative approach for the management of gastro-esophageal reflux disease (GERD).

Science.gov (United States)

Sharma, Braj Gaurav; Khanna, Kushagra; Kumar, Neeraj; Nishad, Dhruv K; Basu, Mitra; Bhatnagar, Aseem

2017-11-01

Calcium chloride is an essential calcium channel agonist which plays an important role in the contraction of muscles by triggering calcium channel. First time hypothesized about its role in the treatment of GER (gastro-esophageal reflux) and vomiting disorder due to its local action. There are two objectives covered in this study as first, the development and optimization of floating formulation of calcium chloride and another objective was to evaluate optimized formulation through gamma scintigraphy in human subjects. Gastro retentive formulation of calcium chloride was prepared by direct compression method. Thirteen tablet formulations were designed with the help of sodium chloride, HPMC-K4M, and carbopol-934 along with effervescing agent sodium bicarbonate and citric acid. Formulation (F8) fitted best for Korsmeyer-Peppas equation with an R 2 value of 0.993. The optimized formulation was radiolabelled with 99m Tc-99 m pertechnetate for its evaluation by gamma scintigraphy. Gastric retention (6 h) was evaluated by gamma scintigraphy in healthy human subjects and efficacy of present formulation confirmed in GER positive human subjects. Gamma scintigraphy results indicated its usefulness in order to manage GERD. Stability studies of the developed formulation were carried out as per ICH guidelines for region IV and found out to be stable for 24 months.

Hyperfunctioning thyroid cancer: a five-year follow-up.

Science.gov (United States)

Azevedo, Monalisa Ferreira; Casulari, Luiz Augusto

2010-02-01

Differentiated thyroid cancer rarely occurs in association with hyperfunctioning nodules. We describe a case of a 47-year-old woman who developed symptoms of hyperthyroidism associated with a palpable thyroid nodule. Thyroid scintigraphy showed an autonomous nodule, and fine-needle aspiration biopsy was suggestive of papillary carcinoma. Laboratorial findings were consistent with the diagnosis of hyperthyroidism. The patient underwent thyroidectomy and a papillary carcinoma of 3.0 x 3.0 x 2.0 cm, follicular variant, was described by histological examination. The surrounding thyroid tissue was normal. Postoperatively, the patient received 100 mCi of (131)I, and whole body scans detected only residual uptake. No evidence of metastasis was detected during five years of follow-up. Hot thyroid nodules rarely harbor malignancies, and this case illustrated that, when a carcinoma occurs the prognosis seems to be very good with no evidence of metastatic dissemination during a long-term follow-up.

GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma

International Nuclear Information System (INIS)

Hammes, Jochen; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang; Pietrzyk, Uwe; Wuppertal Univ.

2011-01-01

-11% (AF) respectively 7-8% (AM). For each phantom, the dependency of count density ratios upon uptake ratios can be modeled well by both linear and quadratic regression (quadratic: r 2 > 0.99), yielding sets of parameters which in reverse allow the computation of uptake ratios (and thus dose) from count density ratios. A single regression model obtained by fitting the data of all simulations simultaneously did not provide satisfactory results except for GP, while underestimating the true uptake ratios in AF and overestimating them in AM. The scintigraphic count density ratios depend upon the uptake ratios between nodule and rest of thyroid, upon their volumes, and their respective position in a non-trivial way. Further investigations are required to derive a comprehensive rule to calculate the uptake or dose ratios based on post-therapeutic scintigraphy. (orig.)

[Contributions of the measurement of TSH, T4 and thyroglobulin, of 99m Tc scintigraphy and of cervical ultrasonography to the early diagnosis of congenital hypothyroidism].

Science.gov (United States)

Delisle, M J; Gibold, C; Deltour, G; Pennaforte, F

1988-01-01

Over 10 years, extending from 1978, 200,000 newborns of the Champagne-Ardennes Region have been tested within the screening program for congenital hypothyroidism. Congenital hypothyroidism was diagnosed in 96 infants (28 boys, 68 girls): 73 thyroid dysgenesis (50 ectopic glands and 23 undetectable thyroid tissue) and 23 thyroid dyshormonogenesis (14 permanent and 9 transient defects). Our local frequency was 1/2,600, significantly higher than the French and European frequencies. There was a marked shortening of the age at diagnosis during the 10 year period (mean age: 45 days between 1978 and 1980, 18 days in 1987). The TSH measurement was found to be the most sensitive tool for the diagnosis. Scintigraphy and more recently ultrasonography were performed in order to characterize the anatomical variety. For the last year, the following protocol was used: high frequency ultrasonography at first, then 123I or 99 m Tc scintigraphy (using parallel colimator and digital acquisition) depending on whether the thyroid gland was seen on ultrasound or not. Treatment of thyroid dyshormonogenesis was withdrawn after 5 years for reassessment.

Primary and secondary hyperparathyroidism among vitamin D deficient Hashimoto's thyroiditis patients and the need for a parathyroid scan.

Science.gov (United States)

Mazokopakis, Elias; Papadomanolaki, Maria; Skarakis, Spyridon-Nikitas N; Tsekouras, Konstantinos

2017-01-01

The patients with Hashimoto thyroiditis must be investigated mainly for secondary hyperparathyroidism due to vitamin D deficiency/insufficiency. Parathyroid scintigraphy has no place in the diagnosis of primary, secondary or tertiary hyperparathyroidism or in the decision for surgical treatment. Parathyroid scintigraphy is a useful preoperative technique for the localization of the pathological parathyroid glands.

Use of 99mTc pertechnetate in patients with differentiated thyroid carcinoma

International Nuclear Information System (INIS)

Garcia del Rio, Hernan; Degrossi, Osvaldo J.; Pena, M.; Alvarez, L.; Faure, E.

2006-01-01

The possibility of using 99m Tc as an effective marker for the follow up of differentiated thyroid carcinoma is demonstrated. 99m Tc will avoid the blind use of radioiodine and it makes possible, in the case of rhTSH stimulation, to establish the need of 131 I therapy and the prompt application of this treatment [es

Dysfunctional ectopic thyroid gland: A case report

Directory of Open Access Journals (Sweden)

Stokić Edita

2014-01-01

Full Text Available Introduction. Lingual thyroid gland is a rare anomaly of thyroid gland development, occurring more frequently in females. If it causes local symptomatology such as dysphagia, dysphonia or dyspnea it is diagnosed in childhood, however, if it is asymptomatic it is usually diagnosed in adulthood. Case Outline. We present a 23-year-old female patient in whom we diagnosed lingual thyroid gland coincidentally during diagnostic procedures of a concomitant disease. The application of 131I scintigraphy showed an oval field of intensive accumulation of radio markers in the zone of medial face line, around tongue base, with the absence of thyroid gland in its physiological position. Functional testing proved primary hypothyroidism and we started the application of substitution therapy. The application of levothyroxine resulted in reaching euthyroid state and the reduction of thyroid gland size. Conclusion. We present a very rare anomaly of the thyroid gland, and so far there have been no clear attitudes about further treatment. The general condition of the patient, age, the size of ectopic thyroid gland and the existence of local symptomatology or complications represent the factors that have influence on the choice of treatment method.

Method for in vitro labelling of erythrocytes with 99mTc-pertechnetate

International Nuclear Information System (INIS)

Kostadinova, I.D.; Hadzhikostova, H.K.; Shejretova, E.T.; Garcheva-Tsacheva, M.B.

1987-01-01

The method is easy to apply and gives a possibility to lead the radiopharmaceutical directly to erythrocytes. It includes: blocking of the structures accumulating 99m Tc-pertechnetate by potassium perchlorite; attenuation of the erythrocytes by an intervenous injection of tin pyrophosphate; preparation of the necessary blood quantity with acidum citricum dextrose mixing with 99m Tc-pertechnetate and reinjection. 1 cl

Development of thyroid anthropomorphic phantoms for use in nuclear medicine

Science.gov (United States)

Cerqueira, R. A. D.; Maia, A. F.

2014-02-01

The objective of this study was to develop thyroid anthropomorphic phantoms to be used in control tests of medical images in scintillation cameras. The main difference among the phantoms was the neck shape: in the first, called OSCT, it was geometrically shaped, while in the second, called OSAP, it was anthropomorphically shaped. In both phantoms, thyroid gland prototypes, which were made of acrylic and anthropomorphically shaped, were constructed to allow the simulation of a healthy thyroid and of thyroids with hyperthyroidism and hypothyroidism. Images of these thyroid anthropomorphic phantoms were obtained using iodine 131 with an activity of 8.695 MBq. The iodine 131 was chosen because it is widely used in studies of thyroid scintigraphy. The images obtained proved the effectiveness of the phantoms to simulate normal or abnormal thyroids function. These phantoms can be used in medical imaging quality control programs and, also in the training of professionals involved in the analysis of images in nuclear medicine centers.

99Tcm pertechnetate uptake by hepatoma cells induced by tissue specific hNIS gene expression

International Nuclear Information System (INIS)

Chen Libo; Luo Quanyong; Yu Yongli; Yuan Zhibin; Lu Hankui; Zhu Ruisen; Guo Lihe

2007-01-01

Objective: Human sodium/iodide symporter (hNIS) gene could be used both as an ideal reporter gene and promising therapeutic gene. Rather than radioiodine, 99 Tc m pertechnetate has been proven to be a better radiopharmaceutical for tracing and imaging purposes. Herein, the authors investigated the feasibility of monitoring hNIS gene expression in hepatoma cells using 99 Tc m pertechnetate as a tracer. Methods: Hepatoma cells MH3924A were stably transfected with recombinant retroviral vector in which hNIS cDNA was driven by murine albumin enhancer/promoter (mAlb) and coupled to hygromycin resistance gene. The uptake and efflux of 99 Tc m pertechnetate by transfected hepatoma cells were tested with 99 Tc m pertechnetate (74 kBq) solution adulterated into the culture media and counted after media suspension discharge at different intervals. In further tests, 50 μmol/L NaClO 4 and 500 μmol/L Ouabain were added into the media for 99 Tc m inhibition tests. For in vive studies, five ACI rats bearing NIS transfected hepatoma xenografts were injected with 99 Tc m pertechnetate (15.8 MBq) and followed by dynamic acquisition (0.57 1, 2 and 4 h) with small gamma camera to semi-quantitatively analyze the radioactivity distribution. Results: In vitro tests, the peak uptake of 99 Tc m pertechnetate by cultured transfected MH3924A cells was up to 254 folds higher than that by the wild type cells. 99 Tc m uptake by transfected cells were significantly inhibited by NaClO 4 down to 2.44% (P 99 Tc m pertechnetate out of cultured transfected cells became rapid immediately after renewal of culture media (half life 99 Tc m accumulations by hNIS transfected tumor xenografts were obvious in early phases of the acquisition with peak uptake at 12 min and gradually declining later on. Conclusions: hNIS transfected hepatoma cells can avidly uptake 99 Tc m pertechnetate both in vitro and in vive. It is feasible to utilize 99 Tc m pertechnetate for monitoring and even quantitatively analyzing

Thyroid nodule guidelines: agreement, disagreement and need for future research

DEFF Research Database (Denmark)

Paschke, Ralf; Hegedüs, Laszlo; Alexander, Erik

2011-01-01

, clinically very relevant areas of uncertainty need to be addressed by further research. This situation applies, for instance, to better definition of ultrasound malignancy criteria and the evaluation of emerging new diagnostic and therapeutic techniques, including molecular markers. For clinicians who advise......This article reviews agreement, disagreement and need for future research of the thyroid nodule guidelines published by the British Thyroid Association, National Cancer Institute, American Thyroid Association and the joint, transatlantic effort of three large societies, the American Society...... of Clinical Endocrinologists, Associazione Medici Endocrinologi and the European Thyroid Association, published in 2010. Consensus exists for most topics in the various guidelines. A few areas of disagreement, such as the use of scintigraphy, are mostly due to differences in disease prevalence in different...

Role of single photon emission computed tomography/computed tomography in diagnostic iodine-131 scintigraphy before initial radioiodine ablation in differentiated thyroid cancer

International Nuclear Information System (INIS)

Agrawal, Kanhaiyalal; Bhattacharya, Anish; Mittal, Bhagwant Rai

2005-01-01

The study was performed to evaluate the incremental value of single photon emission computed tomography/computed tomography (SPECT/CT) over planar radioiodine imaging before radioiodine ablation in the staging, management and stratification of risk of recurrence (ROR) in differentiated thyroid cancer (DTC) patients. Totally, 83 patients (21 male, 62 female) aged 17–75 (mean 39.9) years with DTC were included consecutively in this prospective study. They underwent postthyroidectomy planar and SPECT/CT scans after oral administration of 37–114 MBq iodine-131 (I-131). The scans were interpreted as positive, negative or suspicious for tracer uptake in the thyroid bed, cervical lymph nodes and sites outside the neck. In each case, the findings on planar images were recorded first, without knowledge of SPECT/CT findings. Operative and pathological findings were used for postsurgical tumor–node–metastasis staging. The tumor staging was reassessed after each of these two scans. Single photon emission computed tomography/computed tomography localized radioiodine uptake in the thyroid bed in 9/83 (10.8%) patients, neck nodes in 24/83 (28.9%) patients and distant metastases in 8/83 (9.6%) patients in addition to the planar study. Staging was changed in 8/83 (9.6%), ROR in 11/83 (13.2%) and management in 26/83 (31.3%) patients by the pretherapy SPECT/CT in comparison to planar imaging. SPECT/CT had incremental value in 32/83 patients (38.5%) over the planar scan. Single photon emission computed tomography/computed tomography is feasible during a diagnostic I-131 scan with a low amount of radiotracer. It improved the interpretation of pretherapy I-131 scintigraphy and changed the staging and subsequent patient management

Impact of chronic lymphocytic thyroiditis co-existing with differentiated thyroid cancer on the effectiveness of remnants ablation

International Nuclear Information System (INIS)

Boughattas, S.; Chatti, K.; Trimeche, M.; Mokni, M.

2004-01-01

Full text: Some stages of chronic lymphocytic thyroiditis (CLT) are functionally characterized by an organification defect with large intra thyroid inorganic iodide pool, which can be discharged during perchlorate test. Fluorescent scan study indicates that most patients with CLT have decreased stable iodine store in the thyroid gland. The aim of our study was to investigate the possible consequences of these organification abnormalities during remnants ablation in patients with coexisting differentiated thyroid cancer (DTC) and chronic lymphocytic thyroiditis. We reviewed our series of patients of DTC being followed at the department of nuclear medicine of the university hospital Sahloul. Among the 350 patients with DTC, 30 (8.5%) had histologically proved chronic lymphocytic thyroiditis, with infiltration of the non-tumoral thyroid tissue. A second group of 60 patients (without evidence of lymphocytic infiltration) was selected randomly and used as control. The median of follow-up for these two groups was 4 years. All patients had undergone total thyroidectomy followed by scintigraphy 4-6 weeks later. In patients with thyroid remnants, standard ablative dose of 3.7 GBq of I-131 (100 mCi) was administrated with 6 months duration between all therapies, until the negativity of thyroid bed activity on follow up survey scan performed 48 to 72 hours after administering 2 to 3 mCi of I-131. Thyroglobulin (Tg) serum level was not considered as a criterion of ablation, because of the frequency of anti-thyroid antibodies in CLT. In the group with CLT, 3 patients had negative postoperative neck scintigraphy. Complete ablation was achieved with a single standard dose in 14, two standard doses in 5, and more than 200 mCi in two patients (300 in one and 400 in two). In five patients, ablation is not yet achieved. In the control group, ablation was obtained with 100 mCi in 43 patients, 200 mCi in 9, and 300 mCi in 3. In five patients ablation has not been achieved. Considering

Technetium-99m high resolution tomographic imaging in the thyroid gland diseases

Energy Technology Data Exchange (ETDEWEB)

Reitblat, A; Ben-Horin, C [Barzilai Nedical Center, Ashkelon (Israel)

1996-12-01

In the experiments with the thyroid phantom and first studies of patients with hyperthyroidism it was proved that in combining SPECT imaging technique and high resolution ability of pinhole collimator (commonly used for conventional scintigraphy of the thyroid) it is possible to obtain quantitative information concerning the structure and unhomogenities of the thyroid tissue , not available tom the planar imaging. The following applications of the the method are expected: 1) Estimation of the thyroid dimensions and volume for the accurate dosimetry of the following Iodine-131 - therapy. 2) Determination of the location of the thyroid in the neck , occurrences of the retrotracheal, retrolaryngeal and retrostemal extension of the goiter. 3) Estimation of the structure and unhomogenities of the thyroid gland . 4) Locations and dimensions of cold nodules in the thyroid tissue . Some of these applications are illustrated in our studies of the patients with different thyroid gland diseases (authors).

Biodistribution of technetium-{sup 99m} pertechnetate after Roux-en-Y gastric bypass (Capella technique) in rats

Energy Technology Data Exchange (ETDEWEB)

Rego, Amalia Cinthia Meneses do; Jacome, Daniel Torres; Ramalho, Rachel de Alcantara Oliveira [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil); Araujo-Filho, Irami; Azevedo, Italo Medeiros; Medeiros, Aldo Cunha, E-mail: aldo@ufrnet.b [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil). Dept. of Surgery

2010-01-15

Purpose: The biodistribution of sodium pertechnetate, the most used radiopharmaceutical in nuclear medicine, has not been studied in details after bariatric surgery. The objective was to investigate the effect of Roux-en-Y gastric bypass (RYGB) on biodistribution of sodium pertechnetate (Na{sup 99m}Tc-) in organs and tissues of rats. Methods: Twelve rats were randomly divided into two groups of 6 animals each. The RYGB group rats were submitted to the Roux-en-Y gastric bypass and the control group rats were not operated. After 15 days, all rats were injected with 0.1mL of Na{sup 99m}Tc- via orbital plexus with average radioactivity of 0.66 MBq. After 30 minutes, liver, stomach, thyroid, heart, lung, kidney and femur samples were harvested, weighed and percentage of radioactivity per gram (%ATI/g) of each organ was determined by gamma counter Wizard Perkin-Elmer. We applied the Student t test for statistical analysis, considering p<0.05 as significant. Results: Significant reduction in mean %ATI/g was observed in the liver, stomach and femur in the RYGB group animals, compared with the control group rats (p<0.05). In other organs no significant difference in %ATI/g was observed between the two groups. Conclusion: This work contributes to the knowledge that the bariatric surgery RYGB modifies the pattern of biodistribution of Na{sup 99m}Tc{sup -}. (author)

The role of scintigraphy and ultrasound in the imaging of neonatal hypothyroidism: 5-year retrospective review of single-centre experience

International Nuclear Information System (INIS)

De Silva, Ami; Jong, Ian; McLean, Glenda; Nandurkar, Dee; Bergman, Philip; Brown, Justin; Rodda, Christina

2014-01-01

Congenital hypothyroidism (CH), as indicated by an elevation of capillary thyroid-stimulating hormone (TSH) at newborn screening, is a preventable cause of mental retardation with varying aetiology; it can be transient or permanent. Radionuclide assessment is currently the gold standard for imaging CH. This study aimed to (i) review the different scintigraphic patterns and correlate them with TSH levels/patient outcomes, (ii) assess the role of sonography in neonates with apparent agenesis as indicated by scintigraphy and (iii) develop a diagnostic investigative algorithm. The technetium thyroid scans of 83 consecutive patients (49 females, average age 32 days) with CH scanned between 2005 and 2009 were retrospectively reviewed. Two nuclear medicine physicians blinded to the clinical details interpreted the scans in consensus. Scintigram appearances were categorised into five groups. Patients scintigraphically diagnosed with thyroid agenesis were evaluated with ultrasound. TSH values and scintigraphic and sonographic findings were correlated with patients' final diagnosis. Based on scintigraphy, 14, 13 and 19 patients out of 83 were assessed as having normal thyroid sites with normal, increased and decreased uptake, respectively. Twenty-two of 83 patients had no uptake, and 15 of 83 patients had ectopic uptake. Higher median TSH levels were seen in no-uptake and ectopic uptake subgroups. Eighteen of 22 patients with no uptake were evaluated with ultrasound. Three of the 18 patients had a normal thyroid gland, and three of 18 patients had a hypoplastic thyroid. Scintigram findings in patients with congenital hypothyroidism fall into five major categories, which have therapeutic implications (lifelong thyroxine in agenesis versus trial of stopping thyroxine in other subgroups). Sonographic demonstration of thyroid tissue in patients scintigraphically diagnosed with thyroid agenesis has major management implications.

Value of sialography and salivary gland scintigraphy in the evaluation of rheumatoid polyarthritis

International Nuclear Information System (INIS)

Rousse, M.M.

1976-01-01

This work aims to establish the frequency and severity of salivary gland disease. Very many techniques are available for the exploration of these glands. Each patient was subjected to: a parotid sialograph, a technetium 99m exploration of the salivary glands and mouth cavity. These two methods of salivary gland exploration should be carried out together, since sialographic data are largely static and anatomical while scintigraphy mainly supplies dynamic, functional data. The scintigraphic examinations were carried out with a Picker Dyna Camera II coupled to data processing units (NUKAB system with recorded programmes). The radiotracer used is technetium 99m. 2 millicuries of technetium as pertechnetate are injected intraveinously and reach the salivary glands through their vascular networks, thus being available to the different tissues of each gland: interstitial tissue, acini, intralobular ducts, efferent ducts [fr

Gastrointestinal scintigraphy using sup(99m)Tc- or 111In-labelled polymer beads

International Nuclear Information System (INIS)

Jordaan, J.H.; Dormehl, I.C.; Pilloy, W.J.

1984-01-01

In order to establish normal and pathological stomach emptying characteristics by external measurement of a radioactive meal using a gamma camera and computer system, it is necessary for the radioactively labelled substance to have the same behaviour in the stomach as the ingested food. Resins containing chelating groups which enable binding to either reduced sup(99m)TcO 4 - or 111 In +3 were tested for their suitability as tracers mixed into solid food. The preparation of such styrene-divinyl-benzene resins containing either triethylenetetramine substituents or the fully carboxymethylated derivatives is discussed, as well as the procedures of labelling with either sup(99m)Tc-pertechnetate or 111 In-chloride. An evaluation of the resins for gastrointestinal scintigraphy was performed on 3 chacma baboons and a male human volunteer with encouraging results. (orig.) [de

GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma

Energy Technology Data Exchange (ETDEWEB)

Hammes, Jochen; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Pietrzyk, Uwe [Forschungszentrum Juelich GmbH (Germany). Inst. fuer Neurowissenschaften und Medizin (INM-4); Wuppertal Univ. (Germany). Fachbereich C - Physik

2011-07-01

effect is smaller: 9-11% (AF) respectively 7-8% (AM). For each phantom, the dependency of count density ratios upon uptake ratios can be modeled well by both linear and quadratic regression (quadratic: r{sup 2} > 0.99), yielding sets of parameters which in reverse allow the computation of uptake ratios (and thus dose) from count density ratios. A single regression model obtained by fitting the data of all simulations simultaneously did not provide satisfactory results except for GP, while underestimating the true uptake ratios in AF and overestimating them in AM. The scintigraphic count density ratios depend upon the uptake ratios between nodule and rest of thyroid, upon their volumes, and their respective position in a non-trivial way. Further investigations are required to derive a comprehensive rule to calculate the uptake or dose ratios based on post-therapeutic scintigraphy. (orig.)

GATE based Monte Carlo simulation of planar scintigraphy to estimate the nodular dose in radioiodine therapy for autonomous thyroid adenoma.

Science.gov (United States)

Hammes, Jochen; Pietrzyk, Uwe; Schmidt, Matthias; Schicha, Harald; Eschner, Wolfgang

2011-12-01

) respectively 7-8% (AM). For each phantom, the dependency of count density ratios upon uptake ratios can be modeled well by both linear and quadratic regression (quadratic: r(2)>0.99), yielding sets of parameters which in reverse allow the computation of uptake ratios (and thus dose) from count density ratios. A single regression model obtained by fitting the data of all simulations simultaneously did not provide satisfactory results except for GP, while underestimating the true uptake ratios in AF and overestimating them in AM. The scintigraphic count density ratios depend upon the uptake ratios between nodule and rest of thyroid, upon their volumes, and their respective position in a non-trivial way. Further investigations are required to derive a comprehensive rule to calculate the uptake or dose ratios based on post-therapeutic scintigraphy. Copyright © 2011. Published by Elsevier GmbH.

Our experience with radioiodine therapy of thyroid functional autonomies

International Nuclear Information System (INIS)

Kraft, Otakar

2005-01-01

Full text: In this paper the author presents his experience with radioiodine therapy of thyroid functional autonomies. The objectives of this study were to establish the efficacy and determine the adverse effects of radioiodine therapy of patients with thyroid functional autonomies. The main pathologic attribute of thyroid functional autonomies is the loss of regulation in the axis of hypothalamus-hypophysis-thyroid. The main cause of functional autonomy of the thyroid is iodine deficiency. Over a period of 30 years (1974-2004) 799 patients (age from 33 to 86 years; average age 58.7 years; the female: male ration was 7.4:1) with unifocal functional autonomy (UFA), multifocal functional autonomy (MFA) and disseminated functional autonomy (DFA) received at least one treatment of radioiodine. For diagnostics and the evaluation of radioiodine therapeutic effect of functional autonomies a thyroid scintigraphy is the basic and necessary procedure. In some patients a common scintigraphy with special imaging modulation, in some patients a scintigraphy after suppression or stimulation by means of thyroid hormones or TSH were done. We have also performed a thyroid ultrasonography, an assessment of a serum level of a total and free thyroxine, total triiodothyronine, TSH, radioiodine accumulation test, estimation of radioiodine effective half-life, in some patients TRH-TSH test. The follow-up examinations were done in all patients after 4-6 months, another examination after one year in 545 patients and after two years in 254 patients. One therapeutic dose received 733 patients (91.74%) and it was sufficient for an elimination of functional autonomies. Some patients were retreated if there was the evidence of small or no treatment effect and no elimination of functional autonomies. Two radioiodine treatments received 62 patients (7.76%) and three treatments 4 patients (0.5%). We advocate individual pre-therapeutic dosimetry to determine the activity necessary to achieve a

Pertechnetate immobilization in aqueous media with hydrogen sulfide under anaerobic and aerobic environments

International Nuclear Information System (INIS)

Liu, Y.; Jurisson, S.; Terry, J.

2007-01-01

The basic chemistry for the immobilization of pertechnetate (TcO 4 - ) by hydrogen sulfide was investigated in aqueous solution under both aerobic and anaerobic environments. Pertechnetate immobilization was acid dependent, with accelerated rates and increased immobilization yields as the acid concentration increased. Oxygen had no effect under acidic conditions. Under anaerobic alkaline conditions, the pH, and therefore the speciation of sulfide, was the determining factor on the immobilization of pertechnetate. Only 53% of the TcO 4 - was immobilized at pH 8, while the yield increased to 83% at pH 9 as HS - became the dominant sulfide species. The immobilization yield then decreased to 73% at pH 13. No reaction was observed between TcO 4 - and sulfide under aerobic alkaline conditions, indicating that oxygen suppressed this reaction. Pertechnetate immobilization was found to be first order with respect to both sulfide and pertechnetate in acidic solutions, and in alkaline solution under anaerobic conditions. The results of stoichiometry studies and product analysis under alkaline anaerobic environments indicated that Tc 2 S 7 was obtained at pH 9. EXAFS (extended X-ray absorption fine structure) and XANES (X-ray absorption near edge structure) studies suggested that the samples obtained from acidic, aerobic solution and alkaline anaerobic solution were both Tc 2 S 7 . The stability of Tc 2 S 7 is affected by O 2 with accelerated dissolution at high pH. (orig.)

Nongoitrous autoimmune thyroiditis with facial palsy

Directory of Open Access Journals (Sweden)

Hyung Jik Lee

2013-12-01

Full Text Available We report a case of severe hypothyroidism with nongoitrous, autoimmune thyroiditis and pituitary hyperplasia in a 13-year-old boy, who presented with sudden palsy on the left side of his face. Prednisolone and antiviral medication was administered. However, the facial palsy did not improve completely. The medications were replaced with thyroxine, and the facial palsy recovered. Endocrinological testing showed severe hypothyroidism as follows: thyroid stimulating hormone (TSH level >100 µIU/mL, T4 of 1.04 µg/dL, T3 of 0.31 ng/mL, and free T4 of 0.07 ng/dL. Level of serum antithyroid peroxidase antibodies was 1,933.39 IU/mL, and that of antithyroglobulin antibodies was 848.16 IU/mL. Level of TSH receptor antibodies was >40 IU/L. Bioassay result for TSH receptor stimulating antibodies was negative. Thyroid sonography revealed no increase in the size or vascularity of the bilateral gland. Thyroid scintigraphy with 99mTc showed decreased uptake, and magnetic resonance imaging demonstrated an enlarged pituitary gland.

Model-based comparison of maternal and foetal organ doses from 99mTc pertechnetate, DMSA, DTPA, HDP, MAA and MAG3 diagnostic intakes during pregnancy

International Nuclear Information System (INIS)

Saunders, Margaret; Palmer, Maria; Preece, Alan; Millard, Roger

2002-01-01

Organ residence times were calculated for diagnostic intakes of 99m Tc pertechnetate, 2,3-dimercaptosuccinic acid (DMSA), diethylene triamine penta-acetic acid (DTPA), hydroxymethylene diphosphonate (HDP), macroaggregated albumin (MAA) and mercapto-acetyltriglycine (MAG 3 ) during the 1st and 3rd stages of pregnancy and used with the MIRDOSE3 pregnant female phantoms for generation of dose estimates. At stage 3 individual foetal organ doses were estimated via a surrogate phantom based on that for the new-born but with mean dose/cumulated activity (S) values scaled for compatibility with foetal whole body S. Stage 1 or 3 whole foetus doses ranged from 5.2 to 0.77 μGy MBq -1 respectively, analogous to current ICRP estimates for these agents using similar in vivo biodistribution model databases. Most stage 3 maternal and foetal organ doses were similar within a factor of 3, being higher in the foetus than the mother with pertechnetate, DTPA and MAG 3 , and lower with DMSA, HDP and MAA. Doses were more uniformly distributed among foetal organs than in the mother. Placental transfer was greatest with pertechnetate, where dose to the stage 3 foetal thyroid was 60-140 μGy MBq -1 . With each agent there was more placental transfer in stage 3 than in stage 1, but doses to stage 1 whole foetus were always higher, with the contribution from the mother dominant. For DMSA, HDP and MAG 3 the maternal contribution to total foetal body dose exceeded 93% for both stages. (orig.)

Preoperative imaging in primary hyperparathyroidism. Role of thallium-technetium subtraction scintigraphy

International Nuclear Information System (INIS)

Foster, G.S.; Bekerman, C.; Blend, M.J.; Byrom, E.; Pinsky, S.M.

1989-01-01

Primary hyperparathyroidism, although often silent clinically, may lead to significant morbidity if it remains untreated. In more than 95% of all cases the cause is a parathyroid adenoma or glandular hyperplasia. Regression of disease follows successful surgical excision of the abnormal parathyroid gland. Recurrent or persistent hyperparathyroidism is most commonly caused by solitary adenomas, which may have an ectopic location. Preoperative localization of lesions may improve postoperative cure rates and decrease morbidity. Thallium T1 201 chloride-technetium Tc 99m pertechnetate subtraction scintigraphy was performed on 15 patients with primary hyperparathyroidism. The sensitivity and specificity for detection of abnormal glands were 90% and 95%, respectively. False-positive or false-negative results were minimize by strict adherence to a protocol and by the use of well-defined diagnostic criteria. Because of the superior sensitivity and specificity, this modality should be the primary imaging method of choice for preoperative evaluation of primary hyperparathyroidism. The relative role of other imaging modalities is also discussed. 31 references

Achalasia diagnosed by {sup 99m}Tc pertechnetate scintigraphy; Diagnose einer Achalasie durch {sup 99m}Tc-Pertechnetat-Szintigraphie

Energy Technology Data Exchange (ETDEWEB)

Mikosch, P. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie; Gallowitsch, H.J. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie; Kresnik, E. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie; Lind, P. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie

1997-06-01

A 73-year-old patient presented a {sup 99m}Tc scintiscan with a focal tracer accumulation left and caudal of the thyroid gland. Further investigations with sonography, CT, esophagoscopy and barium swallow provided the diagnosis of achalasia as the reason for focal {sup 99m}Tc retention caudal of the thyroid gland. Explanation for {sup 99m}Tc accumulation within the esophagus may be the nonspecific accumulation of {sup 99m}Tc not only in the thyroid gland but also in the salivary glands. Excretion of the tracer follows with the saliva. Structural and motor disorders of the esophagus can thus lead to focal tracer retention within the esophagus simulating thyroid tissue. (orig.) [Deutsch] Eine 73jaehrige Patientin zeigte bei der {sup 99m}Tc-Schilddruesenszintigraphie eine von der Schilddruese abgesetzte deutliche fokale Speicherung links kaudal der Schilddruese. Die weitere diagnostische Abklaerung mittels Sonographie, CT, Oesophagoskopie und videoassistiertem Kontrastmittelschluckakt ergab als Ursache der {sup 99m}Tc-Speicherung eine Achalasie. Die Erklaerung einer {sup 99m}Tc-Speicherung in der Speiseroehre waere die unspezifische {sup 99m}Tc-Aufnahme in den Speicheldruesen mit nachfolgender Tracerelimination ueber den Speichel. Depotbildungen von Speichel bei Erkrankungen der Speiseroehre, die mit einer Transportstoerung des Speichels verbunden sind, koennen dadurch Schilddruesengewebe vortaeuschen. (orig.)

Thyroid nodules with indeterminate cytology: molecular imaging with 99mTc-methoxyisobutylisonitrile (MIBI) is more cost-effective than the Afirma registered gene expression classifier

International Nuclear Information System (INIS)

Heinzel, Alexander; Mueller, Dirk; Behrendt, Florian F.; Giovanella, Luca; Mottaghy, Felix M.; Verburg, Frederik A.

2014-01-01

To compare the cost-effectiveness of 99m Tc-methoxyisobutylisonitrile (MIBI) thyroid scintigraphy and the Afirma registered gene expression classifier for the assessment of cytologically indeterminate thyroid nodules. A decision tree model was used. Costs were calculated from the perspective of the German health insurance system. The robustness of the results was assessed with probabilistic sensitivity analyses using a Monte Carlo simulation. Life expectancy was 34.3 years (estimated costs per patient EUR1,459 - EUR2,224) for the MIBI scan and 34.1 years (estimated costs EUR3,560 - EUR4,071) for the molecular test. These results were confirmed by the Monte Carlo simulation. MIBI thyroid scintigraphy is more cost-effective than the gene expression classifier. (orig.)

Development of thyroid anthropomorphic phantoms for use in nuclear medicine

International Nuclear Information System (INIS)

Cerqueira, R.A.D.; Maia, A.F.

2014-01-01

The objective of this study was to develop thyroid anthropomorphic phantoms to be used in control tests of medical images in scintillation cameras. The main difference among the phantoms was the neck shape: in the first, called OSCT, it was geometrically shaped, while in the second, called OSAP, it was anthropomorphically shaped. In both phantoms, thyroid gland prototypes, which were made of acrylic and anthropomorphically shaped, were constructed to allow the simulation of a healthy thyroid and of thyroids with hyperthyroidism and hypothyroidism. Images of these thyroid anthropomorphic phantoms were obtained using iodine 131 with an activity of 8.695 MBq. The iodine 131 was chosen because it is widely used in studies of thyroid scintigraphy. The images obtained proved the effectiveness of the phantoms to simulate normal or abnormal thyroids function. These phantoms can be used in medical imaging quality control programs and, also in the training of professionals involved in the analysis of images in nuclear medicine centers. - Highlights: ► Two thyroid phantoms were developed (OSCT and OSAP) with different types of acrylics. ► Thyroid glands were represented anthropomorphically in the both phantoms. ► Different prototypes of thyroid were built of simulate healthy or unhealthy glands. ► Images indicate that anthropomorphic phantoms correctly simulate the thyroid gland

Study of pertechnetate and perrhenate of calcium using infrared spectroscopy and PMR methods

International Nuclear Information System (INIS)

Teterin, Eh.G.; Zajtseva, L.L.; Samsonov, V.E.; Aksenenko, A.V.

1986-01-01

PMR and IR spectroscopic study of hydrates of calcium pertechnetate and perrhenates is carried out and their dehydration is studied. IR spectra analysis showed that dihydrates of calcium pertechnetate and perrhenate possess two types of crystal water molecules to which in spectra two sets of valence and deformation vibration bands and at least two types of pertechnetate and perrhenate groups correspond. During dehydration of calcium perrhenate dihydrate to monohydrate one type bond water molecules are withdrawn. The band set characteristic of the second type bond disappears only at complete dehydration of perrhenate, followed by spectrum simplification also in the region of perrhenate group absorption. Change of interproton distance in crystal water molecules under the action of crystal field, modifying during dehydration of calcium perrhenate dihydrate, is detected using PMR method

Thyroid scintigraphy and perchlorate test after recombinant human TSH: a new tool for the differential diagnosis of congenital hypothyroidism during infancy

International Nuclear Information System (INIS)

Fugazzola, Laura; Vannucchi, Guia; Mannavola, Deborah; Beck-Peccoz, Paolo; Persani, Luca; Carletto, Marco; Longari, Virgilio; Vigone, Maria C.; Cortinovis, Francesca; Weber, Giovanna; Beccaria, Luciano

2007-01-01

Prompt initiation of l-thyroxine therapy in neonates with congenital hypothyroidism (CH) often prevents the performance of functional studies. Aetiological diagnosis is thus postponed until after infancy, when the required investigations are performed after l-thyroxine withdrawal. The aim of this study was to verify the efficacy and safety of new protocols for rhTSH (Thyrogen) testing during l-thyroxine replacement in the differential diagnosis of CH. Ten CH patients (15-144 months old) were studied. Seven had neonatal evidence of gland in situ at the ultrasound examination performed at enrolment and received two rhTSH injections (4 μg/kg daily, i.m.) with 123 I scintigraphy and perchlorate test on day 3. Three patients with an ultrasound diagnosis of thyroid dysgenesis received three rhTSH injections with 123 I scintigraphy on days 3 and 4. TSH and thyroglobulin (Tg) determinations were performed on days 1, 3 and 4, and neck ultrasound on day 1. rhTSH stimulation caused Tg levels to increase in eight cases. Blunted Tg responses were seen in two patients with ectopia and hypoplasia. Interestingly, in two cases the association of different developmental defects was demonstrated. Perchlorate test revealed a total iodide organification defect in two patients, including one with a neonatal diagnosis of Pendred's syndrome, who were subsequently found to harbour TPO mutations. rhTSH did not cause notable side-effects. These new rhTSH protocols always resulted in accurate disease characterisation, allowing specific management and targeted genetic analyses. Thus, rhTSH represents a valid and safe alternative to l-thyroxine withdrawal in the differential diagnosis of CH in paediatric patients. (orig.)

Thyroid scintigraphy and perchlorate test after recombinant human TSH: a new tool for the differential diagnosis of congenital hypothyroidism during infancy

Energy Technology Data Exchange (ETDEWEB)

Fugazzola, Laura; Vannucchi, Guia; Mannavola, Deborah; Beck-Peccoz, Paolo [University of Milan and Fondazione Policlinico IRCCS, Department of Medical Sciences, Milan (Italy); Persani, Luca [University of Milan and Istituto Auxologico Italiano, Department of Medical Sciences, Via Zucchi, Cusano, Milan (Italy); Carletto, Marco; Longari, Virgilio [Fondazione Policlinico IRCCS, Department of Nuclear Medicine, Milan (Italy); Vigone, Maria C.; Cortinovis, Francesca; Weber, Giovanna [Universita Vita-Salute S. Raffaele, Centro di Endocrinologia dell' Infanzia e dell' Adolescenza, Milan (Italy); Beccaria, Luciano [A. Manzoni Hospital, Paediatric Unit, Lecco (Italy)

2007-09-15

Prompt initiation of l-thyroxine therapy in neonates with congenital hypothyroidism (CH) often prevents the performance of functional studies. Aetiological diagnosis is thus postponed until after infancy, when the required investigations are performed after l-thyroxine withdrawal. The aim of this study was to verify the efficacy and safety of new protocols for rhTSH (Thyrogen) testing during l-thyroxine replacement in the differential diagnosis of CH. Ten CH patients (15-144 months old) were studied. Seven had neonatal evidence of gland in situ at the ultrasound examination performed at enrolment and received two rhTSH injections (4 {mu}g/kg daily, i.m.) with {sup 123}I scintigraphy and perchlorate test on day 3. Three patients with an ultrasound diagnosis of thyroid dysgenesis received three rhTSH injections with {sup 123}I scintigraphy on days 3 and 4. TSH and thyroglobulin (Tg) determinations were performed on days 1, 3 and 4, and neck ultrasound on day 1. rhTSH stimulation caused Tg levels to increase in eight cases. Blunted Tg responses were seen in two patients with ectopia and hypoplasia. Interestingly, in two cases the association of different developmental defects was demonstrated. Perchlorate test revealed a total iodide organification defect in two patients, including one with a neonatal diagnosis of Pendred's syndrome, who were subsequently found to harbour TPO mutations. rhTSH did not cause notable side-effects. These new rhTSH protocols always resulted in accurate disease characterisation, allowing specific management and targeted genetic analyses. Thus, rhTSH represents a valid and safe alternative to l-thyroxine withdrawal in the differential diagnosis of CH in paediatric patients. (orig.)

False-positive radioactive iodine uptake mimicking miliary lung metastases in a patient affected by papillary thyroid cancer and IgA deficiency

Energy Technology Data Exchange (ETDEWEB)

Demidowich, Andrew Paul; Reynolds, James C. [National Institutes of Health, Bethesda (United States); Kundu, Amartya [Dept. of MedicineUniversity of Massachusetts Medical School, Worcester (United States); Celi, Francesco S. [Div. of Endocrinology and MetabolismVirginia Commonwealth UniversityRichmond (United States)

2016-09-15

A 42-year-old female with immunoglobulin A deficiency and recurrent sinopulmonary infections underwent thyroidectomy for papillary thyroid cancer (PTC). Follow-up {sup 123}I scintigraphy demonstrated diffuse pulmonary uptake, suggesting metastatic disease. However, subsequent pathologic, biochemical and radiographic testing proved that she was in fact disease free, and the initial {sup 123}I pulmonary uptake was identified as a false positive. Inflammatory conditions may rarely cause iodine uptake in non-thyroidal tissues due to local retention, organification, and/or immunologic utilization. To avoid exposing patients to unnecessary treatments, it is critical for clinicians to recognize that comorbid pulmonary conditions may mimic metastatic PTC on radioiodine scintigraphy.

Streptozotocin (STZ) and schistosomiasis mansoni change the biodistribution of radiopharmaceutical sodium 99mTc-pertechnetate in mice

International Nuclear Information System (INIS)

Góes, Vanessa Coelho; Neves, Renata Heisler; Arnóbio, Adriano; Bernardo-Filho, Mario; Machado-Silva, José Roberto

2016-01-01

Introduction: Technetium-99m ( 99m Tc) is a radionuclide commonly used in nuclear medicine to obtain 99m Tc-radiopharmaceuticals, which can be used to evaluate either physiological processes or changes related to diseases. It is also used in some experimental studies. Streptozotocin (STZ) administration to rodents causes lesions in very early stages and induces severe and permanent diabetes. Most morbidity of schistosomiasis mansoni is attributed to a granulomatous inflammatory response and associated liver fibrosis. This study was designed to investigate whether STZ administration and schistosomiasis modify the biodistribution of the radiopharmaceutical sodium 99m Tc-pertechnetate. Methods: Adult female mice were infected by exposure to 100 Schistosoma mansoni cercariae (BH strain, Belo Horizonte, Brazil) and euthanized after nine weeks. STZ was administered by a single intraperitoneal injection of 100 mg/kg body weight, 3 or 15 days before euthanasia. Each animal received 100 μl of sodium (Na) 99m Tc-pertechnetate ( 99m TcO 4 − ) (740 kBq). The animals were divided into four groups: A, uninfected; B, infected; C, uninfected + STZ; and D, infected + STZ. Blood, brain, thyroid, heart, lungs, liver, spleen, pancreas and kidneys were removed. The radioactivity was counted and the percentage of the injected dose of Na 99m TcO 4 per gram of the organ (% ID/g) was determined. Results: Three days after the STZ injection, there was a decrease of Na 99m TcO 4 uptake by the liver, lungs, pancreas and kidneys (p < 0.05) in group D when compared with group A. After 15 days, the decrease of Na 99m TcO 4 uptake occurred also in the brain, thyroid, heart, spleen and blood (p < 0.05) in group D. Conclusion: We demonstrated modifications on the biodistribution of Na 99m TcO 4 due to STZ administration and schistosomiasis, possibly due to physiological alterations in some organs. Advances in Knowledge and Implications for Patient Care: The biodistribution of radiopharmaceutical

Thyroid nodules with indeterminate cytology: molecular imaging with {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) is more cost-effective than the Afirma registered gene expression classifier

Energy Technology Data Exchange (ETDEWEB)

Heinzel, Alexander [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen, Pauwelsstrasse 30 (Germany); Institute for Neuroscience and Medicine (INM-4), Research Centre, Juelich (Germany); Mueller, Dirk [University of Cologne, Institute for Health Economics and Clinical Epidemiology, Cologne (Germany); Behrendt, Florian F. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen, Pauwelsstrasse 30 (Germany); Giovanella, Luca [Institute of Southern Switzerland, Department of Nuclear Medicine Oncology, Belinzona (Switzerland); Mottaghy, Felix M.; Verburg, Frederik A. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Aachen, Pauwelsstrasse 30 (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands)

2014-08-15

To compare the cost-effectiveness of {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) thyroid scintigraphy and the Afirma registered gene expression classifier for the assessment of cytologically indeterminate thyroid nodules. A decision tree model was used. Costs were calculated from the perspective of the German health insurance system. The robustness of the results was assessed with probabilistic sensitivity analyses using a Monte Carlo simulation. Life expectancy was 34.3 years (estimated costs per patient EUR1,459 - EUR2,224) for the MIBI scan and 34.1 years (estimated costs EUR3,560 - EUR4,071) for the molecular test. These results were confirmed by the Monte Carlo simulation. MIBI thyroid scintigraphy is more cost-effective than the gene expression classifier. (orig.)

Contribution of sup(99m)Tc labelled sodium pyrophosphate bone scintigraphy to the diagnosis of bone metastases

International Nuclear Information System (INIS)

Remi, J.-P.

1976-01-01

Bone scintigraphy, by its ease of application and the use of short-lived isotopes, has revolutionised the conditions of bone metastase diagnosis. Scintigraphy possesses two advantages, the possibility it offers of exploring the whole skeleton at once and its extreme simplicity. This technique should therefore find its place at the very beginning of the bone examination, an attitude which also has dosimetric repercussions: a 'whole skeleton' examination delivers 170 mrad to the marrow, whereas spinal and pelvic X-rays deliver 325 mrad. Unfortunately the sup(99m)Tc-labelled sodium pyrophosphate bone scintigraphy is not specific to any given lesion. Diagnosis can only be improved by the appearance of tracers taken up specifically on the neoplasic tissue, as is already the case of 131 I for thyroid cancer metastases. Labelled bleomycine and 67 Ga have so far given disappointing results [fr

Removal of Pertechnetate-Related Oxyanions from Solution Using Functionalized Hierarchical Porous Frameworks

Energy Technology Data Exchange (ETDEWEB)

Banerjee, Debasis [Physical and Computational Science Directorate, Pacific Northwest National Laboratory, Richland WA 99352 USA; Elsaidi, Sameh K. [Physical and Computational Science Directorate, Pacific Northwest National Laboratory, Richland WA 99352 USA; Chemistry Department, Faculty of Science, Alexandria University, P.O. Box 426, Ibrahimia Alexandria 21321 Egypt; Aguila, Briana [Department of Chemistry, University of South Florida, USA; Li, Baiyan [Department of Chemistry, University of South Florida, USA; Kim, Dongsang [Energy and Environment Directorate, Pacific Northwest National Laboratory, Richland WA 99354 USA; Schweiger, Michael J. [Energy and Environment Directorate, Pacific Northwest National Laboratory, Richland WA 99354 USA; Kruger, Albert A. [US Department of Energy, Office of River Protection, Richland WA 99352 USA; Doonan, Christian J. [Department of Chemistry, The University of Adelaide, Adelaide South Australia 5005 Australia; Ma, Shengqian [Department of Chemistry, University of South Florida, USA; Thallapally, Praveen K. [Physical and Computational Science Directorate, Pacific Northwest National Laboratory, Richland WA 99352 USA

2016-10-20

Efficient and cost-effective removal of radioactive pertechnetate anions from nuclear waste is a key challenge to mitigate long-term nuclear waste storage issues. Traditional materials such as resins and layered double hydroxides (LDHs) were evaluated for their pertechnetate or perrhenate (the non-radioactive surrogate) removal capacity, but there is room for improvement in terms of capacity, selectivity and kinetics. A series of functionalized hierarchical porous frameworks were evaluated for their perrhenate removal capacity in the presence of other competing anions.

Thyroid to parotid ratio (TPR) - A simple and cost effective parameter for the diagnosis and differential diagnosis of high uptake thyroid disorders

International Nuclear Information System (INIS)

Das, B.K.; Malhotra, G.; Senthilnathan, M.S.; Pradhan, P.K.; Nagabhushan, S.

2002-01-01

Aim: There is high incidence of goiter and goiter associated thyroid problems including high uptake disorders in iodine deficient areas. Most of the patients referred for diagnosis and therapy belong to poor socio-economic status. It is important to develop a simple and cost effective technique, which can provide diagnosis with high sensitivity and specificity. The aim of this on-going study is to evaluate thyroid to parotid ratio (TPR) as a diagnostic tool for routine management of functional thyroid disorders. Method: A total of 850 non selected consecutive have been included in this study. Apart from thorough clinical examination and documentation of symptoms in a specially designed thyroid proforma, blood samples for T3, T4 and TSH estimations were drawn before injecting 37 - 74 MBq (1-2 mCi) 99mTc - Pertechnetate. After about 30 min thyroid scans were performed under a gamma camera (ORBITOR 7500, Siemens AG). From the anterior image, regions of interest were designated over the thyroid and parotid glands and the ratio of the activity were calculated. In 20 normal volunteers TPR was calculated in the same manner. Results: In normal volunteers TPR was found to be 1.725+- 0.395 (Mean +- 1 SD). And the upper limit of normal was kept as 2.5 (Mean +- 2 SD). In all euthyroid patients the TPR was less than 2.5. Hyperthyroid patients(Graves' disease + Hyperthyroid nodular goiters) showed high TPR (more than 2.5) in 92% of the patients. Compared to the diagnosis based on T3, T4 and TSH values TPR showed a sensitivity of 93.7% and specificity of 88.5%. In 51 proven cases of thyroiditis TPR could correctly differentiate thyroiditis from hyperthyroidism in 92%. Conclusion: TPR appears to be a simple diagnostic parameter with high sensitivity and specificity for the diagnosis of hyperthyroidism. It can effectively differentiate thyroiditis from hyperthyroidism. Since TPR results can be made available along with morphological information from thyroid scan it appears to be

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

Energy Technology Data Exchange (ETDEWEB)

Yoshinari, M.; Tokuyama, T.; Okamura, K.; Sato, K.; Kusuda, K.; Fujishima, M.

1988-04-15

An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate /sup 131/I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of /sup 131/I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved.

Iodide-induced thyrotoxicosis in a thyroidectomized patient with metastatic thyroid carcinoma

International Nuclear Information System (INIS)

Yoshinari, M.; Tokuyama, T.; Okamura, K.; Sato, K.; Kusuda, K.; Fujishima, M.

1988-01-01

An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate 131 I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of 131 I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved

Myocardial perfusion scintigraphy with technetium 99m-MIBI in the diagnosis of coronary artery disease in women

International Nuclear Information System (INIS)

Peix, C. Amalia; Chacon, Deylis; Llerena, Lorenzo; Torres, Maritza; Garcia, Ernesto Javier; Cabrera, Lazaro Omar

2006-01-01

The results of technetium 99 m - methoxy-isobutyl-isonitrile scintigraphy in a one-day protocol: rest - physical or combined stress bicycle plus endovenoous dipyridamole were compared with those of coronary angiography in 20 women referred for the evaluation of pre cordial pain and of the usefulness of myocardial perfusion scintigraphy. The uptake of the radio drug under stress and at rest varied from 93 + - 9 to 94 + - 7 % in the 204 segments with normal uptake under stress, from 67 He articulates it analyzes the reasons or utility of the employment of the radioactive iodine in the diagnosis and treatment of the thyroid affections + - 9 to 75 + - 17 % in the 89 with moderate reduction, and from 33 + - 9 to 64 + - 28 % in the 27 with severe reduction. The qualitative and quantitative uptake analyses coincided in 18 patients. The perfusion scintigraphy and the angiography agreed in 70 % of the patients. It was concluded that the myocardial perfusion scintigraphy with technetium 99 -MIBI contributes to the diagnosis of the coronary artery disease in women

Model-based comparison of maternal and foetal organ doses from {sup 99m}Tc pertechnetate, DMSA, DTPA, HDP, MAA and MAG{sub 3} diagnostic intakes during pregnancy

Energy Technology Data Exchange (ETDEWEB)

Saunders, Margaret; Palmer, Maria; Preece, Alan; Millard, Roger [Centre for Physics and Engineering Research in Medicine, University of Bristol, Bristol Oncology Centre, Horfield Road, Bristol BS2 8ED (United Kingdom)

2002-10-01

Organ residence times were calculated for diagnostic intakes of {sup 99m}Tc pertechnetate, 2,3-dimercaptosuccinic acid (DMSA), diethylene triamine penta-acetic acid (DTPA), hydroxymethylene diphosphonate (HDP), macroaggregated albumin (MAA) and mercapto-acetyltriglycine (MAG{sub 3}) during the 1st and 3rd stages of pregnancy and used with the MIRDOSE3 pregnant female phantoms for generation of dose estimates. At stage 3 individual foetal organ doses were estimated via a surrogate phantom based on that for the new-born but with mean dose/cumulated activity (S) values scaled for compatibility with foetal whole body S. Stage 1 or 3 whole foetus doses ranged from 5.2 to 0.77 {mu}Gy MBq{sup -1} respectively, analogous to current ICRP estimates for these agents using similar in vivo biodistribution model databases. Most stage 3 maternal and foetal organ doses were similar within a factor of 3, being higher in the foetus than the mother with pertechnetate, DTPA and MAG{sub 3}, and lower with DMSA, HDP and MAA. Doses were more uniformly distributed among foetal organs than in the mother. Placental transfer was greatest with pertechnetate, where dose to the stage 3 foetal thyroid was 60-140 {mu}Gy MBq{sup -1}. With each agent there was more placental transfer in stage 3 than in stage 1, but doses to stage 1 whole foetus were always higher, with the contribution from the mother dominant. For DMSA, HDP and MAG{sub 3} the maternal contribution to total foetal body dose exceeded 93% for both stages. (orig.)

Fine needle aspiration cytology: sensitivity and specificity in thyroid lesions

International Nuclear Information System (INIS)

Musani, M.A.; Khan, F.A.; Malik, S.; Khambaty, Y.

2011-01-01

Background: Thyroid enlargement is one of the common problems in patients presenting at outpatients department of ENT particularly in females. Thyroid nodules are common, thyroid cancer is uncommon and the most common way for it to present is as a solitary thyroid nodule. This study was conducted to evaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in thyroid diseases. Method: This prospective analytic study was conducted at ENT Department of Karachi Medical and Dental College/Abbasi Shaheed Hospital during year 2004-8. One hundred and five cases were enrolled who underwent thyroid surgery after complete evaluation by history, clinical examination, Thyroid profile, Thyroid Scintigraphy, Ultrasound neck and FNAC. In cases which were revealed malignant by FNAC, CT scan were done to see the extent of disease and neck node status. Surgery was done in all cases and specimens sent for histopathology. Results: Male to female ratio of the patients was 1:8.5. Most common lesion was benign nodule (96). Malignant lesions were 9 in FNAC. In histopathology, the benign nodules were 92, and malignant cases were 13. Sensitivity of FNAC was 61.53% and specificity was 98.9%. Conclusion: FNAC in Thyroid has high sensitivity and specificity. (author)

Survey of management of solitary thyroid nodules in Germany.

Science.gov (United States)

Dietlein, M; Wegscheider, K; Vaupel, R; Schmidt, M; Schicha, H

2008-01-01

To compare the opinions of practitioners in primary care with those of thyroid specialists in Germany on the management of solitary thyroid nodules (Papillon 2005). Questionnaires were filled in by 2,191 practitioners and 297 thyroid specialists between June 1 and September 30, 2005. The test cases and their modifications described a solitary thyroid nodule of 2-3 cm with different levels of thyroid function and a hypoechogenic nodule of 1 cm in diameter. TSH determination and sonography were found to be standard procedures, followed by scintigraphy (selected by 84.7% of practitioners and 95.1% of specialists, p nodule calcitonin determination was advocated by 54.0% of endocrinologists and by 32.2% of nuclear medicine physicians (p thyroid nodule would be treated medically by 77.8% of practitioners and by 85.7% of specialists, the combination of levothyroxine and iodine being clearly preferred (60.9% of practitioners and 67.1% of specialists). For a hyperfunctioning nodule the preference of radioiodine therapy was significantly higher in the specialist group (88.8%) than among the practitioners (52.2%). The main differences of opinion between practitioners and specialists focused on calcitonin screening and referral to radioiodine therapy.

Characterization of Non-pertechnetate Species Relevant to the Hanford Tank Waste

Energy Technology Data Exchange (ETDEWEB)

Chatterjee, Sayandev [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Andersen, Amity [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Du, Yingge [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Engelhard, Mark H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hall, Gabriel B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Levitskaia, Tatiana G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lukens, Wayne W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Shutthanandan, Vaithiyalingam [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Walter, Eric D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Washton, Nancy M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2017-03-27

Among radioactive constituents present in the tank waste stored at the U.S. DOE Hanford Site, technetium-99 (Tc), which is generated from the fission of ²³⁵U and ²³⁹Pu in high yields, presents a unique challenge in that it has a long half-life ( = 292 keV; T1/2 = 2.11105 y) and exists predominately in soluble forms in the liquid supernatant and salt cake fractions of the waste. In the strongly alkaline environments prevalent in most of the tank waste, its dominant chemical form is pertechnetate (TcO₄^-, oxidation state +7). However, attempts to remove Tc from the Hanford tank waste using ion-exchange processes specific to TcO₄^- only met with limited success, particularly when processing tank waste samples containing elevated concentrations of organic complexants. This suggests that a significant fraction of the soluble Tc can be present as low-valent Tc (oxidation state < +7) (non-pertechnetate). The chemical identities of these non-pertechnetate species are poorly understood. Previous analysis of the SY-101 and SY-103 tank waste samples provided strong evidence that non-pertechnetate can be comprised of [fac-Tc(CO)₃]⁺ complexes containing Tc in oxidation state +1 (Lukens et al. 2004). During the last three years, our team has expanded this work and demonstrated that high-ionic-strength solutions typifying tank waste supernatants promote oxidative stability of the [fac-Tc(CO)₃]⁺ species (Rapko et al. 2013a; 2013b; Levitskaia et al. 2014; Chatterjee et al. 2015). Obtained results also suggest possible stabilization of Tc(VI) and potentially Tc(IV) oxidation states in the high-ionic-strength alkaline matrices particularly in the presence of organic chelators, so that Tc(IV, VI) can serve as important redox intermediates facilitating the reduction of Tc(VII) to Tc(I). Designing strategies for effective Tc management, including separation and immobilization

Combined static and perfusion scintigraphy for differential diagnosis of focal and diffuse affections of the liver

International Nuclear Information System (INIS)

Yakovleva, L.Ya.; Volkov, A.A.; Granov, A.M.; Borisov, A.E.

1985-01-01

Combined application of dynamic and static scintigraphy is recommended by use of /sup 99m/Tc-pertechnetate, /sup 113m/In-chloride, /sup 99m/Tc-sulphur colloid, /sup 119m/In-colloid, and 67 Ga-citrate, respectively, to detect diffuse and focal affections of the liver. In patients with abscesses, echinococcus, or a cyst of the liver the blood supply in the tumor decreased tremendously or was not perceivable at all. In primary or secondary tumors the blood supply was decreased in focus, the half-life period of the preparation storage was extended, and the reception speed was decreased by 50% at most. The alteration of quantitative blood supply values by 150 - 200% and the prevalence of arterial components in liver blood supply for all segments can be considered a sign of cirrhotic liver damage. (author)

Extraction of pertechnetate anion as a ligand in metal complexes with tributylphosphate

International Nuclear Information System (INIS)

Macasek, F.; Kadrabova, J.

1979-01-01

The extraction of the pertechnetate anion has been investigated in the systems tributylphosphate (TBP)-solvent (carbon tetrachloride, n-heptane, chloroform) - metal salt (uranyl nitrate and chloride, thorium nitrate) -ammonium salt. In the absence of a metal, the solvates HTcO 4 xiTBP (i=4) are extracted, while in the presence of uranium and thorium, the distribution of technetium corresponds, to the formation of the mixed complexes: UO 2 (NO 3 )(TcO 4 )x2TBP, UO 2 Cl(TcO 4 )x2TBP and Th(NO 3 ) 3 (TcO 4 )x2TBP. The effective constants of the reactions H + + TcO 4 - + i(TBP)sub(org) reversible (HTcO 4 xiTBP)sub(org), and (MLsub(n)x2TBP)sub(org) + TcO 4 - reversible (MLsub(n-1)TcO 4 x2TBPsub(org) + L were established in the above systems. The extraction of pertechnetate ion is more effective when it is coordinated to a cation solvated by TBP than the extraction in the form of pertechnetate acid solvated by TBP. (author)

Role of serum thyroglobulin levels in the assessment of thyroid disease (abstract)

International Nuclear Information System (INIS)

Abbas, H.G.; Khan, M.S.

1998-01-01

Thyroglobulin (Tg), a glycoprotein, is the principal iodoprotein of the thyroid gland and is the major component of the thyroid mass. As Tg is specific to thyroid gland and thyroid related-cells, its measurement in the circulation is potentially useful to study the pathogenesis, establish the diagnosis and follow the course of thyroid disorders. Serum Tg is a suitable marker for the differentiated thyroid carcinoma after total thyroid ablation by surgery and /sup 131/I treatment. Radioimmunoassay (RIA) and immunoradiometric (IRMA) methodologies are important to measure hormones for diagnosis of various diseases. In addition to /sup 131/I uptake, /sup 131/I whole body scintigraphy and estimation of T3, T4 and TSH levels, serum Tg levels in euthyroids (n=42), hyper thyroids (n=55) and treated cases (thyroidectomy and /sup 131/I ablation) of carcinoma (CA) thyroid were 9.7 - +9.96, 109.9 - +160.3 and 2.2 - + 4.2 respectively. Serum Tg levels were significantly higher (P < 0.005) in hyper thyroids and significantly lower (P < 0.025) in treated CA thyroids when compared with those of euthyroids. In treated patients (surgery and /sup 131/I ablation) serum Tg assay is an excellent method to assess the treatment and recurrence of disease. (author)

Clinical evaluation of lung scintigraphy with sup 99m Tc-technegas

Energy Technology Data Exchange (ETDEWEB)

Inoue, Tomio; Watanabe, Naoyuki; Oriuchi, Noboru; Tateno, Madoka; Tomiyoshi, Katsumi; Mitomo, Osamu; Hayakawa, Kazushige; Niibe, Hideo [Gunma Univ., Maebashi (Japan). School of Medicine; Sasaki, Yasuhito

1990-12-01

The aim of this study is to evaluate the safety and clinical usefulness of the lung scintigraphy using {sup 99m}Tc-technegas produced by the evaporation of pertechnetate elution at 2500deg C. Lung images were recorded by the gammacamera-computer system after a few deep inspiration of {sup 99m}Tc-technegas. One healthy volunteer and 32 patients including 10 with lung cancer, 8 with chronic obstructive lung disease, 5 with pulmonary embolism, 2 with interstitial pneumonia, 2 with bronchiectasis and 12 with the other various diseases were studied. Delayed images were taken at more than 1 hour later in one healthy and 13 patients to investigate the interval changes of the intrapulmonary distribution of {sup 99m}Tc-technegas. Obvious difference of radioactive distribution between early and delayed images were observed in only 2/14 cases. Penetration index (P.I.) averaged 0.81{plus minus}0.11 for early images and 0.85{plus minus}0.12 for delayed images. There was no significant difference between P.I. for early and delayed images. More than 97 MBq of {sup 99m}Tc-macroaggregated albumin ({sup 99m}Tc-MAA) were required to obtain the adequate perfusion images after the acquisition of lung images with about 37 MBq of {sup 99m}Tc-technegas. Bronchial deposits of {sup 99m}Tc-technegas were shown in 12/33 cases and pathological defects in 26/32 patients (81.3%). Twenty three of 33 cases also had a perfusion scintigraphy with {sup 99m}Tc-MAA. Ventilation perfusion mismatches were presented in 5/5 patients with pulmonary embolism and 1/10 patients with lung cancer. The safety was confirmed in all cases and clinical usefulness in 30/32 patients (94%). In conclusion, the safety and clinical usefulness of the lung scintigraphy with {sup 99m}Tc-technegas were proven in this study. (author).

Persistent Graves' hyperthyroidism despite rapid negative conversion of thyroid-stimulating hormone-binding inhibitory immunoglobulin assay results: a case report.

Science.gov (United States)

Ohara, Nobumasa; Kaneko, Masanori; Kitazawa, Masaru; Uemura, Yasuyuki; Minagawa, Shinichi; Miyakoshi, Masashi; Kaneko, Kenzo; Kamoi, Kyuzi

2017-02-06

Graves' disease is an autoimmune thyroid disorder characterized by hyperthyroidism, and patients exhibit thyroid-stimulating hormone receptor antibody. The major methods of measuring circulating thyroid-stimulating hormone receptor antibody include the thyroid-stimulating hormone-binding inhibitory immunoglobulin assays. Although the diagnostic accuracy of these assays has been improved, a minority of patients with Graves' disease test negative even on second-generation and third-generation thyroid-stimulating hormone-binding inhibitory immunoglobulins. We report a rare case of a thyroid-stimulating hormone-binding inhibitory immunoglobulin-positive patient with Graves' disease who showed rapid lowering of thyroid-stimulating hormone-binding inhibitory immunoglobulin levels following administration of the anti-thyroid drug thiamazole, but still experienced Graves' hyperthyroidism. A 45-year-old Japanese man presented with severe hyperthyroidism (serum free triiodothyronine >25.0 pg/mL; reference range 1.7 to 3.7 pg/mL) and tested weakly positive for thyroid-stimulating hormone-binding inhibitory immunoglobulins on second-generation tests (2.1 IU/L; reference range hyperthyroidism for more than 8 years, requiring 15 mg/day of thiamazole to correct. During that period, he tested negative on all first-generation, second-generation, and third-generation thyroid-stimulating hormone-binding inhibitory immunoglobulin assays, but thyroid scintigraphy revealed diffuse and increased uptake, and thyroid ultrasound and color flow Doppler imaging showed typical findings of Graves' hyperthyroidism. The possible explanations for serial changes in the thyroid-stimulating hormone-binding inhibitory immunoglobulin results in our patient include the presence of thyroid-stimulating hormone receptor antibody, which is bioactive but less reactive on thyroid-stimulating hormone-binding inhibitory immunoglobulin assays, or the effect of reduced levels of circulating thyroid

Comparative methods for quantifying thyroid volume using planar imaging and SPECT

International Nuclear Information System (INIS)

Zaidi, H.

1996-01-01

Thyroid volume determination using planar imaging is a procedure often performed in routine nuclear medicine, but is hampered by several physical difficulties, in particular by structures which overlie or underlie the organ of interest. SPECT enables improved accuracy over planar imaging in the determination of the volume since it is derived from the 3-D data rather than from a 2-D projection with a certain geometric assumption regarding the thyroid configuration. By using the phantoms of known volume, it was possible to estimate the accuracy of 3 different methods of determining thyroid volume from planar imaging used in clinical routine. The experimental results demonstrate that compared with conventional scintigraphy, thyroid phantom volumes were most accurately determined with SPECT when attenuation and scatter corrections are performed which allows accurate radiation dosimetry in humans without the need for assumptions on organ size or concentrations. Poster 181. (author)

Risk Stratification of iodine-induced thyrotoxicosis before contrast agent application

International Nuclear Information System (INIS)

Fricke, E.

2004-01-01

Today, examinations using iodine containing contrast media are rather frequent. Even though in modern contrast agents the content of free iodine is low, in vivo deiodination results in a non physiologic high iodine load of the thyroid gland. Whilst in normal thyroid tissue iodine metabolism and hormone production are self-regulating in spite of the variable iodine load, those mechanisms are disturbed in autonomous thyroid tissue. Clinical studies displayed low risk of iodine induced thyrotoxicosis after application of contrast agent. Nonetheless the clinician has to assess the risk of thyrotoxicosis for each individual patient and he has to decide how to cope with this risk. Thyroid scintigraphy using Tc-99m-pertechnetate with quantitative measurement of the thyroidal uptake (TcTU) has been shown to be a useful tool in this question, especially when performed under suppression of the non-autonomous tissue (TcTUs). In particular patients with pre-existing suppression of the TSH secretion should be selected for this investigation. Also at risk are elderly persons and those with diffuse or nodular goitres. In spite of the high frequency of contrast agent applications, data on scintigraphy for risk evaluation of thyrotoxicosis and on efficacy of prophylactic medication are scarce. Based on own results and on a review of literature, the risk of thyrotoxicosis seems to be negligible in patients with a TcTUs of less than 1% even in case of preexistent latent hyperthyroidism. If a suppressed TSH level is known and TcTUs is higher than 1%, prophylactic medication should be given. There is evidence for a combination therapy inhibiting both iodine uptake and metabolism, i.e. with perchlorate and thiamazole, being more efficient than monotherapy, particularly in patients with high risk of thyrotoxicosis. (orig.)

Risk Stratification of iodine-induced thyrotoxicosis before contrast agent application; Prognosebeurteilung bei geplanter Kontrastmittelexposition

Energy Technology Data Exchange (ETDEWEB)

Fricke, E. [Inst. fuer Molekulare Biophysik, Radiochemie und Nuklearmedizin, Herz- und Diabeteszentrum, Nordrheinwestfalen, Bad Oeynhausen (Germany)

2004-06-01

Today, examinations using iodine containing contrast media are rather frequent. Even though in modern contrast agents the content of free iodine is low, in vivo deiodination results in a non physiologic high iodine load of the thyroid gland. Whilst in normal thyroid tissue iodine metabolism and hormone production are self-regulating in spite of the variable iodine load, those mechanisms are disturbed in autonomous thyroid tissue. Clinical studies displayed low risk of iodine induced thyrotoxicosis after application of contrast agent. Nonetheless the clinician has to assess the risk of thyrotoxicosis for each individual patient and he has to decide how to cope with this risk. Thyroid scintigraphy using Tc-99m-pertechnetate with quantitative measurement of the thyroidal uptake (TcTU) has been shown to be a useful tool in this question, especially when performed under suppression of the non-autonomous tissue (TcTUs). In particular patients with pre-existing suppression of the TSH secretion should be selected for this investigation. Also at risk are elderly persons and those with diffuse or nodular goitres. In spite of the high frequency of contrast agent applications, data on scintigraphy for risk evaluation of thyrotoxicosis and on efficacy of prophylactic medication are scarce. Based on own results and on a review of literature, the risk of thyrotoxicosis seems to be negligible in patients with a TcTUs of less than 1% even in case of preexistent latent hyperthyroidism. If a suppressed TSH level is known and TcTUs is higher than 1%, prophylactic medication should be given. There is evidence for a combination therapy inhibiting both iodine uptake and metabolism, i.e. with perchlorate and thiamazole, being more efficient than monotherapy, particularly in patients with high risk of thyrotoxicosis. (orig.)

Graves disease and papillary thyroid cancer: An association that can be missed

International Nuclear Information System (INIS)

Al-Omari, Ahmad A.; Haddad, Fares H.; Malkawi, Omar M.; Khushman, Haytham M.

2005-01-01

Thyroid nodules are frequently found in association with Graves' disease. Papillary carcinoma can arise from these nodules. We report a 65-year-old gentleman who presented with classical features of Graves disease. Technetium 99 scintigraphy revealed diffuse goiter with a cold nodule over the isthmus. Papillary thyroid cancer was suggested by the enlarging thyroid gland, and by the presence of cold nodule, and was proven by fine needle aspiration biopsy of this nodule. The diagnosis was confirmed by histopathology of thyroid specimen after total thyroidectomy, which also showed local invasion; metastatic work up revealed pulmonary and liver metastasis. Despite treatment by total thyroidectomy, twice radioactive iodine I131 ablation and levothyroxine replacement in a thyroid stimulating hormone suppressive dose, he still harbors metastases with elevated thyroglobulin level. This case should raise the index of suspicion of the treating physician to consider similar association, and to prompt early diagnosis and surgical treatment to prevent dreadful consequences that might adversely affect the outcome. (author)

Autonomously hyperfunctioning cystic nodule harbouring thyroid carcinoma - Case report and literature review.

Science.gov (United States)

Lima, Maria João; Soares, Virgínia; Koch, Pedro; Silva, Artur; Taveira-Gomes, António

2018-01-01

Hyperthyroidism is rarely associated with malignancy, but it cannot rule out thyroid cancer. Although there is published data describing this coexistence, thyroid carcinomas inside autonomously functioning nodules are uncommon. A 49-year-old woman presented with a cervical mass, unexplained weight loss and anxiousness, sweating and insomnia. On physical examination, she had a palpable left thyroid nodule. Thyroid function tests showed suppressed TSH (nodule. 99mTC thyroid scintigraphy showed a hyperfunctioning nodule with suppression of the remainder parenchyma. Fine-needle aspiration cytology was nondiagnostic (cystic fluid). The patient was started on thiamazole 5 mg daily with subsequent normalization of thyroid function, but she developed cervical foreign body sensation and a left hemithyroidectomy was performed. Histology showed a 4 cm cystic nodule with a follicular variant papillary carcinoma and the patient underwent completion thyroidectomy, followed by radio-iodine ablation. Published literature showed an increased prevalence of autonomously functioning nodules, harbouring thyroid carcinomas in adults. Papillary carcinoma is the most frequently described but the follicular variant is rare. Although rare, thyroid cancer is not definitively excluded in hyperthyroid patients and it should always be considered as differential diagnosis. Copyright © 2018. Published by Elsevier Ltd.

Selective Extraction of Perrhenate and Pertechnetate by New Macrocyclic Compounds

International Nuclear Information System (INIS)

Paviet-Hartmann, Patricia; Horkley, Jared; Wolfrom, Earle; Pak, Joshua

2008-01-01

The long half-life of technetium-99 and its ability to form an anionic species makes it a major concern when considering long-term disposal of high-level radioactive waste. Furthermore, as its most stable species in the environment, the pertechnetate ion, TcO 4 - is highly mobile and is considered as a long-term hazard in nuclear waste disposal. There is a need for the development of new extractant systems, such as systems based on crown ethers that may serve to selectively extract and separate this long lived radionuclide from different streams for potential industrial application. In this paper, we are reporting the design and synthesis of new macrocyclic compounds to selectively extract technetium and rhenium from complex mixtures. Preliminary tests performed for the selective extraction of pertechnetate and perrhenate are presented. (authors)

Congenital hypothyroidism. The role of nuclear medicine in diagnosis: a case of lingual thyroid

International Nuclear Information System (INIS)

Maggs, J.; Cotter, A.; Bartholomeusz, D.; Chatterton, B.

2005-01-01

Hypothyroidism present from birth is a devastating condition and causes cretinism, which results in delayed development and mental retardation unless treated very early. All neonates in Australia are screened by a blood test when about two days old to exclude hypothyroidism (and several other biochemical conditions). A non-invasive nuclear scan may be able to recognise the cause of neonatal hypothyroidism: 1. Thyroid dysgenesis, (anatomical anomalies) including aplasia or hypoplasia of the thyroid gland; and ectopy of the thyroid, often with hypoplasia, in which there is insufficient tissue to match the demands of the infant or growing child. The abnormal anatomy is seen on thyroid scanning. 2. Dyshormonogencsis, (organification defects) a serious error in thyroid hormone synthesis. In general, thyroid trapping of pertechnctate or iodine will be increased, and demonstrated on the radionuclide study. 3. Hypopituitarism (secondary hypothyroidism) due to pituitary aplasia or midline brain developmental defects. There may also be hypothalamic dysfunction (tertiary hypothyroidism). An anatomically normal thyroid will show reduced uptake. Lingual thyroid is a rare developmental anomaly caused by failure of migration of the thyroid gland to its normal position in the neck. The incidence is relatively rare and sex incidence is four or five to one in favour of females. If untreated, there are sequelae of hypothyroidism, or growth of the mass in base of the tongue to the mass of a normal thyroid gland, which may cause respiratory compression. Thyroid malignancies may also be more frequent. This poster reports a case of lingual thyroid in a 19-day-old baby girl with biochemically diagnosed hypothyroidism. T4 = 9 (N > 12), TSH = 80, (N < 5). Scanning with a pinhole collimator 20min after IV injection of 40 MBq of Pertechnetate showed the only uptake to be in the base of the tongue, a lingual thyroid. Uptake was estimated at 2%, (N not available in infants)

99Tcm-octreotide scintigraphy in patients with graves' ophthalmopathy

International Nuclear Information System (INIS)

Liu Wei; Li Yongjun

2004-01-01

Purpose: To evaluate 99 Tc m -Octreotide scintigraphy in patients with Graves' ophthalmopahty (GO). Methods: 11 confirmed GO patients (3 male and 8 female, with average age of 47.7 years, average GD history 9.3 mo and average GO history 9.2 mo), who were being treated with anti-thyroid drugs but never immunosuppressive medications, were included. Clinical activity score (CAS) were recorded before imaging. At 2 hours after administration of 99 Tc m -Octreotide (20 mCi, I.V), scintigraphy were performed with SPECT. Regions of interesting (ROI) of orbit and skull were draw on transverse slices. Counts per pixel (c/p) in each ROI and the ratio of orbit counts to skull counts (O/S) were calculated. The difference of c/p between ROI of orbit and skull were tested, while the correlations between CAS and O/S were evaluated. Results: Accumulation of radioactivity in orbit of all cases were intense than that in skull. The difference of c/p between orbit and skull were significant ( p=0.0027 left eye, 0.0014 right eye). Average O/S was 1.57 and CAS were between 3-7. The correlation factors of O/S and CAS were: left eye 0.64 (p=0.032), right eye 0.73 (p=0.011). Conclusion: SM receptor scintigraphy with 99 Tc m -Octreotide, a newly developed SM receptor imaging agent, could be used as a objective means to evaluate the activity of GO. (authors)

Changes in hepatic perfusion index determined by Tc-99m pertechnetate first pass scintigraphy in acute viral hepatitis

International Nuclear Information System (INIS)

Ali, M.K.

1993-01-01

Computerized sequential radionuclide angiography was used to analyze the first pass kinetics of peripherally injected bolus of Tc-99m-pertechnetate. The relative arterial/total hepatic blood flow, the Hepatic Perfusion Index (HPI%), was determined in normal subjects while 20 cases of Acute Viral Hepatitis (AVH) were studied serially. In addition, biochemical blood analysis as also carried out. The mean value of HPI in first study of all patients was 61.23% in comparison to 31.12% of control group. The patients were divided into three groups, based upon the duration elapsed between the onset of symptoms and the first study. HPI was found significantly high in first study of each group as compared to controls. In first group there was no significant correlation of mean HPI with other biochemical parameters. In second and third groups, significant correlation were observed between the mean HPI and serum bilirubin, serum alanine trans-aminase with mean HPI in the third group. The serum proteins correlated negatively with HPI in second group. This technique offers a simple, rapid, non-invasive and quantitative method to determine a new index which mostly behaves like other biochemical parameter and can be used to follow the course of acute viral hepatitis. (author)

Thyrotoxicosis-induced acute myocardial infarction due to painless thyroiditis.

Science.gov (United States)

Kim, Hee Jin; Jung, Tae Sik; Hahm, Jong Ryeal; Hwang, Seok-Jae; Lee, Sang Min; Jung, Jung Hwa; Kim, Soo Kyoung; Chung, Soon Il

2011-10-01

Thyrotoxicosis influences cardiovascular hemodynamics and can induce coronary vasospasm. Patients with thyrotoxicosis-induced acute myocardial infarction (AMI) are unusual and almost all reported cases have been associated with Graves' disease. Patients with painless thyroiditis show a thyrotoxic phase during the early stages. Here we describe a very rare case of thyrotoxicosis with painless thyroiditis-induced AMI. A 35-year-old Korean man visited the emergency room for a 2-hour duration of typical AMI chest pain. The patient did not have any coronary artery disease (CAD) risk factors. The electrocardiogram showed 3 mm of ST-segment elevation in leads II, III, and aVF, which is consistent with inferior AMI. We immediately treated the patient with aspirin, clopidogrel, and nitroglycerine and performed emergent coronary angiography. Coronary angiography showed normal coronary arteries without any stenotic lesions. Consistent with AMI, cardiac enzyme levels of serum creatine kinase (CK), CK-MB, and troponin-I were also elevated. Laboratory findings showed thyrotoxicosis without any thyroid autoantibodies. A 99m-technetium scintigraphy showed markedly decreased thyroid uptake compatible with thyroiditis. We treated the patient with calcium channel blockers and nitrates. The patient spontaneously recovered normal thyroid function after 6 weeks of observation and did not complain of chest pain. Thyrotoxicosis due to painless thyroiditis provoked AMI in a young man who had no atherosclerotic coronary lesions and no CAD risk factors.

Selective Extraction of Perrhenate and Pertechnetate by New Macrocyclic Compounds

Energy Technology Data Exchange (ETDEWEB)

Paviet-Hartmann, Patricia; Horkley, Jared; Wolfrom, Earle [Idaho State University/Idaho National Laboratory, 1776 Science Center Drive, Idaho Falls, ID 83402 (United States); Pak, Joshua [Idaho State University, 921 S. 8th Avenue, Pocatello, ID 83209 (United States)

2008-07-01

The long half-life of technetium-99 and its ability to form an anionic species makes it a major concern when considering long-term disposal of high-level radioactive waste. Furthermore, as its most stable species in the environment, the pertechnetate ion, TcO{sub 4}{sup -} is highly mobile and is considered as a long-term hazard in nuclear waste disposal. There is a need for the development of new extractant systems, such as systems based on crown ethers that may serve to selectively extract and separate this long lived radionuclide from different streams for potential industrial application. In this paper, we are reporting the design and synthesis of new macrocyclic compounds to selectively extract technetium and rhenium from complex mixtures. Preliminary tests performed for the selective extraction of pertechnetate and perrhenate are presented. (authors)

Evaluation of the formation of esophageal varices by per-rectal portal scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Ikeoka, Naoko; Monna, Takeyuki; Shiomi, Susumu; Kuroki, Tetsuo; Kobayashi, Kenzo; Ochi, Hironobu; Onoyama, Yasuto (Osaka City Univ. (Japan). Faculty of Medicine); Yamamoto, Sukeo

1989-12-01

Portal circulation in patients with liver diseases was evaluated by {sup 99m}Tc-pertechnetate per-rectal portal scintigraphy, and we retrospectively examined the relationship between the extent of abnormality in the portal circulation and the development of esophageal varices. The per-rectal portal shunt index (PRPSI) was calculated for 13 healthy subjects and 79 patients with chronic hepatitis and 214 with cirrhosis of the liver. In the healthy subjects, the mean PRPSI was 4.8%. In the patients with hepatitis, the mean PRPSI was 8.4%, and in the patients with cirrhosis, it was 48.5%. The PRPSI was significantly higher in the cirrhotic patients with esophageal varices than in those without it, and also in the cirrhotic patients with encephalopathy than in those without it. The cumulative incidence of esophageal varices in the 3 years of the study in patients whose PRPSI was 20% or over was significantly higher than that in patients whose PRPSI was under 20%. The results suggested that this non-invasive method should be useful for predictions of the formation of esophageal varices. (author).

Evaluation of the formation of esophageal varices by per-rectal portal scintigraphy

International Nuclear Information System (INIS)

Ikeoka, Naoko; Monna, Takeyuki; Shiomi, Susumu; Kuroki, Tetsuo; Kobayashi, Kenzo; Ochi, Hironobu; Onoyama, Yasuto; Yamamoto, Sukeo.

1989-01-01

Portal circulation in patients with liver diseases was evaluated by 99m Tc-pertechnetate per-rectal portal scintigraphy, and we retrospectively examined the relationship between the extent of abnormality in the portal circulation and the development of esophageal varices. The per-rectal portal shunt index (PRPSI) was calculated for 13 healthy subjects and 79 patients with chronic hepatitis and 214 with cirrhosis of the liver. In the healthy subjects, the mean PRPSI was 4.8%. In the patients with hepatitis, the mean PRPSI was 8.4%, and in the patients with cirrhosis, it was 48.5%. The PRPSI was significantly higher in the cirrhotic patients with esophageal varices than in those without it, and also in the cirrhotic patients with encephalopathy than in those without it. The cumulative incidence of esophageal varices in the 3 years of the study in patients whose PRPSI was 20% or over was significantly higher than that in patients whose PRPSI was under 20%. The results suggested that this non-invasive method should be useful for predictions of the formation of esophageal varices. (author)

Significant clinical differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease

International Nuclear Information System (INIS)

Masatsugu, Toshihiro; Kuroki, Syoji; Tanaka, Masao

2005-01-01

We evaluated the differences in diagnosis and treatment for primary hyperparathyroidism (pHPT) in patients with and those without concomitant thyroid disease. One hundred and ten patients with pHPT underwent parathyroid localization and thyroid examination by ultrasonography (US) and sestamibi scintigraphy (MIBI). The clinical and biochemical findings, parathyroid localization, and operations performed were compared in 49 patients without thyroid disease and 61 patients with thyroid disease. Asymptomatic hypercalcemia was significantly more prevalent in patients with concomitant thyroid disease (88.5%) than in those without thyroid disease (49.0%) (P<0.01). The mean serum calcium was significantly higher and the inorganic phosphate level was significantly lower in patients without concomitant thyroid disease than in those with concomitant thyroid disease (P<0.05, P<0.01, respectively). The pathologic parathyroid gland was identified significantly more often in patients without concomitant thyroid disease than in those with concomitant thyroid disease both by US and MIBI (P<0.05). Unilateral exploration was performed more often in patients without thyroid disease than in those with thyroid disease (P<0.01). Primary hyperparathyroidism was diagnosed at an earlier stage in patients with concomitant thyroid disease. Thyroid disease concomitant with pHPT influenced parathyroid localization as well as the indication for minimally invasive parathyroidectomy. (author)

Investigation of uranyl-ion hydrolysis in uranyl pertechnetate and uranyl perchlorates solutions by two-phases potentiometric titration method

International Nuclear Information System (INIS)

Volk, V.I.; Belikov, A.D.

1977-01-01

The applicability of the method of two-phase potentiometric titration for studying hydrolysis of multi-charge ions has been shown. Hydrolysis of uranyl-ion has been investigated and hydrolysis constants in the solutions of uranyl pertechnetate and perchlorate have been calculated equal to (6.2+-0.15)x10 -5 and (9.25+-0.5)10 -5 , respectively. Infrared spectra of the initial crystallohydrates of uranyl pertechnetate and perchlorate has been analyzed. The data on hydrolysis of an uranyl-ion and IR spectra of crystallohydrates of the investigated salts have revealed the ability of pertechnetate ion to complexing with an uranyl group

Coincidence of scintigraphic false positive and false negative findings in parathyroid and thyroid adenomas (case report)

Energy Technology Data Exchange (ETDEWEB)

Mana, O.; Zatta, G.; Boccolari, S.; Barbesti, S.; Tarolo, G.L.

1987-04-01

The subtractive double tracer scintigraphy with /sup 201/Tl and /sup 99m/Tc is a useful technique in studying parathyroid nodules; nevertheless, this method can give misleading informations especially in presence of thyroid nodules with false positive and false negative findings. In this case report the technique was applied in studying a patient with three nodules (two thyroid adenomas and one parathyroid adenoma), where both scintigraphic and echographic methods provided misleading informations. The selective uptake of /sup 201/Tl in the upper region of the right thyroid lobe gave a false positive finding, while the increased uptake of /sup 99m/Tc in a hyperfunctioning thyroid adenoma of left lobe masked the parathyroid adenoma laying below, giving a false negative finding.

Differentiation between healthy thyroid remnants and tumor tissue after radioiodine therapy in patients with differentiated thyroid carcinoma using in-vitro phosphorus-31 magnetic resonance spectroscopy

International Nuclear Information System (INIS)

Moka, D.; Dietlein, M.; Schicha, H.; Raffelt, K.; Hahn, J.

2002-01-01

Full text: In many tumors, tumor growth and spread is triggered by changes in cell membrane metabolism, which can lead to systemic alterations in levels of phospholipids. The aim of this study was to differentiate between healthy remnants of thyroid tissue and residual/recurrent tumor tissue or metastases in patients with thyroid carcinoma by measurement of plasma levels of various phospholipids. Phospholipid concentrations was measured by in-vitro phosphorus-31-magnetic resonance spectroscopy ( 31 P-MRS) in blood samples from 30 patients with thyroid cancer, who had been rendered hypothyroid in preparation for diagnostic/therapeutic administration of iodine-131. All patients were already thyroidectomized. 131 I-whole-body scintigraphy and measurements of thyroglobulin values in a 2-year-follow-up were used to distinguish between patients in remission, patients with only healthy thyroid remnants and patients with cancerous thyroid tissue and/or metastases. Significantly lower blood plasma levels of systemic sphingomyelin (0.33±0.06 vs. 0.46±0.03 (controls) mmol/l; p 31 P-MRS can be used to differentiate between the presence of tumor tissue, healthy remnants of thyroid tissue not requiring further treatment and remission in patients with thyroid cancer. In future, therefore, plasma 31 P-MRS could be developed as an additional diagnostic tool for the follow-up of differentiated thyroid cancer. (author)

Gastroesophageal scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Malmud, L.S.; Fisher, R.S.

1980-01-01

The technique of gastroesophageal scintigraphy was developed in order to quantitatively detect reflux from the stomach into the esophagus. The scintigraphic technique was compared to previous diagnostic tests. None of the other techniques is as sensitive as gastroesophageal scintigraphy for the detection of reflux, in comparison to the acid reflux test. Gastroesophageal scintigraphy is able to detect gastroesophageal reflux acurately, rapidly, noninvasively, and more sensitively than other diagnostic techniques. In addition, it is able to be employed to quantitate reflux and is suitable for studying the effects of various therapeutic modalities.

Preoperative Thyroid Ultrasound Is Indicated in Patients Undergoing Parathyroidectomy for Primary Hyperparathyroidism

Directory of Open Access Journals (Sweden)

Cletus A. Arciero, Zita S. Shiue, Jeremy D. Gates, George E. Peoples, Alan P. B. Dackiw, Ralph P. Tufano, Steven K. Libutti, Martha A. Zeiger, Alexander Stojadinovic

2012-01-01

Full Text Available Background: Primary hyperaparathyroidism (pHPT is often accompanied by underlying thyroid pathology that can confound preoperative parathyroid localization studies and complicate intra-operative decision making. The aim of this study was to examine the utility of preoperative thyroid ultrasonography (US in patients prior to undergoing parathyroidectomy for pHPT.Methods: An Institutional Review Board approved prospective study was undertaken from January 2005 through July 2008. All patients with pHPT meeting inclusion criteria (n=94 underwent preoperative thyroid ultrasound in addition to standard 99mTc-sestamibi scintigraphy for parathyroid localization. Demographics, operative management and final pathology were examined in all cases.Results: Fifty-four of the 94 patients (57% were noted to have a thyroid nodule on preoperative US, of which 30 (56% underwent further examination with fine needle aspiration biopsy. Alteration of the operative plan attributable to underlying thyroid pathology occurred in 16 patients (17%, with patients undergoing either total thyroidectomy (n=9 or thyroid lobectomy (n=7. Thyroid cancer was noted in 33% of patients undergoing thyroid resection, and 6% of all patients with HPT.Conclusions: The routine utilization of preoperative thyroid ultrasound in patients prior to undergoing parathyroid surgery for pHPT is indicated. The added information from this non-invasive modality facilitates timely management of co-incidental, and sometimes malignant, thyroid pathology.

A young woman with a supraclavicular swelling; some diagnostic aspects of thyroid carcinoma

International Nuclear Information System (INIS)

Logmans, S.C.; Jobsis, A.C.; Schoot, J.V. van der; Schipper, M.E.I.; Kromhout, J.G.

1983-01-01

The case is reported of a woman aged 24 years who presented a supraclavicular swelling caused by a lymph-node metastasis of an adenopapillary carcinoma. The primary tumour was found in the thyroid in which palpation and scintigraphy failed to reveal any abnormalities. The diagnosis and the diagnostic value of scintigraphic and immunohistological examination are considered. (Auth.)

A Rare Complication following Thyroid Percutaneous Ethanol Injection: Plummer Adenoma

Directory of Open Access Journals (Sweden)

Roberto Cesareo

2017-01-01

Full Text Available Percutaneous ethanol injection (PEI is a technique used only for benign thyroid nodules, cystic or mixed cystic-solid with a large fluid component. It is a quite low-cost, safe, and outpatient method of treatment. Rare and severe complications have been described after PEI: jugular vein thrombosis and severe ethanol toxic necrosis of the larynx combined with necrotic dermatitis. Moreover, only four thyrotoxicosis cases due to Graves’ disease have been reported. We report a case of 58-year-old female with a voluminous thyroid cystic nodule, occupying almost the entire left thyroid lobe. Our patient had already performed surgical visit and intervention of thyroidectomy had been proposed to her, which she refused. At baseline, our patient has a normal thyroid function with negative autoantibodies. According to the nodular structure, intervention of PEI has been performed with a significant improvement of compressive symptoms and cosmetic disorders. About 30 days after treatment, there was a significant volume reduction, but patient developed an acclaimed symptomatic thyrotoxicosis. After ruling out several causes of hyperthyroidism and according to the thyroid scintigraphy findings, we made the diagnosis of Plummer adenoma. To our knowledge, our patient is the first case of Plummer adenoma following PEI treatment of nontoxic thyroid nodule.

Papillary thyroid carcinoma, dermoid cyst and polycystic ovary syndrome: a case report

International Nuclear Information System (INIS)

Plaizier, M.A.B.D.; Pieters, J.J.P.M.; Hamming, J.F.; Heul, C. van der; Misere, J.

2002-01-01

Full text: Total body scintigraphy after the I-131 treatment for thyroid carcinoma is a routine procedure in staging. For smaller tumors uptake outside the neck is seldomly seen, usually benign and without clinical significance. However, a conscientious analysis of there accumulations can be relevant. A 33 year-old female presented in December 1998 with a T2N1M0 papillary thyroid carcinoma. Thyroidectomy, neck dissection and 50 mCi 1-131 treated her. The post-therapy scan was negative except for a small spot in the neck (thyroidremnant: 3.0 %). In September 1999 150 mCi was administered and the scan afterwards showed a focus median in the neck (thyroid remnant: 0.3 %) and a persistent hotspot in the left lower quadrant of the abdomen (figure). The thyreoglobuline was 3.8 μg/l (unchanged to the first I-131 therapy) during maximal TSH Stimulation (174 mu/l). Transvaginal ultrasound revealed an enlarged left ovary which was laparoscopical removed and appeared to be a dermoid cyst with hair- and skincomponents, respiratory epithelia and bone. Only after staining on thyreoglobuline thyroid tissue was demonstrated; there were no signs of malignancy. Six months later a 10 mCi I-131 scintigraphy was negative; thyreoglobuline was < 0.5 μg/l and TSH 161 mg/l suggesting no thyroid tissue was present in the Body. Her medical history showed a polycystic ovary syndrome (PCOS). She received treatment for ovulation induction including clomiphene, HCG, FSH and LH. Her thyroid function was normal. After two miscarriages She gave birth to a daughter. Germ cells must been present since birth to form a dermoid cyst during life. In our patient, the dermoid cyst with benign thyroid cells was visualized only after the second I-131 therapy. We assume that the sensitivity of a scan after 50 mCi and 150 mCi I-131 is equal. Therefore, probably not the ovulation induction medication but the TSH stimulation for the I-131 therapy is the reason for the development of the dermoid cyst. That only

Two peptide receptor ligands (99m)Tc-EDDA/HYNIC-Tyr(3)-octreotide and (99m)Tc-EDDA/HYNIC-(D)Glu-octagastrin for scintigraphy of medullary thyroid carcinoma.

Science.gov (United States)

Kosowicz, Jerzy; Mikołajczak, Renata; Czepczyński, Rafał; Ziemnicka, Katarzyna; Gryczyńska, Maria; Sowiński, Jerzy

2007-10-01

Somatostatin and gastrin receptors are overexpressed in medullary thyroid carcinoma (MTC) cells; hence, both of them are potential targets for peptide receptor scintigraphy and radiotherapy. Therefore, the aim of our study was to assess the clinical value of two technetium-99m-labeled peptides, a new gastrin analog, the EDDA/HYNIC-(D)Glu-octagastrin and a somatostatin analog, EDDA/HYNIC-Tyr(3)-octreotide (EDDA/HYNIC-TOC) for scintigraphy in patients with MTC to detect recurrences and metastases and select patients for peptide receptor radiotherapy. Thirty (30) patients, 20 females and 10 males, 22-83 years of age (mean, 52.7) with the diagnosis of MTC in different stages of the disease (preoperative, postsurgery, remission, recurrence, or metastatic disease) were included in this study. Before surgery, in all patients serum calcitonin concentrations were elevated. The diagnosis of MTC was confirmed in all cases by histopathology of the removed tumor and immunohistochemical staining giving positive reactions for calcitonin and chromogranin A. Imaging studies using (99m)Tc-EDDA/HYNIC-TOC and a new minigastrin analog, (99m)Tc-EDDA/HYNIC-(D)Glu-octagastrin, were performed in each patient and the results compared with each other and with other imaging methods. Scans of the whole body, head, neck, and chest were performed 2 and 4 hours after injections of the tracer, 500-600 MBq in each case, using a double-head Varicam (Elscint, Israel) gamma camera. (99m)Tc-EDDA/HYNIC-TOC detected somatostatin receptor-positive lesions in 20 patients with MTC, whereas (99m)Tc-EDDA/HYNIC-(D)Glu-octagastrin displayed gastrin receptors in 11 patients. In 9 cases, the scans were positive in both methods, although in 2 cases different pathologic foci were visualized. In 12 cases, only (99m)Tc-EDDA/HYNIC-TOC scintigraphy was positive, whereas in 3 other cases only (99m)Tc-EDDA/HYNIC-(D)Glu-octagastrin revealed pathologic lesions. Scintigraphy using (99m)Tc-HYNIC-TOC permits the visualization

Adrenal scintigraphy

International Nuclear Information System (INIS)

Beierwaltes, W.H.

1979-01-01

The following items are discussed:anatomy and physiology of adrenal glands, clinical indications of scintigraphy, radiobiology and radiochemistry, scintigraphic imaging, adrenocortical hyperfunction, aldosteronism and hypertension associated with low renin level, excess of androgen, adrenocortical hyperfunction and future perspectives of adrenal scintigraphy. (M.A.) [pt

Fluorine-18 fluorodeoxyglucose positron emission tomography in the follow-up of differentiated thyroid cancer

International Nuclear Information System (INIS)

Gruenwald, F.; Schomburg, A.; Bender, H.; Klemm, E.; Menzel, C.; Bultmann, T.; Palmedo, H.; Ruhlmann, J.; Kozak, B.; Biersack, H.J.

1996-01-01

Whole-body fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging was performed during the follow-up of 33 patients suffering from differentiated thyroid cancer. Among them there were 26 patients with papillary and seven with follicular tumours. Primary tumour stage (pT) was pT1 in six cases, pT2 in eight cases, pT3 in three cases and pT4 in 14 cases. FDG PET was normal in 18 patients. In three patients a slightly increased metabolism was observed in the thyroid bed, assumed to be related to remnant tissue. In one case local recurrence, in ten cases lymph node metastases (one false-positive, caused by sarcoidosis) and in three cases distant metastases were found with FDG PET. In comparison with whole-body scintigraphy using iodine-131 (WBS) there were a lot of discrepancies in imaging results. Whereas three patients had distant metastases (proven with 131 I) and a negative FDG PET, in four cases 131 I-negative lymph node metastases were detectable with PET. Even in the patients with concordant ''staging'', differences between 131 I and FDG were observed as to the exact lesion localization. Therefore, a coexistence of 131 I-positive/FDG-negative, 131 I-negative/FDG-positive and 131 I-positive/FDG-positive malignant tissue can be assumed in these patients. A higher correlation of FDG PET was observed with hexakis (2-methoxyisobutylisonitrile) technetium-99m (I) (MIBI) scintigraphy (performed in 20 cases) than with WBS. In highly differentiated tumours 131 I scintigraphy had a high sensitivity, whereas in poorly differentiated carcinomas FDG PET was superior. The clinical use of FDG PET can be recommended in all cases of suspected or proven recurrence and/or metastases of differentiated thyroid cancer and is particularly useful in cases with elevated serum thyroglobulin levels and negative WBS. (orig.). With 3 figs., 2 tabs

A study of sorption of pertechnetate anion on chitosan

International Nuclear Information System (INIS)

Pivarciova, L.; Rosskopfova, O.; Rajec, P.; Galambos, M.

2015-01-01

Chitosan is one of the natural materials of biological origin. The sorption of pertechnetate anions from aqueous solutions on chitosan was studied in a batch system. This work was aimed to study influence of the contact time, effect of pH and effect of different ions on sorption of pertechnetate anions on chitosan. This sorbent was characterized by BET-surface area and potentiometric titration. The point of zero charge (pH pzc ) was at pH=7.15. The highest percentage of technetium sorption on chitosan was near pH 3. The adsorption capacity of chitosan decreased with increase in pH value above 3. In the initial pH range of 4-10, final pHs are the same. The selectivity of chitosan for these cations with concentration above 1·10 -3 mol·dm -3 was in the order Na + > Ca 2+ > Fe 3+ > Fe 2+ . The competition effect of (SO 4 ) 2- towards TcO 4 - sorption was stronger than the competition effect (ClO 4 ) - of ions. (authors)

(18)F-Dihydroxyphenylalanine PET in patients with biochemical evidence of medullary thyroid cancer : Relation to tumor differentiation

NARCIS (Netherlands)

Koopmans, Klaas P.; de Groot, Jan Willem B.; Plukker, John T. M.; de Vries, Elisabeth G. E.; Kema, Ido P.; Sluiter, Wim J.; Jager, Pieter L.; Links, Thera P.

Curative treatment for recurrent medullary thyroid cancer (MTC), diagnosed by rising serum calcitonin, is surgery, but tumor localization is difficult. Therefore, the value of (18)F-dihy-droxyphenylanaline PET ((18)F-DOPA PET), (18)F-FDG PET, (99m)Tc-V-di-mercaptosulfuricacid (DMSA-V) scintigraphy,

Dosimetric evaluation in organs of the Tc99m, I123 bio-kinetics to estimate dose in thyroid children 1 and 5 years

International Nuclear Information System (INIS)

Vasquez, A. M.; Quispe, R.; Vasquez, D. J.; Rocha, M. D.; Morales, N. R.; Marin, R. K.; Zelada, A. L.

2012-10-01

Using the formalism MIRD and the representation of Cristy-Eckerman for the thyroid in children of 1 and 5 years, is demonstrated that the dosimetric contribution of the organs of I 123 (iodure) bio-kinetics is not significant in the dose estimate. The total dose absorbed by the gland is its auto dose. The dosimetric contribution of the organs source of the Tc 99m (pertechnetate) bio-kinetics in the gland is significant in the dose estimate like to be ignored. The reported results for the iodure are not significantly different to the found for the Marinelli scheme (auto-dose) for thyroid represented by a sphere of 1,78 and 3,45 grams. (Author)

A Pilot Comparison of 18F-fluorocholine PET/CT, Ultrasonography and 123I/99mTc-sestaMIBI Dual-Phase Dual-Isotope Scintigraphy in the Preoperative Localization of Hyperfunctioning Parathyroid Glands in Primary or Secondary Hyperparathyroidism

Science.gov (United States)

Michaud, Laure; Balogova, Sona; Burgess, Alice; Ohnona, Jessica; Huchet, Virginie; Kerrou, Khaldoun; Lefèvre, Marine; Tassart, Marc; Montravers, Françoise; Périé, Sophie; Talbot, Jean-Noël

2015-01-01

Abstract We compared 18F-fluorocholine hybrid positron emission tomography/X-ray computed tomography (FCH-PET/CT) with ultrasonography (US) and scintigraphy in patients with hyperparathyroidism and discordant, or equivocal results of US and 123I/99mTc-sesta-methoxyisobutylisonitrile (sestaMIBI) dual-phase parathyroid scintigraphy. FCH-PET/CT was performed in 17 patients with primary (n = 11) lithium induced (n = 1) or secondary hyperparathyroidism (1 dialyzed, 4 renal-transplanted). The reference standard was based on results of surgical exploration and histopathological examination. The results of imaging modalities were evaluated, on site and by masked reading, on per-patient and per-lesion bases. In a first approach, equivocal images/foci were considered as negative. On a per-patient level, the sensitivity was for US 38%, for scintigraphy 69% by open and 94% by masked reading, and for FCH-PET/CT 88% by open and 94% by masked reading. On a per-lesion level, sensitivity was for US 42%, for scintigraphy 58% by open and 83% by masked reading, and for FCH-PET/CT 88% by open and 96% by masked reading. One ectopic adenoma was missed by the 3 imaging modalities. Considering equivocal images/foci as positive increased the accuracy of the open reading of scintigraphy or of FCH-PET/CT, but not of US. FCH-PET/CT was significantly superior to US in all approaches, whereas it was more sensitive than scintigraphy only for open reading considering equivocal images/foci as negative (P = 0.04). FCH uptake was more intense in adenomas than in hyperplastic parathyroid glands. Thyroid lesions were suspected in 9 patients. They may induce false-positive results as in one case of oncocytic thyroid adenoma, or false-negative results as in one case of intrathyroidal parathyroid adenoma. Thyroid cancer (4 cases) can be visualized with FCH as with 99mTc-sestaMIBI, but the intensity of uptake was moderate, similar to that of parathyroid hyperplasia. This pilot study confirmed

Behavior of technetium in alkaline solution: Identification of non-pertechnetate species in high-level nuclear waste tanks at the Hanford reservation

International Nuclear Information System (INIS)

Lukens, Wayne W. Jr.; Shuh, David K.; Schroeder, Norman C.; Ashley, Kenneth R.

2003-01-01

Technetium is a long-lived (99Tc: 213,000 year half-life) fission product found in nuclear waste and is one of the important isotopes of environmental concern. The known chemistry of technetium suggests that it should be found as pertechnetate, TcO4-, in the extremely basic environment of the nuclear waste tanks at the Hanford site. However, other chemical forms of technetium are present in significant amounts in certain tanks, and these non-pertechnetate species complicate the treatment of the waste. The only spectroscopic characterization of these non-pertechnetate species is a series of X-ray absorption near edge structure (XANES) spectra of actual tank waste. To better understand the behavior of technetium under these conditions, we have investigated the reduction of pertechnetate in highly alkaline solution in the presence of compounds found in high-level waste. These results and the X-ray absorption fine structure (XAFS) spectra of these species are compared to the chemical behavior and XANES spectra of the actual non-pertechnetate species. The identity of the nonpertechnetate species is surprising

Features of radionuclide research after thyroidectomy at the thyroid gland cancer

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David В Dolidze

2015-02-01

Full Text Available AimTo clarify the possibility of postoperative radioisotope studies in determining the remnants of thyroid tissue in patients with thyroid carcinoma.Materials and methodsThe work is based on the study results of surgical treatment and postoperative examination of 120 patients with thyroid cancer, at the Botkin hospital during the period from 2007 to 2013. All patients were performed extrafascial intervention. 118 (98.3% patients were provided thyroidectomy (including lymph node dissection. For all patients in the postoperative period after 2–4 weeks were performed thyroid and whole-body scan with iodine and technetium, as well as ultrasound and computed tomography of the neck and the chest cavity.ResultsDuring the research, 16 (13.3% patients after scanning with 123I (7 (5.8% patients, 131I (3 (2.5% patients, 99mTs-Pertechnetate (6 (5% patients and applying them consistently (6 (5% patients received the accumulation of the radiopharmaceutical in the operation area, as in the midline in the area of the isthmus, and the locations of the right, left and pyramidal thyroid share. These facts were interpreted as an accumulation of the isotope in the remnants of thyroid tissue after surgery. With additional research methods were revealed swelling and infiltration of tissues in 10 (8.3% cases in the sterno-hyoid and sterno-thyroid muscles, and in 6 (5% cases – in the paratracheal and paralaryngeal areas. After fine-needle aspiration biopsy from infiltrative zone was received cytology of nonspecific inflammation. All patients received antiinflammatory and antibiotic therapy with a positive effect. Control ultrasound noted a gradual reduction of the inflammatory infiltrate. After 6 months of thyroid scan was recorded decrease area of uptake, and a year later its complete disappearance.ConclusionsThus, postoperative radionuclide scanning in patients with thyroid gland carcinoma in some cases gives false-positive results, regardless of the type

Ultrasound-guided laser thermal ablation in the treatment of autonomous hyperfunctioning thyroid nodules and compressive nontoxic nodular goiter.

Science.gov (United States)

Spiezia, Stefano; Vitale, Giovanni; Di Somma, Carolina; Pio Assanti, Angelo; Ciccarelli, Antonio; Lombardi, Gaetano; Colao, Annamaria

2003-10-01

Percutaneous laser thermal ablation (LTA) has been applied in several tumors. In this study we evaluated the safety and long-term efficacy of LTA in the treatment of benign thyroid nodules. Seven patients with autonomous hyperfunctioning thyroid nodule (group A) and five patients with compressive nodular goiter (group B) were treated with LTA. Up to three needles were positioned centrally in the thyroid nodule and laser fiber was placed in the lumen of the needle. Laser illumination was performed reaching a maximal energy deposition of 1800 J per fiber. Thyroid nodule volume, endocrinologic, and clinical evaluation were performed at baseline, 3, and 12 months after the treatment. Scintigraphy was performed at diagnosis and 12 months after the first session in group A. In group A, mean thyroid volume decreased from 3.15 +/- 1.26 mL to 0.83 +/- 0.49 mL (p thyroid volume decreased from 11.14 +/- 4.99 mL to 3.73 +/- 1.47 mL (p thyroid nodules.

Adrenal scintigraphy

International Nuclear Information System (INIS)

Veen, E.A. van der.

1978-01-01

The visualization of functioning adrenocortical tissue by scintigraphy became possible with the introduction of radioiodinated cholesterol derivatives. According to the literature, there is evidence that one of these iodinated cholesterols, 6-β-iodomethyl-nor-cholesterol, concentrates in the adrenal cortex to a much greater extent than 131 I-19-odocholesterol. Results comparing both radiopharmaceuticals are described. The authors investigated the possibility of increasing the uptake of iodinated cholesterol using simultaneous ACTH and the 'cholesterol side-chain cleavage enzymeblocker': aminoglutethimide. The results of adrenal scintigraphy performed in 37 patients are described. Finally, the literature on adrenal scintigraphy is reviewed, and results reported in various studies are compared. (Auth.)

Bone marrow scintigraphy vs bone scintigraphy and radiography in multiple myeloma

International Nuclear Information System (INIS)

Feggi, M.; Prandini, N.; Orzincolo, C.; Bagni, B.; Scutellari, P.N.; Spanedda, R.; Gennari, M.; Scapoli, C.L.

1988-01-01

The radiography patterns of the skeleton of 73 patients affected by multiple myeloma (MM) were compared to the correspondent scintigraphic findings. Whole body scans were performed using Tc-diphosphonates 99m (bone scintigraphy). And Tc-microcolloides 99m (bone marrow scintigraphy). The results indicate that: a) radiography is more sensitive and accurate than scintigraphy in detecting typical myeloma-related bone lesions; b) bone scintigraphy is useful in detecting alterations in particular locations-i.e. sternum, ribs, scapulae, etc.-which are difficult to demonstrate by plain X-rays; moreover, the recovery of the fractures can be visualized; c) bone marrow scintigraphy is employed to demonstrate the presence of marrow expasion, of cold/hot spots, and relative marrow uptake, related to phagocytic activity. Since in adult men red marrow is confined to the epiphysis of long bones and to the spine, all the diseases affecting bone marrow cause medullary expansion/reduction, which are both easily detected by specific radiopharmaceuticals. The peripheral expasions is clearly documented especially in distal humeri and femora since marrow uptake is included, in healthy adults, in the axial and proximal appendicular skeleton. In spite of its yielding unique informetion, bone marrow scintigraphy remains an additional technique of bone scan, because of its low diagnoditc accuracy

Quantitative HPLC determination of [99mTc]-pertechnetate in radiopharmaceuticals and biological samples: Pt. 1

International Nuclear Information System (INIS)

Tianze Zhou; Hirth, W.W.; Heineman, W.R.; Deutsch, Edward

1988-01-01

Techniques have been developed which allow HPLC (high performance liquid chromatography) to be used for the quantitative determination of [ 99m Tc]pertechnetate in radiopharmaceuticals and biological samples. An instrumental technique accounts for 99m Tc species which do not elute from the HPLC column, while a chemical technique obviates interferences caused by Sn(II). These two techniques are incorporated into an anion exchange HPLC procedure which is applied to the determination of [ 99m Tc]pertechnetate in 99m Tc-diphosphonate radiopharmaceuticals and biological samples. (author)

In patients with well differentiated thyroid carcinoma, the blind administration for 131I for ablation or therapeutical purposes could be avoid

International Nuclear Information System (INIS)

Garcia del Rio, H.; Degrossi, Osvaldo J.; Alak, M. del C.; Balbuena, R.L.; Valest, S.; Copat, L.; Alvarez, L.

2004-01-01

Several physicians considering the possibility of stunning or under rhTSH stimulation, indicate the administration of high activities of 131 I with the uncertainty of the existence of normal or pathological thyroid tissue concentrating radioiodine. This procedure reach its maximum score in the so called 'shoot in the dark' (SD). Other groups of physicians and the medical physics, considering the increasing radio sanitary risk and the dubious results of the use of SD, are not in agree with this position. A third position is the utilization of 123 I, that remains out of possibilities for the majority of the nuclear medicine laboratories. In a effort to conciliate these mismatched positions we propose the following procedure utilizing 99m Tc as pertechnetate, as its radiation dose is negligible compared with dose of radioiodines. We study 2 groups of patients DTC, G-A, 6 patients, 5 female, 1 male, 39-56 years old; with indication of 131 I administration for follow up or therapeutic purposes, 2 with rhTSH stimulation and 4 withdrawing hormone therapy; G-B, 5 patients, 4 females 1 male, 32-92 years old, with indication of scintigraphy previous to 131 I ablation post surgery. In both groups, previous to radioiodine, the same day, 370 MBq of 99m Tc pertechnetate was administered iv and a whole body scan (WBS) and uptake (Up) of positive areas were carried out. Immediately radioiodine was administered, 148 MBq in G-A and 11.1 MBq in G-B and WBS and Up were performed at 48 and 24 hours respectively. In all patients serum figures of TSH, Tg and antibodies anti Tg were obtained. The images obtained with both radioactive tracer were similar in all cases, as well as the active areas with positive uptake values. The Up for both tracer in positive areas was different in agree with the differences in the mechanism of concentration and metabolic behavior. These preliminary results allow us to considered that 99m Tc Up and WBS could be used top determine the possibility of 131 I

Lung scintigraphy

International Nuclear Information System (INIS)

Dalenz, Roberto.

1994-01-01

A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies

Diagnostic and Treatment Patterns Among Children, Adolescents, and Young Adults with Thyroid Cancer in Ontario: 1992-2010.

Science.gov (United States)

Pole, Jason D; Zuk, Aleksandra M; Wasserman, Jonathan D

2017-08-01

Thyroid carcinoma is rare in young children, with a sharp increase in incidence among adolescents and young adults between 15 and 29 years of age. The incidence of thyroid carcinoma is increasing worldwide. Limited prospective population-based data are available to describe diagnostic and treatment practices in this age group. This study undertook a population-based review of thyroid carcinoma among 0- to 29-year-old individuals in Ontario, Canada, utilizing linked administrative data to describe the demographic and care patterns over nearly two decades. Cases from the Ontario Cancer Registry were identified and linked to administrative data sources at the Institute for Clinical Evaluative Sciences. Cases diagnosed prior to a patient's 30th birthday between 1992 and 2010 were considered eligible. Billing records identified ultrasonography, fine-needle aspiration biopsy, radioiodine therapy, and surgical approach. A total of 2552 patients aged 0-29 years were diagnosed with thyroid carcinoma during the study period. There was a 2.1-fold increase in standardized incidence rate over the 19 years of this study. Thyroid carcinoma was diagnosed subsequent to a prior malignancy in 47/2552 patients at a median interval of 11.6 years after initial cancer diagnosis. Seventeen individuals developed a second malignancy after treatment for thyroid carcinoma. Most patients (90.44%) underwent preoperative ultrasound (ranging from 1 to 13 preoperative studies). Preoperative thyroid scintigraphy was used in 44% of patients, with a significant decline in usage over the study period. Fine-needle aspiration biopsy usage rose by 20% over the study period, although 26% of patients had no biopsy prior to surgery. Primary total thyroidectomy followed by two-stage thyroidectomy were the most frequently performed procedures, and 56% of patients received therapeutic radioiodine. This study establishes a foundation of diagnostic and practice patterns over nearly two decades. The study

Analysis of the behavior and characteristics of thyroid lesions identified by biopsy fine needle aspiration and gammagraphic diagnosis: Hospital Calderon Guardia: period 2004-2006

International Nuclear Information System (INIS)

Serrano Frago, Erasmo

2007-01-01

Thyroid lesions have meant one of the most important pathological entities in the Costa Rican population for many years, which have been increased by new diagnostic examinations and early detection and timely thanks to the preventive medicine that is exerted on the security of the country. After the nuclear accident Chernobyl in the former Soviet Union for several decades ago has shown an increase in neoplastic lesions as well as was appreciated after the implementation of the first atomic bomb in World War II, this behavior is the interest to see how thyroid pathology develops in the environment and what have been the Costa Rican experiences in correlation with the expected time to the global statistics. The behavior pattern observed of the lessons of the thyroid gland and based on clinical findings and in some cases together with scintigraphy have allowed to study the development seen through the ultrasound and cytopathological result. The behavior of the patients was similar to global statistics, being most frequent the benign lesions than malignant, and the scintigraphy correlation with lesions were found to be cold was significant for determination of malignant or suspicious for malignancy. Some of these lesions that were suspicious for malignancy scintigraphy and ultrasound were benign have been found to fall within the expected rate for this type of injury. The study consisted of sampling in 2023 noted that the prevalence was 9:1 in women compared with men, which agrees as thyroid diseases are more common in women than in men as well as the expected results in malignant lesions that remained the same behavior. As expected in the age ranges of suffering from thyroid lesions remained between the fifth and sixth decade of life, which has allowed to observe the frequency of different benign and malignant lesions that occurred during this study in the decades and periods covered. While before the study of thyroid lesions was occupied by scintigraphy and

Unilateral parotid concentration of radiogallium: Comparison with bilateral uptake and with pertechnetate imaging

International Nuclear Information System (INIS)

Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-01-01

Unilateral parotid accumulation of radioactivity was noted in 4 elderly (80-95 years) patients after intravenous administration of 67 Ga citrate. In 2 of these individuals, it was possible to carry out pertechnetate salivary gland imaging. The involved glands were functional in terms of pertechnetate accumulation, although no drainage was noted after lemon stimulation. A retrospective analysis of 72 radiogallium studies failed to show unilateral parotid uptake in any of them. However, ten cases (14%) had bilateral parotid accumulation of radiogallium. Probable causes of the bilateral parotid concentration of 67 Ga were discussed. These were compared with poor oral hygiene and dehydration as possible contributing factors to unilateral parotid radiogallium concentration in the elderly. (orig.) [de

Unilateral parotid concentration of radiogallium: Comparison with bilateral uptake and with pertechnetate imaging

Energy Technology Data Exchange (ETDEWEB)

Levy, H.A.; Sziklas, J.J.; Spencer, R.P.; Rosenberg, R.J.

1983-12-01

Unilateral parotid accumulation of radioactivity was noted in 4 elderly (80-95 years) patients after intravenous administration of /sup 67/Ga citrate. In 2 of these individuals, it was possible to carry out pertechnetate salivary gland imaging. The involved glands were functional in terms of pertechnetate accumulation, although no drainage was noted after lemon stimulation. A retrospective analysis of 72 radiogallium studies failed to show unilateral parotid uptake in any of them. However, ten cases (14%) had bilateral parotid accumulation of radiogallium. Probable causes of the bilateral parotid concentration of /sup 67/Ga were discussed. These were compared with poor oral hygiene and dehydration as possible contributing factors to unilateral parotid radiogallium concentration in the elderly.

18F-FDG-PET in the follow-up of thyroid cancer

International Nuclear Information System (INIS)

Lind, P.; Kresnik, E.; Kumnig, G.; Gallowitsch, H.-J.; Igerc, I.; Matschnig, S.; Gomez, I.

2003-01-01

Differentiated thyroid cancer is a rare tumor with an incidence of 4-9/100000/year. For preoperative assessment of thyroid nodules, ultrasonography (US) and US-guided fine needle aspiration biopsy are the methods of choice to detect thyroid cancer. The value of preoperative fluorine-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) in differentiating malignant from benign nodules, especially in cases of follicular proliferation, has not yet been evaluated. After thyroidectomy and radioiodine remnant ablation, several methods are used to follow patients with differentiated thyroid cancer, including serum thyroglobulin, ultrasonography of the neck, iodine-131 ( 131 I) whole body scintigraphy (WBS) and scintigraphy with nonspecific tracers such as technetium-99 m ( 99m Tc) Tetrofosmin or Sestamibi. Whereas the specificity of 131 I-WBS is high, sensitivity is low, especially if one takes into account that only two-thirds of recurrences or metastases store iodine. With the introduction of 18 F-FDG in oncology, it is also used for the detection of local recurrences and metastases of differentiated thyroid cancer. Elevated thyroglobulin but negative 131 I-WBS belongs to the 1a indications for 18 F-FDG-PET in oncology according to the German Consensus Conference 2000. The sensitivity for detecting 131 I-negative metastases with 18 F-FDG-PET can be increased by elevated thyroid-stimulating hormone (TSH) after withdrawal of thyroid hormone therapy or after intra-muscular injection of recombinant TSH. Most of the 131 I-negative metastases demonstrate 18 F-FDG uptake, which represents rapid tumor growth and poor differentiation, whereas most of the 131 I-positive metastases are 18 F-FDG negative. The combination of 131 I-WBS and 18 F-FDG-PET leads to an increase in the detection rate to more than 90-95 % in cases of elevated thyroglobulin, because well- and less-differentiated cancer cells may be present in one patient. In rare cases, a recurrent tumor or

Development of a simulator with thyroid nodules for nuclear medicine

International Nuclear Information System (INIS)

Ferreira, F.C.L.; Peixoto, J.A.; Maciel, M.F.; Souza, D.N.; Cunha, C.J.

2009-01-01

Nuclear medicine is one of the methods used to diagnose diseases by the use of ionizing radiation. In this method, a radioisotope is injected into the patient and is directed to the body that should be evaluated. After this the patient is examined by a scintigraphic chamber, which will result in an image to view the organs evaluated. To verify the ability to view the chambers are made of quality control tests using simulators with objects that may have characteristics similar to that of human organs and systems. In this work, an object was made of acrylic thyroid simulator used for quality control in scintillation chamber for use in teaching morphological analysis of the thyroid. To simulate the thyroid nodules were included in the simulator of acrylic columns with different diameters. The analysis of thyroid scintigraphy was also used for quality control tests. These tests were conducted in scintigraphic chamber GE Millennium MG. In quality control was verified the spatial resolution of the equipment. The radiopharmaceutical used was 99m Tc. The phantom image was closer to an image with the presence of thyroid nodules. The simulator thyroid tested in this work can now be used for quality control tests in other scintillation chambers, enabling students and professionals in nuclear medicine know more about the objects simulators. (author)

Studies on sup(99m)Tc-pertechnetate from the MEK solvent extraction generator

International Nuclear Information System (INIS)

Mohammad, R.; Moore, D.E.; Maddalena, D.J.; Boyd, R.E.

1984-12-01

Analysis by gas chromatography-mass spectrometry and high performance liquid chromatography has revealed organic residues in sup(99m)Tc-pertechnetate obtained from 99 Mo-molybdate by extraction, using the organic solvent methylethylketone (MEK). The organic residues have been identified as either (i) low molecular weight carbonyl compounds such as formaldehyde, acetaldehyde and acetone, presumably caused by the effects of γ-radiation on MEK, or (ii) condensation products resulting from the action of strong alkali on MEK during the extraction process. The quantities of organic residues varied from batch to batch of extracted pertechnetate; up to 40 μ mL -1 was found. When these compounds were tested, in rats, by addition to a pyrophosphate bone-seeking radiopharmaceutical, the tissue distribution was not significantly different from that in the control, which contained no added compound. Assay for 99 Tc in MEK-derived pertechnetate indicated up to 10 μg mL -1 of 99 Tc carrier. An assessment of the biological effect of 99 Tc carrier was obtained by (i) red blood cell labelling, where 6 ng mL -1 of 99 Tc was sufficient to reduce labelling efficiency; and (ii) pyrophosphate tissue distribution, where a significant effect was obtained in the presence of 10 μ mL -1 of 99 Tc carrier

Intrathoracic stomach mimicking bone metastasis from thyroid cancer in whole-body iodine-131 scan diagnosed by SPECT/CT

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Garcia-Gomez, Francisco Javier; Riva-Perez, Pablo Antonio de la; Calvo-Moron, Cinta; Bujan-Lloret, Cristina; Cambil-Molina, Teresa; Castro-Montano, Juan [Dept. of Nuclear Medicine, Virgen Macarena University Hospital, Sevilla (Spain)

2017-05-15

The whole-body iodine-131 scintigraphy is an imaging technique in monitoring patients with a history of thyroid cancer. Although the rate of false positives is negligible, it is not nonexistent. We report the case of an intervened and treated patient for thyroid cancer with good clinical and biochemical response. Scintigraphic findings were consistent with unsuspected bone metastasis. Fused SPECT/CT data allowed accurate diagnosis of giant diaphragmatic hernia associated with intrathoracic stomach, a very rare pathology that can lead to false positive results. (author)

Thyroid cancer in child (about 9 cases)

International Nuclear Information System (INIS)

Ech-Charraq, I.; Ben Rais, N.

2009-01-01

Children thyroid cancer is a very uncommon affection. Its incidence has sharply risen among the patients who underwent therapeutic irradiation and after the Chernobylsk accident in the contaminated regions. Our study consists of emphasizing the distinctive features of children thyroid cancer on the epidemiological, clinical and para clinical aspects, in order to discuss diagnostic difficulties, prognostic elements as well as a therapeutic approach. Through a study conducted in the nuclear medical department of Rabat, we brought together 9 cases of thyroid cancer in children aged between 11 and 15 years old. In our series, the average age is 13 years, with a feminine prevalence. A family notion of goitre is reported in one case, without notion of irradiation, the revealing mode is mainly an euthyroid goitre and the cervical adenopathies, with good general health conditions being maintained. The scintigraphy showed a cold nodule, witch anatomo-pathological examination is papillary carcinoma. Extensive surgery, ira therapy and substitute hormonal treatment combined allowed a high recovery rate among our patients, with no side effects. The medium-term evolution was positive even in metastases cases. The prognostic is generally good, especially in the differentiated forms. (authors)

Hyperthyroidism and thyroid cancer: the diagnosis is not always what is expected. contribution of the SPECT-T.D.M. in the diagnosis; Hyperthyroidie et cancer thyroidien: le diagnostic n'est pas toujours celui attendu. Apport de la TEMP-TDM dans le diagnostic

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Chabert, C.; Garby, L.; Scheiber, C.; Bournaud, C. [Centre de medecine nucleaire, groupement hospitalier Est, Lyon, (France); Picq, R. [service d' endocrinologie, clinique Saint-Charles, Roussillon, (France); Chaix, P.A. [HFME, service de chirurgie gynecologique, (France)

2009-05-15

The objective is to illustrate the interest of a tomo-scintigraphy coupled to computed tomography (SPECT-T.D.M.) in the scintigraphy with iodine 131. Conclusions: The ovarian mature teratomas of several tissues are germinal tumors more often benign ones, able to include some thyroid tissue. This one is in the most of case, non functional and of gynecological presentation. Exceptionally, the thyroid contingent is responsible of a hyperthyroidism whom diagnosis is often delayed. The contribution of hybrid imaging allowed an immediate diagnosis and a fast management of the patient. (N.C.)

Small cell lung cancer with metastasis to the thyroid in a patient with toxic multinodular goiter.

Science.gov (United States)

Ozgu, Eylem Sercan; Gen, Ramazan; Ilvan, Ahmet; Ozge, Cengiz; Polat, Ayşe; Vayisoglu, Yusuf

2012-11-01

Thyroid metastasis of lung cancer is rarely observed in clinical practice. The primary cancers which metastasize to the thyroid gland are mostly renal cell carcinoma, lung cancer, and breast cancer. Transient destructive thyrotoxicosis is caused by massive metastasis of extrathyroid tumors. We herein present a case report of a patient with small cell carcinoma of lung with metastasis to the thyroid and thyrotoxicosis due to toxic multinodular goiter. A 66-year-old man complained of swelling around the right side of the neck, dyspnea, progressive weight loss, and palpitation starting since 3 months before his admission. The patient was diagnosed with small cell carcinoma of lung with metastasis to the thyroid and thyrotoxicosis due to toxic multinodular goiter. The case report presented here illustrates the challenge of making a definitive and adequate diagnosis, particularly if the patient presents with 2 potential causes of thyrotoxicosis. Thyroid scintigraphy is an important tool for differential diagnosis of thyrotoxicosis.

Skeleton scintigraphy in trauma

International Nuclear Information System (INIS)

Ansari, M.

2002-01-01

Skeletal trauma is common and presents both an opportunity and a problem in skeletal scintigraphy. The opportunity arises in the ability of skeletal scintigraphy to demonstrate abnormalities early after direct trauma. It is well recognized that the early detection of fractures in some sites cannot be reliably achieved by standard radiography, especially in the femoral neck and scaphoid bone. The problem comes in recognizing the effects of skeletal trauma when using skeletal scintigraphy for another purpose, such as the detection of metastatic disease. iatrogenic trauma to either the skeleton or soft tissues may be manifest scintigraphic ally. For example Craniotomy typically leaves a rim pattern at the surgical margin. Rib Retraction during thoracotomy can elicit periosteal reaction. Areas of the skeletal receiving curative levels of ionizing radiation (typically 4000 rads or greater) characteristically demonstrate decreased uptake within 6 months to 1 year after therapy. The generally high sensitivity of the skeletal scintigraphy seems to make it an ideal survey test in cases of suspected child abuse especially in which radiographs are unrevealing. Because of difficulties in obtaining a history of trauma from a preschool child or even eliciting a satisfactory description of the location and nature of the pain, skeletal scintigraphy provides a simple and reliable investigation in these children. Subtle trauma, such as that from stress fractures is often difficult to visualize on a plain radiograph. Skeletal scintigraphy is frequently positive at the time of clinical presentation. Skeletal scintigraphy is exquisitely sensitive to the remodeling process and typically shows abnormalities 1 to 2 weeks or more before the appearance of radiographic changes in stress fractures. The periosteal reaction can be visualized within hours of the injury. Insufficiency and fatigue fractures such as vertebral compression fracture, which is probably the most common consequence of

Clinical course, radiodiagnosis and therapy of thyroid cancer in children and juveniles

International Nuclear Information System (INIS)

Tkachenko, G.Yi.; Rozdyil's'kij, S.Yi.; Moskalenko, M.V.; Kyinoshenko, Yu.T.; Astap'jeva, O.M.; Afanas'jeva, N.Yi.; Vasil'jev, L.Ya.; Vyikman, Ya.E.; Lozins'ka, Yi.M.

1995-01-01

One hundred and two patients (18 boys and 84 girls) aged 7-17 with thyroid cancer have been investigated and treated. Whole-body scintigraphy after administration of 37-200 MBq of Na 131 I has been established to be the most informative diagnostic procedure which allows to visualize thyroid tumor and its metastases as well as to determine the tumor functional activity. In metastatic involvement of the lung parenchyma, intensive accumulation of I-131 was observed. After administration of combined radiotherapy resorption of metastatic neck lymphatic nodes occurred 2 years later,disappearance of metastases in the lungs and bones was noted within 6 months'- 5 years period at systematic administration of radioiodine therapy

Thyroid carcinoma: The experience at the Oncology Centre in Nicosia, Cyprus

International Nuclear Information System (INIS)

Frangos, S.; Petrou, M.; Katodritis, N.

2004-01-01

based on ultrasonography, thyroid scintigraphy and FNA. FNA performed in 12 of the 34 patients showed 4 to be negative, 6 positive for papillary, 1 suspicious for papillary, and 1 was positive for follicular but the histopathology showed papillary. Ultrasound done in 15 patients showed one or more nodules in all. Scintigraphy performed in these 15 patients showed cold nodules in 13, normal findings in 1 and Graves' disease in 1 patient. In most of the patients direct radio ablation was done without performing a pre-therapy scan. The ablation dose ranged from 1850 to 4810 MBq. Iodine-131 whole body scan was performed 6 and 18 months after ablation in 16 patients. 11 patients were negative, 4 had residual thyroid tissue and underwent second therapy and 1 had minimal tissue. In the subsequent follow up scan 1 more patients became negative. Thyroxin substitutions in our patients varied from 125mcg to 200mcg without any correlation to body weight. The protocol of ablation was based on the SNM and EANM guidelines for therapy with iodine-131. We chose to give direct therapy without pre-therapy scan to avoid stunning effect. Our experience of iodine-131 treatment in this small number of patients of thyroid cancer showed very promising results. (author)

Clinical Value of Thyrotropin Receptor Antibodies for the Differential Diagnosis of Interferon Induced Thyroiditis.

Science.gov (United States)

Benaiges, D; Garcia-Retortillo, M; Mas, A; Cañete, N; Broquetas, T; Puigvehi, M; Chillarón, J J; Flores-Le Roux, J A; Sagarra, E; Cabrero, B; Zaffalon, D; Solà, R; Pedro-Botet, J; Carrión, J A

2016-01-01

The clinical value of thyrotropin receptor antibodies for the differential diagnosis of thyrotoxicosis induced by pegylated interferon-alpha remains unknown. We analyzed the diagnostic accuracy of thyrotropin receptor antibodies in the differential diagnosis of thyrotoxicosis in patients with chronic hepatitis C (CHC) receiving pegylated interferon-alpha plus ribavirin. Retrospective analysis of 274 patients with CHC receiving pegylated interferon-alpha plus ribavirin. Interferon-induced thyrotoxicosis was classified according to clinical guidelines as Graves disease, autoimmune and non- autoimmune destructive thyroiditis. 48 (17.5%) patients developed hypothyroidism, 17 (6.2%) thyrotoxicosis (6 non- autoimmune destructive thyroiditis, 8 autoimmune destructive thyroiditis and 3 Graves disease) and 22 "de novo" thyrotropin receptor antibodies (all Graves disease, 2 of the 8 autoimmune destructive thyroiditis and 17 with normal thyroid function). The sensitivity and specificity of thyrotropin receptor antibodies for Graves disease diagnosis in patients with thyrotoxicosis were 100 and 85%, respectively. Patients with destructive thyroiditis developed hypothyroidism in 87.5% of autoimmune cases and in none of those with a non- autoimmune etiology (pthyroid scintigraphy for the differential diagnosis of thyrotoxicosis in CHC patients treated with pegylated interferon. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical applications of radioiodine 131 (I131) in the thyroid diseases

International Nuclear Information System (INIS)

Gonzalez Rivero, Levi; Turcios Trista, Silvia Elena; Velasco Mirabal, Milagros

2012-01-01

Radioiodine 131 is a radioactive isotope that is successfully used for the diagnosis and the treatment of benign and malignant thyroid diseases. Its quality of selectively integrating to the thyroid metabolism and emitting a signal allows it to describe the gland functioning through capture studies, and to delimit the morphology and location of the tissues that capture iodine by means of scintigraphy. It is also a simple, safe and cost-effective radiotherapy used as first-line therapeutics in the control of hyperthyroidism. The dose and right time of application should be individualized according to the etiology and the clinic of each patient. Radioiodine 131 offers an efficient alternative to reduce the size of non-toxic goiter in addition to supporting the surgical treatment of the differentiated thyroid carcinoma and destroying with ablative doses the tissular remains and the metastatic lesions that can be detected during the gammagraphic follow-up. Radioiodine 131 depends on the fulfillment of safety regulations against radioactivity

An unusual mature thyroid teratoma on CT and {sup 99}Tcm scintigraphy imaging in a child

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Zhang, Yu-Zhen; Li, Wen-Hua; Li, Yu-Hua; Gao, Yu [Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai (China); Zhu, Ming-Jie [Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai (China); Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Department of Pathology, Shanghai (China)

2010-11-15

We report the imaging findings of a mature thyroid teratoma in a 5-year-old girl. Nuclear imaging showed a decrease in {sup 99}Tcm uptake in the right lobe of the thyroid gland. CT scan showed a slightly lobulated soft-tissue mass without calcification, fat or cystic components. Histological analysis showed that the tumor was composed of mature neural tissue, cartilaginous, and epithelial elements. This case study provides new insights into the CT appearance of mature thyroid teratomas. (orig.)

A case of simultaneous occurrence of Graves′ disease and Hashimoto′s thyroiditis

Directory of Open Access Journals (Sweden)

Anirban Majumder

2012-01-01

Full Text Available Introduction: Simultaneous occurrence of Hashimoto′s thyroiditis (HT, and Graves′ disease (GD is rare. Aims and Objectives: We report a case of simultaneous occurrence of GD and HD, at presentation. Case Report: A 60-year-old lady presented with tremulousness of hands, palpitation, and excessive sweating. She had a history of weight loss and neck-swelling. Her weight was 46 kg, BMI 17, afebrile, regular pulse rate of 110/min with fine tremor in hands. Thyroid gland was symmetrically enlarged, firm, without any bruit, but mildly tender with lobular surface. There were no occular manifestations. Initial thyroid function tests (TFT revealed: T3: 3.80 ng/ml (0.80-2.10, T4: 12.40 ug/dl (5.10-12, thyroid stimulating hormone (TSH: 0.20 μU/L (0.70-5. Her anti thyroperoxidase (TPO antibody: 374 IU/ml (normal [nl.] <35 and TSH receptor antibody: 15 U/L (nl. <1 were both strongly positive. Ultrasonogram of thyroid revealed a hypoechoic enlarged gland. 99mTc pertechnetate scan showed an enlarged gland with increased uptake of radiocontrast: 17% (nl. 0.4-4% with some patchy defects in both lower poles. Thyroid fine needle aspiration cytology (FNAC showed sheets of Hurthle cells with abdunce of lymphocytes indicating HT. She was observed on beta blockers. Repeat TFT, 3 months later showed: T3: 4.20 ng/ml, T4: 14.40 ug/dl, TSH: 0.001 μU/L, with increased uptake on repeat scan. Conclusion: HT rarely occurs following GD. Our case of an elderly lady with no eye signs, lobular, firm tender goiter with patchy uptake in both lower poles on Tc99m scan were odd points in diagnosing isolated GD. FNAC confirmed simultaneous HD with GD.

Improved brain scan specificity utilizing /sup 99m/Tc-pertechnetate and /sup 99m/Tc(Sn)-diphosphonate

International Nuclear Information System (INIS)

Fischer, K.C.; McKusick, K.A.; Pendergrass, H.P.; Potsaid, M.S.

1975-01-01

Each of 36 patients was studied with two separate brain scans performed sequentially after the injection of 20 mCi of /sup 99m/Tc-pertechnetate or 20 mCi of /sup 99m/Tc(Sn)-diphosphonate. The resulting scans were qualitatively compared, and lesion-to-nonlesion ratios of activity determined. Diagnoses were established by clinical criteria and were supported in the majority of cases by computerized axial tomography or roentgen angiography or both. Histologic confirmation was available in five cases of tumor and in the single cases of subdural hematoma and cerebral abscess. Of 22 cerebral infarctions, 15 were better demonstrated with /sup 99m/Tc-(Sn)-diphosphonate than with /sup 99m/Tc-pertechnetate. Of the seven remaining cases, three were visualized equally well with each agent, and three were better demonstrated with /sup 99m/Tc-pertechnetate. One was not seen with either agent. Of the 12 tumors, 11 were visualized better with /sup 99m/Tc-pertechnetate than with /sup 99m/Tc(Sn)-diphosphonate while in one case the lesion was seen equally as well with both agents. In no case was a lesion definitely seen with one radio- pharmaceutical and not with the other. These results indicate that this dual method is helpful in differentiating gliomas and metastases from cerebral infarctions. (U.S.)

Subclinical thyrotoxicosis in an outpatient population - predictors of outcome.

Science.gov (United States)

Schouten, Belinda J; Brownlie, Bevan E W; Frampton, Chris M; Turner, John G

2011-02-01

Individuals with endogenous subclinical thyrotoxicosis (SCT) may subsequently require treatment for overt disease. We aimed to evaluate the frequency of progression to hyperthyroidism and factors influencing this outcome. This is a retrospective analysis of outcome in 96 consecutive patients (aged 16-91 years) diagnosed with SCT over a 6-year period. Individuals with secondary causes of TSH suppression were excluded. Mean follow-up was 3·8 years. The significance of age, gender, family history of thyrotoxicosis, symptoms at presentation, thyroid nodule(s) on clinical examination, entry TSH level, antithyroid antibody status and (99m) Tc pertechnetate thyroid imaging results on subsequent development of overt thyrotoxicosis was assessed. Progression to overt thyrotoxicosis was seen in 8% at 1 year, 16% at 2 years, 21% at 3 years and 26% at 5 years. Multivariate analysis determined that diagnosis as determined by scintiscan to be the only independent predictor of outcome (P = 0·003) with the cumulative percentage requiring therapy at 5 years being 9% for subclinical Graves' disease, 21% for multinodular goitre and 61% for the autonomous nodule subgroup. Progression of SCT to overt hyperthyroidism occurred at a rate of 5-8% per year with disease aetiology, as determined by thyroid scintigraphy, significantly influencing risk of progression. © 2011 Blackwell Publishing Ltd.

Comparison of effects of {sup 131}I treatment for Graves' diseases in Asian countries

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Kitagawa, Mami; Kusakabe, Kiyoko; Kanaya, Kazuko; Kanaya, Shinichi; Noguchi, Yasushi; Maki, Masako [Tokyo Women' s Medical Coll. (Japan); Fukuhisa, Kenjiro; Yamazaki, Toshiro

2001-06-01

For the purpose to establish the standard therapy regimen of Graves' disease, an autoimmune hyperthyroidism, IAEA, since 1994, has been conducting a study on its treatment with {sup 131}I with certain conditions in 10 Asian countries to examine the effect, its dose dependency and area difference. The condition involves, in randomized patients, a low (50-60 Gy) and high (80-90 Gy) dose dependency. This report describes results (summarized in Japan) until the end of March 2000, of 573 patients receiving the treatment for more than 15 months in 9 countries. The {sup 131}I dose (Gy) is calculated by the Quimby equation: 14.7 x EHL (day) x U (%) x Dose (MBq)/W (g) x 3.7 x 100, where W is the thyroid weight determined by thyroid scintigraphy with {sup 99m}Tc-pertechnetate; U, 24 hr iodine uptake by the organ determined by a tracer amount of {sup 131}I; and EHL, effective half life. Evaluation is done on clinical symptoms and thyroid hormones. There is no clear significant difference in doses at present; however, it is considered for the low dose to be suitable in China, India and Japan and for the high dose, in Bangladesh, Singapore and Thailand. (K.H.)

Fluorine-18 fluorodeoxyglucose positron emission tomography in the follow-up of differentiated thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Gruenwald, F [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Schomburg, A [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Bender, H [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Klemm, E [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Menzel, C [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Bultmann, T [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Palmedo, H [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Ruhlmann, J [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Kozak, B [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany); Biersack, H J [Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, D-53127 Bonn (Germany)

1996-03-01

Whole-body fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging was performed during the follow-up of 33 patients suffering from differentiated thyroid cancer. Among them there were 26 patients with papillary and seven with follicular tumours. Primary tumour stage (pT) was pT1 in six cases, pT2 in eight cases, pT3 in three cases and pT4 in 14 cases. FDG PET was normal in 18 patients. In three patients a slightly increased metabolism was observed in the thyroid bed, assumed to be related to remnant tissue. In one case local recurrence, in ten cases lymph node metastases (one false-positive, caused by sarcoidosis) and in three cases distant metastases were found with FDG PET. In comparison with whole-body scintigraphy using iodine-131 (WBS) there were a lot of discrepancies in imaging results. Whereas three patients had distant metastases (proven with {sup 131}I) and a negative FDG PET, in four cases {sup 131}I-negative lymph node metastases were detectable with PET. Even in the patients with concordant ``staging``, differences between {sup 131}I and FDG were observed as to the exact lesion localization. Therefore, a coexistence of {sup 131}I-positive/FDG-negative, {sup 131}I-negative/FDG-positive and {sup 131}I-positive/FDG-positive malignant tissue can be assumed in these patients. A higher correlation of FDG PET was observed with hexakis (2-methoxyisobutylisonitrile) technetium-99m (I) (MIBI) scintigraphy (performed in 20 cases) than with WBS. In highly differentiated tumours {sup 131}I scintigraphy had a high sensitivity, whereas in poorly differentiated carcinomas FDG PET was superior. The clinical use of FDG PET can be recommended in all cases of suspected or proven recurrence and/or metastases of differentiated thyroid cancer and is particularly useful in cases with elevated serum thyroglobulin levels and negative WBS. (orig.). With 3 figs., 2 tabs.

PREDICTION OF RELAPSE FROM HYPERTHYROIDISM FOLLOWING ANTITHYROID MEDICATION WITHDRAWAL USING TECHNETIUM THYROID UPTAKE SCANNING.

Science.gov (United States)

Nakhjavani, Manouchehr; Abdollahi, Soraya; Farzanefar, Saeed; Abousaidi, Mohammadtagi; Esteghamati, Alireza; Naseri, Maryam; Eftekhari, Mohamad; Abbasi, Mehrshad

2017-04-02

Technetium thyroid uptake (TTU) is not inhibited by antithyroid drugs (ATD) and reflects the degree of thyroid stimulation. We intended to predict the relapse rate from hyperthyroidism based on TTU measurement. Out of 44 initially enrolled subjects, 38 patients aged 41.6 ± 14.6 with Graves disease (duration: 84 ± 78 months) completed the study. TTU was performed with 40-second imaging of the neck and mediastinum 20 minutes after injection of 1 mCi technetium-99m pertechnetate. TTU was measured as the percentage of the count of activity accumulated in the thyroidal region minus the mediastinal background uptake to the count of 1 mCi technetium-99m under the same acquisition conditions. Then methimazole was stopped and patients were followed. The optimal TTU cutoff value for Graves relapse prediction was calculated using Youden's J statistic. Hyperthyroidism relapsed in 11 (28.9%) patients 122 ± 96 (range: 15-290) days post-ATD withdrawal. The subjects in remission were followed for 209 ± 81 days (range: 88-390). TTU was significantly higher in patients with forthcoming relapse (12.0 ± 8.0 vs. 3.9 ± 2.0, P = .007). The difference was significant after adjustment for age, sex, history of previous relapse, disease duration, and thyroid-stimulating hormone (TSH) levels before withdrawal. The area under the receiver operative characteristic (ROC) curve was 0.87. The optimal TTU cutoff value for classification of subjects with relapse and remission was 8.7 with sensitivity, specificity, and positive and negative predictive value of 73%, 100%, 100%, and 90%, respectively (odds ratio [OR] = 10.0; 95% confidence interval [CI]: 3.4-29.3). TTU evaluation in hyperthyroid patients receiving antithyroid medication is an accurate and practical method for predicting relapse after ATD withdrawal. ATD = antithyroid drugs RIU = radio-iodine uptake TSH = thyroid-stimulating hormone TSI = thyroid-stimulating immunoglobulin TTU = technetium thyroid uptake.

In-vitro and in-vivo evaluation of diclofenac sodium intramuscular injection using gamma scintigraphy

International Nuclear Information System (INIS)

Soni, S.; Kumar, N.; Mehra, L.; Singh, T.; Mittal, G.; Nishad, D.K.; Sharma, B.G.; Bhatnagar, A.

2010-01-01

Full text: Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) which is available as over-the-counter (OTC) medication for the systemic and topical treatment of painful and inflammatory conditions such as arthritis and back pain. This study was undertaken to investigate the distribution and retention of intramuscularly injected diclofenac sodium (DFN) in white New Zealand rabbit using gamma scintigraphy. A new formulation of the nonselective NSAID diclofenac sodium suitable for intramuscular injection has been developed using sesame oil as a vehicle. The hypothesis of present work is to maintain effective concentration of DFN in blood for prolonged time period. A novel method of radiolabeling with 99m Tc-pertechnetate was adopted using stannous ions as reducing agent. The radiolabeled product was tested for quality control using ascending instant thin layer chromatography (ITLC) technique. ITLC-SG, (Gelman, USA) and acetone were used as the stationary phase and mobile phase respectively in the chromatographic procedure. In vitro and in vivo stability parameters were evaluated. Biodistribution studies and blood kinetics of 99m Tc-DFN was done in balb c mice and white New Zealand rabbit respectively. 99m Tc-DFN retention at depot site was evaluated using gamma scintigraphy. 99m Tc-DFN, when incubated at 37 deg C for 24 hr in normal saline and human serum showed disintegration of only 6.6% and 3.5% respectively, thereby indicating high stability of radiolabeled product. Protein binding studies of 99m Tc-DFN shows more than 85% serum protein binding. Blood clearance of radiopharmaceutical in rabbits, exhibited a biphasic exponential pattern in i.v. bolus while in i.m. linear control release pattern were observed up to 24 hrs

Gamma-scintigraphy; La gammascintigraphie

Energy Technology Data Exchange (ETDEWEB)

Desgrez, H.A. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1960-06-15

Gamma-scintigraphy is a medical technique making it possible to fix the image of certain organs after the concentration in these of emitting radioactive products. It is already widely used in the case of the thyroid gland with iodine-132 by applying the isotope iodine 131. The study of the liver and gall bladder is carried out using colloidal gold 198 and Bengal pink marked with iodine 131. Serum albumin marked with iodine 131 makes it possible to study rachidian blockages. Other applications can already be foreseen in this direction. (author) [French] La gammascintigraphie est une technique medicale permettant de faire l'image de certains organes apres concentration dans ceux-ci de produits radioactifs emetteurs. Son utilisation deja repandue en ce qui concerne la thyroidine et l'iode-131 est possible avec l'iode-132 pour cette meme glande. Avec l'or colloidal 198 et le rose bengale marque a l'iode-131, on pratique des etudes du foie et de la vesicule biliaire. La serumalbumine marquee a l'iode-131 permet d'etudier les blocages rachidiens. D'autres possibilites sont des maintenant envisageables dans cette direction. (auteur)

Gamma-scintigraphy; La gammascintigraphie

Energy Technology Data Exchange (ETDEWEB)

Desgrez, H A [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1960-06-15

Gamma-scintigraphy is a medical technique making it possible to fix the image of certain organs after the concentration in these of emitting radioactive products. It is already widely used in the case of the thyroid gland with iodine-132 by applying the isotope iodine 131. The study of the liver and gall bladder is carried out using colloidal gold 198 and Bengal pink marked with iodine 131. Serum albumin marked with iodine 131 makes it possible to study rachidian blockages. Other applications can already be foreseen in this direction. (author) [French] La gammascintigraphie est une technique medicale permettant de faire l'image de certains organes apres concentration dans ceux-ci de produits radioactifs emetteurs. Son utilisation deja repandue en ce qui concerne la thyroidine et l'iode-131 est possible avec l'iode-132 pour cette meme glande. Avec l'or colloidal 198 et le rose bengale marque a l'iode-131, on pratique des etudes du foie et de la vesicule biliaire. La serumalbumine marquee a l'iode-131 permet d'etudier les blocages rachidiens. D'autres possibilites sont des maintenant envisageables dans cette direction. (auteur)

Subcutaneous injection of 99mTc pertechnetate at acupuncture points K-3 and B-60

International Nuclear Information System (INIS)

Wu Chung-Chieng; Jong Shiang-Bin; Lin Chun-Ching; Chen Min-Fen; Chen Jong-Rern; Chung Chieng.

1990-01-01

The acupuncture points are known to be morphologically related to the nerves and vessels. Yet the physiological role of blood vessels in the formation of acupuncture points remains unknown. With subcutaneous injection of 99m Tc pertechnetate at the acupuncture points K-3 and B-60 and with intra-acupuncture point injection of 99m Tc pertechnetate at K-3 and B-60, a lower-limb venography like what was obtained by intravenous injection of 99m Tc macroaggregated albumin was demonstrated in the present study. It seems that some acupuncture points do play a role in drainage of tissue fluid from soft tissue into the veins. (author)

Comparative orbital scintigraphy with technetium-99m-P829, indium-111-DOTA-Lanreotide and DOTA-Tyr3-octreotide in Graves disease

International Nuclear Information System (INIS)

Burggasser, G.; Hauff, W.; Thaler, A.; Hurtl, I.; Greifeneder, M.; Virgolini, I.; Traub, T.; Dudczak, R.; Angelberger, P.

2002-01-01

Aim: Receptors (R) for somatostatin (SST) are expressed on various tumor cells as well as activated leukocytes and other lymphoproliferative and immune cells. Our previous data have shown that various SST analogs including 111 In-OctreoScan, 111 In-DOTA-Lanreotide (DLAN), 111 In-DOTA-Tyr3-Octreotide (DTOCT) and 99m Tc-P829 bind with high affinity onto many different types of tumor cells as well as to leukocytes via hSSTR target receptors. We have evaluated the orbital uptake of these tracers in patients with active and inactive thyroid-associated orbitopathy. Material and Methods: Clinical grade of the orbital disease was documented in all patients (n=90) by the NOSPECS classification, the clinical activity score (CAS) as well as the supra nasal index (SNI) measured by standardized echography. 99m Tc-P829 scintigraphy (740 MBq) or scintigraphy with one of the 111 In-labeled SST analogs (150 MBq) was performed in patients with thyroid-associated orbitopathy (duration of the disease: 1 - 360 months). In patients undergoing 99m Tc-P829 scintigraphy, SPECT (360 deg.) and planar studies were completed within 3 h post injection, whereas most patients undergoing scintigraphy with 111 In-labeled SST analogs also had a 24 h image acquisition. Orbital (O) regions of interest (ROIs) were opposed to temporo-parietal (TP) and occipital (OCC) ROIs and the O/TP and O/OCC ratios were calculated. Uptake ratios in Graves disease were compared to orbital data calculated from cancer patients without eye disease. Results: Compared to clinical data, a significant correlation was found only for CAS (p 99m Tc-P829 images (three independent observers) despite of somewhat lower uptake both for O/TP as well as O/OCC uptake ratios. 111 In-DLAN and 111 In-DTOCT biokinetics were comparable in Graves disease patients showing a rapid blood clearance and visualization of the orbit within minutes of injection. In patients without active disease (O/(TP+OCC) / 2 ratio: 1.20 +/- 0.09) as well as in

Clinical importance of technetium-99m-methoxyisobutylisonitrile (MIBI) scintigraphy in differentiated thyroid carcinoma patients with elevated thyroglobulin levels and negative I-131 scanning results

International Nuclear Information System (INIS)

Kuecuek, N.O.; Kulak, H.A.; Aras, G.

2006-01-01

The aim of this study was to evaluate the potential contribution of Tc-99m-MIBI scintigraphy to the follow-up of patients with differentiated thyroid carcinoma, who had elevated Tg levels and negative I-131 whole-body scan (WBS) results. In this retrospective study, we evaluated 28 patients with differentiated thyroid carcinoma, who had total or near total thyroidectomy followed by an ablative dose of I-131 at various time intervals (15 women, 13 men; mean age 43±17 years). All patients were treated with T4 suppression. After a mean follow-up period of 6.1 years (range 3-15) all patients were determined to have a high serum Tg concentrations (>2 ng/ml) and previous negative I-131 WBS results. All patients were examined for metastatic sites using Tc-99m-MIBI scan. Scans were visually evaluated for detecting lymph node metastases and/or local recurrence, lung metastases and skeletal metastases. Tc-99m-MIBI scan demonstrated lesions in 23 patients (83.3%). In five patients with negative Tc-99m-MIBI scan findings (FN results): Chest CT showed small-sized mediastinal LN metastases in 2 patients and lung metastases in another 2 patients (<1 cm); Neck CT showed small-sized cervical LN involvement in 1 patient. The sensitivity of detection for neck was 94.4%, for lung 63.6%, and for bone lesions 100%. For all scan sites taken together, the sensitivity of disease detection was 83.3%, the specificity was 50%, positive predictive value (PPV) was 96.2%, and finally negative predictive value (NPV) was 16.7%. We concluded that Tc-99m-MIBI scan should be considered as a supplementary scintigraphic method for the follow-up of patients with high serum Tg levels and negative I-131 WBS results, and it can help clinicians in making the decision to treat these patients. (author)

Liver and spleen scintigraphy

International Nuclear Information System (INIS)

Devries, D.F.

1988-01-01

Since the introduction of liver and spleen scintigraphy in the early 1950s, it has undergone considerable changes, the most notable being technetium 99m sulfur colloid, the gamma camera, and single photon emission computed tomography (SPECT). What is the role f liver-spleen scintigraphy in this high-technology society? This chapter attempts to address this question by looking at the radiopharmaceuticals, the technique, and most importantly, the application of scintigraphy to the diagnosis of focal and diffuse hepatic and splenic disease

The comparison of Tc99m-pertechnetate/mibi subtraction and double phase Tc99m-mibi techniques in parathyroid imaging

International Nuclear Information System (INIS)

Bilkay, Ue.; Erinc, R.; Karapolat, I.; Kumanlioglu, K.

2001-01-01

Experienced parathyroid surgeons can localize nearly %90-95 of the abnormal parathyroid glands with total thyroid bed exploration. For this reason, for the first surgical exploration preoperative imaging of the gland could be considered unnecessary. However, localization of the abnormal parathyroid tissue preoperatively could be beneficial in ectopic adenomas which consists %20 of all adenomas and also in shortening surgical procedure in single adenomas with the use of unilateral exploration. Re-exploration after an unsuccessful surgery is the most widely accepted indication for parathyroid imaging. Today, although Tc99m-MIBI is the accepted radionuclide with the advantages of giving better image quality with lower radiation dose over Tl-201, for imaging hyper functioning parathyroid tissue, there is no consensus on the ideal imaging protocol. Single-tracer double-phase imaging (STDP) and dual-tracer subtraction technique (Tc99m-pertechnetate/Tc99m-MIBI) (DTST) are proposed protocols using Tc99m-MIBI. The aim of this ongoing study is; to compare STDP imaging with DTST and to compare sensitivity of pinhole and high resolution parallel hole images in STDP protocol

Thyroid mass estimation in Grave's disease by SPECT

International Nuclear Information System (INIS)

Pant, G.S.; Sharma, S.K.; Kumar, R.; Pandey, A.K.; Gupta, A.K.

2002-01-01

Aim: One of the important parts of treatment of Grave's disease with I-131 is the delivery of accurate dose to the target volume. Three important parameters that need to be accurately measured for dosimetry are; the 24 hr thyroid uptake (%), the thyroid mass and effective half life of I-131 in the gland. In this presentation we describe the estimation thyroid mass by SPECT. We have standardised a method to estimated thyroid volume by SPECT using thyroid phantoms of different sizes and then used them for routine thyroid mass estimation in patients with Graves' disease. Materials and Methods: Due to variation in thyroid weight in patients with Grave's disease, we standardised the scintigraphic (SPECT) technique using thyroid phantoms of different volumes such as 5 ml, 9.5 ml, 10.5 ml, 35 ml, 80 ml, 101ml and 110 ml. Each phantom was filled with 99 mTc solution with different activity concentration (100 μCi, 300 μCi, 600 μCi and 1.0 μCi) and SPECT images were acquired on a VARICAM dual head camera in 128x128 matrix. The acquired data was processed using a standardised Metz filter but without attenuation or scatter correction. Coronal slices were used with suitable threshold for edge detection. An irregular ROI was plotted around each lobe and isthmus of the thyroid gland and the enclosed slice area was measured. The area measured from all the frames was added and multiplied by the slice thickness to get the volume of the thyroid gland. The estimated volume of each phantom was compared and correlated with its actual volume. The thyroid mass in 40 patients was estimated by SPECT and compared with that estimated by ultrasonography.Results and Conclusion: The results of thyroid mass estimation with SPECT in phantom study suggested a 30% threshold for all phantom volumes. However, 35% threshold was used in patients' images for estimating thyroid volume. The estimated volumes by scintigraphy were compared with that estimated by ultrasonography. A correlation coefficient

The ventricular function after operative correction of chronic mitral insufficiency. Non-invasive study with technetium-99m pertechnetate. First passage technique

International Nuclear Information System (INIS)

Bougioukas, G.

1982-01-01

14 patients (age 49.6 ± 13.3 years) with pure mitral insufficiency of the second to fourth degree underwent an operative intervention on the mitral valve, whereby in 12 cases the valve was replaced and two times the insufficiency could be cleared up with a plastic reconstruction. On the average of 21.6 ± 11 months after the operation a non-invasive study was done with the help of heart scintigraphy 'first passage technique' with Tc 99m pertechnetate at rest and at maximum ergometeric stress. With this method pre- and postoperative end-diastolic volumes (227/ 114 ml), end-systolic volumes (69/ 46 ml), heart minute volumes (4.5/ 5.7 l/min), total output fraction of the left ventricle (61/ 69%), diastolic filling speed and emptying speed of the ventricle were determined as well as the measuring of the lung flow time. The speed of the rapid filling phase gave no indication of a hindrance as a result of an implanted valve or a plastic reconstruction. The changes under stress indicate a normal reaction of the ventricle. This ability to react corresponds clinically to the improvement of the patients on the average of 1.1 degrees according to the NYHA classification. (orig./TRV) [de

Hybrid imaging (SPECT/CT, PET/CT) in differentiated thyroid cancer; Imagerie hybride (TEMP/TDM, TEP/TDM) et cancer differencie de la thyroide

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Bardet, S.; Ciappuccini, R.; Aide, N. [Unite de concertation pluridisciplinaire thyroide, service de medecine nucleaire, centre Francois-Baclesse, 14 - Caen (France); Barraux, V. [Unite de radiophysique, centre Francois-Baclesse, 14 - Caen (France); Rame, J.P. [Chirurgie ORL, centre Francois-Baclesse, 14 - Caen (France)

2010-08-15

Differentiated thyroid cancer (DTC) is generally associated with a good prognosis. Local recurrences, mainly lymph-node involvement, account for 15-20% of cases and are surgically treated. Distant metastases, mostly in lungs and more rarely in bones, are present in 5% of patients. When iodine uptake is sufficient (in approximately 60% of patients), distant metastases can be destroyed by iterative activities of iodine 131. Serum thyroglobulin (Tg), which can be assessed either on hormonal treatment or on TSH stimulation is considered as the tumour marker in DTC. Functional (iodine 131 scintigraphy, FDG PET, bone scintigraphy) or anatomical (neck ultrasound, thoracic CT, bone MRI) imaging methods can be performed when Tg increases in order to show residual/recurrent disease. In recent years, new hybrid equipments integrating both a gamma camera and CT scan (SPECT/CT) have been commercialized while positron emission tomography cameras associated with CT (PET/CT) have been installed on the whole French territory. These equipments, which allow us to directly correlate functional and anatomical images, greatly improve the interpretation of planar scintigraphy or that of PET alone. Hybrid imaging enables us to precisely localize scintigraphic foci and most often, to immediately verify whether they correspond to tumour lesions. The aim of this article is to review the role of SPECT/CT and PET/CT in the management of patients with DTC in 2010. (authors)

First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

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Chen, Louis C; Green, Jennifer B

2011-06-01

Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range disease was the most likely diagnosis. As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

Color-coded duplex sonography in the study of thyroid pathologic conditions

International Nuclear Information System (INIS)

Anguissola, R.; Bozzini, A.; Campani, R.; Bottinelli, O.; Genovese, E.; Guglielmoni, B.; Fulle, I.; Bandi, G.

1991-01-01

The authors examined 110 patients with suspected pathologic conditions of the thyroid by means of color-coded duplex US. In addition to the information yielded by conventional US, this technique allows organ vascularization to be demonstrated. Five normal patients were considered as a control group: no tissue vascularization was demonstrated in these cases. In 8 patients presenting with carcinoma or recurrences, vascularization was markedly increased both peripheral and central to the nodule. A few doubts are still to be solved as to the diagnostic value of color-coded duplex US in the evaluation of non-carcinomas nodular pathologic conditions. As a matter of fact, non-functioning avascular adenomas can be demonstrated only in a very low percentage of cases (66%). Color-coded duplex US proved extremely sensitive and specific in depicting malignant neoplasms. Moreover, the use of fine.needle biopsy could be optimized and subsequently reduced. Color-coded duplex US proved to be markedly superior to othe rmethods and techniques in the study of thyroid diseases, especially thyroiditis and multiple pathologic conditions. The simultaneous presence of hypocapture at scintigraphy and peripheral and central vascularization in a single nodule or within multinodular struma at color-Doppler was highly suggestive of malignant thyroid neoplasm. Color-coded duplex US is a low-cost technique, which can be performed on an outpatient basis. Moreover, it is not invasive, nor does it damage the thyroid. That is why its use is almost mandatory in the study of pathologic conditions of the thyroid

99mTc-RBC subtraction scintigraphy

International Nuclear Information System (INIS)

Inagaki, Syoichi; Tonami, Syuichi; Yasui, Masakazu; Kuranishi, Makoto; Sugishita, Kouki; Nakamura, Mamoru

1994-01-01

Sequential abdominal scintigrams with 99m Tc-labelled red blood cells (RBC) were subtracted for observing a site of gastrointestinal bleeding and calculating the bleeding rate. This method is technically very easy and can detect the site of bleeding with the minimum rate, as low as 0.2 ml/min., in a phantom experiment. In 23 cases with final diagnosis of gastrointestinal bleeding, conventional non-subtraction scintigraphy detected only 30% (7/23), but subtraction scintigraphy detected 61% (14/23). It was concluded that subtraction scintigraphy had higher sensitivity than conventional scintigraphy for early diagnosing bleeding. A combination of non-subtraction and subtraction scintigraphy is recommended to detect a site of gastrointestinal bleeding in a clinical setting. (author)

Percutaneous ethanol injection of hyperfunctioning thyroid nodules: long-term follow-up in 125 patients.

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Tarantino, Luciano; Francica, Giampiero; Sordelli, Ignazio; Sperlongano, Pasquale; Parmeggiani, Domenico; Ripa, Carmine; Parmeggiani, Umberto

2008-03-01

The purpose of this study was to assess the long-term efficacy of percutaneous ethanol injection (PEI) for the treatment of hyperfunctioning thyroid nodules. One hundred twenty-five patients (88 women, 37 men; age range, 17-76 years; mean age, 53 years) with 127 hyperfunctioning thyroid nodules (volume, 1.2-90 mL; mean, 10.3 mL) were treated with PEI. There were 1-11 PEI sessions per patient (average, 3.9) performed, with injection of 1-14 mL of ethanol per session (total injected ethanol per patient, 3-108 mL; mean, 14.0 mL). Efficacy of the treatment was assessed with color Doppler sonography; scintigraphy; and free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) assays. Follow-up (9-144 months; median, 60 months) was performed with TSH and color Doppler sonography every 2 months for 6 months and every 6 months thereafter. Three (2.4%) of 125 patients refused completion of PEI therapy because of pain. Results are reported in 122 patients with 124 nodules. All 122 patients showed posttreatment normal levels of FT3, FT4, and TSH. A complete cure (absent uptake in the nodule and recovery of normal uptake in the thyroid parenchyma) was obtained in 113 (93%) of 122 patients-115 (92.7%) of 124 treated nodules. Residual hyperfunctioning nodular tissue along with decreased thyroid parenchyma uptake (partial cure) was present in nine patients accounting for nine (7.3%) of 124 nodules. Rates of complete cure after PEI were: overall nodules, 115 (92.7%) of 124; nodules nodules > 10 to nodules > 30 to nodules > 60 mL, three (100%) of three. The overall rate of major complications (transient laryngeal nerve damage, two patients; abscess and hematoma, one patient each) was four (3.2%) of 125 patients. Follow-up examinations showed marked shrinkage of 112 treated nodules ranging from 50% to 90% of the pretreatment volume (mean, 66%) and new growth of hyperfunctioning tissue in four patients at color Doppler sonography and scintigraphy at 12

Effect of tumour mass animal gender on specific uptake of [99Tc] pertechnetate in the EMT6 tumor in mice

International Nuclear Information System (INIS)

Maddalena, D.J.; Snowdon, G.M.

1990-01-01

The effects of tumour mass and animal gender on tumour uptake of [ 99m Tc] pertechnetate were examined in balb/c mice bearing an EMT-6 tumour showing high affinity for pertechnetate. The injected dose per gram found in the tumours appears to be inversely related to the tumour mass with good correlation suggesting a high specific uptake. The tumours grown in female mice had greater uptakes and rates of uptake than those grown in the male mice. Studies carried out in animals treated with perchlorate to block active anion transport showed low pertechnetate uptake into the tumours suggesting that the high affinity of 99m TcO 4 - for the tumour was due to a specific 99m TcO 4 - transport mechanism. 15 refs., 3 tabs., 3 figs

Value of radioimmuno-assay of triiodothyronine and thyrotropic hormone in the diagnosis of thyroid disease

International Nuclear Information System (INIS)

Hesch, R.D.; Emrich, D.; Muehlen, A. von zur; Breuel, H.P.; Goettingen Univ.

1975-01-01

Results of a purely in-vitro test were compared with previously available methods in 425 patients. For triiodothyronine, a normal range must be differentiated from the so-called euthyroid range (0.8-2.0 ng/ml) for patients with euthyroid goitre. The accuracy for triiodothyronine is then more than 95% and in hyperthyroidism 97.5%. It is, therefore, superior to other in-vitro measurements. But a disadvantage is that it is easily influenced by thyroid and extrathyroid factors. Similar accuracy is obtained for the TRH function test (thyrotropine-releasing hormone). Notable is a 'negative' TRH test in 20% of patients with euthyroid goitre. The significance of triiodothyronine determination is decreased in autonomous adenoma, in which the TRH test has an accuracy of 96.5%. In rare diseases of the thyroid all diagnostic possibilities must be taken into account. In ordinary practice a stepwise course is suggested. RT 3 U, T 4 , T 3 and thyroid scan with sup(99m)Tc pertechnetate are useful as basic tests. PBI is still thought to be important. The second step involves the TRH test rather than 131 I function test. Triiodothyronine determination is best for therapeutic and follow-up purposes, a situation in which TRH test is of limited value. (orig.) [de

Subcutaneous injection of sup 99m Tc pertechnetate at acupuncture points K-3 and B-60

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Wu Chung-Chieng; Jong Shiang-Bin; Lin Chun-Ching; Chen Min-Fen; Chen Jong-Rern (Kaohsiung Medical Coll., Taiwan (China)); Chung Chieng

1990-06-01

The acupuncture points are known to be morphologically related to the nerves and vessels. Yet the physiological role of blood vessels in the formation of acupuncture points remains unknown. With subcutaneous injection of {sup 99m}Tc pertechnetate at the acupuncture points K-3 and B-60 and with intra-acupuncture point injection of {sup 99m}Tc pertechnetate at K-3 and B-60, a lower-limb venography like what was obtained by intravenous injection of {sup 99m}Tc macroaggregated albumin was demonstrated in the present study. It seems that some acupuncture points do play a role in drainage of tissue fluid from soft tissue into the veins. (author).

Image fusion analysis of 99mTc-HYNIC-octreotide scintigraphy and CT/MRI in patients with thyroid-associated orbitopathy: the importance of the lacrimal gland

International Nuclear Information System (INIS)

Kainz, Hartmann; Donnemiller, Eveline; Gabriel, Michael; Decristoforo, Clemens; Moncayo, Roy; Bale, Reto; Kovacs, Peter

2003-01-01

The aim of this study was to describe the anatomical structures that show uptake of the somatostatin analogue octreotide in patients with thyroid-associated orbitopathy (TAO). The study population comprised a series of 20 TAO patients attending the out-patient thyroid clinic and 12 patients presenting head or neck tumours. Scintigraphy was carried out with our newly developed tracer, technetium-99m labelled EDDA-HYNIC-TOC ( 99m Tc-TOC). Morphological imaging was done with either magnetic resonance imaging or X-ray computed tomography without contrast medium. Both imaging procedures were done within an interval of 3-4 weeks. For the image fusion procedure, specific external reference markers were used for each imaging modality. The markers were screwed onto a reference frame, which was held in place via a vacuum-fixed mouthpiece. The anatomical structure showing tracer uptake that was most frequently recognised was the lacrimal gland, followed by the retronasal area, cervical lymph structures, salivary glands, the anterior insertion points of the extra-ocular muscles and discrete areas of the neck extensor muscles. The lacrimal gland and the retronasal area showed the highest and most frequent uptake of 99m Tc-TOC in TAO patients, whereas such uptake did not occur in the retrobulbar space. In spite of knowledge of these results of image fusion, no changes in the involved structures could be detected on morphological imaging. It is concluded that binding of 99m Tc-TOC is more frequently localised to the anterior compartment of the eye and to the neck. The previously used term ''orbital'' uptake should be abandoned and replaced by a descriptive term relating to the anatomically recognised structure showing tracer accumulation, i.e. the lacrimal gland. The uptake of octreotide by lymphoid and salivary glands opens a new field of investigation related to the physiology of somatostatin. (orig.)

Nivolumab-induced thyroid dysfunction in patients with lung cancer.

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Ramos-Levi, Ana M; Rogado, Jacobo; Sanchez-Torres, Jose Miguel; Colomer, Ramón; Marazuela, Mónica

2018-06-14

Nivolumab is an anti-cancer monoclonal antibody that inhibits PD1 and modulates T-cell response. It has been shown to significantly improve survival in several types of cancer, but clinical trials have also reported an increased risk of developing immune-related adverse events (IRAEs). Endocrine IRAEs may be particularly relevant. To comprehensively evaluate the clinical presentation of endocrine IRAEs in patients with lung cancer treated with nivolumab. Potential risk factors are analyzed, and strategies for IRAE management are proposed. Forty consecutive patients treated with nivolumab for advanced non-small cell lung cancer (NSCLC) were studied, paying particular attention to development of endocrine IRAEs (thyroid, hypophyseal, adrenal, or pancreatic) and clinical outcome. Thyroid function changes were found in 9 patients (22.5%), of which six developed hypothyroidism and three had hyperthyroidism after a median of 3.8 and 2.3 cycles of nivolumab respectively. Only one patient had thyroid-related symptoms. Thyroid autoimmunity was negative in all cases. Hyperthyroid patients showed no uptake in iodine scintigraphy, and their hormone values returned to normal in less than six months. Nivolumab was discontinued for toxicity in one patient. One patient with hyperthyroidism also developed autoimmune diabetes, and one patient with hypothyroidism also had hypogonadism. After a median follow-up of 7.6 months, 25 patients (62.5%) showed response to nivolumab. Univariate and multivariate analyses showed no differences between patients who developed thyroid changes and those who did not. Thyroid changes after treatment with nivolumab are common and warrant active laboratory monitoring. The underlying mechanisms and their relevance deserve further research. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Treatment room length-of-stay and patient throughput with radioiodine thyroid remnant ablation in differentiated thyroid cancer: comparison of thyroid-stimulating hormone stimulation methods.

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Vallejo Casas, Juan Antonio; Mena Bares, Luisa M; Gálvez, María Angeles; Marlowe, Robert J; Latre Romero, José M; Martínez-Paredes, María

2011-09-01

We sought to empirically compare treatment room length-of-stay and patient throughput for recombinant human thyroid-stimulating hormone (rhTSH)-aided thyroid remnant ablation with thyroid hormone withdrawal (THW)-aided ablation in patients with differentiated thyroid carcinoma (DTC). We retrospectively reviewed charts of all eligible (near) totally thyroidectomized patients with DTC undergoing ablation and 1-year ablation success evaluation at our tertiary referral centre from January 2003 to February 2009 (N=274). M1 disease caused exclusion unless discovered by a postablation scan or present when rhTSH was the only tolerable stimulation method. We extracted data on the length-of-stay, defined as the time between treatment room admission and discharge, and patient throughput, defined as patients ablated per treatment room per week. The treatment room discharge criterion was a whole-body dose rate of less than 60 μSv/h at 50 cm. The treatment groups (rhTSH, n=187; THW, n=87) had mostly statistically similar characteristics, but differed in primary tumour status distribution. In addition, at ablation, the rhTSH patients had a greater prevalence of prior diagnostic scintigraphy, higher mean serum TSH, and shorter interval since surgery, and received a 5.6% larger mean ablation activity. On average, rhTSH patients had a significantly lower peak whole-body dose rate (57.1 vs. 83.4 μSv/h at 50 cm; P<0.0001) and a significantly shorter treatment room stay than did the THW patients (1.41 vs. 2.02 days; P<0.001). rhTSH use allowed significantly more patients to be ablated per room per week (2.7 vs. 1.2; P<0.001). Relative to THW, rhTSH use to aid ablation reduced mean treatment room length-of-stay by almost one-third and more than doubled the average weekly patient throughput, both of which were significant differences.

Adrenal scintigraphy using 131I-Adosterol

International Nuclear Information System (INIS)

Fukunaga, Masao; Dokoh, Shigeharu; Yamamoto, Itsuo; Morita, Rikushi; Torizuka, Kanji

1977-01-01

131 I-Adosterol (6β-iodomethyl-19-norcholest-5(10)-3β-ol) was administered to evaluate adrenal grand in 20 patients including 9 patients with primary aldosteronism, 5 with Cushing's syndrome, one with pheochromocytoma, one with retroperitoneal tumor, 3 with essential hypertension and one with obesity. Standard scintigraphies were performed at 3rd day and again 6th day after administration of 131 I-adosterol (1-1.5 mCi). Suppression scintigraphies were obtained while the patients were taking dexamethasone 2 to 3 mg daily from 3 days prior to injection of the tracer until adrenal imaging. In the cases with essential hypertension and obesity, both adrenal glands were delineated equally by standard scintigraphy, and in one patient, undergone suppression scintigraphy, the uptake of 131 I-adosterol by both glands were completely inhibited by dexamethasone administration. In primary aldosteronism, six of the 9 patients demonstrated the increased radioactivity in one side, and were diagnosed as aldosteronoma. In 3 cases, failed to show the lesions on standard scintigraphy, the lesions could be detected by suppression scintigraphy, and aldosteronomas measuring 1 x 1 x 0.7, 2 x 2 x 1 and 1.7 x 1.5 x 0.8 cm were confirmed by operation. In Cushing's syndrome, standard scintigraphy could easily distinguish between adenoma (one case) and bilateral hyperplasia (4 cases). Adrenal scintigraphy was also a useful method in order to assess the effect of pituitary irradiation therapy in the case of hyperplasia. In pheochromocytoma and retroperitoneal tumor, the side of the lesion was identified by the absence of a functioning gland. Suppression scintigraphy was particularly useful in detecting the localization of the small tumor in primary aldosteronism. (auth.)

Comparison of whole-body 18F-FDG PET, 99mTc-MIBI SPET, and post-therapeutic 131I-Na scintigraphy in the detection of metastatic thyroid cancer

International Nuclear Information System (INIS)

Iwata, Masahiro; Kasagi, Kanji; Misaki, Takashi; Matsumoto, Keiichi; Nakamoto, Yuji; Iida, Yasuhiro; Ishimori, Takayoshi; Higashi, Tatsuya; Saga, Tsuneo; Konishi, Junji

2004-01-01

The usefulness of fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) in differentiated thyroid cancer (DTC) has been demonstrated by many investigators, but in only a small number of studies have FDG-PET images been compared with those obtained using other non-iodine tumour-seeking radiopharmaceuticals. In most of the studies, planar imaging was performed for comparison using thallium-201 chloride or technetium-99m 2-methoxyisobutylisonitrile ( 99m Tc-MIBI). Furthermore, FDG-PET studies were not always performed in the hypothyroid state with increased levels of thyroid stimulating hormone (TSH), which are known to increase FDG uptake by DTC. The aim of this study was to compare the ability of FDG-PET to detect metastatic DTC with that of 99m Tc-MIBI whole-body single-photon emission tomography (SPET) and post-therapeutic iodine-131 scintigraphy, evaluated under TSH stimulation. Nineteen patients (8 men, 11 women; age range, 38-72 years, mean 60 years; 17 thyroidectomised and 2 inoperable patients following 131 I ablation of the remaining thyroid tissue; 16 papillary and 3 follicular carcinomas) with metastatic DTC underwent FDG-PET whole-body scan (WBS) and 99m Tc-MIBI SPET WBS at an interval of less than 1 week, followed by 131 I therapy. The SPET images were reconstructed using the maximum likelihood expectation maximisation (ML-EM) method. All patients were hypothyroid at the time of each scan. 131 I WBS was performed 3-5 days after oral administration of the therapeutic dose. A total of 32 lesions [10 lymph node (LN), 15 lung, 6 bone, 1 muscle] were diagnosed as metastases, as confirmed by histopathology and/or other imaging modalities (X-ray, US, CT, MRI, bone, 201 Tl and 131 I scans). FDG-PET, 99m Tc-MIBI SPET and post-therapeutic 131 I scintigraphy respectively revealed a total of 26 (81.3%), 20 (62.5%) and 22 (68.8%) lesions. These techniques respectively demonstrated nine (90.0%), eight (80.0%) and six (60.0%) LN metastases, and eleven

Evaluation of percutaneous ethanol injections in benign thyroid nodules.

Science.gov (United States)

Perez, Camila Luhm Silva; Fighera, Tayane Muniz; Miasaki, Fabiola; Mesa Junior, Cleo Otaviano; Paz Filho, Gilberto Jorge da; Graf, Hans; Carvalho, Gisah Amaral de

2014-12-01

The objective of this study was to evaluate the efficacy and safety of percutaneous ethanol injection (PEI) in the treatment of benign thyroid nodules. We evaluated 120 patients with benign thyroid nodules. Patients underwent evaluation of serum TSH and free T4, cervical ultrasound, and thyroid scintigraphy (in those with suppressed TSH levels). The application of sterile ethanol 99% was guided by ultrasound, with the injected volume amounting to one-third of the nodule volume. Response was considered complete (reduction of 90%); partial (reduction between 50 and 90%); or none (reduction of nodules were evaluated for normalization of TSH levels. Among the nodules studied, 30.8% were solid, 56.7% were mixed, 12.5% were cystic, and 21.6% were hyperfunctioning. The initial volume of the treated nodules ranged from 0.9 to 74.8 mL (mean 13.1 ± 12.4 mL). We performed 1-8 sessions of PEI, applying an average of 6.2 mL of ethanol for patient. After 2 years of follow-up, 17% of patients achieved a complete response (94% reduction); 53%, a partial response (70% reduction); and 30%, no response. A reduction in the volume of autonomous nodules was noted in 70% of cases, and 54% had a normalized value of TSH. The main side effect is local pain, lasting less than 24 hours in most cases. This study showed that PEI is a safe and effective procedure for treatment of benign, solid or mixed thyroid nodules. Most cases resulted in significant reduction in nodule volume, with normalization of thyroid function.

Scintigraphy of spinal disorders in adolescents

Energy Technology Data Exchange (ETDEWEB)

Mandell, G.A. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States)); Harcke, H.T. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States))

1993-08-01

Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

Scintigraphy of spinal disorders in adolescents

International Nuclear Information System (INIS)

Mandell, G.A.; Harcke, H.T.

1993-01-01

Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

Reduction And Sequestration Of Pertechnetate To Technetium Dioxide And Protection From Reoxidation

International Nuclear Information System (INIS)

Duncan, J. B.; Johnson, J. M.; Moore, R. C.; Hagerty, K.; Rhodes, R. N.; Huber, H. J.; Moore, W. P.

2012-01-01

This effort is part of the technetium management initiative and provides data for the handling and disposition of technetium. To that end, the objective of this effort was to challenge tin(lI)apatite (Sn(II)apatite) against double-shell tank 241-AN-105 simulant spiked with pertechnetate (TcO 4 ). The Sn(II)apatite used in this effort was synthesized on site using a recipe developed at and provided by Sandia National Laboratories; the synthesis provides a high quality product while requiring minimal laboratory effort. The Sn(ll)apatite reduces pertechnetate from the mobile +7 oxidation state to the non-mobile +4 oxidation state. It also sequesters the technetium and does not allow for re-oxidization to the mobile +7 state under acidic or oxygenated conditions within the tested period of time (6 weeks). Previous work indicated that the Sn(II) apatite can achieve an ANSI leachability index in Cast Stone of 12.8. The technetium distribution coefficient for Sn(lI)apatite exhibited a direct correlation with the pH of the technetium-spiked simulant media

Lung scintigraphy; Centellograma pulmonar

Energy Technology Data Exchange (ETDEWEB)

Dalenz, Roberto

1994-12-31

A review of lung scintigraphy, perfusion scintigraphy with SPECT, lung ventilation SPECT, blood pool SPECT. The procedure of lung perfusion studies, radiopharmaceutical, administration and clinical applications, imaging processing .Results encountered and evaluation criteria after Biello and Pioped. Recommendations and general considerations have been studied about relation of this radiopharmaceutical with other pathologies.

A case of metastatic follicular thyroid carcinoma complicated with Graves' disease after total thyroidectomy.

Science.gov (United States)

Aoyama, Mariko; Takizawa, Hiromitsu; Tsuboi, Mitsuhiro; Nakagawa, Yasushi; Tangoku, Akira

2017-12-28

Thyroid cancer and Graves' disease may present simultaneously in one patient. The incidence of the development of hyperthyroidism from metastatic differentiated thyroid carcinoma is rare. We herein report a case of metastatic follicular carcinoma complicated with Graves' disease after total thyroidectomy. A 57-year-old woman underwent right hemithyroidectomy for follicular carcinoma. Metastatic lesions appeared in the lungs and skull two years after the first surgery, and remnant thyroidectomy was performed for radioactive iodine-131 (RAI) therapy, during which the TSH receptor antibody (TRAb) was found to be negative. The patient was treated with RAI therapy four times for four years and was receiving levothyroxine suppressive therapy. Although radioiodine uptake was observed in the lesions after the fourth course of RAI therapy, metastatic lesions had progressed. Four years after the second surgery, she had heart palpitations and tremors. Laboratory data revealed hyperthyroidism and positive TRAb. She was diagnosed with Graves' disease and received a fifth course of RAI therapy. 131I scintigraphy after RAI therapy showed strong radioiodine uptake in the metastatic lesions. As a result, the sizes and numbers of metastatic lesions decreased, and thyroid function improved. Metastatic lesions produced thyroid hormone and caused hyperthyroidism. RAI therapy was effective for Graves' disease and thyroid carcinoma.

Adjuvant thyroid remnant ablation in patients with differentiated thyroid carcinoma confined to the thyroid. A comparison of ablation success with different activities of radioiodine (I-131)

International Nuclear Information System (INIS)

Prpic, M.; Dabelic, N.; Stanicic, J.; Jukic, T.; Kusic, Z.; Milosevic, M.

2012-01-01

The objective of this study was to assess efficiency of various I-131 activities on thyroid remnant ablation in thyroid cancer patients. The significance of patients' characteristics, pathologic features and levels of Tg were analyzed. This study included 259 consecutive differentiated thyroid cancer patients, with disease confined to the thyroid, treated with I-131 after total thyroidectomy. Patients were divided into the three groups: 80 patients receiving low [1110-1850 MBq (30-50 mCi)], 121 intermediate [2775 MBq (75 mCi)] and 58 high [3700 MBq (100 mCi)] postoperative I-131 activities. Six to eight months after the application of radioiodine, measurements of TSH, Tg, anti-Tg antibodies (in hypothyroid state) together with ultrasound exam and whole-body scintigraphy were performed. The ablation was significantly more effective (after the first application) in patients receiving 100 mCi of I-131-89.7% than in patients receiving lower activities (P=0.016). There was no significant difference in ablation rate between the 30-50 mCi (77.5%) and 75 mCi (70.2%) groups. In the group receiving 30-50 mCi, patients with solitary tumors had significantly higher ablation rate (P=0.038). In patients receiving 75 mCi ablation rates were higher among older patients (P=0.005), with infiltration of the single lobe (P=0.005), and with solitary tumor (P=0.012). The rates of successful ablation after the second application of I-131 (after 12-16 months) amounted to 96, 97 and 96% in the 30-50, 75 and 100 mCi groups, respectively. The activity of I-131 and age were independent factors for thyroid ablation failure after the first application of I-131 (model of binary logistic regression). The results of remnant ablation were satisfactory with all activities applied. Although after the first application of I-131 the activity of 100 mCi is significantly more effective in thyroid ablation than the administration of 30-50 mCi and 75 mCi, the ablation rates between all the three groups are

Interferon-alpha-induced destructive thyroiditis followed by Graves' disease in a patient with chronic hepatitis C: a case report.

Science.gov (United States)

Kim, Bu Kyung; Choi, Young Sik; Park, Yo Han; Lee, Sang Uk

2011-12-01

Interferon-induced thyroiditis (IIT) is a major clinical problem for patients receiving interferon-alpha (IFN-α) therapy. But, destructive thyroiditis followed by Graves' disease associated with IFN-α therapy is very rarely reported. Herein, we report a rare case of pegylated IFN-α (pegIFN-α) induced destructive thyroiditis followed by Graves' disease in a patient with HCV infection. A 31-yr-old woman suffered from chronic active hepatitis C and was treated with pegIFN-α and ribavirin for 12 months. Results of a thyroid function test and autoantibody levels were normal before IFN-α therapy was initiated. Destructive thyrotoxicosis appeared seven months after the initiation of IFN-α therapy, followed by Graves' thyrotoxicosis two months after the cessation of therapy. The diagnoses of destructive thyroiditis and Graves' disease were confirmed by the presence of TSH receptor antibodies in addition to Tc-99m scintigraphy findings. The patient's antithyroglobulin antibody titer increased gradually during IFN-α therapy and remained weakly positive after IFN-α therapy was discontinued.

Lacrimal scintigraphy in the diagnosis of epiphora

International Nuclear Information System (INIS)

Hanna, I.T.; MacEwen, C.J.; Kennedy, N.

1992-01-01

The value of lacrimal scintigraphy in the assessment of nasolacrimal duct obstruction was determined by comparing the results with syringing in 67 patients (83 eyes). As expected, of 28 lacrimal drainage systems which were obstructed on syringing, 23 (82%) had abnormalities of tear drainage on scintigraphy. However, in 55 lacrimal drainage systems that were patent on syringing, 19 (35%) were normal, but in 36 (65%) abnormalities not apparent on syringing were detected on scintigraphy. Thus scintigraphy is a very useful technique in the assessment of nasolacrimal duct obstruction particularly in systems patent on syringing. Since the site of obstruction can be determined, lacrimal scintigraphy can facilitate the planning of the appropriate surgery. (author)

The efficacy of Per-rectal portal scintigraphy with Tc-99m pertechnetate for evaluation of prognosis in the early phase of cirrhosis caused by hepatitis virus

International Nuclear Information System (INIS)

Etsushi Kawamura; Daiki Habu; Takehiro Hayashi; Ai Oe; Jin Kotani; Hirotaka Ishizu; Kenji Torii; Joji Kawabe; Takashi Tanaka; Shuhei nishiguchi; Susumu Shiomi

2004-01-01

Purpose: Hepatitis C virus (HCV) is the commonest cause of chronic liver diseases in several countries, including Japan, and is becoming a topic of worldwide interest. Chronic hepatitis due to HCV (CH-C) is common, but its clinical course has not been fully defined. Despite treatments including injection of interferon plus peroral ribavirin, many patients with CH-C develop cirrhosis of the liver (LC). Thus we tried to establish a non-invasive and effective means of evaluating the prognosis of patients with LC-C as an alternative to classic indicators such as serum biochemical tests, The portal shunt index (SI) obtained by per-rectal portal scintigraphy is a non-invasive test for evaluating the portal circulation and hepatic functional reserve in cirrhosis. Methods: Scintigraphy with Tc-99m pertechnetate was performed in 122 patients (group A; 37 of SI≤10%, group B; 46 of 10%< SI<30%, group C; 39 of 30% ≤ SI) with LC-C of Child's grade A who attended our hospital over a period 24 years. 370 MBq of Tc-99m pertechnetate was given into the upper rectum and summed color images were recorded. The portal SI was calculated from the rate of counts for the heart to counts for the heart and liver integrated for 24 seconds immediately after the appearance of the liver time-activity curve. Statistical analyses were done using Student's t test or the Wilcoxon rank sum test where appropriate for continuous variables, Regression analyses with Cox's proportional hazards model were done using Statistical Analysis System version 8,2. We evaluated the following factors in predicting the outcomes of interest (progression to HCC, Child's grade B, or esophagogastric varices): sex, age, albumin, total bilirubin (T-bil), prothrombin time (PT), ICG test, cholinesterase, total cholesterol (T-chol), and platelets. Results: The cumulative incidence rate of hepatocellular carcinoma (HCC) was not significantly higher in group B than in group A, in group C than in group A, or in group C than