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Sample records for remnant thyroid ablation

  1. Efficacy of different I-131 doses for thyroid remnant ablation

    International Nuclear Information System (INIS)

    Nguyen, X.C.; Thiep, T.V.; Hung, N.C.

    2007-01-01

    Full text: Radioactive iodine 131 I has been widely used as a treatment modality of differentiated thyroid carcinoma. The need for high dose radioiodine ablation of thyroid remnant is still in question. The aim of this prospective study was to assess the efficacy of 131 I different single and fractionated doses in ablation of post-operative thyroid remnant. Patients and methods: One hundred-twelve patients were included in this study. Sixty-one patients with TSH≥30 μU/ml were treated 30 mCi in group 1 (36 patients) or 100 mCi in group 2 (25 patients). Fifty one patients with TSH 131 I high dose of 100 mCi and no severe adverse effect in the other groups. Conclusion: Single high dose (100 mCi) may be more efficient than single low dose (30 mCi) for post-operative remnant ablation with serum TSH≥30 μU/ml and the efficacy of low fractionated doses (30+30 mCi) was comparable with high-fractionated dose (30+100 mCi) for post-operative remnant ablation with low serum TSH in differentiated thyroid carcinoma. (author)

  2. Protocol for thyroid remnant ablation after recombinant TSH in thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, F.; Salvai, M.E.; Niepomniszcze, H.; Tamer, E. El

    2009-01-01

    In some countries, in order to perform rhTSH-aided thyroid remnant ablation (TRA) after surgery, it is generally necessary to confirm that thyroidectomy has been almost complete. Otherwise, the nuclear medicine specialist will not administer a high radioiodine dose because it might be hazardous due to the possibility of thyroid remnant actinic thyroiditis. Considering this, it would be necessary to use two rhTSH kits (one for diagnostic purposes and the other one to administer the 131 I dose). In this study, we used an alternative protocol for TRA with the use of one kit of rhTSH in twenty patients diagnosed with low risk papillary thyroid carcinoma. All patients had negative titers of anti-thyroglobulin antibodies. Successful thyroid remnant ablation was confirmed with an undetectable rhTSH stimulated thyroglobulin level ( [es

  3. Temporary ovarian failure in thyroid cancer patients after thyroid remnant ablation with radioactive iodine

    International Nuclear Information System (INIS)

    Raymond, J.P.; Izembart, M.; Marliac, V.; Dagousset, F.; Merceron, R.E.; Vulpillat, M.; Vallee, G.

    1989-01-01

    We studied ovarian function retrospectively in 66 women who had regular menstrual cycles before undergoing complete thyroidectomy for differentiated thyroid cancer and subsequent thyroid remnant ablation with 131 I. Eighteen women developed temporary amenorrhea accompanied by increased serum gonadotropin concentrations during the first year after 131 I therapy. No correlation was found between the radioactive iodine dose absorbed, thyroid uptake before treatment, oral contraceptive use, or thyroid autoimmunity. Only age was a determining factor, with the older women being the most affected. We conclude that radioiodine ablation therapy is followed by transient ovarian failure, especially in older women

  4. Temporary ovarian failure in thyroid cancer patients after thyroid remnant ablation with radioactive iodine

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    Raymond, J.P.; Izembart, M.; Marliac, V.; Dagousset, F.; Merceron, R.E.; Vulpillat, M.; Vallee, G.

    1989-07-01

    We studied ovarian function retrospectively in 66 women who had regular menstrual cycles before undergoing complete thyroidectomy for differentiated thyroid cancer and subsequent thyroid remnant ablation with /sup 131/I. Eighteen women developed temporary amenorrhea accompanied by increased serum gonadotropin concentrations during the first year after /sup 131/I therapy. No correlation was found between the radioactive iodine dose absorbed, thyroid uptake before treatment, oral contraceptive use, or thyroid autoimmunity. Only age was a determining factor, with the older women being the most affected. We conclude that radioiodine ablation therapy is followed by transient ovarian failure, especially in older women.

  5. Effect of Hashimoto thyroiditis on low-dose radioactive-iodine remnant ablation.

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    Kwon, Hyungju; Choi, June Young; Moon, Jae Hoon; Park, Hyo Jin; Lee, Won Woo; Lee, Kyu Eun

    2016-04-01

    Radioactive-iodine remnant ablation is an integral part of the papillary thyroid carcinoma (PTC) treatment. Although a minimum dose is usually recommended, there is controversy as to whether the low-dose (1100 MBq) radioactive-iodine remnant ablation is adequate for selected patients. A retrospective cohort study was conducted on 691 patients. Patients with no remnant thyroid on the follow-up whole body scan and low stimulated thyroglobulin (sTg) level (Hashimoto thyroiditis based on histopathology diagnosis (odds ratio [OR] = 3.23; p Hashimoto thyroiditis and elevated sTg are negative predictive factors for successful low-dose radioactive-iodine remnant ablation treatment. An appropriate risk-adjusted approach may improve the efficacy of radioactive-iodine remnant ablation treatment. © 2015 Wiley Periodicals, Inc. Head Neck 38: E730-E735, 2016. © 2015 Wiley Periodicals, Inc.

  6. Combined use of radioiodine therapy and radiofrequency ablation in treating postsurgical thyroid remnant of differentiated thyroid carcinoma

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    Bin Long

    2015-01-01

    Conclusion: Combined use of RAI therapy and radiofrequency ablation in treating excessive postsurgical thyroid remnant of DTC can be an effective approach and avoids re-operation. Long-term efficacy monitoring would further determine its feasibility.

  7. 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

  8. Radioiodine remnant ablation in differentiated thyroid cancer after combined endogenous and exogenous TSH stimulation.

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    Vrachimis, A; Schober, O; Riemann, B

    2012-01-01

    Radioiodine remnant ablation (RRA) after (near-)total thyroidectomy (TE) is a key element in patients with differentiated thyroid cancer (DTC). The use of exogenous TSH stimulation (rhTSH) prior to RRA has shown promising results as compared to conventional thyroid hormone withdrawal (THW). As yet, the efficacy of RRA after brief THW and single rhTSH administration has not been assessed. The study sample comprised 147 patients with DTC referred to our center between May 2008 and September 2010. All patients received TE with subsequent RRA. None of these 147 patients had evidence of distant metastasis. 93 patients had endogenous TSH stimulation 4-5 weeks after surgery (group I) and twenty-six received two rhTSH injections (group II). 28 patients were treated with a single rhTSH injection after a brief THW (group III). RRA-Efficacy was assessed three months after therapy by diagnostic whole-body scan and measurement of the tumour marker thyroglobulin (Tg) under TSH stimulation. Three categories of success were defined for remnant ablation. Based on the definition of successful remnant ablation no visible uptake and a Tg ≤ 2.0 ng/ml (category 1) was seen in 62/93 patients in group I, in 17/26 patients in group II (p = n.s.) and in 12/28 patients in group III (p 2.0 ng/ml (category 3) was found in 3/93 patients in group I and 1/26 patients in group II but in no patient in group III. The third strategy of remnant ablation using a single injection of rhTSH after a brief THW period resulted in a significant higher rate of patients with residual uptake in the thyroid bed and a Tg level below 2 ng/ml three months after remnant ablation in comparison to THW. However, the overall efficacy of the third protocol was not significantly different as compared to two rhTSH injections. Under the aspect of the supply shortage of rhTSH the combined endogenous and exogenous TSH stimulation may be an attractive alternative for remnant ablation in differentiated thyroid cancer.

  9. 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

  10. Thyroid remnant ablation success and disease outcome in stage III or IV differentiated thyroid carcinoma: recombinant human thyrotropin versus thyroid hormone withdrawal.

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    Vallejo Casas, Juan A; Mena Bares, Luisa M; Gálvez Moreno, Maria A; Moreno Ortega, Estefanía; Marlowe, Robert J; Maza Muret, Francisco R; Albalá González, María D

    2016-06-01

    Most publications to date compare outcomes after post-surgical thyroid remnant ablation stimulated by recombinant human thyrotropin (rhTSH) versus thyroid hormone withholding/withdrawal (THW) in low-recurrence risk differentiated thyroid carcinoma (DTC) patients. We sought to perform this comparison in high-risk patients. We retrospectively analyzed ~9-year single-center experience in 70 consecutive adults with initial UICC (Union for International Cancer Control) stage III/IV, M0 DTC undergoing rhTSH-aided (N.=54) or THW-aided (N.=16) high-activity ablation. Endpoints included ablation success and DTC outcome. Assessed ≥1 year post-ablation, ablation success comprised a) no visible scintigraphic thyroid bed uptake or pathological extra-thyroidal uptake; b) undetectable stimulated serum thyroglobulin (Tg) without interfering autoantibodies; c) both criteria. DTC outcome, determined at the latest visit, comprised either 1) "no evidence of disease" (NED): undetectable Tg, negative Tg autoantibodies, negative most recent whole-body scan, no suspicious findings clinically, on neck ultrasonography, or on other imaging; 2) persistent disease: failure to attain NED; or 3) recurrence: loss of NED. After the first ablative activity, ablation success by scintigraphic plus biochemical criteria was 64.8% in rhTSH patients, 56.3% in THW patients (P=NS). After 3.5-year versus 6.2-year median follow-up (P<0.05), DTC outcomes were NED, 85.2%, persistent disease, 13.0%, recurrence, 1.9%, in the rhTSH group and NED, 87.5%, persistent or recurrent disease, 6.3% each, in the THW group (P=NS). In patients with initial stage III/IV, M0 DTC, rhTSH-aided and THW-assisted ablation were associated with comparable remnant eradication or DTC cure rates.

  11. The efficacy of radioiodine remnant ablation for differentiated thyroid carcinoma patients with an incomplete thyroidectomy

    International Nuclear Information System (INIS)

    FU, Hongliang; MA, Chao; LI, Jianing; FENG, Fang; WU, Shuqi; YE, Zhiyi; WANG, Hui

    2016-01-01

    The aim of this study was to evaluate the efficacy of radioiodine remnant ablation (RRA) for differentiated thyroid carcinoma (DTC) patients with an incomplete thyroidectomy. The medical histories of post surgical DTC patients who accepted RRA between 2010 and 2012 were retrospectively reviewed. Among them, 113 patients who had undergone a total or near-total thyroidectomy comprised the complete thyroidectomy group (CT group) and the remaining 40 patients who had undergone a lobectomy or sub-total thyroidectomy comprised the incomplete thyroidectomy group (ICT group). The difference in the patients’ age, gender, histology, serum TSH level and 24hr radioactive iodine uptake (RIU) between the two groups was analyzed by χ2 Test or ANOVA. The efficacy of RRA in ICT group was evaluated by comparing its rate of complete ablation after the first RRA and its cumulative rate of complete ablation after the second RRA to the rate of complete ablation after the first RRA in CT group respectively by χ2 Test. Of all the clinical characteristics, only serum TSH level and 24hr RIU have significant difference between two groups (P<0.01 for both). The rate of complete ablation after the first RRA was 67.26% in CT group. The rate of complete ablation after the first RRA and the cumulative rate of complete ablation after the second RRA was 27.50% and 67.50% respectively in ICT group. The ablative rate of the first RRA between the two groups was compared by χ2 Test and the difference was significant (P<0.01). The ablative rate of the first RRA in CT group was compared with the cumulative rate of the second RRA in ICT group and the difference was not significant (P=0.978). Although the efficacy of RRA in DTC patients with an incomplete thyroidectomy is not as good as that of patients with a complete thyroidectomy after the first RRA, a higher ablative rate can still be achieved after the second or third RRA.

  12. Blood doses and remnant biokinetics after thyroid ablation therapy of differentiated thyroid cancer: withdrawal vs. rh TSH

    International Nuclear Information System (INIS)

    Lassmann, Michael; Haenscheid, Heribert; Luster, Markus; Reiners, Christoph; Ablation, Trial Study Group

    2005-01-01

    Full text: An international randomized multicenter trial (9 sites; North America: 5, Europe: 4) was carried out investigating the effectiveness of ablation therapy with 3.7 GBq 131 I in differentiated thyroid cancer. We present the results of the trial dosimetry assessments. 63 patients were randomized after thyroidectomy to either hypothyroidism (THW) or euthyroidism in combination with rh TSH (0.9 mg q d x 2, Thyrogen). The biokinetics and residence times (RT) of the remnants were assessed from 3 neck scans starting 48 h after administration. The blood doses (a surrogate for the bone marrow dose) were calculated from activity concentrations in blood samples and 131 I whole body retention measurements between 2 and 168 h after 131 I administration. The overall dosimetry results were calculated centrally (Wuerzberg) in an externally audited standardized data evaluation procedure. The patient ablation rate was 100%. The 48 h 131 I uptake was lower in the remnant tissue of the rh TSH group: 0.5 ± 0.7%; THW group: 0.9 ±1.0% (p=0.1), the effective half life showed smaller values for the THW group (48.0 ± 52.6 h vs. 67.6 ± 48.9 h, p=0.0116). The mean RT in the remnant tissue was shorter in the rh TSH group: 0.9 ± 1.3 h; THW group: 1.4 ± 1.5 h (p=0.1). A greater decrease in the mean percentage of administered activity in the blood at 48 h, and a lower mean residence time was seen in the rh TSH group: 0.8%, RT: 2.3 ± 0.7 h; THW group: 1.8% (p=0.0011), RT: 3.5 ± 1.63 h (p=0.0004). The mean specific blood dose was significantly lower (p<0.0001) in the rh TSH group (0.072 ± 0.017 mGy/MBq, blood vessel radius (VR):0.2 mm; 0.104 ± 0.025 mGy/MBq, VR: 5 mm) than in the Hypothyroid group (0.106 ± 0.037 mGy/MBq, VR: 0.2 mm; 0.158 ± 0.059 mGy/MBq, VR: 5 mm). Conclusion: Although the remnant RT tended to be lower in the rh TSH group the ablation rates in the 2 study arms were comparable. The radiation dose to the blood was significantly lower in the rh TSH group. This

  13. Radioiodine Thyroid Remnant Ablation after Recombinant Human Thyrotropin or Thyroid Hormone Withdrawal in Patients with High-Risk Differentiated Thyroid Cancer

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    Fabián Pitoia

    2012-01-01

    Full Text Available To supplement limited relevant literature, we retrospectively compared ablation and disease outcomes in high-risk differentiated thyroid carcinoma (DTC patients undergoing radioiodine thyroid remnant ablation aided by recombinant human thyrotropin (rhTSH versus thyroid hormone withdrawal/withholding (THW. Our cohort was 45 consecutive antithyroglobulin antibody- (TgAb- negative, T3-T4/N0-N1-Nx/M0 adults ablated with high activities at three referral centers. Ablation success comprised negative (<1 μg/L stimulated serum thyroglobulin (Tg and TgAb, with absent or <0.1% scintigraphic thyroid bed uptake. “No evidence of disease” (NED comprised negative unstimulated/stimulated Tg and no suspicious neck ultrasonography or pathological imaging or biopsy. “Persistent disease” was failure to achieve NED, “recurrence,” loss of NED status. rhTSH patients (n=18 were oftener ≥45 years old and higher stage (P=0.01, but otherwise not different than THW patients (n=27 at baseline. rhTSH patients were significantly oftener successfully ablated compared to THW patients (83% versus 67%, P<0.02. After respective 3.3 yr and 4.5 yr mean follow-ups (P=0.02, NED was achieved oftener (72% versus 59% and persistent disease was less frequent in rhTSH patients (22% versus 33% (both comparisons P=0.03. rhTSH stimulation is associated with at least as good outcomes as is THW in ablation of high-risk DTC patients.

  14. Radioiodine thyroid remnant ablation after recombinant human thyrotropin or thyroid hormone withdrawal in patients with high-risk differentiated thyroid cancer.

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    Pitoia, Fabián; Marlowe, Robert J; Abelleira, Erika; Faure, Eduardo N; Bueno, Fernanda; Schwarzstein, Diego; Lutfi, Rubén Julio; Niepomniszcze, Hugo

    2012-01-01

    To supplement limited relevant literature, we retrospectively compared ablation and disease outcomes in high-risk differentiated thyroid carcinoma (DTC) patients undergoing radioiodine thyroid remnant ablation aided by recombinant human thyrotropin (rhTSH) versus thyroid hormone withdrawal/withholding (THW). Our cohort was 45 consecutive antithyroglobulin antibody- (TgAb-) negative, T3-T4/N0-N1-Nx/M0 adults ablated with high activities at three referral centers. Ablation success comprised negative (<1 μg/L) stimulated serum thyroglobulin (Tg) and TgAb, with absent or <0.1% scintigraphic thyroid bed uptake. "No evidence of disease" (NED) comprised negative unstimulated/stimulated Tg and no suspicious neck ultrasonography or pathological imaging or biopsy. "Persistent disease" was failure to achieve NED, "recurrence," loss of NED status. rhTSH patients (n = 18) were oftener ≥45 years old and higher stage (P = 0.01), but otherwise not different than THW patients (n = 27) at baseline. rhTSH patients were significantly oftener successfully ablated compared to THW patients (83% versus 67%, P < 0.02). After respective 3.3 yr and 4.5 yr mean follow-ups (P = 0.02), NED was achieved oftener (72% versus 59%) and persistent disease was less frequent in rhTSH patients (22% versus 33%) (both comparisons P = 0.03). rhTSH stimulation is associated with at least as good outcomes as is THW in ablation of high-risk DTC patients.

  15. 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.

  16. Impact of recombinant TSH on quality of life in thyroid carcinoma patients undergoing remnant ablation or diagnostic whole body scanning

    International Nuclear Information System (INIS)

    Schroeder, Pamela R.; Ladenson, Paul W.; for the Members of the Thyrogen Trials

    2005-01-01

    Full text: Thyroid remnant ablation with 131 I is often necessary in the initial treatment of thyroid carcinoma. A recent study demonstrated that use of recombinant TSH (rh TSH) was equivalently effective to withdrawal from levothyroxine (L-T 4 ) for postoperative remnant ablation. Quality of life was also shown to be negatively impacted in patients withdrawn from L-T 4 , but not those maintained euthyroid and treated after rh TSH. In this study, we compare the impact of rh TSH on quality of life in patients undergoing remnant ablation versus those undergoing diagnostic whole body scanning (WBS) in a previous trial. Health-related quality of life was measured using the SF-36 survey, which consists of 8 domains describing the physical and mental functioning of patients and 2 physical and mental summary domains, in both trials at baseline on L-T 4 , after rh TSH while on L-T 4 and after L-T 4 withdrawal. Mean SF-36 scores declined from the rh TSH treatment versus L-T 4 withdrawal in both trials to a similar extent in all 8 domains and the 2 summary domains, as evidenced by overlapping 95% confidence intervals. Further SF-6D scores, which summarize all 8 domains in a single zero-to-one metric, were used to characterize the overall quality of life among patients in the two trials. The SF-6D scores for patients after rh TSH administration in the diagnostic and ablation trials were 0.803 and 0.714, respectively. In contrast, SF-6D scores for patients undergoing L-T 4 withdrawal in the diagnostic and ablation trials were 0.637 and 0.548, respectively (p 4 withdrawal both experience a comparable decrease in quality of life, which can be prevented by use of rh TSH in the euthyroid state. (author)

  17. Radioiodine Remnant Ablation: A Critical Review

    International Nuclear Information System (INIS)

    Bal, Chandra Sekhar; Padhy, Ajit Kumar

    2015-01-01

    Radioiodine remnant ablation (RRA) is considered a safe and effective method for eliminating residual thyroid tissue, as well as microscopic disease if at all present in thyroid bed following thyroidectomy. The rationale of RRA is that in the absence of thyroid tissue, serum thyroglobulin (Tg) measurement can be used as an excellent tumor marker. Other considerations are like the presence of significant remnant thyroid tissue makes detection and treatment of nodal or distant metastases difficult. Rarely, microscopic disease in the thyroid bed if not ablated, in the future, could be a source of anaplastic transformation. On the other hand, microscopic tumor emboli in distant sites could be the cause of distant metastasis too. The ablation of remnant tissue would in all probability eliminate these theoretical risks. It may be noted that all these are unproven contentious issues except postablation serum Tg estimation that could be a good tumor marker for detecting early biochemical recurrence in long-term follow-up strategy. Radioactive iodine is administered as a form of “adjuvant therapy” for remnant ablation. There have been several reports with regard to the administered dose for remnant ablation. The first report of a prospective randomized clinical trial was published from India by a prospective randomized study conducted at the All India Institute of Medical Sciences, New Delhi in the year 1996. The study reported that increasing the empirical 131 I initial dose to more than 50 mCi results in plateauing of the dose-response curve and thus, conventional high-dose remnant ablation needs critical evaluation. Recently, two important studies were published: One from French group and the other from UK on a similar line. Interestingly, all three studies conducted in three different geographical regions of the world showed exactly similar conclusion. The new era of low-dose remnant ablation has taken a firm scientific footing across the continents

  18. Outpatient thyroid remnant ablation using repeated low 131-iodine activities (740 MBq/20 mCix2) in patients with low-risk differentiated thyroid cancer.

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    Clerc, Jérôme; Bienvenu-Perrard, Marie; de Malleray, Caroline Pichard; Dagousset, Françoise; Delbot, Thierry; Dreyfuss, Marc; Groussin, Lionel; Marlowe, Robert J; Leger, Françoise Aubène; Chevalier, Alain

    2012-03-01

    In low-risk differentiated thyroid cancer (DTC), postoperative (131)I remnant ablation should employ a minimum effective activity; reports increasingly suggest efficacy of low activities, e.g. 1110 MBq/30 mCi. OBJECTIVES, DESIGN, PATIENTS, AND INTERVENTIONS: We retrospectively studied the ablation capability and diagnostic utility of the Minidose protocol, two 740-MBq/20 mCi outpatient administrations, 6-18 months apart, plus related diagnostic procedures, in 160 consecutive (near-) totally thyroidectomized low-risk DTC (pT1/N0-Nx) patients. Successful ablation comprised negative 740-MBq whole-body scintigraphy with cervical uptake below 0.1%, negative stimulated thyroglobulin (STg) (<1 ng/ml, negative thyroglobulin antibodies), and negative Doppler ultrasonography (performed around Minidose 2). The study took place at a referral center. Minidose imaging found unsuspected nodal or distant metastases in nine of 160 patients (5.6%). Ablation success rates after one (two) 740-MBq activity (activites) were 75.9% (90.2%) in 145 (132) evaluable imaging-negative patients. Compared with thyroid hormone withdrawal, recombinant human TSH stimulation was associated with higher urinary iodine excretion/creatinine, lower cervical uptake, and more frequent ablation success after the first 740 MBq; success rates no longer differed significantly after both administrations. Patients with STg below 10 ng/ml at Minidose 1 were oftener ablated at Minidose 2 (odds ratio=13.9, 95% confidence interval=2.5-76.4, P<0.003), attaining 92.0% final ablation success after recombinant human TSH preparation, suggesting that one 740-MBq activity should suffice in this subgroup. All 81 evaluable patients with prolonged follow-up (mean 41.8±21.9 months after Minidose 1) had no evidence of disease at the last visit. The Minidose outpatient ablation protocol is effective and diagnostically useful in low-risk DTC.

  19. Radioiodine remnant ablation of differentiated thyroid cancer does not further increase oxidative damage to membrane lipids - early effect

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    Makarewicz Jacek

    2010-10-01

    Full Text Available Abstract Introduction Radioiodine (131I therapy is widely accepted as an essential part of therapeutic regimens in many cases of differentiated thyroid cancer. Radiation-induced oxidative damage to macromolecules is a well known phenomenon. Frequently examined process to evaluate oxidative damage to macromolecules is lipid peroxidation (LPO, resulting from oxidative damage to membrane lipids. The aim of the study was to examine serum LPO level in hypothyroid (after total thyroidectomy cancer patients subjected to ablative activities of 131I. Materials and methods The study was carried out in 21 patients (18 females and 3 males, average age 52.4 ± 16.5 years after total thyroidectomy for papillary (17 patients or follicular (4 patients thyroid carcinoma. Hypothyroidism was confirmed by increased TSH blood concentration (BRAHMS, Germany, measured before 131I therapy. Activity of 2.8 - 6.9 GBq of 131I was administered to the patients orally as sodium iodide (OBRI, Poland. Concentrations of malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA, as an index of LPO (LPO-586 kit, Calbiochem, USA, were measured in blood serum just before 131I administration (day "0" and on the days 1-4 after 131I therapy. Sera from 23 euthyroid patients served as controls. Correlations between LPO and TSH or 131I activity were calculated. Results Expectedly, serum LPO level, when measured before 131I therapy, was several times higher (p 131I therapy. LPO did not correlate with TSH concentration. In turn, negative correlation was found between 131I activity and LPO level on the day "2" after radioiodine treatment. Conclusions Radioiodine remnant ablation of differentiated thyroid cancer does not further increase oxidative damage to membrane lipids, at least early, after therapy.

  20. Recombinant human TSH and ablation of post-surgical thyroid remnants in differentiated thyroid cancer: the effect of pre-treatment with furosemide and furosemide plus lithium

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    Barbaro, Daniele; Lapi, Paola; Pasquini, Cristina; Orsini, Paola; Turco, Anna [General Hospital of Livorno, Endocrinology Unit, Livorno (Italy); Grosso, Mariano; Boni, Giuseppe; Mariani, Giuliano [University of Pisa Medical School, Regional Center of Nuclear Medicine, Pisa (Italy); Meucci, Giuseppe [General Hospital of Livorno, Division of General Surgery, Livorno (Italy); Marzola, Maria Cristina; Rubello, Domenico [' Santa Maria della Misericordia' Hospital, Department of Nuclear Medicine, PET Centre, Rovigo (Italy); Berti, Piero; Miccoli, Paolo [University of Pisa Medical School, Department of Surgery, Pisa (Italy)

    2010-02-15

    Recombinant human TSH (rhTSH) can be used for post-surgical radioiodine (I-131) thyroid remnants ablation in differentiated thyroid cancer (DTC) patients after surgery. Debate exists in literature about the optimal amount of I-131 that should be given for obtaining an effective ablation and about the role of iodine pool during treatment. Therefore, the aim of the present study was to assess whether I-131 ablation during rhTSH stimulus can be improved by reducing the circulating iodine pool and by increasing thyroid cell uptake and retention of I-131 obtained by administering furosemide and lithium. A total of 201 consecutive DTC patients were entered in the study: they were treated by total thyroidectomy and I-131 therapy during rhTSH stimulus to ablate thyroid remnants. Patients were divided into two groups according to the TNM stage: group 1 included patients in stage I-II who were treated with a low 30-mCi I-131 dose, while group 2 included patients in stage III-IV who were treated by a high 100-mCi I-131 dose. Moreover, both groups were further subdivided into three subgroups. Subgroup (a) included 45 patients from group 1 and 22 from group 2: they were treated with I-131 under rhTSH stimulus, following a short 4-day withdrawal of L-thyroxine (LT4). Subgroup (b) included 45 patients from group 1 and 22 from group 2: they were treated with I-131 under rhTSH stimulus, following a short 4-day withdrawal of L-T4, and after furosemide administration (25 mg/day orally) during the 3 days before I-131. Subgroup (c) included 45 patients from group 1 and 22 from group 2: they were treated with I-131 under rhTSH stimulus, following a short 4-day L-T4 withdrawal, and after administration of furosemide (25 mg/day orally) during the 3 days prior I-131 and lithium (450 mg/day orally) during the 3 days following I-131. Another group (group 3) of 20 patients characterized by a very low-risk cancer (unifocal tumor <1.0 cm in diameter, without extra-capsular extension, N0) was

  1. Empiric 131I treatment of high thyroglobulin levels in differentiated thyroid carcinoma after remnant ablation

    International Nuclear Information System (INIS)

    Kalender, E.; Elboga, U.; Celen, Y.; Demir, H.; Yilmaz, M.; Sahin, E.

    2015-01-01

    Full text of publication follows. Objective: serum thyroglobulin (Tg) measurements are usually the best marker of residual or metastatic disease after the treatment of differentiated thyroid carcinoma (DTC). It is not rare to find patients with detectable serum Tg levels after ablative 131 I treatment (AIT). The objective of this study is to establish the efficacy of empiric 131 I treatment (EIT) given for patients whose Tg levels remained high after AIT. Materials and methods: 28 patients (23 women, 5 men; mean age 47.4 ± 16.8) without distant metastasis, who were treated empirically for high Tg levels after AIT in our clinic were studied retrospectively. In all patients stimulated Tg levels before AIT (Tg I) and 6 months after AIT (Tg II) were measured. The Tg cutoff level for EIT was accepted 10 ng/ml. After EIT, post-therapeutic whole-body scintigraphy (PWBS) was performed to all patients. 18 F-FDG PET CT was performed to patients who had negative PWBS but continued high Tg II levels. Results: PWBS was positive in 14 patients (50%) and negative in 14 patients (50%). 14 patients did not respond to EIT (50%), and 14 patients (50%) responded to EIT at different rates. Eight patients (28.6%) responded to EIT completely, and 6 patients (21.4%) responded to EIT partially. Tg I was 60.7 ± 40 ng/ml and Tg II was 31 ± 20.4 ng/ml in responded patients. Tg I was 87.6 ± 96 ng/ml and Tg II was 114.3 ± 106 ng/ml in non-responding patients. 18 F-FDG PET CT was performed to 14 patients who had negative PWBS. 18 F-FDG PET CT was positive in 11 patients and negative in 3 patients. 18 F-FDG PET CT positive patients were referred to surgery. Conclusion: Our findings, suggested that the EIT is not beneficial in patients who have higher Tg II than Tg I and the cure rate is low in increasing Tg levels. The patients who have high Tg II but lower than Tg I can be treated empirically with 131 I. In these patients EIT may be beneficial. (authors)

  2. Does remnant from differentiated thyroid micro-carcinoma patients really not be treated with Iodine-131 ablation?

    International Nuclear Information System (INIS)

    D'Antuono, F.; Gallicchio, R.; Venetucci, A.; Giacomobono, S.; Tempone, A.; Di Leo, A.; Storto, G.; Nardelli, A.; Pellegrino, T.; Gattozzi, D.

    2015-01-01

    Full text of publication follows. Aim: Remnant ablation by radioiodine is generally not recommended in patients presenting uni- or multifocal cancer <1 cm, without other higher risk features. We retrospectively studied low-risk patients (pts) with differentiated thyroid cancer (DTC) less than 1 cm recruited for radioiodine therapy (RAI). Methods: 91 pts (79 women, age 49.4 ± 10 years) with DTC were recruited for RAI. Pts underwent pre-therapy ultrasonography (US), those with suspected/ambiguous lymph-nodes were excluded and proposed for cytology. Treated pts underwent post-therapeutic whole body scan (WBSt) completed by neck/chest SPECT-CT, when necessary (e.g. evidence of uptake outside of thyroid bed). A target lesion on SPECT-CT was defined as an identifiable lymph-nodal site presenting a matched significant iodine uptake. Patients were followed up for 13 ± 2 months thereafter. Results: All pts/cancers were pT1. Mean histological diameter was (0.66 ± 0.25) cm. Six patients were excluded because of clear nodal involvement at US. Thirty (35%) out of 85 pts had suspicious WBSt as per lymph-nodal involvement which was confirmed at the following SPECT-CT acquisition in most part of pts (25/30; 83 %). Overall detected target lesions was 34, ten (29%) had interim positive fine needle cytology. Conclusions: a significant part of low risk DTC patients, for whom RAI is not recommended, presents an incidental evidence of lymph-nodal involvement at WBSt confirmed by SPECT-CT, when performed. Such setting would have not been treated by I-131. Indications for RAI in DTC low risk patients could be revised at least considering a different dimensional cut-off for the primary lesion. (authors)

  3. The role of postoperative Tc-99m pertechnetate scintigraphy in estimation of remnant mass and prediction of successful ablation in patients with differentiated thyroid cancer.

    Science.gov (United States)

    Ozdemir, Didem; Cuhaci, Fatma N; Ozdemir, Elif; Aydin, Cevdet; Ersoy, Reyhan; Turkolmez, Seyda; Cakir, Bekir

    2016-06-01

    Surgery and radioactive iodine (RAI) ablation constitute the mainstay of the treatment of differentiated thyroid carcinoma (DTC). In this study, we aimed to evaluate the diagnostic value of postoperative early Tc-99m pertechnetate scanning to detect remnant thyroid tissue and predict ablation success. DTC patients evaluated with postoperative Tc-99m pertechnetate scintigraphy and treated with RAI between January 2007 and December 2014 were recruited. The results of Tc-99m pertechnetate scanning were compared with therapeutic I-131 whole-body scanning (TxWBS) and diagnostic I-131 whole-body scanning (DxWBS) performed 6-9 months after RAI. There were 154 (21.5%) male and 563 (78.5%) female patients, with a mean age of 49.11±12.35 years. Postoperative Tc-99m pertechnetate scanning was positive in 499 patients (69.6%) and negative in 218 (30.4%) patients. There were 673 (93.9%) patients with a positive TxWBS scan and 44 (6.1%) patients with negative TxWBS scan. Considering TxWBS as the standard test, sensitivity, specificity, positive predictive value, and negative predictive value of Tc-99m pertechnetate scanning were 72.2, 70.5, 97.4, and 14.2%, respectively. DxWBS was positive in 57 (9.0%) and negative in 564 (91%) patients. Ablation dose was higher and preablation thyroglobulin was lower in patients with negative DxWBS (P=0.001 and 0.04, respectively). Overall, 171 (92.9%) of 184 patients with negative Tc-99m pertechnetate had negative DxWBS. Postoperative Tc-99m pertechnetate scintigraphy has a high positive predictive value to detect remnant tissue in patients with DTC. Although negative Tc-99m pertechnetate scanning does not indicate removal of all thyroid tissue, it is related to successful ablation in more than 90% of patients.

  4. Thyroid remnant ablation using 1,110 MBq of I-131 after total thyroidectomy. Regulatory considerations on release of patients after unsealed radioiodine therapy

    International Nuclear Information System (INIS)

    Kusakabe, Kiyoko; Yokoyama, Kunihiko; Ito, Koichi

    2012-01-01

    This study was undertaken to measure the radiation exposure level of caregivers following outpatient NaI (I-131) 1,110 MBq therapy for remnant thyroid ablation after total thyroidectomy in patients with differentiated thyroid cancer, and to evaluate the influence of activities of daily living on radiation exposure level, with the goal of proposing an optimum method of I-131 therapy. The study included 37 patients with differentiated thyroid cancer, who had undergone total thyroidectomy and received outpatient based remnant thyroid ablation using NaI (I-131) 1,110 MBq, who were satisfying the following requirements: patients who have no evidence of distant metastases, whose living environments were appropriate for outpatient I-131 (1,110 MBq) therapy, and patients who gave written informed consent. The dose rate at a distance of 1 m from the body surface of the patient at the moment of release was measured using survey meters of the GM type or ionization chamber type. The dose level for the caregiver was measured with a personal dosimeter in all cases. The dose rate at a distance of 1 m from the patient's body surface 1 h after I-131 administration was in the range of 29-115 μSv/h (mean 63.8 μSv/h). The 7-day cumulative effective dose of caregivers was 0.11±0.08 mSv, on an average, in 34 dosimeters. In 31 of 34 dosimeters, cumulative effective dose of caregivers was below 0.2 mSv. Dose levels exceeding 0.2 mSv were recorded in 3 cases (0.21, 0.35 and 0.43 mSv in one case each). These results suggest that the exposure level of family members (caregiver and others) was minimal and is lower than the radiation levels affecting human environments. Outpatient-based remnant thyroid ablation with I-131 (1,110 MBq) performed after total thyroidectomy in patients with differentiated thyroid cancer is safe if applied in accordance with the appropriate supervision and guidance by experts with certain qualifications. (author)

  5. Prospective randomized trial for the evaluation of the efficacy of low vs. high dose I-131 for post operative remnant ablation in differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Barrenechea, E.A.; Laureta, E.G.; Gaston, J.C.; Al-Nahhas, A.; Padhy, A.K.

    2005-01-01

    The study was done under the auspices of the IAEA to evaluate the efficacy of low dose (50-60mCi) vs. High dose (100 mCi) for the post-operative remnant ablation of differentiated thyroid cancer and to determine other factors associated with successful ablation. There were eighty-six patients included in the study with a diagnosis of papillary, follicular or mixed type of thyroid cancer. They all have undergone near total thyroidectomy or total thyroidectomy and without any evidence of metastatic disease. Four to six weeks after the surgery and without thyroid hormone maintenance as well as iodine free diet and drugs, they underwent a total body scan and uptake using 1-3 mci of I-131. Serum TSH and thyroglobulin were also taken. Randomization was made thru the IAEA and the patients either got a low dose or a high dose depending on such randomization. Of the 86 patients included, there were a total of 76 evaluable cases. There were three dropouts because of other medical conditions as upper GI bleeding, lung cancer and leg fracture. The 7 other patients have not completed their follow-up body scan. Among these patients were 67 females and 19 males whose age range was 19 to 84 years old. There were 65 cases with histologic type of papillary cancer, 15 follicular and 6 mixed varieties. Forty-one patients were randomized to the high dose group while 35 patients were assigned to the low dose therapy group. These patients were confined till their radiation activity was below 2mR/hr. Monitoring of the patients were done during their hospital stay. Post-therapy body scan was done but not with all patients. Most of the side effects noted were sialitis, mild neck pains, nausea and occasional vomiting as well as ageusia. These patients were maintained on thyroid hormone depending on their sensitivity but almost all were given 200-300mgs per day. The older patients tolerated only around 150mcgs/day. After four to six months, serum TSH, thyroglobulin and total body scan were

  6. Quality of life changes and clinical outcomes in thyroid cancer patients undergoing radioiodine remnant ablation (RRA) with recombinant human TSH (rhTSH): a randomized controlled study.

    Science.gov (United States)

    Taïeb, D; Sebag, F; Cherenko, M; Baumstarck-Barrau, K; Fortanier, C; Farman-Ara, B; De Micco, C; Vaillant, J; Thomas, S; Conte-Devolx, B; Loundou, A; Auquier, P; Henry, J F; Mundler, O

    2009-07-01

    Recombinant human TSH (rhTSH) has become the modality of choice for radioiodine remnant ablation (RRA) in low-risk thyroid cancer patients. The aims of the present prospective randomized study were to evaluate the impact of TSH stimulation procedure (hypothyroidism vs. rhTSH) on quality of life (QoL) of thyroid cancer patients undergoing RRA and to evaluate efficacy of both procedures. L-T4 was initiated in both groups after thyroidectomy. After randomization, L-T4 was discontinued in hypothyroid (hypo) group and continued in rhTSH group. A measure of 3.7 GBq of radioiodine was given to both groups. The functional assessment of chronic illness therapy-fatigue (FACIT-F) was administered from the early postoperative period to 9 months. Socio-demographic parameters, anxiety and depression scales were also evaluated (CES-D, BDI and Spielberger state-trait questionnaires). At 9 months, patients underwent an rhTSH stimulation test, diagnostic (131)I whole body scan (dxWBS) and neck ultrasonography. A total of 74 patients were enrolled for the study. There was a significant decrease in QoL from baseline (t0) to t1 (RRA period) in the hypothyroid group with significant differences in FACIT-F TOI (P hypothyrodism. However, there is a wide heterogeneity in the clinical impact of hypothyroidism.

  7. Comparison of urine iodine/creatinine ratio between patients following stringent and less stringent low iodine diet for radioiodine remnant ablation of thyroid cancer

    International Nuclear Information System (INIS)

    Roh, Jee Ho; Kim, Byung Il; Ha, Ji Su; Chang, Sei Joong; Shin, Hye Young; Choi, Joon Hyuk; Kim, Do Min; Kim, Chong Soon

    2006-01-01

    A low iodine diet (LID) for 1 ∼ 2 weeks is recommended for patients who undergoing radioiodine remnant ablation. However, the LID educations for patients are different among centers because there is no concrete recommendation for protocol of LID. In this investigation, we compared two representative types of LID protocols performed in several centers in Korea using urine iodine to creatinine tatio (urine I/Cr). From 2006, April to June, patients referred to our center for radioiodine remnant ablation of thyroid cancer from several local hospitals which had different LID protocols were included. We divided into two groups, stringent LID for 1 week and less stringent LID for 2 weeks, then measured their urine I/Cr ratio with spot urine when patients were admitted to the hospital. Total 27 patients were included in this investigation (M:F = 1:26; 13 in one-week stringent LID; 14 in two-week less stringent LID). Average of urine I/Cr ratio was 127.87 ± 78.52 μ g/g in stringent LID for 1 week, and 289.75 ± 188.24 μ g/g in less stringent LID for 2 weeks. It was significantly lower in stringent LID for 1 week group (ρ = 0.008). The number of patients whose urine I/Cr ratios were below 100 μ g/g was 6 of 13 in stringent LID for 1 week group, and 3 of 14 in less stringent LID for 2 weeks group. Stringent LID for 1 week resulted in better urinary I/Cr ratio in our investigation compared with the other protocol. However it still resulted in plenty of inadequate range of I/Cr ratio, so more stringent protocol such as stringent LID for 2 weeks is expected more desirable

  8. Vocal cord paralysis following I-131 ablation of a postthyroidectomy remnant

    International Nuclear Information System (INIS)

    Lee, T.C.; Harbert, J.C.; Dejter, S.W.; Mariner, D.R.; VanDam, J.

    1985-01-01

    Vocal cord paralysis has been reported following I-131 therapy of thyrotoxicosis and following ablation of the whole thryoid. However, this rare complication has not previously been described following I-131 ablation of a postthyroidectomy remnant. The authors report a patient who required tracheostomy for bilateral vocal cord paralysis following I-131 ablation after near-total thyroidectomy for papillary thyroid carcinoma

  9. HiLo: Multicentre randomized phase III clinical trial of high vs low dose radioiodine, with or without recombinant human thyroid stimulating hormone (rhTSH), for remnant ablation for differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mallick, U. [Freeman Hospital, Newcastle, Newcastle upon Tyne (United Kingdom); Harmer, C.; Clarke, S.; Moss, L.; Nicol, A.; Clarke, P.; Smellie, J.; McCready, R.; Farnell, K.; Franklyn, J.; John, R.; Nutting, C.; Yap, B.; Lemon, C.; Wadlsey, J.; Gerrard, G.; Roques, T.; Macias, E.; Whitaker, S.; Abdul-Hamid, A.; Alvarez, P.; Kadalayil, L.; Hackshaw, A.

    2012-07-01

    Recommended treatment for most patients with differentiated thyroid cancer is surgery followed by radioiodine ablation. Current practice in many centres is to use a high administered activity of 3.7 GBq (100 mCi). However, a lower activity (1.1 GBq or 30 mCi) has advantages including a shorter stay in hospital isolation and lower risk of side effects, including the risk of a second cancer. Also, Thyrogen (rhTSH) allows patients to continue thyroid hormone replacement during ablation, avoiding symptoms of hypothyroidism and also reduces total body radiation dose. We conducted a large randomized factorial multi centre trial to simultaneously address whether ablation success rates are similar using (i) either 1.1 GBq or 3.7 GBq, and (ii) either Thyrogen or thyroid hormone withdrawal. It is the first ever national prospective trial in thyroid cancer in the UK. Final results will be available in 2011

  10. A comparison of 1850 (50 mCi) and 3700 MBq (100 mCi) 131-iodine administered doses for recombinant thyrotropin-stimulated postoperative thyroid remnant ablation in differentiated thyroid cancer.

    Science.gov (United States)

    Pilli, Tania; Brianzoni, Ernesto; Capoccetti, Francesca; Castagna, Maria Grazia; Fattori, Sara; Poggiu, Angela; Rossi, Gloria; Ferretti, Francesca; Guarino, Elisa; Burroni, Luca; Vattimo, Angelo; Cipri, Claudia; Pacini, Furio

    2007-09-01

    Recently, a multicenter study in differentiated thyroid cancer (DTC) patients showed that 3700 MBq 131-iodine ((131)I) after recombinant human TSH (rhTSH) had a successful thyroid ablation rate similar to that obtained after thyroid hormone withdrawal. We investigated whether 1850 MBq (131)I had a similar successful rate to 3700 MBq in patients prepared with rhTSH. A total of 72 patients with DTC were randomly assigned to receive 1850 (group A, n = 36) or 3700 MBq (group B, n = 36) (131)I after rhTSH. One injection of 0.9 mg rhTSH was administered for 2 consecutive days; (131)I therapy was delivered 24 h after the last injection, followed by a posttherapy whole-body scan. Successful ablation was assessed 6-8 months later. Successful ablation (no visible uptake in the diagnostic whole-body scan after rhTSH stimulation) was achieved in 88.9% of group A and B patients. Basal and rhTSH-stimulated serum thyroglobulin was undetectable (<1 ng/ml) in 78.9% of group A and 66.6% of group B patients (P = 0.46). Similar rates of ablation were obtained in both groups also in patients with node metastases. Therapeutic (131)I activities of 1850 MBq are equally effective as 3700 MBq for thyroid ablation in DTC patients prepared with rhTSH, even in the presence of node metastases.

  11. A dose-effect correlation for radioiodine ablation in differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Flux, Glenn D; Chittenden, Sarah J; Buckley, Susan; Hindorf, Cecilia [Royal Marsden NHS Foundation Trust, Department of Physics, Sutton, Surrey (United Kingdom); Haq, Masud; Newbold, Kate; Harmer, Clive L [Royal Marsden NHS Foundation Trust, Thyroid Unit, Sutton, Surrey (United Kingdom)

    2010-02-15

    The aim of this study was to determine the range of absorbed doses delivered to thyroid remnants, blood, and red marrow from fixed administrations of radioiodine and to ascertain whether the success of ablation is more dependent on these absorbed doses than on the administered activity. Twenty-three patients received 3,000 MBq radioiodine following near-total thyroidectomy. The maximum absorbed dose to remnants was calculated from subsequent single photon emission tomography scans. Absorbed doses delivered to blood and red marrow were calculated from blood samples and from whole-body retention measurements. The protein bound iodine (PBI) was also calculated. Maximum absorbed doses to thyroid remnants ranged from 7 to 570 Gy. Eighteen of the 23 patients had a successful ablation. A significant difference was seen between the absorbed doses delivered to thyroid remnants, blood, and red marrow for those patients that had a successful ablation compared to those with a failed ablation (p = 0.030, p = 0.043 and p = 0.048, respectively). The difference between the PBI values acquired at day 1 and day 6 were also indicative of response (p = 0.074). A successful ablation is strongly dependent on the absorbed dose to the thyroid remnant. Dosimetry-based personalized treatment can prevent both sub-optimal administrations, which entails further radioiodine therapy, and excessive administration of radioactivity, which increases the potential for radiation toxicity. (orig.)

  12. Study of ablation efficiency of 3600 MBq of I-131 in the treatment of thyroid carcinoma

    International Nuclear Information System (INIS)

    Takavar, A.; Eftekhari, M.; Fard-Esfahani, A.; Beiki, D.

    2005-01-01

    Full text: The basic question of threshold for the ablation of thyroid remnant after surgery remains unanswered. However, radioiodine therapy is still being used as a standard method of treatment. In present investigation treatment responses of 100 patients with thyroid cancer treated with 3600 MBq of 131 I is studied. Response to treatment of 100 patients (33 males and 67 females) was evaluated by serum TSH, Tg levels and areas of thyroid remnant as measured by whole body scan with 131 I performed 6 months after therapy. Treatment response was evident by decreased or lack of 131 I uptake in the thyroid bed and Tg 5 ng/ml. Remnant area was decreased about 74.5% in females and 75.5% in males. No significant difference between sex groups was observed. Because of radiation protection concerns and socioeconomic reasons, lower ablations doses of 131 I ( 1110 MBq) might be as effective, and should be evaluated. (author)

  13. Thermal Ablation for Benign Thyroid Nodules: Radiofrequency and Laser

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Jung Hwan; Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Valcavi, Roberto [Endocrinology Division and Thyroid Disease Center, Arcispedale Santa Maria Nuova, Reggio Emilia (Italy); Pacella, Claudio M. [Diagnostic Imaging and Interventional Radiology Department, Ospedale Regina Apostolorum, Albano Laziale-Rome (IT); Rhim, Hyun Chul [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Na, Dong Kyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of)

    2011-10-15

    Although ethanol ablation has been successfully used to treat cystic thyroid nodules, this procedure is less effective when the thyroid nodules are solid. Radiofrequency (RF) ablation, a newer procedure used to treat malignant liver tumors, has been valuable in the treatment of benign thyroid nodules regardless of the extent of the solid component. This article reviews the basic physics, techniques, applications, results, and complications of thyroid RF ablation, in comparison to laser ablation.

  14. Thyroid radiofrequency ablation: Updates on innovative devices and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Sun; Baek, Jung Hwan; Chung, Sae Rom; Choi, Young Jun; Lee, Jeong Hyun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Park, Auh Whan [Dept. of Radiology, Vascular and Interventional Radiology Section, University of Virginia Health System, Charlottesville (United States)

    2017-08-01

    Radiofrequency ablation (RFA) is a well-known, effective, and safe method for treating benign thyroid nodules and recurrent thyroid cancers. Thyroid-dedicated devices and basic techniques for thyroid RFA were introduced by the Korean Society of Thyroid Radiology (KSThR) in 2012. Thyroid RFA has now been adopted worldwide, with subsequent advances in devices and techniques. To optimize the treatment efficacy and patient safety, understanding the basic and advanced RFA techniques and selecting the optimal treatment strategy are critical. The goal of this review is to therefore provide updates and analysis of current devices and advanced techniques for RFA treatment of benign thyroid nodules and recurrent thyroid cancers.

  15. Percutaneous laser ablation of benign and malignant thyroid nodules.

    Science.gov (United States)

    Papini, Enrico; Bizzarri, Giancarlo; Pacella, Claudio M

    2008-10-01

    Percutaneous image-guided procedures, largely based on thermal ablation, are at present under investigation for achieving a nonsurgical targeted cytoreduction in benign and malignant thyroid lesions. In several uncontrolled clinical trials and in two randomized clinical trials, laser ablation has demonstrated a good efficacy and safety for the shrinkage of benign cold thyroid nodules. In hyperfunctioning nodules, laser ablation induced a nearly 50% volume reduction with a variable frequency of normalization of thyroid-stimulating hormone levels. Laser ablation has been tested for the palliative treatment of poorly differentiated thyroid carcinomas, local recurrences or distant metastases. Laser ablation therapy is indicated for the shrinkage of benign cold nodules in patients with local pressure symptoms who are at high surgical risk. The treatment should be performed only by well trained operators and after a careful cytological evaluation. Laser ablation does not seem to be consistently effective in the long-term control of hyperfunctioning thyroid nodules and is not an alternative treatment to 131I therapy. Laser ablation may be considered for the cytoreduction of tumor tissue prior to external radiation therapy or chemotherapy of local or distant recurrences of thyroid malignancy that are not amenable to surgical or radioiodine treatment.

  16. Initial radioiodine remnant ablation success rates compared by diagnostic scan methods: I123 versus I131

    International Nuclear Information System (INIS)

    Choi, W.; Choi, E.; Yoo, I.; Kim, S.; Han, E.; Lee, S.; Lee, W.

    2015-01-01

    Full text of publication follows. Objective: to see if diagnostic whole body scan (DxWBS) performed with I-131 prior diminishes the success rate of initial radioiodine remnant ablation (RRA) compared to I-123 DxWBS in differentiated thyroid cancer patients. Material and methods: consecutive thyroid cancer patients who received total thyroidectomy for differentiated thyroid cancer and then high dose RRA (either 100 mCi or 150 mCi) within 6 months were included. DxWBSs were performed with I-123 or with I-131. Prior to the DxWBSs, all patients followed strict low iodine diet for 2 weeks and withdrew hormone to stimulate TSH above 30 mIU/l. Patients with extra-thyroidal extension of tumor, lymph node metastasis, or distant metastasis were excluded. The initial RRA was defined as successful if the next DxWBS done 6 months to 1 year later was negative and stimulated thyroglobulin level was below 2 ng/ml. Results: of 71 patients who had I-123 DxWBSs, 31 patients went on to receive RRA with 100 mCi and 40 patients received 150 mCi. Of 73 patients who had I-131 DxWBSs, 66 received 100 mCi and 7 patients received 150 mCi. The overall success rate was 79% for patients who had I-123 DxWBS prior to RRA (68% for 100 mCi and 86% for 150 mCi), and 68% for patient who had I-131 DxWBSs (68% for 100 mCi and 71% for 150 mCi). Conclusion: for patients who received 100 mCi, the RRA success rate was the same for I-123 DxWBS and I-131 DxWBS. For patients treated with 150 mCi, the success rate may be lower in patients who receive RRA following DxWBS with I-131 compared to DxWBS with I-123. (authors)

  17. Benign thyroid nodule unresponsive to radiofrequency ablation treated with laser ablation: a case report.

    Science.gov (United States)

    Oddo, Silvia; Balestra, Margherita; Vera, Lara; Giusti, Massimo

    2018-05-11

    Radiofrequency ablation and laser ablation are safe and effective techniques for reducing thyroid nodule volume, neck symptoms, and cosmetic complaints. Therapeutic success is defined as a nodule reduction > 50% between 6 and 12 months after the procedure, but a percentage of nodules inexplicably do not respond to thermal ablation. We describe the case of a young Caucasian woman with a solid benign thyroid nodule who refused surgery and who had undergone radiofrequency ablation in 2013. The nodule did not respond in terms of either volume reduction or improvement in neck symptoms. After 2 years, given the patient's continued refusal of thyroidectomy, we proposed laser ablation. The nodule displayed a significant volume reduction (- 50% from radiofrequency ablation baseline volume, - 57% from laser ablation baseline), and the patient reported a significant improvement in neck symptoms (from 6/10 to 1/10 on a visual analogue scale). We conjecture that some benign thyroid nodules may be intrinsically resistant to necrosis when one specific ablation technique is used, but may respond to another technique. To the best of our knowledge, this is the first description of the effect of performing a different percutaneous ablation technique in a nodule that does not respond to radiofrequency ablation.

  18. Long-term outcome of lobar ablation in differentiated thyroid cancer (DTC): a comparative study with patients of completion thyroidectomy

    International Nuclear Information System (INIS)

    Santra, Amburanjan; Maharjan, S.; Bal, C.

    2010-01-01

    Full text: Completion thyroidectomy (CT) is usually recommended after partial surgery in patients with differentiated thyroid cancer. Radioiodine lobar ablation (RAILA) is an easy alternative and avoids complications that might be associated with re-surgery. But its effectiveness in terms of long-term outcome and recurrence free survival is yet to be established. This study was aimed to compare long term outcome of RAILA with that of completion thyroidectomy. Materials and Methods: A retrospective analysis was done from the case records of patients treated in our thyroid clinic for last 25 years. Records of all patients of RAILA (364) and CT (372) were analyzed. Complete ablation rate, cumulative dose needed for complete ablation, Recurrence rate and recurrence free survival was estimated in each group. Comparison was made between two groups by statistical method. Results: There was 73% ablation rate at 1st dose of RAILA itself. Second dose in LA and first dose of remnant ablation after CT is comparable (92% and 93% respectively). Cumulative dose to achieve 100% ablation rate is more for RAILA group. Seven patients developed recurrence in RAILA group, compared to 14 in CT group. No statistically significant difference was noted between recurrence rate and recurrence free survival between two groups. Conclusion: Radioiodine Lobar ablation is a safe, effective and less costly alternative to completion thyroidectomy in patients with differentiated thyroid cancer with comparable long term outcome like recurrence rate and recurrence free survival

  19. Percutaneous radiofrequency ablation for benign nodules of the thyroid gland

    International Nuclear Information System (INIS)

    Baek, Jung Hwan; Jeong, Hyun Jo; Kim, Yoon Suk; Kwak, Min Sook; Chang, Sun Hee; Rhim, Hyun Chul

    2005-01-01

    We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83 ± SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83 ± SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland

  20. Innovative techniques for image-guided ablation of benign thyroid nodules: Combined ethanol and radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Sun; Baek, Jung Hwan; Choi, Young Jun; Lee, Jeong Hyun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-06-15

    In the treatment of benign thyroid nodules, ethanol ablation (EA), and radiofrequency ablation (RFA) have been suggested for cystic and solid thyroid nodules, respectively. Although combining these ablation techniques may be effective, no guidelines for or reviews of the combination have been published. Currently, there are three ways of combining EA and RFA: additional RFA is effective for treatment of incompletely resolved symptoms and solid residual portions of a thyroid nodule after EA. Additional EA can be performed for the residual unablated solid portion of a nodule after RFA if it is adjacent to critical structures (e.g., trachea, esophagus, and recurrent laryngeal nerve). In the concomitant procedure, ethanol is injected to control venous oozing after aspiration of cystic fluid prior to RFA of the remaining solid nodule.

  1. Efficacy of 131I SPECT/CT in the initial nodal staging in patients with differentiated thyroid carcinoma at the first ablative radioiodine therapy

    International Nuclear Information System (INIS)

    Kisiel, N.; Garcia-Burillo, A.; Barios, M.; Dellepiane, F.; Castell-Conesa, J.

    2015-01-01

    Full text of publication follows. Background: after the first radioiodine ablative dose, planar Whole-Body Scanning (WBS) offers the possibility for detecting thyroid remnant, loco-regional node involvement and distant metastases. Nevertheless, available anatomic information is scarce and the high activity of thyroid remnants can interfere with the detection of cervical lymphatic nodes. Objective: to determine the additional value of the SPECT-CT over planar WBS, performed seven days after ablative treatment with 131 I, in patients who were operated on for Differentiated Thyroid Cancer (DTC). Methods: from January 2009 to December 2012, 132 patients with DTC were admitted for radio-ablation with 131 I after thyroidectomy. All of them underwent WBS seven days after ablation, and 91 had an additional SPECT-CT, 71 women and 20 men, with ages ranged from 15 to 89 years (mean, age 54 years). All patients had histological confirmed DTC (73 papillary, 17 follicular -2 cases with double tumour, papillary and follicular-, and 1 insular type). In addition to the thyroidectomy, lymph node dissection was performed in 54 patients (59%): 20 patients were classified as N0 and 29 as N1. The remaining 42 patients were classified as Nx. Planar and tomographic images were independently evaluated by two experienced nuclear medicine physicians. Results: 195 cervical focal uptake were observed in the 91 planar WBSs. No additional foci were observed in SPECT-CT. Findings: Planar WBS........... SPECT-CT........... Number of Foci Thyroid remnant...... Thyroid remnant..........51........... LNM...........0 Indeterminate.......... Thyroid remnant..........84............. LNM............5 LNM............ Thyroid remnant.........12............ Indeterminate.............0............ LNM..........43. Total Number of Foci............. 195. Compared to the nodal staging prior to ablation based on the histopathological diagnosis, we had an upstaging from N0 to N1 in 4 of 20 patients and from Nx to

  2. Cooled microwave ablation of thyroid nodules: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Korkusuz, Yücel [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); Mader, Oscar Maximilian, E-mail: info@dzta.de [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); Kromen, Wolfgang [Department of Neuro Radiology University Hospital (Germany); Happel, Christian [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); German Centre for Thermoablation of Thyroid Nodules, University Hospital, Frankfurt (Germany); Ahmad, Shadi [Department of General and Visceral Surgery, Agaplesion Elisabethenstift, Darmstadt (Germany); Gröner, Daniel; Koca, Mithat; Mader, Alexander [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); Grünwald, Frank; Korkusuz, Hüdayi [Department of Nuclear Medicine, University Hospital Frankfurt (Germany); German Centre for Thermoablation of Thyroid Nodules, University Hospital, Frankfurt (Germany)

    2016-11-15

    Highlights: • cMWA is a safe and effective treatment for thyroid nodules. • Ultrasound imaging allows guidance during microwave ablation. • Pain level during cMWA treatment is reduced in comparison to RFA. - Abstract: Objective: To evaluate if internally cooled microwave ablation (cMWA) is a safe and effective method for treatment of benign and malign thyroid nodules. Methods: 9 patients with 11 symptomatic cold benign thyroid nodules and 1 recurrent thyroid carcinoma ranging in volume from 9.1 to 197 ml (mean size 52 ±  57 ml) were treated with cMWA. The mean age of the patients was 59 years. Pain during the treatment was measured on a 10-point scale. Side effects revealed by ultrasound or patients’ complaints were documented. Periablative efficacy was measured 24 h after cMWA as change (Δ) in serum thyreoglobulin (Tg). Nodule elasticity was measured on a 4-point scale, blood circulation and echogenicity on a 3-point scale. Results: All patients tolerated cMWA well. Median pain intensity averaged 2.1 ± 0.8 (range: 1–3). Postablative hematoma was observed in all cases. In no cases ablation led to hoarseness, superficial burns, nodule ruptures, vagal reactions or dysphagia. cMWA lead to a significant decrease of blood circulation, nodule echogenicity and a significant increase of elasticity (Δ  =  1.1  ±  0.33; 0.8  ±  0.4 and 1.1  ±  0.6 points)(p < 0.05). An average increase of 4495 ng/ml Tg was measured (p < 0.05). Conclusions: cMWA is an effective and secure method for treatment of thyroid nodules.

  3. Use of Radiofrequency Ablation in Benign Thyroid Nodules: A Literature Review and Updates

    OpenAIRE

    Wong, KP; Lang, HHB

    2013-01-01

    Successful thermal ablation using radiofrequency has been reported in various tumors including liver or kidney tumors. Nonsurgical minimally invasive ablative therapy such as radiofrequency ablation (RFA) has been reported to be a safe and efficient treatment option in managing symptomatic cold thyroid nodules or hyperfunctioning thyroid nodules. Pressure and cosmetic symptoms have been shown to be significantly improved both in the short and long terms after RFA. For hyperfunctioning thyroid...

  4. Optimizing radioiodine for ablation of residual thyroid

    International Nuclear Information System (INIS)

    Bal, C.S.

    1999-01-01

    The thyroid cancer (TC) has been studied in great detail in the form of the clinical experience during the past several decades. This has led to the retrospective analysis of various prognostic factors that have separated DTC into various risk groups. On one hand, the prognosis in the low-risk group is excellent with survival rate of 98 %, whereas the other end of the spectrum consists of high-risk group patients with poor survival, approximating only 50% at 10 years. Clearly, the understanding of the prognostic factors and risk groups is critically important in distinguishing a patient at low-risk from that at a high-risk which can make an impact in decision making regarding the extent of thyroidectomy and adjuvant treatment such as radioactive iodine ( 131 I) therapy

  5. Short-term amiodarone treatment for atrial fibrillation after catheter ablation induces a transient thyroid dysfunction

    DEFF Research Database (Denmark)

    Diederichsen, Søren Zöga; Darkner, Stine; Chen, Xu

    2016-01-01

    ablation in a randomised, double-blind clinical trial. METHODS: 212 patients referred for AF ablation at two centres were randomized to 8weeks of oral amiodarone or placebo. Thyroid function tests (TSH, thyroid stimulating hormone; T4, thyroxine; T3, triiodothyronine; fT4, free T4; fT3, free T3) were...

  6. The absorbed dose to the blood is a better predictor of ablation success than the administered {sup 131}I activity in thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik A.; Lassmann, Michael; Reiners, Christoph; Haenscheid, Heribert [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Maeder, Uwe [University of Wuerzburg, Comprehensive Cancer Center Mainfranken, Wuerzburg (Germany); Luster, Markus [University of Ulm, Department of Nuclear Medicine, Ulm (Germany)

    2011-04-15

    The residence time of {sup 131}I in the blood is likely to be a measure of the amount of {sup 131}I that is available for uptake by thyroid remnant tissue and thus the radiation absorbed dose to the target tissue in {sup 131}I ablation of patients with differentiated thyroid cancer (DTC). This hypothesis was tested in an investigation on the dependence of the success rate of radioiodine remnant ablation on the radiation absorbed dose to the blood (BD) as a surrogate for the amount of {sup 131}I available for iodine-avid tissue uptake. This retrospective study included 449 DTC patients who received post-operative {sup 131}I ablation in our centre in the period from 1993 to 2007 and who returned to us for diagnostic whole-body scintigraphy. The BD was calculated based on external dose rate measurements using gamma probes positioned in the ceiling. Success of ablation was defined as a negative diagnostic {sup 131}I whole-body scan and undetectable thyroglobulin levels at 6 months follow-up. Ablation was successful in 56.6% of the patients. The rate of successful ablation correlated significantly with BD but not with the administered activity. Patients with blood doses exceeding 350 mGy (n = 144) had a significantly higher probability for successful ablation (63.9%) than the others (n = 305, ablation rate 53.1%, p = 0.03). In contrast, no significant dependence of the ablation rate on the administered activity was observed. The BD is a more powerful predictor of ablation success than the administered activity. (orig.)

  7. Use of radiofrequency ablation in benign thyroid nodules: a literature review and updates.

    Science.gov (United States)

    Wong, Kai-Pun; Lang, Brian Hung-Hin

    2013-01-01

    Successful thermal ablation using radiofrequency has been reported in various tumors including liver or kidney tumors. Nonsurgical minimally invasive ablative therapy such as radiofrequency ablation (RFA) has been reported to be a safe and efficient treatment option in managing symptomatic cold thyroid nodules or hyperfunctioning thyroid nodules. Pressure and cosmetic symptoms have been shown to be significantly improved both in the short and long terms after RFA. For hyperfunctioning thyroid nodules, RFA is indicated for whom surgery or radioiodine are not indicated or ineffective or for those who refuse surgery or radio-iodine. Improvement of thyroid function with decreased need for antithyroid medications has been reported. Complication rate is relatively low. By reviewing the current literature, we reported its efficacy and complications and compared the efficacy of RFA relative to other ablative options such as ethanol ablation and laser ablation.

  8. Use of Radiofrequency Ablation in Benign Thyroid Nodules: A Literature Review and Updates

    Directory of Open Access Journals (Sweden)

    Kai-Pun Wong

    2013-01-01

    Full Text Available Successful thermal ablation using radiofrequency has been reported in various tumors including liver or kidney tumors. Nonsurgical minimally invasive ablative therapy such as radiofrequency ablation (RFA has been reported to be a safe and efficient treatment option in managing symptomatic cold thyroid nodules or hyperfunctioning thyroid nodules. Pressure and cosmetic symptoms have been shown to be significantly improved both in the short and long terms after RFA. For hyperfunctioning thyroid nodules, RFA is indicated for whom surgery or radioiodine are not indicated or ineffective or for those who refuse surgery or radio-iodine. Improvement of thyroid function with decreased need for antithyroid medications has been reported. Complication rate is relatively low. By reviewing the current literature, we reported its efficacy and complications and compared the efficacy of RFA relative to other ablative options such as ethanol ablation and laser ablation.

  9. Papillary thyroid carcinoma treated with radiofrequency ablation in a patient with hypertrophic cardiomyopathy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jian Yi; Liu, Xiao Sun; Zhang, Qing; Hong, Yan Yun; Song, Bin; Teng, Xiao Dong; Yu, Ji Ren [The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou (China)

    2016-07-15

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

  10. Papillary Thyroid Carcinoma Treated with Radiofrequency Ablation in a Patient with Hypertrophic Cardiomyopathy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jianyi; Liu, Xiaosun; Zhang, Qing; Hong, Yanyun; Song, Bin [Department of Gastrointestinal and Thyroid Surgery, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China); Teng, Xiaodong [Department of Pathology, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China); Yu, Jiren [Department of Gastrointestinal and Thyroid Surgery, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China)

    2016-11-01

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

  11. 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)

  12. Thyroid tissue: US-guided percutaneous laser thermal ablation.

    Science.gov (United States)

    Pacella, Claudio Maurizio; Bizzarri, Giancarlo; Spiezia, Stefano; Bianchini, Antonio; Guglielmi, Rinaldo; Crescenzi, Anna; Pacella, Sara; Toscano, Vincenzo; Papini, Enrico

    2004-07-01

    To evaluate in vivo the safety and effectiveness of percutaneous laser thermal ablation (LTA) in the debulking of thyroid lesions. Twenty-five adult patients at poor surgical risk with cold nodules (n = 8), autonomously hyperfunctioning thyroid nodules (n = 16), or anaplastic carcinoma (n = 1) underwent LTA. One to four 21-gauge spinal needles were inserted with ultrasonographic (US) guidance into the thyroid lesions. A 300-microm-diameter quartz optical fiber was advanced through the sheath of the needle. Nd:YAG laser was used with output power of 3-5 W. Side effects, complications, and clinical and hormonal changes were evaluated at the end of LTA and during follow-up. Linear regression analysis was used to investigate the correlation between energy delivered and reduction in nodule volume. Volume of induced necrosis and reduction in nodule volume were assessed with US or computed tomography. LTA was performed without difficulties in 76 LTA sessions. After treatment with 5 W, two patients experienced mild dysphonia, which resolved after 48 hours and 2 months. Improvement of local compression symptoms was experienced by 12 of 14 (86%) patients. Thyroid-stimulating hormone (TSH) was detectable in five of 16 (31%) patients with hyperfunctioning nodules at 6 months after LTA. Volume of induced necrosis ranged from 0.8 to 3.9 mL per session. Anaplastic carcinoma treated with four fibers yielded 32.0 mL of necrosis. Echo structure and baseline volume did not influence response. Energy load and reduction in nodule volume were significantly correlated (r(2) =.75, P nodule volume reduction at 6 months in hyperfunctioning nodules was 3.3 mL +/- 2.8 (62% +/- 21.4 [SD]) and in cold nodules was 7.7 mL +/- 7.5 (63% +/- 13.8). LTA may be a therapeutic tool for highly selected problems in the treatment of thyroid lesions. Copyright RSNA, 2004

  13. [Postoperative radioiodine ablation in patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan J; Grande, Enrique; Iglesias, Pedro

    2015-01-06

    Most patients with newly diagnosed differentiated thyroid carcinoma have tumors with low risk of mortality and recurrence. Standard therapy has been total or near total thyroidectomy followed by postoperative radioiodine remnant ablation (RRA). Although RRA provides benefits, current clinical guidelines do not recommend it universally, since an increase in disease-free survival or a decrease in mortality in low risk patients has not been demonstrated so far. Advancements in our understanding of the biological behavior of thyroid cancer have been translated into the clinic in a personalized approach to the patients based on their individual risk of recurrence and mortality. Current evidence suggests that RRA is not indicated in most low-risk patients, especially those with papillary carcinomas smaller than 1cm, without extrathyroidal extension, unfavorable histology, lymph node involvement or distant metastases. Follow-up of these patients with serial measurements of serum thyroglobulin and neck ultrasound is adequate. Careful evaluation of all risk factors of clinical relevance will allow a more realistic assessment of each individual patient. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  14. Postnatal fate of the ultimobranchial remnants in the rat thyroid gland.

    Science.gov (United States)

    Vázquez-Román, Victoria; Utrilla, José C; Fernández-Santos, José M; Conde, Esperanza; Bernabé, Reyes; Sampedro, Consuelo; Martín-Lacave, Inés

    2013-07-01

    The ultimobranchial follicles (UBFs) are considered embryonic remnants from the ultimobranchial body (UBB). They are follicular structures that vary in size and appearance depending on the age of the rat. The main objective of this article was to study the progressive changes in shape, size, and frequency of the UBFs in the postnatal rat, from birth to old-age. To accomplish that objective, a systematic morphometric and incidental study of the UBF has been carried out in 110 Wistar rats of different ages and both sexes, divided into three groups: 1) young rats (5-90-day-old); 2) adult rats (6-15-month-old), and 3) old rats (18-24-month-old). The glands were serially sectioned and immunostained for calcitonin at five equidistant levels. According to our results, UBFs were observed in all thyroid glands but a more exhaustive sampling was occasionally necessary in male rats. In young rats, immature UBFs predominantly appeared whereas in adult rats, mature UBFs with cystic appearance and variable luminal content prevailed. We frequently found spontaneous anomalous UBFs in old rats, which we have termed as "ultimobranchial cystadenomata." Additionally, in young rats, UBF areas significantly increased with age and they were larger when compared to that of normal thyroid follicles. Likewise, in adult rats, UBFs were significantly larger than normal thyroid follicles but only in female rats. In general, UBFs in females were also significantly larger than those found in male rats. Finally, all these differences related to UBFs together with a higher incidence in females of UB cystadenomata suggest a sexual dimorphism in regard to the destiny of these embryonic remnants during postnatal thyroid development. Copyright © 2013 Wiley Periodicals, Inc.

  15. Surgical and Pathological Changes after Radiofrequency Ablation of Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    Chiara Dobrinja

    2015-01-01

    Full Text Available Background. Radiofrequency ablation (RFA has been recently advocated as an effective technique for the treatment of symptomatic benign thyroid nodules. It is not known to what extent it may affect any subsequent thyroid surgery and/or histological diagnosis. Materials and Methods. RFA was performed on 64 symptomatic Thy2 nodules (benign nodules and 6 symptomatic Thy3 nodules (follicular lesions/follicular neoplasms. Two Thy3 nodules regrew after the procedure, and these patients accepted to undergo a total thyroidectomy. Here we present how RFA has affected the operation and the final pathological features of the surgically removed nodules. Results and Conclusions. RFA is effective for the treatment of Thy2 nodules, but it should not be recommended as first-line therapy for the treatment of Thy3 nodules (irrespective of their mutational status, as it delays surgery in case of malignancy. Moreover, it is unknown whether RFA might promote residual tumor progression or neoplastic progression of Thy3 lesions. Nevertheless, here we show for the first time that one session of RFA does not affect subsequent thyroid surgery and/or histological diagnosis.

  16. Ultrasound-guided radiofrequency ablation of thyroid gland: a preliminary study in dogs

    International Nuclear Information System (INIS)

    Choi, Ji Won; Yoo, Seung Min; Kwak, Seo Hyun

    2005-01-01

    The purpose of this study was to evaluate the possibility of using radiofrequency ablation as the treatment modality for the benign or malignant thyroid nodules in humans. Therefore, we examined the results of using radiofrequency ablation on the thyroid glands in dogs, in respect of the extent of the ablated tissue and the complications. Five dogs (10 lobes of the thyroid glands) were included in this study. US-guided radiofrequency ablation was undertaken with a 10 mm, uncovered 17 gauge cool-tip needle. The power and duration was 20 wattage and 1 minute in five thyroid lobes (group 1) and 20 wattage and 2 minutes in another 5 thyroid lobes (group 2). The ultrasound scans and the pre-and post-enhancement CT scans were undertaken before and immediately after the procedures, and at 24 hours, 72 hours and 1 week later. The US and CT findings of the ablated tissue and complications were evaluated. Blood sampling was done at the pre-procedure time and 1 week later for evaluating the functional status of the thyroid gland. Laryngoscopy was done at the pre-procedure and post-procedure times, and at 24 hours, 72 hours and 1 week later for the evaluation of any recurrent laryngeal nerve palsy. The echo pattern of the ablated thyroid gland at immediately after the radiofrequency ablation appeared as poorly marginated and hyperechoic. On the US obtained 24 hours after radiofrequency ablation, the echo pattern of the ablated thyroid gland was hypoechoic. The maximum diameters after RFA were 9.4 ρ 0.5 mm in group I and 11.4 ρ 0.5 mm in group II. The pre-enhanced CT scan taken at immediately after the radiofrequency ablation showed ill defined hypodense areas in the ablated thyroid gland. Differentiation between the normal and abnormal portions of the thyroid gland was difficult on the contrast enhanced CT scan. Complications induced by radiofrequency ablation were one recurrent laryngeal nerve palsy, two perforations of esophagus and five thickenings of the esophageal wall

  17. Ultrasound-guided radiofrequency ablation of thyroid gland: a preliminary study in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ji Won; Yoo, Seung Min [College of Medicine, Chungang University, Seoul, (Korea, Republic of); Kwak, Seo Hyun [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2005-07-15

    The purpose of this study was to evaluate the possibility of using radiofrequency ablation as the treatment modality for the benign or malignant thyroid nodules in humans. Therefore, we examined the results of using radiofrequency ablation on the thyroid glands in dogs, in respect of the extent of the ablated tissue and the complications. Five dogs (10 lobes of the thyroid glands) were included in this study. US-guided radiofrequency ablation was undertaken with a 10 mm, uncovered 17 gauge cool-tip needle. The power and duration was 20 wattage and 1 minute in five thyroid lobes (group 1) and 20 wattage and 2 minutes in another 5 thyroid lobes (group 2). The ultrasound scans and the pre-and post-enhancement CT scans were undertaken before and immediately after the procedures, and at 24 hours, 72 hours and 1 week later. The US and CT findings of the ablated tissue and complications were evaluated. Blood sampling was done at the pre-procedure time and 1 week later for evaluating the functional status of the thyroid gland. Laryngoscopy was done at the pre-procedure and post-procedure times, and at 24 hours, 72 hours and 1 week later for the evaluation of any recurrent laryngeal nerve palsy. The echo pattern of the ablated thyroid gland at immediately after the radiofrequency ablation appeared as poorly marginated and hyperechoic. On the US obtained 24 hours after radiofrequency ablation, the echo pattern of the ablated thyroid gland was hypoechoic. The maximum diameters after RFA were 9.4 {rho} 0.5 mm in group I and 11.4 {rho} 0.5 mm in group II. The pre-enhanced CT scan taken at immediately after the radiofrequency ablation showed ill defined hypodense areas in the ablated thyroid gland. Differentiation between the normal and abnormal portions of the thyroid gland was difficult on the contrast enhanced CT scan. Complications induced by radiofrequency ablation were one recurrent laryngeal nerve palsy, two perforations of esophagus and five thickenings of the esophageal

  18. The Success Rate of Initial {sup 131I} Ablation in Differentiated Thyroid Cancer: Comparison Between Less strict and Very Strict Low Iodine Diets

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Ik Dong; Kim, Sung Hoon; Seo, Ye Young; Oh, Jin Kyoung; O, Joo Hyun; Chung, Soo Kyo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-03-15

    To decrease the risk of recurrence or metastasis in differentiated thyroid cancer (DTC), selected patients receive radioactive iodine ablation of remnant thyroid tissue or tumor. A low iodine diet can enhance uptake of radioactive iodine. We compared the success rates of radioactive iodine ablation therapy in patients who followed two different low iodine diets (LIDs). The success rates of postsurgical radioactive iodine ablation in DTC patients receiving empiric doses of 150 mCi were retrospectively reviewed. First-time radioactive iodine ablation therapy was done in 71 patients following less strict LID. Less strict LID restricted seafood, iodized salt, egg yolk, dairy products, processed meat, instant prepared meals, and multivitamins. Very strict LID additionally restricted rice, freshwater fish, spinach, and soybean products. Radioactive iodine ablation therapy was considered successful when follow up {sup 123I} whole body scan was negative and stimulated serum thyroglobulin level was less than 2.0 ng/mL. The success rate of patients following less strict LID was 80.3% and for very strict LID 75.6%. There was no statistically significant difference in the success rates between the two LID groups (P=0.48). Very strict LID may not contribute to improving the success rate of initial radioactive iodine ablation therapy at the cost of great inconvenience to the patient.

  19. Diagnostic value of Tg and TgAb for metastasis following ablation in patients with differentiated thyroid carcinoma coexistent with Hashimoto thyroiditis.

    Science.gov (United States)

    Chai, Hong; Zhu, Zhao-Jin; Chen, Ze-Quan; Yu, Yong-Li

    2016-08-01

    This study was designed to investigate the clinical value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) measurements and the cutoff value after ablation in differentiated thyroid carcinoma (DTC) complicated by Hashimoto thyroiditis (HT) with metastasis. We measured serum Tg and TgAb levels and evaluated the disease status in 164 cases of DTC coexistent with HT in pathologically confirmed patients after surgery and post-remnant ablation during a 3-year follow-up. All Tg and TgAb levels were assessed by chemiluminescent immunoassay (IMA). Receiver operating characteristic (ROC) curve analysis was used to evaluate the prognostic value of Tg and TgAb for disease metastasis. The relationship between Tg and TgAb was analyzed using the scatter diagram distribution method. We found that the cutoff values of Tg and TgAb were 1.48 µg/L and 45 kIU/L, respectively. The area under the ROC curve (AUC) of Tg and TgAb was 0.907 and 0.650, respectively. In DTC coexistent with HT patients, the optimal cutoff value correlated with metastasis in Tg and TgAb was 1.48 µg/L and 45 kIU/L, respectively.

  20. Difficulties in deciding whether to ablate patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study

    Energy Technology Data Exchange (ETDEWEB)

    Frangos, Savvas; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla [Bank of Cyprus Oncology Centre, Department of Nuclear Medicine, Strovolos, Nicosia (Cyprus); Iakovou, Ioannis P.; Mpalaris, Vassilis; Giannoula, Evanthia I. [Aristotle University, Papageorgiou Hospital, Department of Nuclear Medicine, Thessaloniki (Greece); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States)

    2015-12-15

    We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the ''remnant score'' that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0 % of patients (104 of 336) had primary tumour multifocality, 22.0 % (74) had confirmed cervical lymph node metastases, 37.2 % (125) had unknown nodal status, and 38.1 % (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9 % of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with

  1. Difficulties in deciding whether to ablate patients with putatively "low-intermediate-risk" differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study.

    Science.gov (United States)

    Frangos, Savvas; Iakovou, Ioannis P; Marlowe, Robert J; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Mpalaris, Vassilis; Giannoula, Evanthia I

    2015-12-01

    We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively "low-intermediate-risk" differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the "remnant score" that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0% of patients (104 of 336) had primary tumour multifocality, 22.0% (74) had confirmed cervical lymph node metastases, 37.2% (125) had unknown nodal status, and 38.1% (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9% of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with putatively "low

  2. Difficulties in deciding whether to ablate patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma: do guidelines mainly apply in the centres that produce them? Results of a retrospective, two-centre quality assurance study

    International Nuclear Information System (INIS)

    Frangos, Savvas; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Iakovou, Ioannis P.; Mpalaris, Vassilis; Giannoula, Evanthia I.; Marlowe, Robert J.

    2015-01-01

    We determined the reasons for radioiodine thyroid remnant ablation, and the procedure's necessity based on postsurgical remnant size, in patients with putatively ''low-intermediate-risk'' differentiated thyroid carcinoma (DTC). We identified key clinicopathological, treatment and remnant characteristics, and factors associated with remnant size in 336 patients with pT1/2, M0 DTC ablated during the period September 2010 to October 2013 at one Cypriot or one Greek referral centre. Clinicopathological/treatment characteristics were compiled from charts. Experienced nuclear medicine physicians rated the numbers/intensities of uptake foci in the thyroid bed on postablation planar scintigrams using scales of 0-4 points and 0-3 points, respectively. The product of these scores was taken as the ''remnant score'' that ranged from 0 (no remnant) to 12 (multiple remnants, intense uptake). DTC was predominantly papillary. The median [25th-75th percentile] longest primary tumour diameter was 1.0 cm [0.7-1.5 cm]. Despite favourable histotypes and primary tumour classifications, patients often had preablation characteristics suggesting elevated or uncertain risk: 31.0 % of patients (104 of 336) had primary tumour multifocality, 22.0 % (74) had confirmed cervical lymph node metastases, 37.2 % (125) had unknown nodal status, and 38.1 % (128) had antithyroglobulin antibody seropositivity. The median [25th-75th percentile] remnant score was 4 [2-6]; 39.9 % of patients (134 of 336) had scores ≥6. For the entire cohort, T or N stages (r ≤ 0.174, P ≤ 0.05) correlated positively with the remnant score in a univariate Spearman analysis. The numbers of patients referred by the surgeon, cervical lymph nodes excised and metastatic nodes excised correlated negatively (r ≤ 0.243, P ≤ 0.038) with the remnant score, and the first two factors independently predicted the remnant score (P ≤ 0.037) in a multivariate analysis. Patients with

  3. 12-month efficacy of a single radiofrequency ablation on autonomously functioning thyroid nodules.

    Science.gov (United States)

    Bernardi, Stella; Stacul, Fulvio; Michelli, Andrea; Giudici, Fabiola; Zuolo, Giulia; de Manzini, Nicolò; Dobrinja, Chiara; Zanconati, Fabrizio; Fabris, Bruno

    2017-09-01

    Radiofrequency ablation has been advocated as an alternative to radioiodine and/or surgery for the treatment of autonomously functioning benign thyroid nodules. However, only a few studies have measured radiofrequency ablation efficacy on autonomously functioning benign thyroid nodules. The aim of this work was to evaluate the 12-month efficacy of a single session of radiofrequency ablation (performed with the moving shot technique) on solitary autonomously functioning benign thyroid nodules. Thirty patients with a single, benign autonomously functioning benign thyroid nodules, who were either unwilling or ineligible to undergo surgery and radioiodine, were treated with radiofrequency ablation between April 2012 and May 2015. All the patients underwent a single radiofrequency ablation, performed with the 18-gauge needle and the moving shot technique. Clinical, laboratory, and ultrasound evaluations were scheduled at baseline, and after 1, 3, 6, and 12 months from the procedure. A single radiofrequency ablation reduced thyroid nodule volume by 51, 63, 69, and 75 % after 1, 3, 6, and 12 months, respectively. This was associated with a significant improvement of local cervical discomfort and cosmetic score. As for thyroid function, 33 % of the patients went into remission after 3 months, 43 % after 6 months, and 50 % after 12 months from the procedure. This study demonstrates that a single radiofrequency ablation allowed us to withdraw anti-thyroid medication in 50 % of the patients, who remained euthyroid afterwards. This study shows that a single radiofrequency ablation was effective in 50 % of patients with autonomously functioning benign thyroid nodules. Patients responded gradually to the treatment. It is possible that longer follow-up studies might show greater response rates.

  4. Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation.

    Science.gov (United States)

    Che, Y; Jin, S; Shi, C; Wang, L; Zhang, X; Li, Y; Baek, J H

    2015-07-01

    Nodular goiter is one of the most common benign lesions in thyroid nodule. The main treatment of the disease is still the traditional surgical resection, however there are many problems such as general anesthesia, surgical scar, postoperative thyroid or parathyroid function abnormalities, and high nodules recurrence rate in residual gland. The purpose of this study was to compare the efficacy, safety, and cost-effectiveness of 2 treatment methods, surgery and radiofrequency ablation, for the treatment of benign thyroid nodules. From May 2012 to September 2013, 200 patients with nodular goiters who underwent surgery (group A) and 200 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) hyperfunctioning nodules related to thyrotoxicosis, and 4) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18-ga internally cooled electrode were used. We compared the 2 groups in terms of efficacy, safety, and cost-effectiveness during a 1-year follow-up. After radiofrequency ablation, the nodule volume decreased significantly from 5.4 to 0.4 mL (P = .002) at the 12-month follow-up. The incidence of complications was significantly higher from surgery than from radiofrequency ablation (6.0% versus 1.0%, P = .002). Hypothyroidism was detected in 71.5% of patients after surgery but in none following radiofrequency ablation. The rate of residual nodules (11.9% versus 2.9%, P = .004) and hospitalization days was significantly greater after surgery (6.6 versus 2.1 days, P radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules. © 2015 by American

  5. Whole-remnant and maximum-voxel SPECT/CT dosimetry in {sup 131}I-NaI treatments of differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mínguez, Pablo, E-mail: pablo.minguezgabina@osakidetza.eus [Department of Medical Radiation Physics, Lund University, Lund 22185, Sweden and Department of Medical Physics, Gurutzeta/Cruces University Hospital, Barakaldo 48903 (Spain); Flux, Glenn [Joint Department of Physics, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton SM2 5PT (United Kingdom); Genollá, José; Delgado, Alejandro; Rodeño, Emilia [Department of Nuclear Medicine, Gurutzeta/Cruces University Hospital, Barakaldo 48903 (Spain); Sjögreen Gleisner, Katarina [Department of Medical Radiation Physics, Lund University, Lund 22185 (Sweden)

    2016-10-15

    Purpose: To investigate the possible differences between SPECT/CT based whole-remnant and maximum-voxel dosimetry in patients receiving radio-iodine ablation treatment of differentiated thyroid cancer (DTC). Methods: Eighteen DTC patients were administered 1.11 GBq of {sup 131}I-NaI after near-total thyroidectomy and rhTSH stimulation. Two patients had two remnants, so in total dosimetry was performed for 20 sites. Three SPECT/CT scans were performed for each patient at 1, 2, and 3–7 days after administration. The activity, the remnant mass, and the maximum-voxel activity were determined from these images and from a recovery-coefficient curve derived from experimental phantom measurements. The cumulated activity was estimated using trapezoidal-exponential integration. Finally, the absorbed dose was calculated using S-values for unit-density spheres in whole-remnant dosimetry and S-values for voxels in maximum-voxel dosimetry. Results: The mean absorbed dose obtained from whole-remnant dosimetry was 40 Gy (range 2–176 Gy) and from maximum-voxel dosimetry 34 Gy (range 2–145 Gy). For any given patient, the activity concentrations for each of the three time-points were approximately the same for the two methods. The effective half-lives varied (R = 0.865), mainly due to discrepancies in estimation of the longer effective half-lives. On average, absorbed doses obtained from whole-remnant dosimetry were 1.2 ± 0.2 (1 SD) higher than for maximum-voxel dosimetry, mainly due to differences in the S-values. The method-related differences were however small in comparison to the wide range of absorbed doses obtained in patients. Conclusions: Simple and consistent procedures for SPECT/CT based whole-volume and maximum-voxel dosimetry have been described, both based on experimentally determined recovery coefficients. Generally the results from the two approaches are consistent, although there is a small, systematic difference in the absorbed dose due to differences in the

  6. [Current situation and thoughts on radiofrequency ablation in the treatment of thyroid cancers].

    Science.gov (United States)

    Zhang, H; Dong, W W

    2017-08-01

    Radiofrequency ablation (RFA) was originally used primarily for the treatment of regional metastatic lymph nodes from recurrent thyroid cancers in the field of thyroid surgery. In recent years it is gradually used to treat a part of benign thyroid nodules. However, the domestic issues resulting from indiscriminately enlarged RFA indication and lack of standardization of therapy become more and more prominent, including initial treatment of operable thyroid cancers by RFA, which is against by the current consensus about RFA for patients with thyroid nodules and management guidelines for patients with thyroid cancers. Therefore, RFA should be avoided for initial treatment of operable thyroid cancers before the introduction of guidelines based on evidence-based medicine.

  7. Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

    International Nuclear Information System (INIS)

    Caballero-Calabuig, Elisa; Cano-Terol, Carmen; Sopena-Monforte, Ramon; Reyes-Ojeda, Dolores; Abreu-Sanchez, Pedro; Ferrer-Rebolleda, Jose; Sopena-Novales, Pablo; Plancha-Mansanet, Carmen; Felix-Fontestad, Jesus

    2008-01-01

    Stimulated thyroglobulin (Tg) and 131 I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful. Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant. Discordant 131 I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants. We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative. (orig.)

  8. Influence of the thyroid remnant in the elevation of the serum thyroglobulin after thyroidectomy in differentiated thyroid carcinoma. Importance of the diagnostic iodine total-body scanning

    Energy Technology Data Exchange (ETDEWEB)

    Caballero-Calabuig, Elisa; Cano-Terol, Carmen; Sopena-Monforte, Ramon; Reyes-Ojeda, Dolores; Abreu-Sanchez, Pedro; Ferrer-Rebolleda, Jose; Sopena-Novales, Pablo; Plancha-Mansanet, Carmen; Felix-Fontestad, Jesus [Hospital Universitario Dr. Peset - Medicina Nuclear, Valencia, Valencia (Spain)

    2008-08-15

    Stimulated thyroglobulin (Tg) and {sup 131}I total-body scan (TBS) have been the mainstays of differentiated thyroid carcinoma (DTC), but now diagnostic TBS has been eliminated from some follow-up protocols. Nevertheless, Tg can be negative in the presence of thyroid tissue, and moderately elevated Tg poses management problems. The purpose of this study was to check how many patients have Tg negative but visible thyroid tissue and if diagnostic TBS could be clinically useful. Retrospective review of 317 exams (stimulated Tg and TBS) of 128 patients with DTC. Patients with high-grade criteria and/or positive autoantibodies are excluded. Tg is considered positive if higher than the sensitivity level of the technique. TBS is positive if thyroid remnant, lymphatic node or metastases are detected. Results are classified in Tg and TBS concordant or discordant. Discordant {sup 131}I TBS and Tg were found in 74/317 studies (23.3%), 48 (65%) being TBS positive and Tg negative. None of 128 patients had a first post-surgery negative scan, but 13 (10%) were Tg negative, even two patients with lymph node uptake. One year after radioiodine treatment, 26 out of 115 patients (initially Tg and TBS concordant positive) showed Tg negative and TBS still positive due to cervical remnants (20 patients), lymph node uptake (one) and metastasis (five); 20 patients remained Tg and TBS positive, but 14 of them only showed thyroid remnants. We propose to perform periodic diagnostic TBS to improve Tg specificity, at least while neck thyroid activity is detected, even if Tg is negative. (orig.)

  9. Detection of the Single-Session Complete Ablation Rate by Contrast-Enhanced Ultrasound during Ultrasound-Guided Laser Ablation for Benign Thyroid Nodules: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Shuhua Ma

    2016-01-01

    Full Text Available This study aimed to investigate the single-session complete ablation rate of ultrasound-guided percutaneous laser ablation (LA for benign thyroid nodules. LA was performed in 90 patients with 118 benign thyroid nodules. Contrast-enhanced ultrasound (CEUS was used to evaluate complete nodule ablation one day after ablation. Thyroid nodule volumes, thyroid functions, clinical symptoms and complications were evaluated 1, 3, 6, 12, and 18 months after ablation. Results showed that all benign thyroid nodules successfully underwent LA. The single-session complete ablation rates for nodules with maximum diameters ≤2 cm, 2-3 cm and ≥3 cm were 93.4%, 70.3% and 61.1%, respectively. All nodule volumes significantly decreased than that one day after ablation (P0.05. Three patients had obvious pain during ablation; one (1.1% had recurrent laryngeal nerve injury, but the voice returned to normal within 6 months after treatment. Thus, ultrasound-guided LA can effectively inactivate benign thyroid nodules. LA is a potentially viable minimally invasive treatment that offers good cosmetic effects.

  10. Case Experience of Radiofrequency Ablation for Benign Thyroid Nodules: From an Ex Vivo Animal Study to an Initial Ablation in Taiwan

    Directory of Open Access Journals (Sweden)

    Ming-Tsang Lee

    2016-03-01

    Full Text Available Radiofrequency ablation (RFA is a minimally invasive technique, used with ultrasound or computed tomography guidance, which can produce tissue coagulation necrosis in various kinds of tumors in the human body. In the past 10 years, numerous studies about RFA in benign thyroid nodules have been published. Reviewing these studies, we noticed that the effectiveness of ablation was higher when it was performed with the “moving-shot technique” via an internally cooled electrode. A consensus statement published from the Korean Society of Radiology also suggested the moving-shot technique as a standard ablation procedure for benign thyroid nodule ablation in Korea. In Taiwan, most symptomatic benign nodules are currently treated with surgical removal. RFA for mass lesions is primarily performed for the treatment of metastatic hepatic tumors. In our case, we have attempted to introduce RFA for benign thyroid nodules in Taiwan. Because endocrinologists in Taiwan were not familiar with this technique, we adopted a stepwise approach in learning how to perform RFA. We conducted ex vivo animal ablation exercises to gain experience in setting the radiofrequency generator for the right ablation mode and appropriate power output. The thyroid nodule volume reduction rate after 1 year of follow up was approximately 50% in this case. The most important thing we learned from this trial is that we confirmed the safety of thyroid nodule ablation. To the best of our knowledge, this is the first reported study of RFA of a thyroid nodule in Taiwan.

  11. Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients.

    Science.gov (United States)

    Liu, Yu-Jiang; Qian, Lin-Xue; Liu, Dong; Zhao, Jun-Feng

    2017-09-01

    The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients' clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

  12. Clinical significance of vagus nerve variation in radiofrequency ablation of thyroid nodules

    International Nuclear Information System (INIS)

    Ha, Eun Ju; Baek, Jung Hwan; Lee, Jeong Hyun; Shong, Young Kee; Kim, Jae Kyun

    2011-01-01

    To evaluate the types and incidence of vagus nerve variations and to assess factors related to the vulnerability of vagus nerves during the radiofrequency (RF) ablation of thyroid nodules. Bilateral vagus nerves of 304 consecutive patients who underwent ultrasound of the neck were assessed. Two radiologists evaluated vagus nerve type (types 1-4; lateral/anterior/medial/posterior), the shortest distance between the thyroid gland and vagus nerve, and thyroid contour. Vagus nerve vulnerability was defined as a vagus nerve located within 2 mm of the thyroid gland through the ex vivo experiments, and factors associated with vulnerability were assessed. We were unable to find one vagus nerve. Of the 607 vagus nerves, 467 (76.9%) were type 1, 128 (21.1%) were type 2, 10 (1.6%) were type 3, and 2 (0.3%) were type 4, with 81 (13.3%) being vulnerable. Univariate analysis showed that sex, location, thyroid contour and type were significantly associated with vagus nerve vulnerability. Multivariate analysis showed that bulging contour caused by thyroid nodules (P = 0.001), vagus nerve types 2/4 (P < 0.001) and type 3 (P < 0.001) were independent predictors. The operator should pay attention to anatomical variations and the resulting vagus nerve injury during RF ablation of bulging thyroid nodules. (orig.)

  13. The outcome of I-131 ablation therapy for intermediate and high-risk differentiated thyroid cancer using a strict definition of successful ablation

    International Nuclear Information System (INIS)

    Watanabe, Ken; Uchiyama, Mayuki; Fukuda, Kunihiko

    2017-01-01

    This article examines the outcome of radioactive iodine ablation therapy for thyroid cancer in nigh-risk patients and investigates background factors influencing ablation failure. We included 91 patients in this retrospective analysis and evaluated the ablation success rate. Successful ablation was defined as the absence of visible iodine-131 (I-131) accumulation in the thyroid bed after whole-body scans and thyroglobulin levels <2 ng/ml in a TSH-stimulated state after ablation. We extracted data on patients' age, sex, I-131 dose, pathology, resection stump findings, tumor T category and thyroglobulin levels, which could affect ablation outcome. Successful ablation was achieved in only 14 patients (15.4%). Pre-ablation serum thyroglobulin levels were significantly higher in the ablation failure group than in the success group (P < 0.001), while no significant differences were found for other factors between the groups. Furthermore, thyroglobulin levels >10 ng/ml were significantly related to ablation failure after multivariate analysis (odds ratio 27.2; 95% confidence interval 2.469-299.7; P = 0.007). The ablation success rate was very low because of high thyroglobulin levels, even with high-dose I-131. High-risk patients, especially those with high thyroglobulin levels (>10 ng/ml), are unlikely to reach levels low enough to meet successful ablation criteria. (author)

  14. The outcome of I-131 ablation therapy for intermediate and high-risk differentiated thyroid cancer using a strict definition of successful ablation.

    Science.gov (United States)

    Watanabe, Ken; Uchiyama, Mayuki; Fukuda, Kunihiko

    2017-09-01

    This article examines the outcome of radioactive iodine ablation therapy for thyroid cancer in high-risk patients and investigates background factors influencing ablation failure. We included 91 patients in this retrospective analysis and evaluated the ablation success rate. Successful ablation was defined as the absence of visible iodine-131 (I-131) accumulation in the thyroid bed after whole-body scans and thyroglobulin levels sex, I-131 dose, pathology, resection stump findings, tumor T category and thyroglobulin levels, which could affect ablation outcome. Successful ablation was achieved in only 14 patients (15.4%). Pre-ablation serum thyroglobulin levels were significantly higher in the ablation failure group than in the success group (P 10 ng/ml were significantly related to ablation failure after multivariate analysis (odds ratio 27.2; 95% confidence interval 2.469-299.7; P = 0.007). The ablation success rate was very low because of high thyroglobulin levels, even with high-dose I-131. High-risk patients, especially those with high thyroglobulin levels (>10 ng/ml), are unlikely to reach levels low enough to meet successful ablation criteria.

  15. Oedema of the neck after ablation of the thyroid with radioactive iodine

    International Nuclear Information System (INIS)

    Goolden, A.W.G.; Kam, K.C.; Fitzpatrick, M.L.; Munro, A.J.

    1986-01-01

    Six out of 30 patients who underwent thyroid ablation with 131 I during the period 1975-85 developed acute oedema of the neck within 48 h of the therapeutic dose. The condition was painless and responded well to treatment with corticosteroids. The early onset and absence of pain distinguish this complication from radiation thyroiditis. Dosage calculations and thermoluminescent-dosemeter measurements of the dose at various points on the anterior surface of the neck of a patient with a toxic adenoma of the thyroid treated with 131 I were in fairly good agreement with one another and confirmed that the oedema of the neck could not be a direct effect of irradiation on the extrathyroidal tissues. It is suggested that this phenomenon may be a hypersensitivity reaction associated with massive destruction of thyroid tissue. (author)

  16. Laser, radiofrequency, and ethanol ablation for the management of thyroid nodules.

    Science.gov (United States)

    Papini, Enrico; Gugliemi, Rinaldo; Pacella, Claudio Maurizio

    2016-10-01

    The majority of benign thyroid nodules are nearly asymptomatic, remain stable in size, and do not require treatment. However, a minority of patients with growing nodules may complain of local symptoms or have cosmetic concerns, and thus seek surgical consultation. The timely use of ultrasound-guided minimally invasive procedures can change the natural history of benign enlarging thyroid nodules. The procedures produce persistent shrinkage of thyroid nodules and are associated with improvement of local symptoms. Among the various procedures, percutaneous ethanol injection represents the first-line treatment for relapsing thyroid cysts. In solid nonfunctioning nodules, laser and radiofrequency ablation produces a more than 50% reduction in nodular volume that remains persistent over several years. For hyperfunctioning nodules, thermal ablation techniques are not appropriate unless radioactive iodine is contraindicated or not accessible. MITs are best suited for the management of medium or large-sized nodules that are sonographically well visualized. Conversely, large nodules or nodular goiters that extend into the chest are difficult to treat. MITs are performed in outpatient clinics, are less expensive, and have a lower risk of complications, compared to surgery, and usually do not induce thyroid dysfunction. However, malignancy should be ruled out with a dedicated ultrasound neck assessment and repeat fine needle aspiration of the lesion before treatment.

  17. The advent of ultrasound-guided ablation techniques in nodular thyroid disease

    DEFF Research Database (Denmark)

    Papini, Enrico; Pacella, Claudio M; Misischi, Irene

    2014-01-01

    non-functioning thyroid nodules that grow or become symptomatic, trained operators may safely induce, with a single session of laser ablation treatment or radiofrequency ablation, a 50% volume decrease and, in parallel, improve local symptoms. In contrast, hyperfunctioning nodules remain best treated...... minimally invasive treatments, directed towards office-based management of symptomatic nodules, without requiring general anaesthesia, and with negligible damage to the skin and cervical tissues, have been proposed during the past two decades. Today, ultrasound-guided percutaneous ethanol injection...

  18. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Seo, Ye Young [Dept. of Nuclear Medicine, College of Medicine, The Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of); Ryu, Ji Young [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-12-15

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

  19. Correlation of consecutive serum thyroglobulin levels during hormone withdrawal and failure of initial radioiodine ablation in thyroid cancer patients

    International Nuclear Information System (INIS)

    Yoon, Hyuk Jin; Kim, Sung Hoon; O, Joo Hyun; Lee, Yeong Joo; Kim, Hyoung Woo; Seo, Ye Young; Ryu, Ji Young

    2015-01-01

    The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3–4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5–10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients

  20. Iodine-131 saliva secretion in ablation treatment for thyroid cancer patients

    International Nuclear Information System (INIS)

    Nascimento, Ana C.H.; Brandao, Luis E.; Candeiro, Ricardo E.; Rebelo, Ana M.O.; Corbo, Rossana; Dutra, Janaina

    2008-01-01

    In general, well-differentiated thyroid cancer treatment consists in Na 131 I administration following total or a near total thyroidectomy. The activity of a single administration in the majority of nuclear centers ranges from 1 to 4 GBq for residual thyroid tissue elimination and ranges from 4 to 8 GBq for residual thyroid tissue as well as metastases elimination. The high magnitude of 131 I activities administered for thyroid cancer treatment can lead to side effects, where salivary gland dysfunctions are the most common observed. In the absence of thyroid gland, secondary tissues - iodide specific uptake, mainly the salivary glands, rise at the element body retention process. In addition, among nuclear medicine professionals, there is no consensus about suitable restrictions that must be observed by the hospital released patient to avoid 131 I contamination by saliva. The aim of this study is to evaluate qualitatively the secretion of 131 I by salivary glands after the administration of the radionuclide to thyroid cancer patients for ablation purposes. Well-differentiated thyroid cancer patients from Clementino Fraga Filho University Hospital (HUCFF) of Federal University of Rio de Janeiro (UFRJ) followed-up in the present study are female, adult and without additional health diseases detected. After 131 I administration for ablation purposes, saliva samples were collected systematically and counting rate was assessed using a NaI(Tl) scintillator detector. As the study is at an early stage, the preliminary results concern the possibility of conducting an evaluation of 131 I secreted in saliva using the proposed protocol. It can be seen that many factors have potential to influence the behaviour of 1 31 I secretion in saliva, for example the use of Na 131 I in solution or in capsules. It was observed two standards that can be defined according to these variables. (author)

  1. Ultrasound guided percutaneous microwave ablation of benign thyroid nodules: Safety and imaging follow-up in 222 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yue, Wenwen [Binzhou Medical University, #346 Guan-hai Road, Lai-shan, Yantai, Shandong 264003 (China); Wang, Shurong, E-mail: 7762808@sina.com [Department of Ultrasound, Muping Area People' s Hospital, #629 Nan-hua Street, Mu-ping, Yantai, Shandong 264100 (China); Wang, Bin [Binzhou Medical University, #346 Guan-hai Road, Lai-shan, Yantai, Shandong 264003 (China); Xu, Qingling; Yu, Shoujun; Yonglin, Zhang; Wang, Xiju [Department of Ultrasound, Muping Area People' s Hospital, #629 Nan-hua Street, Mu-ping, Yantai, Shandong 264100 (China)

    2013-01-15

    Objective: Microwave ablation is a minimally invasive technique that has been used to treat benign and malignant tumors of liver, lung and kidney. Towards thyroid nodules, only a few cases are reported so far. The aim of the study was to investigate the effectiveness and safety of ultrasound-guided percutaneous microwave ablation in the treatment of benign thyroid nodules with a large sample. Materials and methods: A total of 477 benign thyroid nodules in 222 patients underwent microwave ablation in our department from July 2009 to March 2012. Microwave ablation was carried out using microwave antenna (16G) under local anesthesia. Nodule volume, thyroid function and clinical symptoms were evaluated before treatment and at 1, 3, more than 6 months. The study was ethics committee approved and written informed consents were obtained from all patients. Results: All thyroid nodules significantly decreased in size after microwave ablation. A 6-month follow-up was achieved in 254 of 477 nodules, and the mean decrease in the volume of thyroid nodules was from 2.13 ± 4.42 ml to 0.45 ± 0.90 ml, with a mean percent decrease of 0.65 ± 0.65. A volume-reduction ratio greater than 50% was observed in 82.3% (209/254) of index nodules, and 30.7% (78/254) of index nodules disappeared 6-month after the ablation. The treatment was well tolerated and no major complications were observed except pain and transient voice changes. Conclusions: Microwave ablation seems to be a safe and effective technique for the treatment of benign thyroid nodules. Further prospective randomized studies are needed to define the role of the procedure in the treatment of thyroid nodules.

  2. Prognostic value of postoperative stimulated thyroglobulin levels on 131I ablation therapy in papillary thyroid cancer

    International Nuclear Information System (INIS)

    Gao Zairong; Chang Wei; Cui Kunwei; Chang Guoxiang; Huang Daijuan; Zhang Yongxue

    2009-01-01

    Objective: Stimulated thyroglobulin (Tg) levels postablation was associated with disease recurrence in papillary thyroid cancer (PTC). The aim of this study was to evaluate the prognostic value of postoperative stimulated Tg level on future Tg positivity after 131 I ablation therapy in PTC. Methods: One hundred and thirty-eight patients (28 men, 110 women; age range 6-70 years, mean age 39.4 years) with PTC were included in this study. All patients underwent total or near-total thyroidectomy, and 102 of these patients had lymphadenectomy. All patients had a documented PTC. 131 I ablation was performed in 3- 4 weeks after thyroidectomy. Sera levels of thyroid hormones (FT 3 , FT 4 ), thyrotropin (TSH), anti-Tg anti-body (TgAb), and Tg were measured before and after 13I ablation. Statistical analysis was performed with SPSS 13.0 software, and correlation analysis and t-test were used. Results: Postoperative stimulated Tg lev-el had a significantly positive association with postablation stimulated Tg level (r = 0. 960, P 131 I ablation therapy. Total or near-total thyroidectomy simultaneously conjugated with lymphadenectomy might have a better result in lower postablation stimulated Tg positivity in patients with PTC. (authors)

  3. Differentiated thyroid cancer. New concept of radioiodine ablation; Differenziertes Schilddruesenkarzinom. Fortschritte bei der Radioiodablation

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    Dietlein, M.; Kobe, C. [Universitaetsklinikum Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Universitaetsklinikum Koeln (Germany), Zentrum fuer Integrierte Onkologie Koeln-Bonn; Luster, M. [Universitaetsklinikum Ulm (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2010-12-15

    Ablative radioiodine therapy is the treatment of choice in patients with differentiated thyroid cancer, the only exception being the unifocal, very small papillary thyroid cancer. The TSH-stimulation can be achieved by a waiting period for 2-3 weeks after thyroidectomy without medication or by the use of recombinant human TSH (rhTSH). Both options lead to high success rates. 'Single dose cure' using activities between 1.85 and 3.7 GBq {sup 131}I is standard. Since 2010 rhTSH is approved by the EMA for the indications pT1-4, N0-1, cM0. Survey studies did not find any inferiority of ablation with rhTSH or iatrogenic hypothyroidism in the high-risk patient group. Renal clearance is not reduced after rhTSH administration, thus the {sup 131}I blood dose and the whole body doses are lower in patients under rhTSH. Comparing identical {sup 131}I activities after endogeneous or exogeneous stimulation, rhTSH will minimize the acute adverse effects of {sup 131}I. A short-term withdrawal of levothyroxine some days before rhTSH-injection lowers the iodine plasma level, which may be advantageous for the ablation success if lower 131I activities are used. A rhTSH-based diagnostic {sup 131}I whole-body scintigraphy 3-6 months after ablation is standard for therapy control. At this time, the rhTSH-stimulated thyroglobulin-level is essential for a personalized risk stratification. Tg-measurements by a second generation assay should be used for follow-up care. Metaanalyses have shown that radioiodine ablation lowers the mortality rate, the risk of locoregional recurrences and the risk of late metastasizing. Therefore, ablation has shown a clear benefit. (orig.)

  4. Destruction of post-surgery thyroid remnants by 19 mCi (703 MBq) of iodine 131

    International Nuclear Information System (INIS)

    Tassy, D.; Lonchampt, M.F.; Minebois, A.; Antigny, J.F.

    1997-01-01

    The adjuvant treatment by iodine 131 in good prognostic forms of differentiated thyroid cancers (DTC) makes not the object of a general consensus. There is no study demonstrating the benefit from such a treatment. Administration of an elevated iodine 131 activity and the constraint of a supplementary hospitalization are in these conditions questionable. In 6 patients, presenting the criteria of good prognostic and in post-operation, ambulatory conditions, administration of 19 mCi (703 MBc) of iodine 131 was done without previous administration of tracing dosage, followed after 72 hours by a whole-body scintigraphy, in the usual pause conditions. This administration was repeated 6 to 12 months later and followed by a new scintigraphic examination. The cervical fixation of iodine 131 was established qualitatively and quantitatively (as compared with a control zone). Five/six patients presented initially a cervical intense fixation with the star-like usual image and 1/6 patient a moderated fixation. Beginning with the second administration no cervical fixation was noted in 4/6 patients and a very low fixation in 2/6 patients. The concomitantly measured thyroglobulin, under simulation by TSH endogenous, was 131 I after quasi-total thyroidectomy in good-prognostic forms of DTC, without administration of previous tracing dosage to avoid possible phenomena of thyroid tissue blocking, allows probably, in overwhelming majority of cases, both a full or quasi-full destruction of the thyroid remnants and a severe reduction in the thyroglobulin rate measured in the conditions of pause of hormone-therapy

  5. Factors associated with initial incomplete ablation for benign thyroid nodules after radiofrequency ablation: First results of CEUS evaluation.

    Science.gov (United States)

    Zhao, Chong-Ke; Xu, Hui-Xiong; Lu, Feng; Sun, Li-Ping; He, Ya-Ping; Guo, Le-Hang; Li, Xiao-Long; Bo, Xiao-Wan; Yue, Wen-Wen

    2017-01-01

    To assess the factors associated with initial incomplete ablation (ICA) after radiofrequency ablation for benign thyroid nodules (BTNs). 69 BTNs (mean volume 6.35±5.66 ml, range 1.00-25.04 ml) confirmed by fine-needle aspiration cytology (FNAC) in fifty-four patients were treated with ultrasound-guided percutaneous radiofrequency ablation (RFA) and the local treatment efficacy was immediately assessed by intra-procedural contrast-enhanced ultrasound (CEUS). The RFA was performed with a bipolar electrode (CelonProSurge 150-T20, output power: 20 W). CEUS was performed with a second generation contrast agent under low acoustic power (i.e. coded phase inversion, CPI). Characteristics of clinical factors, findings on conventional gray-scale ultrasound, color-Doppler ultrasound, and CEUS were evaluated preoperatively. Factors associated with initial ICA and initial ICA patterns on CEUS were assessed. Volume reduction ratios (VRRs) of ICA nodules were compared with those with complete ablation (CA). The RFA procedures were accomplished with a mean ablation time and mean total energy deposition of 11.13±3.39 min (range, 5.38-22.13 min) and 12612±4466 J (range, 6310-26130 J) respectively. CEUS detected initial ICA in 21 of 69 (30.8%) BTNs and 16 (76.2%) of the 21 BTNs with initial ICA achieved CA after additional RFA, leading to a final CA rate of 92.8% (64/69). The factors associated with initial ICA were predominantly solid nodule, nodule close to danger triangle area, nodule close to carotid artery, and peripheral blood flow on color-Doppler ultrasound (all P 50% at the 6-month follow-up, among which 7 nodules (10.1%) had VRRs of >90%. There were significant differences in VRRs between ICA nodules and CA nodules at the 3- and 6-month follow-up (all P ultrasound. CEUS assists quick treatment response evaluation and facilitates subsequent additional RFA and final CA of the nodules. Nodules with CA achieve a better outcome in terms of VRR in comparison with

  6. Effectiveness of L-thyroxine treatment on TSH suppression during pregnancy in patients with a history of thyroid carcinoma after total thyroidectomy and radioiodine ablation

    International Nuclear Information System (INIS)

    Krhin, Blaz; Besic, Nikola

    2012-01-01

    There are scarce data about the optimal increase of L-thyroxine dose during pregnancy in patients with a history of thyroid carcinoma. The first aim of the study was to find out if routine therapeutic measures enable adequate TSH suppression in pregnancy. The other aim was to find out the optimal dose of L-thyroxine for TSH suppression in pregnant women. In this retrospective observational study, we analysed 36 pregnancies of 32 women with a history of thyroid carcinoma. Before pregnancy, all of them underwent total thyroidectomy and radioiodine ablation of thyroid remnant, and they were on suppressive doses of L-thyroxine. Thyroid function tests were obtained before, during and after pregnancy. Mean L-thyroxine dose before pregnancy, in the first, second and, third trimester and after delivery was 149, 147, 155, 165 and 158 micrograms daily, respectively. TSH concentration remained suppressed in 9 pregnancies, it was within normal range in 22 and elevated in 5 pregnancies. The mean dose of L-thyroxine in patients with suppressed TSH before pregnancy, in the first, second and, third trimester and after delivery was 154, 154, 164, 160 and 161 micrograms daily, respectively. When the dose had to be changed, the mean increase of the dose was 31.5 micrograms daily. The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide. TSH was adequately suppressed in only 25% of pregnancies. The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively

  7. Role of ultrasound in the assessment of percutaneous laser ablation of cervical metastatic lymph nodes from thyroid carcinoma.

    Science.gov (United States)

    Zhang, Lu; Zhou, Wei; Zhan, WeiWei

    2018-04-01

    Background Few studies have examined the feasibility and efficiency of performing ultrasound and contrast-enhanced ultrasound (CEUS) after percutaneous laser ablation (PLA) of cervical metastatic lymph nodes from thyroid cancer. Purpose To investigate and describe the use of conventional ultrasound and CEUS in evaluating PLA of metastatic lymph nodes. Material and Methods PLA was performed in a small, prospective, observational study of 21 metastatic lymph nodes in 17 thyroid cancer patients who underwent radical thyroid resection. CEUS was conducted prior to PLA and 1 h and seven days after ablation. Conventional ultrasound examination of all nodes was performed during follow-up after ablation. We observed contrast agent perfusion in the lymph nodes, calculated perfusion defect volumes using CEUS and determined the rates of reduction for metastatic lymph nodes for a mean duration of 17.86 ± 4.704 months (range = 12-27 months). Results CEUS demonstrated that the perfusion defect volume was larger on day 7 than on day 1 post-ablation in 47% of the ablated nodes. Compared to the largest diameters and volumes pre-PLA, the corresponding post-PLA values significantly decreased ( P  0.05 versus baseline). Conclusion CEUS can be effectively used to distinguish the margins of ablated regions, assess the accuracy of PLA, and monitor short-term changes in necrotic areas. However, long-term follow-up assessments of the curative effect of PLA will predominantly rely on conventional ultrasonography.

  8. Heath-related quality of life in thyroid cancer patients following radioiodine ablation

    Directory of Open Access Journals (Sweden)

    Henry Jean-françois

    2011-05-01

    Full Text Available Abstract Background There is limited information about the medium to long-term health-related quality of life (QOL in thyroid cancer patients after initial therapy and the existing studies suffer from limitations. The aim of the study was to assess the determinants of medium-term QOL after the initial therapy. Methods Following a total thyroidectomy, 88 thyroid cancer patients received either rhTSH or hypothyroid-assisted radioiodine ablation (RRA using 3.7 GBq (100 mCi of radioiodine. QOL evaluation of the patients using the validated Functional Assessment of Chronic Illness & Therapy (FACIT was performed at the time of inclusion (t0 and later at the 9-month post-RRA (t1. Results 83 patients were eligible for the final evaluation. Medium-term FACIT scores were not statistically different between t0 and t1 patients. All but one domain of the QOL score was similar between t0 and t1. Using a multivariate analysis, only age and immediate postoperative QOL scores were found to be determinants of the overall medium term 9-month QOL scores. Analysis showed that 'high QOL levels' (baseline and 9-month and 'no depression', 'low anxiety levels', were associated with ' Conclusions The use of radioiodine ablation does not seem to affect the medium term QOL scores of patients. Medium-term QOL is mainly determined by pre-ablation QOL. The assessment of baseline QOL might be interesting to evaluate in order to adapt the treatment protocols, the preventive strategies, and medical information to patients for potentially improving their outcomes.

  9. The follow-up of patients with differentiated thyroid cancer and undetectable thyroglobulin (Tg) and Tg antibodies during ablation

    NARCIS (Netherlands)

    Phan, Ha T. T.; Jager, Pieter L.; van der Wal, Jacqueline E.; Sluiter, Wim J.; Plukker, John T. M.; Dierckx, Rudi A. J. O.; Wolffenbuttel, Bruce H. R.; Links, Thera P.

    Objective: This retrospective study describes the rote of serum thyroglobulin (Tg) in relation to tumor characteristics in the prediction of persistent/recurrent disease in patients with differentiated thyroid cancer (DTC) with negative Tg at the time of ablation. Design: Between 1989 and 2006, 94

  10. The prevalence of thyroid tissue along the thyroglossal tract on SPECT/CT following I131 ablation therapy after total thyroidectomy for thyroid cancer

    International Nuclear Information System (INIS)

    Barber, T.W.; Cherk, M.H.; Yap, K.S.K.; Kalff, V.; Topliss, D.J.; Serpell, J.W.

    2015-01-01

    Full text of publication follows. Aim: the aims of this study are first to determine the prevalence of thyroid tissue along the thyroglossal tract on SPECT/CT and secondly to assess the contribution of this tissue to total neck I-131 activity in patients treated with I-131 ablation therapy after total thyroidectomy for thyroid cancer. Materials and methods: a total of 63 consecutive patients with well differentiated thyroid cancer treated with total thyroidectomy underwent whole body planar imaging and SPECT/CT of the neck 48 hours following ablative I-131 therapy. On SPECT/CT, thyroglossal tract thyroid tissue was defined as radioiodine activity in the anterior neck, superior to the thyroid bed in close proximity to the midline without evidence of localisation to lymph nodes. On planar imaging, thyroglossal tract thyroid tissue was defined as linear radioiodine activity in the midline of the neck superior to the thyroid bed. SPECT/CT and planar images were classified by two independent reviewers as positive, negative or equivocal with interobserver agreement quantified using a Kappa score. Disagreement was resolved using a third reviewer. Quantitation of thyroglossal tract thyroid tissue and total neck I-131 activity was performed using region of interest analysis on planar imaging following localisation on SPECT/CT. Results: thyroglossal tract thyroid tissue was present in 31/63 (49%; 95% CI: 37-61%) patients on SPECT/CT. In these 31 patients, thyroglossal tract thyroid tissue contributed to an average of 49% of total neck activity. Interobserver agreement was substantial on SPECT/CT (Kappa = 0.76; 95% CI: 0.61-0.91) and fair on planar imaging (Kappa = 0.31; 95% CI: 0.15-0.47). Conclusion: thyroid tissue along the thyroglossal tract was present in one half of patients in our study population and can contribute to a significant amount of total neck I-131 activity. Given the high prevalence of thyroglossal tract thyroid tissue, our results suggest that total neck

  11. Effect of Thyroid Remnant Volume on the Risk of Hypothyroidism After Hemithyroidectomy: A Prospective Study.

    Science.gov (United States)

    Lang, Brian Hung-Hin; Wong, Carlos K H; Wong, Kai Pun; Chu, Kelvin Ka-Wan; Shek, Tony W H

    2017-06-01

    Hypothyroidism is a common sequel after a hemithyroidectomy. Although various risk factors leading to hypothyroidism have been reported, the effect of the contralateral lobe's volume has been understudied. This study aimed to examine the association between the preoperative contralateral lobe's volume and the risk of postoperative hypothyroidism. During a 2-year period, 150 eligible patients undergoing a hemithyroidectomy were evaluated. The volume of the contralateral nonexcised lobe was estimated preoperatively by independent assessors on ultrasonography using the following formula: width (in cm) × depth (in cm) × length (in cm) × (π/6), adjusted for the body surface area (BSA). Postoperative hypothyroidism was defined as serum thyroid-stimulating hormone (TSH) exceeding 4.78 mIU/L. Any significant characteristics in the univariate analysis were entered into the multivariate analysis to determine independent factors. After a mean follow-up period of 53.5 ± 9.4 months, 44 patients (29.3 %) experienced postoperative hypothyroidism, and 10 of these patients required thyroxine replacement. Hypothyroidism was associated with a higher preoperative TSH level (p hypothyroidism. Patients with a BSA-adjusted volume smaller than 3.2 ml had a threefold greater hypothyroidism risk than those with a BSA-adjusted volume of 3.2 ml or more (p hypothyroidism risk was observed after hemithyroidectomy. Together with a higher preoperative TSH level and fewer ipsilateral nodules, a smaller BSA-adjusted volume measured by preoperative ultrasonography independently predicted hypothyroidism.

  12. Length and cost of hospital stay of radioiodine ablation in thyroid cancer patients: comparison between preparation with thyroid hormone withdrawal and thyrogen

    International Nuclear Information System (INIS)

    Borget, I.; Chevalier, J.; Remy, H.; Ricard, M.; Schlumberger, M.; Allyn, M.; Pouvourville, G. de

    2008-01-01

    Treatment of thyroid cancer consists of thyroidectomy and radioiodine ablation following thyroid-stimulating hormone (TSH) stimulation. Similar ablation rates were obtained with either thyroid hormone withdrawal (THW) or rhTSH. But with rhTSH, the elimination of radioiodine is more rapid, thus reducing its whole-body retention and potentially resulting in a shorter hospital stay. The aim of this study was to assess the financial impact of a reduced length of hospital stay with the use of rhTSH. This was a case-control study of thyroid cancer patients treated postoperatively with 3,700 MBq (100 mCi) radioiodine; 35 patients who received rhTSH were matched with 64 patients submitted to THW according to covariates influencing radioiodine retention. The length of hospitalization (LOH) was estimated for each method according to the threshold of radioiodine retention below which the patient can be discharged from the hospital. The economic analysis was conducted from a hospital perspective. Simulations were performed. For a threshold of 400 MBq, the LOH was 2.4 days and 3.5 days with rhTSH and THW, respectively, and the cost for an ablation stay was, respectively, 2,146 and 1,807 EUR. In the French context, 57% of the acquisition cost of rhTSH was compensated by the reduction of the length of hospitalization. By increasing the iodine excretion, rhTSH allows a shorter hospitalization length, which partially compensates its acquisition cost. (orig.)

  13. The advent of ultrasound-guided ablation techniques in nodular thyroid disease: towards a patient-tailored approach.

    Science.gov (United States)

    Papini, Enrico; Pacella, Claudio M; Misischi, Irene; Guglielmi, Rinaldo; Bizzarri, Giancarlo; Døssing, Helle; Hegedus, Laszlo

    2014-08-01

    Surgery is the long-established therapeutic option for benign thyroid nodules, which steadily grow and become symptomatic. The cost of thyroid surgery, the risk of temporary or permanent complications, and the effect on quality of life, however, remain relevant concerns. Therefore, various minimally invasive treatments, directed towards office-based management of symptomatic nodules, without requiring general anaesthesia, and with negligible damage to the skin and cervical tissues, have been proposed during the past two decades. Today, ultrasound-guided percutaneous ethanol injection and thermal ablation with laser or radiofrequency have been thoroughly evaluated, and are accessible procedures in specialized centres. In clinical practice, relapsing thyroid cysts are effectively managed with percutaneous ethanol injection treatment, which should be considered therapy of choice. In solid non-functioning thyroid nodules that grow or become symptomatic, trained operators may safely induce, with a single session of laser ablation treatment or radiofrequency ablation, a 50% volume decrease and, in parallel, improve local symptoms. In contrast, hyperfunctioning nodules remain best treated with radioactive iodine, which results in a better control of hyperthyroidism, also in the long-term, and fewer side-effects. Currently, minimally invasive treatment is also investigated for achieving local control of small size neck recurrences of papillary thyroid carcinoma in patients who are poor candidates for repeat cervical lymph node dissection. This particular use should still be considered experimental. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation

    Directory of Open Access Journals (Sweden)

    Ho-Su Kim

    2013-09-01

    Full Text Available Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L. Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH, 1,911 pg/mL. Neck ultrasonography and 99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; 99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.

  15. US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules.

    Science.gov (United States)

    Deandrea, Maurilio; Limone, Paolo; Basso, Edoardo; Mormile, Alberto; Ragazzoni, Federico; Gamarra, Elena; Spiezia, Stefano; Faggiano, Antongiulio; Colao, Annamaria; Molinari, Filippo; Garberoglio, Roberto

    2008-05-01

    The aim of the study was to define the effectiveness and safety of ultrasound-guided percutaneous radiofrequency (RF) thermal ablation in the treatment of compressive solid benign thyroid nodules. Thirty-one patients not eligible for surgery or radioiodine (131I) treatment underwent RF ablation for benign nodules; a total of 33 nodules were treated (2 patients had 2 nodules treated in the same session): 10 cold nodules and 23 hyperfunctioning. Fourteen patients complained of compressive symptoms. Nodule volume, thyroid function and compressive symptoms were evaluated before treatment and at 1, 3 and 6 mo. Ultrasound-guided RF ablation was performed using a Starbust RITA needle, with nine expandable prongs; total exposure time was 6 to 10 min at 95 degrees C in one area or more of the nodule. Baseline volume (measured at the time of RF ablation) was 27.7 +/- 21.5 mL (mean +/- SD), but significantly decreased during follow-up: 19.2 +/- 16.2 at 1 mo (-32.7%; p nodules remained euthyroid: five patients with hot nodules normalized thyroid function, and the remaining sixteen showed a partial remission of hyperthyroidism. Besides a sensation of heat and mild swelling of the neck, no major complications were observed. Improvement in compressive symptoms was reported by 13 patients, with a reduction on severity scale from 6.1 +/- 1.4 to 2.2 +/- 1.9 (p nodules. Hyperfunction was fully controlled in 24% of patients and partially reduced in the others.

  16. Ethanol ablation of predominantly cystic thyroid nodules: Evaluation of recurrence rate and factors related to recurrence

    International Nuclear Information System (INIS)

    Suh, C.H.; Baek, J.H.; Ha, E.J.; Choi, Y.J.; Lee, J.H.; Kim, J.K.; Chung, K.-W.; Kim, T.Y.; Kim, W.B.; Shong, Y.K.

    2015-01-01

    Aim: To evaluate recurrence rate and associated risk factors for recurrence after ethanol ablation (EA) in patients with predominantly cystic thyroid nodules. Materials and methods: This observational study was approved by the Ethics Committee of the Institutional Review Board and informed consent for procedures was obtained. From April 2009 to April 2013, 107 consecutive patients with predominantly cystic nodules were treated using EA. Recurrence was defined as nodules showing a residual solid portion with internal vascularity, cosmetic problems remaining, or persistent symptoms, and patients who requested additional therapy to resolve their symptomatic or cosmetic problems. Delayed recurrence was defined as treated nodules that showed no recurrent features at 1 month, but showed newly developed recurrent features during the longer follow-up period. Multivariate analysis was used for variables to demonstrate the independent factors related to volume reduction. Results: One month after EA, 18.7% of patients (20/107) showed recurrence. Among 87 patients with non-recurrence, 24.1% (21/87) showed delayed recurrence. The total recurrence rate was 38.3% (41/107). Patients with recurrence (n = 41) were treated using radiofrequency ablation (n = 28), second EA (n = 4), and refused further treatment (n = 9). These patients responded well to repeat EA and radiofrequency ablation. Multivariate analysis demonstrated that the initial nodule volume (>20 ml; p < 0.036) and vascularity (grade >1; p < 0.049) were independent predictors of volume reduction at last follow-up. Conclusions: The results revealed that although EA seemed to be effective during the initial period, delayed recurrence should be considered during longer-term follow-up. The independent predictors of recurrence were initial volume (>20 ml) and vascularity. - Highlights: • Ethanol ablation showed unsatisfactory results in 18.7% of patient at one month. • Delayed recurrence was observed in 24

  17. Radiofrequency versus ethanol ablation for treating predominantly cystic thyroid nodules:A randomized clinical trial

    Energy Technology Data Exchange (ETDEWEB)

    Beak, Jung Hwan; Ha, Eun Ju; Choi, Young Jun; Shong, Young Kee [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Sung, Jin Yong [Dept. of Radiology, Thyroid Center, Daerim St. Mary' s Hospital, Seoul (Korea, Republic of); Kim, Jae Kyun [Dept. of Radiology, Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    2015-12-15

    To compare single-session radiofrequency ablation (RFA) and ethanol ablation (EA) for treating predominantly cystic thyroid nodules (PCTNs). This single-blind, randomized trial was approved by the Institutional Review Board of two centers and informed consent was obtained from all patients before enrollment. Fifty patients with a single PCTN (cystic portion less than 90% and greater than 50%) were randomly assigned to be treated by either RFA (25 patients) or EA (25 patients) at two hospitals. The primary outcome was the tumor volume reduction ratio (%) at the six-month follow-up and the superiority margin was set at 13% (RFA minus EA). Analysis was performed primarily in an intention-to-treat manner. The secondary outcomes were the therapeutic success rate, improvement of symptomatic and cosmetic problems, and the number of major complications. The mean volume reduction was 87.5 ± 11.5% for RFA (n = 22) and 82.4 ± 28.6% for EA (n = 24) (p = 0.710; mean difference [95% confidence interval], 5.1% [-8.0 to 18.2]), indicating no significant difference. Regarding the secondary outcomes, therapeutic success (p = 0.490), mean symptom (p = 0.205) and cosmetic scores (p = 0.710) showed no difference. There were no major complications in either group (p > 0.99). The therapeutic efficacy of RFA is not superior to that of EA; therefore, EA might be preferable as the first-line treatment for PCTNs.

  18. Treatment of Metastatic Lymph Nodes in the Neck from Papillary Thyroid Carcinoma with Percutaneous Laser Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Mauri, Giovanni, E-mail: vanni.mauri@gmail.com [European Institute of Oncology, Division of Interventional Radiology (Italy); Cova, Luca [General Hospital of Busto Arsizio, Unit of Interventional Oncology (Italy); Ierace, Tiziana [IRCCS Istituto Clinico Humanitas, Unit of Interventional Radiology (Italy); Baroli, Alberto; Di Mauro, Enzo [General Hospital of Busto Arsizio, Department of Nuclear Medicine (Italy); Pacella, Claudio Maurizio [Regina Apostolorum Hospital, Department of Diagnostic Imaging (Italy); Goldberg, Shraga Nahum [Hadassah Hebrew University Medical Center, Image-guided Therapy and Interventional Oncology Unit (Israel); Solbiati, Luigi [IRCCS Istituto Clinico Humanitas, Unit of Interventional Radiology (Italy)

    2016-07-15

    PurposeTo assess the effectiveness of percutaneous laser ablation (PLA) of cervical lymph node metastases from papillary thyroid carcinoma.Materials and Methods24 patients (62.3 ± 13.2 year; range 32–80) previously treated with thyroidectomy, neck dissection, and radioiodine ablation underwent ultrasound-guided PLA of 46 {sup 18}FDG-PET/CT—positive metachronous nodal metastases. All patients were at high surgical risk or refused surgery and were unsuitable for additional radioiodine ablation. A 300 µm quartz fiber and a continuous-wave Nd-YAG laser operating at 1.064 mm were used. Technical success, rate of complications, rate of serological conversion, and local control at follow-up were derived. Fisher’s exact test and Mann–Whitney U test were used and Kaplan–Meier curve calculated.ResultsTechnical success was obtained in all 46 lymph nodes (100 %). There were no major complications. Thyroglobulin levels decreased from 8.40 ± 9.25 ng/ml before treatment to 2.73 ± 4.0 ng/ml after treatment (p = 0.011), with serological conversion in 11/24 (45.8 %) patients. Overall, local control was obtained in 40/46 (86.9 %) lymph nodes over 30 ± 11 month follow-up, with no residual disease seen at imaging in 19/24 (79.1 %) patients. Local control was achieved in 40/46 (86.9 %) lymph nodes at 1 year and in all of the 25 nodes (100 %) followed for 3 years. Estimated mean time to progression was 38.6 ± 2.7 m.ConclusionUltrasound-guided PLA is a feasible, safe, and effective therapy for the treatment of cervical lymph node metastases from papillary thyroid carcinoma.

  19. 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.

  20. Thyroiditis

    Science.gov (United States)

    ... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroiditis Resources Thyroiditis Brochure PDF Thyroiditis FAQs PDF En Español Tiroiditis El folleto de Tiroiditis Tiroiditis, Preguntas Frecuentes (FAQ) Search ...

  1. Long-Term Results after Treatment of Very Low-, Low-, and High-Risk Thyroid Cancers in a Combined Setting of Thyroidectomy and Radio Ablation Therapy in Euthyroidism

    Directory of Open Access Journals (Sweden)

    Nikos Emmanouilidis

    2013-01-01

    Full Text Available Introduction. Differentiated thyroid cancer treatment usually consists of thyroidectomy and radio ablation in hypothyroidism 4-6 weeks after surgery. Replacing hypothyroidism by recombinant human thyroid stimulating hormone can facilitate radio ablation in euthyroidism within one week after surgery. The outcome of this approach was investigated. Methods. This is a prospective randomized trial to compare thyroidectomy and radio ablation within a few days after preconditioning with recombinant human thyroid stimulating hormone versus thyroidectomy and radio ablation separated by four weeks of L-T4 withdrawal. Tumors were graded into very low-, low- , or high-risk tumors. Recurrence-free survival was confirmed at follow-up controls by neck ultrasound and serum thyroglobulin. Suspected tumor recurrence was treated by additional radio ablation or surgery. Quality-of-life questionnaires with additional evaluation of job performance and sick-leave time were used in all patients. Results. Radio ablation in euthyroidism in quick succession after thyroidectomy did not lead to higher tumor recurrence rates of differentiated thyroid cancers in any risk category and was significantly advantageous with respect to quality-of-life (P<0.001, sick-leave time (P<0.001, and job performance (P=0.002. Conclusion. Recombinant human thyroid stimulating hormone can be used safely and with good efficacy to allow radio ablation under sustained euthyroidism within one week after thyroidectomy.

  2. Endogenous TSH levels at the time of 131I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Riemann, Burkhard; Maeder, Uwe; Reiners, Christoph; Verburg, Frederik A.

    2016-01-01

    Based on a single older study it is established dogma that TSH levels should be ≥30 mU/l at the time of postoperative 131 I ablation in differentiated thyroid cancer (DTC) patients. We sought to determine whether endogenous TSH levels, i.e. after levothyroxine withdrawal, at the time of ablation influence ablation success rates, recurrence-free survival and DTC-related mortality. A total of 1,873 patients without distant metastases referred for postoperative adjuvant 131 I therapy were retrospectively included from 1991 onwards. Successful ablation was defined as stimulated Tg <1 μg/l. Age, gender and the presence of lymph node metastases were independent determinants of TSH levels at the time of ablation. TSH levels were not significantly related to ablation success rates (p = 0.34), recurrence-free survival (p = 0.29) or DTC -elated mortality (p = 0.82), but established risk factors such as T-stage, lymph node metastases and age were. Ablation was successful in 230 of 275 patients (83.6 %) with TSH <30 mU/l and in 1,359 of 1,598 patients (85.0 %) with TSH ≥30 mU/l. The difference was not significant (p = 0.55). Of the whole group of 1,873 patients, 21 had recurrent disease. There were no significant differences in recurrence rates between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.16). Ten of the 1,873 patients died of DTC. There were no significant differences in DTC-specific survival between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.53). The precise endogenous TSH levels at the time of 131 I ablation are not related to the ablation success rates, recurrence free survival and DTC related mortality. The established dogma that TSH levels need to be ≥30 mU/l at the time of 131 I ablation can be discarded. (orig.)

  3. Endogenous TSH levels at the time of {sup 131}I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality

    Energy Technology Data Exchange (ETDEWEB)

    Vrachimis, Alexis; Riemann, Burkhard [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Maeder, Uwe; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany)

    2016-02-15

    Based on a single older study it is established dogma that TSH levels should be ≥30 mU/l at the time of postoperative {sup 131}I ablation in differentiated thyroid cancer (DTC) patients. We sought to determine whether endogenous TSH levels, i.e. after levothyroxine withdrawal, at the time of ablation influence ablation success rates, recurrence-free survival and DTC-related mortality. A total of 1,873 patients without distant metastases referred for postoperative adjuvant {sup 131}I therapy were retrospectively included from 1991 onwards. Successful ablation was defined as stimulated Tg <1 μg/l. Age, gender and the presence of lymph node metastases were independent determinants of TSH levels at the time of ablation. TSH levels were not significantly related to ablation success rates (p = 0.34), recurrence-free survival (p = 0.29) or DTC -elated mortality (p = 0.82), but established risk factors such as T-stage, lymph node metastases and age were. Ablation was successful in 230 of 275 patients (83.6 %) with TSH <30 mU/l and in 1,359 of 1,598 patients (85.0 %) with TSH ≥30 mU/l. The difference was not significant (p = 0.55). Of the whole group of 1,873 patients, 21 had recurrent disease. There were no significant differences in recurrence rates between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.16). Ten of the 1,873 patients died of DTC. There were no significant differences in DTC-specific survival between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.53). The precise endogenous TSH levels at the time of {sup 131}I ablation are not related to the ablation success rates, recurrence free survival and DTC related mortality. The established dogma that TSH levels need to be ≥30 mU/l at the time of {sup 131}I ablation can be discarded. (orig.)

  4. Bipolar radiofrequency ablation of benign thyroid nodules using a multiple overlapping shot technique in a 3-month follow-up.

    Science.gov (United States)

    Kohlhase, Konstantin David; Korkusuz, Yücel; Gröner, Daniel; Erbelding, Christian; Happel, Christian; Luboldt, Wolfgang; Grünwald, Frank

    2016-08-01

    Purpose The aim of this study was to evaluate the decrease of benign thyroid nodules after bipolar radiofrequency ablation (RFA) in a 3-month follow-up using a multiple overlapping shot technique ('MOST'). Methods A total of 18 patients with 20 symptomatic benign thyroid nodules (17 cold nodules, 3 hyperfunctioning nodules) were treated in one single session by bipolar RFA. Bipolar ablation was performed using MOST. The nodule volumes were measured prior to ablation and 3 months after the procedure using ultrasound. The population consisted of either solid (>80% solid tissue within the volume of interest), complex, or cystic nodules (nodule volume (ΔV), median 5.3 mL (range 0.13-43.1 mL), corresponding to a relative reduction in mean of 56 ± 17.9%. Median initial volume was 8 mL (range 0.48-62 mL); 3 months after ablation a median volume of 2.3 mL (range 0.3-32 mL) was measured. Nodule growth ≥50% occurred in 70% (14 nodules). At the follow-up no complications such as infections, persisting pain, nerve injuries or immunogen stimulation occurred. Patients with cold nodules (15) remained euthyroid, with hyperfunctioning nodules either euthyroid (2) or latent hypofunctional (1). Conclusion The use of bipolar RFA is an effective, safe and suitable thermoablative technique to treat benign thyroid nodules. Combined with the multiple overlapping shot technique it allows sufficient ablation.

  5. Differences in Brain Glucose Metabolism During Preparation for 131I Ablation in Thyroid Cancer Patients: Thyroid Hormone Withdrawal Versus Recombinant Human Thyrotropin.

    Science.gov (United States)

    Jeong, Hyeonseok S; Choi, Eun Kyoung; Song, In-Uk; Chung, Yong-An; Park, Jong-Sik; Oh, Jin Kyoung

    2017-01-01

    In preparation for 131 I ablation, temporary withdrawal of thyroid hormone is commonly used in patients with thyroid cancer after total thyroidectomy. The current study aimed to investigate brain glucose metabolism and its relationships with mood or cognitive function in these patients using 18 F-fluoro-2-deoxyglucose positron emission tomography ( 18 F-FDG-PET). A total of 40 consecutive adult patients with thyroid carcinoma who had undergone total thyroidectomy were recruited for this cross-sectional study. At the time of assessment, 20 patients were hypothyroid after two weeks of thyroid hormone withdrawal, while 20 received thyroid hormone replacement therapy and were euthyroid. All participants underwent brain 18 F-FDG-PET scans and completed mood questionnaires and cognitive tests. Multivariate spatial covariance analysis and univariate voxel-wise analysis were applied for the image data. The hypothyroid patients were more anxious and depressed than the euthyroid participants. The multivariate covariance analysis showed increases in glucose metabolism primarily in the bilateral insula and surrounding areas and concomitant decreases in the parieto-occipital regions in the hypothyroid group. The level of thyrotropin was positively associated with the individual expression of the covariance pattern. The decreased 18 F-FDG uptake in the right cuneus cluster from the univariate analysis was correlated with the increased thyrotropin level and greater depressive symptoms in the hypothyroid group. These results suggest that temporary hypothyroidism, even for a short period, may induce impairment in glucose metabolism and related affective symptoms.

  6. Acknowledging gray areas: 2015 vs. 2009 American Thyroid Association differentiated thyroid cancer guidelines on ablating putatively low-intermediate-risk patients.

    Science.gov (United States)

    Frangos, Savvas; Iakovou, Ioannis P; Marlowe, Robert J; Eftychiou, Nicolaos; Patsali, Loukia; Vanezi, Anna; Savva, Androulla; Mpalaris, Vassilis; Giannoula, Evanthia I

    2017-02-01

    Typically formulated by investigators from "world centres of excellence," differentiated thyroid carcinoma (DTC) management guidelines may have more limited applicability in settings of less expert care and fewer resources. Arguably the world's leading DTC guidelines are those of the American Thyroid Association, revised in 2009 ("ATA 2009") and 2015 ("ATA 2015"). To further explore the issue of "real-world applicability" of DTC guidelines, we retrospectively compared indications for ablation using ATA 2015 versus ATA 2009 in a two-centre cohort of ablated T1-2, M0 DTC patients (N = 336). Based on TNM status and histology, these patients were low-intermediate risk, but many ultimately had other characteristics suggesting elevated or uncertain risk. Working by consensus, two experienced nuclear medicine physicians considered patient and treatment characteristics to classify each case as having "no indication," a "possible indication," or a "clear indication" for ablation according to ATA 2009 or ATA 2015. The physicians also identified reasons for classification changes between ATA 2015 versus ATA 2009. Classification was unblinded, but the physicians had cared for only 138/336 patients, and the charts encompassed September 2010-October 2013, several years before the classification was performed. One hundred of 336 patients (29.8 %) changed classification regarding indication for ablation using ATA 2015 versus ATA 2009. Most reclassified patients (70/100) moved from "no indication" or "clear indication" to "possible indication." Reflecting this phenomenon, "possible indication" became the largest category according to the ATA 2015 classification (141/336, 42.0 %, versus 96/336, 28.6 %, according to ATA 2009). Many reclassifications were attributable to multiple clinicopathological characteristics, most commonly, stimulated thyroglobulin or anti-thyroglobulin antibody levels, multifocality, bilateral involvement, or capsular/nodal invasion. Regarding

  7. Monopolar Radiofrequency Ablation of Thyroid Nodules: A Prospective Austrian Single-Center Study.

    Science.gov (United States)

    Dobnig, Harald; Amrein, Karin

    2018-04-01

    Monopolar radiofrequency ablation is currently deemed an exotic treatment option for benign thyroid nodules in many central European countries. The aim of this study was to evaluate prospectively the safety and efficacy of this method in a large patient cohort following its introduction in Austria. Peri- and post-interventional complications were analyzed for 277 patients. Efficacy was determined for 300 and 154 nodules at 3 and 12 months post treatment, respectively. All treatments were performed with an internally cooled 18G radiofrequency electrode using a free-hand, "moving-shot" technique following subcutaneous and local perithyroidal anesthesia. Mean patient age (SD) was 52 ± 12.9 years (75% female), and overall mean baseline nodule volume (SD) was 13.8 ± 15.9 mL. Nodules were visible in 62.8% of patients, 40% had a symptom score ≥4 on a 10-point visual analogue scale, and 14.4% had hyperthyroidism. Mean overall nodule volume reduction rates (VRR) at 3 and 12 months were 68 ± 16% and 82 ± 13%, respectively (p 30 mL) or baseline nodule composition (solid, mixed, cystic) revealed significantly higher VRRs for smaller and cystic nodules. Moreover, nodule shrinkage was accompanied by significantly improved symptom and cosmetic scores after 3 and 12 months (p hyperthyroid patients, 27 (84%) were euthyroid, four had subclinical hyperthyroidism, and one had subclinical hypothyroidism at last follow-up. Post-procedural complications were absent in 83% of patients, minimal in 12.9%, moderate and reversible in 3.2% (1.8% voice change, 0.7% hyperthyroidism, 0.3% wound infection treated with antibiotics, 0.3% epifascial hematoma), and irreversible in 0.7% (one case with hypothyroidism and one with a wound infection treated by surgery). It is concluded that a single treatment course with monopolar radiofrequency ablation is both safe and highly effective in terms of nodule volume reduction, relief of local symptoms, and (in patients with

  8. Determinants of successful ablation and complete remission after total thyroidectomy and 131I therapy of paediatric differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Verburg, Frederik A.; Maeder, Uwe; Luster, Markus; Haenscheid, Heribert; Reiners, Christoph

    2015-01-01

    In adult differentiated thyroid cancer (DTC) patients, successful ablation and the number of 131 I therapies needed carry a prognostic significance. The goal was to assess the prognosis of DTC in children and adolescents treated in our centre in relation to the number of treatments needed and to establish the determinants of both complete remission (CR) and successful ablation. Seventy-six DTC patients <21 years of age at diagnosis were included. Recurrence and death rates, rates of CR (=negative stimulated thyroglobulin, negative neck ultrasound and negative 131 I whole-body scintigraphy) and successful ablation (=CR after initial 131 I therapy) were studied. No patients died of DTC. Seven patients were treated by surgery alone and did not show signs of recurrence during follow-up. Of the 69 patients also treated with 131 I therapy, 47 patients achieved CR, 25 of whom had successful ablation. In multivariate analysis, female gender and the absence of distant metastases were independent determinants of a higher CR rate. Female gender, lower T stage and higher 131 I activity (successful ablation, median activity 3.1 GBq, unsuccessful ablation 2.6 GBq) were determinants of a higher rate of successful ablation. After 131 I therapy no patient showed recurrence after reaching CR or disease progression if CR was not reached. In our paediatric DTC population prognosis is extremely good with no deaths or recurrences occurring regardless of the number of 131 I therapies needed or whether CR was reached. The determinants of CR and successful ablation can be used to optimize the chance of therapy success. (orig.)

  9. Determinants of successful ablation and complete remission after total thyroidectomy and {sup 131}I therapy of paediatric differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Maeder, Uwe [University of Wuerzburg, Comprehensive Cancer Center Mainfranken, Wuerzburg (Germany); Luster, Markus [University Hospital Giessen and Marburg, Department of Nuclear Medicine, Marburg (Germany); Haenscheid, Heribert; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany)

    2015-08-15

    In adult differentiated thyroid cancer (DTC) patients, successful ablation and the number of {sup 131}I therapies needed carry a prognostic significance. The goal was to assess the prognosis of DTC in children and adolescents treated in our centre in relation to the number of treatments needed and to establish the determinants of both complete remission (CR) and successful ablation. Seventy-six DTC patients <21 years of age at diagnosis were included. Recurrence and death rates, rates of CR (=negative stimulated thyroglobulin, negative neck ultrasound and negative {sup 131}I whole-body scintigraphy) and successful ablation (=CR after initial {sup 131}I therapy) were studied. No patients died of DTC. Seven patients were treated by surgery alone and did not show signs of recurrence during follow-up. Of the 69 patients also treated with {sup 131}I therapy, 47 patients achieved CR, 25 of whom had successful ablation. In multivariate analysis, female gender and the absence of distant metastases were independent determinants of a higher CR rate. Female gender, lower T stage and higher {sup 131}I activity (successful ablation, median activity 3.1 GBq, unsuccessful ablation 2.6 GBq) were determinants of a higher rate of successful ablation. After {sup 131}I therapy no patient showed recurrence after reaching CR or disease progression if CR was not reached. In our paediatric DTC population prognosis is extremely good with no deaths or recurrences occurring regardless of the number of {sup 131}I therapies needed or whether CR was reached. The determinants of CR and successful ablation can be used to optimize the chance of therapy success. (orig.)

  10. Timing of post 131I ablation diagnostic whole body scan in differentiated thyroid cancer patients. Less than four months post ablation may be too early.

    Science.gov (United States)

    Winter, M; Winter, J; Heinzel, A; Behrendt, F F; Krohn, T; Mottaghy, F M; Verburg, F A

    2015-01-01

    to determine whether the first three months after 131I ablation is too early to perform radioiodine diagnostic whole body scintigraphy (dxWBS) in differentiated thyroid carcinoma patients. The files of 462 patients who were treated for DTC in our hospital were reviewed. All patients underwent surgical thyroidectomy. 146 patients had data available on a. a dxWBS which was performed less than four months (max 120 days) after 131I ablation with concurrent stimulated TSH stimulated thyroglobulin (Tg) measurement without further therapeutic measures between ablation and dxWBS and b. a second dxWBS or 131I therapy (rxWBS) within 1.5 years after ablation. A discordance between the initial and follow-up scan was found in 25/129 (19%) patients: of 54 patients with a positive initial dxWBS, scan results of a second dxWBS or rxWBS obtained with a suitable distance to the initial scan contradicted the initial one in 15 patients (27%). New lesions were discovered in 10/74 negative first dxWBS cases (14%). A discordance between the initial and follow-up stimulated Tg was found in 5/129 (4%) patients: 2/90 (2%) of patients with a negative stimulated Tg at initial dxWBS subsequently showed a positive results whereas 3/29 (10%) patients with an initially positive Tg showed a negative Tg level at the second procedure. Less than four months after 131I ablation is too early to perform radioiodine diagnostic whole body scintigraphy with concurrent TSH stimulated Tg measurement. The identification of the right, later, timepoint however requires further research.

  11. [Thyroiditis].

    Science.gov (United States)

    Buffet, Camille; Groussin, Lionel

    2013-02-01

    The diagnosis of thyroiditis encompasses a broad spectrum of thyroid disorders. Analysis of signs and symptoms, biochemical changes, neck ultrasound characteristics and radioactive iodine uptake values allows an accurate diagnosis. Recent studies of the whole genome have helped to identify many susceptibility genes for autoimmune thyroiditis. However, none of these genes contribute to a significant increase in risk of developing this thyroiditis. Clinical awareness of the characteristic presentations of exceptional thyroiditis (acute suppurative thyroiditis, Riedel's thyroiditis) is an important issue. Selenium administration seems to be beneficial for reducing the incidence of thyroiditis. Finally, certain drug-induced thyroiditis remains a therapeutic challenge for the physician.

  12. Radiofrequency ablation of benign symptomatic thyroid nodules: prospective safety and efficacy study.

    Science.gov (United States)

    Ugurlu, M Umit; Uprak, Kivilcim; Akpinar, Ihsan N; Attaallah, Wafi; Yegen, Cumhur; Gulluoglu, Bahadir M

    2015-04-01

    Radiofrequency ablation (RFA) is a relatively novel procedure in the management of benign nodular goiter. This study was conducted to evaluate the safety and efficacy of ultrasound (US)-guided percutaneous RFA for benign symptomatic thyroid nodules as an alternative to surgery. The study involved patients for whom a fine needle aspiration biopsy had proved a diagnosis of benign nodular goiter and had nodule-related symptoms such as dysphagia, cosmetic problems, sensation of foreign body in the neck, hyperthyroidism due to autonomous nodules or fear of malignancy. Percutaneous RFA was performed as an outpatient procedure under local anesthesia. The primary outcome was an evaluation of the changes in symptom scores (0-10) for pain, dysphagia and foreign body sensation at the 1st, 3rd, and 6th months after the RFA procedure. Secondary outcomes were assessing volume changes in nodules, complication rates, and changes in thyroid function status. A total of 33 patients (24% female, 76% male) and a total of 65 nodules were included into the study. More than one nodule was treated in 63.6% of the patients. We found a statistically significant improvement from baseline to values at the 1st, 3rd, and 6th months, respectively, as follows: pain scores (2.9 ± 2.7, 2.3 ± 2.01, 1.8 ± 1.7, and 1.5 ± 1.2, p 0.005), dysphagia scores (3.9 ± 2.7, 2.6 ± 1.9; 1.7 ± 1.6, and 1.1 ± 0.3, p 0.032), and foreign body sensation scores 3.6 ± 3, 2.5 ± 2.2; 1.6 ± 1.5, and 1.1 ± 0.4, p 0.002).The mean pre-treatment nodule volume was 7.3 ± 8.3 mL. There was a statistically significant size reduction in the nodules at the 1st, 3rd, and 6th months after RFA (3.5 ± 3.8, 2.7 ± 3.4, and 1.2 ± 1.7 mL, p 0.002). The volume reduction was found to be 74% at 6th months following the RFA (p 0.005). 8 patients had autonomously functioning nodules in the pre-treatment period, 50% (n: 4) became euthyroid at the 6th month after RFA. There were no complaints other than pain (12%). RFA can be an

  13. Radioiodine treatment for malignant thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Gertrud [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology

    2006-12-15

    Radioiodine treatment for thyroid disease has been given for half a decade in Sweden. The most common indication for treatment is hyperthyroidism, when iodine uptake is high. The situation in which radioiodine treatment is used in thyroid cancer is less favourable and measures therefore have to be taken to optimize the treatment. Treatment should be performed early in the course of the disease to achieve the highest possible differentiation. Before treatment the iodine and goitrogen intake should be kept low. Stimulation of the thyrocytes by thyroid-stimulating hormone (TSH) should be high. It is conventionally achieved by thyroid hormone withdrawal rendering the patient hypothyroid, or by the recently available recombinant human TSH (rhTSH) which can be recommended for ablation of the thyroid remnant after thyroidectomy and for treatment of metastases in fragile patients unable to undergo hypothyroidism. Finally, stunning - the negative effect of a prior test dose from radioactive iodine - should be avoided.

  14. 14. International Thyroid Congress (ITC2010) - Selection of abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-01

    This international thyroid congress is organized every 5 years in a different country and gathers a large community of experts in the field of oncology, endocrinology, nuclear medicine, surgery, cytology and biology. A series of abstracts from this congress has been selected on the basis of the availability and on topics linked to nuclear medicine or radiation damage such as the use of I{sup 131} in thyroidectomy, the impact of radiation in thyroid cells, the optimization of the dose for remnant thyroid ablation, side effect of radiotherapy with I{sup 131} or the health hazards of Chernobyl radioactive fallout

  15. 14. International Thyroid Congress (ITC2010) - Selection of abstracts

    International Nuclear Information System (INIS)

    2012-01-01

    This international thyroid congress is organized every 5 years in a different country and gathers a large community of experts in the field of oncology, endocrinology, nuclear medicine, surgery, cytology and biology. A series of abstracts from this congress has been selected on the basis of the availability and on topics linked to nuclear medicine or radiation damage such as the use of I 131 in thyroidectomy, the impact of radiation in thyroid cells, the optimization of the dose for remnant thyroid ablation, side effect of radiotherapy with I 131 or the health hazards of Chernobyl radioactive fallout

  16. Remnant lipoproteins

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G.

    2017-01-01

    Purpose of review: To review recent advances in the field of remnant lipoproteins and remnant cholesterol with a focus on cardiovascular disease risk. Recent findings: In line with previous years' research, current observational, genetic, and mechanistic studies find remnant lipoproteins (defined...... of cardiovascular disease risk reduction through remnant lipoprotein lowering are under way....

  17. Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer:

    DEFF Research Database (Denmark)

    Giovanella, Luca; Clark, Penelope M; Chiovato, Luca

    2014-01-01

    Differentiated thyroid cancer (DTC) is the most common endocrine cancer and its incidence has increased in recent decades. Initial treatment usually consists of total thyroidectomy followed by ablation of thyroid remnants by iodine-131. As thyroid cells are assumed to be the only source...... at low concentrations now allows detection of very low Tg concentrations reflecting minimal amounts of thyroid tissue without the need for TSH stimulation. Use of these highly sensitive Tg assays has not yet been incorporated into clinical guidelines but they will, we believe, be used by physicians...

  18. A prospective clinical trial to assess the efficacy of radioiodine ablation as an alternative to completion thyroidectomy in patients with differentiated thyroid cancer undergoing sub-total thyroidectomy

    International Nuclear Information System (INIS)

    Bal, C.S.; Kumar, Ajay; Pant, G.S.; Chandra, Prem; Dwivedi, S.N.

    2006-01-01

    We conducted a prospective clinical trial to evaluate whether radioiodine ablation can be an effective alternative to completion thyroidectomy in patients undergoing sub-total thyroidectomy and if yes, the optimum activity of 131 I and frequency of ablation. A total of 85 patients (F-63; M-22) with mean age of 37.9±12.3 years were recruited in this study. The pre-ablation mean 24 hour radioiodine neck uptake, effective half-life, residual thyroid tissue weight and TSH values were 13.9±8.5%, 4.5±0.9 days, 9.6±3.6 g and 11.7±6.4 μIU/ml, respectively. Thyroid tissue was completely ablated in 50 patients (58.8%, 95% CI:50-68%) after mean 1st administered activity of 32.3±10.7 mCi of 131 I and the cumulative ablation rate was 91.8% after two doses of 131 I. During mean follow-up duration of 49 months no local/distant recurrence has been observed so far in this cohort. It appears that radioiodine ablation may be an attractive alternative to completion thyroidectomy and an activity as low as 35 mCi may achieve reasonable ablation

  19. Management of low-risk patients with thyroid carcinoma and detectable thyroglobulin on T4 after thyroidectomy and ablation with iodine-131

    Energy Technology Data Exchange (ETDEWEB)

    Rosario, Pedro Weslley Souza [Clinica de Endocrinologia e Metabologia (CEPCEM), Belo Horizonte, MG (Brazil). Centro de Estudos e Pesquisa]. E-mail: pedrorosario@globo.com; Borges, Michelle A.R.; Costa, Graciela B.C.; Resende, Leonardo L.; Padrao, Eduardo L.; Barroso, Alvaro L.; Purish, Saulo [Santa Casa de Belo Horizonte, MG (Brazil). Dept. de Tireoide. Servico de Endocrinologia; Santa Casa de Belo Horizonte, MG (Brazil). Servico de Medicina Nuclear

    2007-01-15

    Objective: To evaluate the positive predictive value of detectable Tg during T4 therapy (Tg on T4) in patients with thyroid cancer after total thyroidectomy and remnant ablation, discussing the work-up in this situation and the empirical indication of {sup 131}I. Patients and methods: Initially, 234 low-risk patients [tumor {<=} 5 cm, completely resected, no extensive extrathyroid invasion (pT4)] submitted to total thyroidectomy and ablation with {sup 131}I (3.7-5.5 GBq) who presented no ectopic uptake on RxWBS were studied. Of these, 23 patients with detectable Tg on T4 (> 1 ng/ml) during the first year after initial therapy were selected. Results: Metastases were detected by neck US in 7 patients, by chest CT in 2 and by US and CT in 3. Four of five patients with lung metastases upon CT had a positive RxWBS. Eleven patients with negative US and CT received a new {sup 131}I dose (without DxWBS), and RxWBS showed ectopic uptake in 3 patients. Among the patients with negative RxWBS, 7 remained free of apparent disease and Tg was declining (5 with undetectable Tg on T4 at the end of the study). One patient presented an increase in Tg and FDG-PET was positive for lymph node and bone metastases. Conclusions: All patients with Tg on T4 > 5 ng/ml presented apparent disease. In these cases, even when US and CT are negative, the administration of a therapeutic dose of {sup 131}I (without DxWBS) and FDG-PET are recommended. Among patients with detectable Tg on T4 {<=} 5 ng/ml and negative US and CT, only 12% presented ectopic uptake on RxWBS. These cases could be followed up by monitoring Tg on T4, and RxWBS and FDG-PET should only be performed if this marker does not decrease after 1-2 years. (author)

  20. Management of low-risk patients with thyroid carcinoma and detectable thyroglobulin on T4 after thyroidectomy and ablation with iodine-131

    International Nuclear Information System (INIS)

    Rosario, Pedro Weslley Souza; Borges, Michelle A.R.; Costa, Graciela B.C.; Resende, Leonardo L.; Padrao, Eduardo L.; Barroso, Alvaro L.; Purish, Saulo; Santa Casa de Belo Horizonte, MG

    2007-01-01

    Objective: To evaluate the positive predictive value of detectable Tg during T4 therapy (Tg on T4) in patients with thyroid cancer after total thyroidectomy and remnant ablation, discussing the work-up in this situation and the empirical indication of 131 I. Patients and methods: Initially, 234 low-risk patients [tumor ≤ 5 cm, completely resected, no extensive extrathyroid invasion (pT4)] submitted to total thyroidectomy and ablation with 131 I (3.7-5.5 GBq) who presented no ectopic uptake on RxWBS were studied. Of these, 23 patients with detectable Tg on T4 (> 1 ng/ml) during the first year after initial therapy were selected. Results: Metastases were detected by neck US in 7 patients, by chest CT in 2 and by US and CT in 3. Four of five patients with lung metastases upon CT had a positive RxWBS. Eleven patients with negative US and CT received a new 131 I dose (without DxWBS), and RxWBS showed ectopic uptake in 3 patients. Among the patients with negative RxWBS, 7 remained free of apparent disease and Tg was declining (5 with undetectable Tg on T4 at the end of the study). One patient presented an increase in Tg and FDG-PET was positive for lymph node and bone metastases. Conclusions: All patients with Tg on T4 > 5 ng/ml presented apparent disease. In these cases, even when US and CT are negative, the administration of a therapeutic dose of 131 I (without DxWBS) and FDG-PET are recommended. Among patients with detectable Tg on T4 ≤ 5 ng/ml and negative US and CT, only 12% presented ectopic uptake on RxWBS. These cases could be followed up by monitoring Tg on T4, and RxWBS and FDG-PET should only be performed if this marker does not decrease after 1-2 years. (author)

  1. Update on the role of ultrasound guided radiofrequency ablation for thyroid nodule treatment

    DEFF Research Database (Denmark)

    Radzina, Maija; Cantisani, Vito; Rauda, Madara

    2017-01-01

    Thyroid nodules can be frequently detected in general population, most of them are benign, however malignant cases are rising in the past decades. Ultrasound (US) is the most common imaging modality to assess thyroid nodular lesions, plan patient work-up and guide minimally invasive treatment...

  2. Cost-effectiveness of using recombinant human thyroid-stimulating hormone before radioiodine ablation for thyroid cancer treatment in Spanish hospitals.

    Science.gov (United States)

    Vallejo, J A; Muros, M A

    In thyroid cancer treatment, the thyroid-stimulating hormone (TSH) must be elevated before radioiodine ablation, either by exogenous (with recombinant human thyrotropin [rhTSH]) or endogenous stimulation by thyroid hormone withdrawal (THW). The use of rhTSH avoids hypothyroidism and favours the subsequent elimination of radioiodine, but involves the cost of the product. For this reason, a cost-effectiveness analysis was performed, taking into account all costs involved and the benefits associated with the use of this therapy. Using a Markov modelling with two analysis arms (rhTSH and THW), stratified into high (100mCi/3700 MBq) and low (30mCi/1110 MBq) radioiodine doses, and using 17 weekly cycles, the incremental cost per quality-adjusted life-year (QALY) related to the use of rhTSH was determined. The clinical inputs included in the model were based on published studies and in a treatment survey conducted in Spain. Radioablation preparation with rhTSH is superior to THW, showing additional benefits (0.048 AVAC), as well as cost savings (-€614.16), with an incremental cost-effectiveness rate (ICER) of -€12,795/QALY. The univariate and multivariate sensitivity analyses showed the result to be robust. The use of rhTSH previous to radioablation in Spain has cost savings, as well as a series of health benefits for the patient, making it highly cost-effective. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  3. No survival difference after successful {sup 131}I ablation between patients with initially low-risk and high-risk differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik Anton [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Stokkel, Marcel P.M.; Verkooijen, Robbert B.T. [Leiden University Medical Center, Department of Radiology, Division of Nuclear Medicine, Leiden (Netherlands); Dueren, Christian; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Maeder, Uwe [University of Wuerzburg, Comprehensive Cancer Center, Wuerzburg (Germany); Isselt, Johannes W. van [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States); Smit, Johannes W. [Leiden University Medical Center, Department of Endocrinology, Leiden (Netherlands); Luster, Markus [University of Ulm, Department of Nuclear Medicine, Ulm (Germany)

    2010-02-15

    To compare disease-specific survival and recurrence-free survival (RFS) after successful {sup 131}I ablation in patients with differentiated thyroid carcinoma (DTC) between those defined before ablation as low-risk and those defined as high-risk according to the European Thyroid Association 2006 consensus statement. Retrospective data from three university hospitals were pooled. Of 2009 consecutive patients receiving ablation, 509 were identified as successfully ablated based on both undetectable stimulated serum thyroglobulin in the absence of antithyroglobulin antibodies and a negative diagnostic whole-body scan in a follow-up examination conducted 8.1{+-}4.6 months after ablation. Of these 509 patients, 169 were defined as high-risk. After a mean follow-up of 81{+-}64 months (range 4-306 months), only three patients had died of DTC, rendering assessment of disease-specific survival differences impossible. Of the 509 patients, 12 (2.4%) developed a recurrence a mean 35 months (range 12-59 months) after ablation. RFS for the duration of follow-up was 96.6% according to the Kaplan-Meier method. RFS did not differ between high-risk and low-risk patients (p=0.68). RFS differed slightly but significantly between those with papillary and those with follicular thyroid carcinoma (p=0.03) and between those aged {<=}45 years those aged >45 years at diagnosis (p=0.018). After (near) total thyroidectomy and successful {sup 131}I ablation, RFS does not differ between patients classified as high-risk and those classified as low-risk based on TNM stage at diagnosis. Consequently, the follow-up protocol should be determined on the basis of the result of initial treatment rather than on the initial tumour classification. (orig.)

  4. 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

  5. The significance of 1-131 scan dose in patients with thyroid cancer: determination of ablation: concise communication

    International Nuclear Information System (INIS)

    Waxman, A.; Ramanna, L.; Chapman, N.; Chapman, D.; Brachman, M.; Tanasescu, D.; Berman, D.; Catz, B.; Braunstein, G.

    1981-01-01

    Twenty-four patients with differentiated thyroid cancer were studied with diagnostic I-131 neck chest scans after having undergone bilateral subtotal thyroidectomy and initial I-131 therapy with either 30- or 100-mCi doses. With an endogenous stimulation protocol, follow-up studies were performed with neck and chest scans using 2 and 10 mCi I-131. A 400% increase in sensitivity was found with a 10-mCi dose relative to a 2-mCi dose. Comparison with therapeutic doses of 30 and 100 mCi resulted in further increases in the detection of residual iodine-avid tissue. We conclude that a 2-mCi or lower dose of I-131 is inadequate in evaluating residual iodine-avid tissue visually in patients with thyroid cancer. The study does not answer the critical question of whether it is necessary to treat a patient presenting a negative 2-mCi but a positive 10-mCi scan. It may be appropriate to define ablation visually as well as clinically, with further studies directed toward determining a treatment rationale in this patient population

  6. Graves' disease in a 3 year-old patient with agranulocytosis due to anti-thyroid drugs: Radioiodine ablation therapy as an effective alternative.

    Science.gov (United States)

    Espinosa-Muñoz, E; Ramírez-Ocaña, D; Martín-García, A M; Ruiz-García, F J; Puentes-Zarzuela, C

    The case is presented of a 3 year-old girl with mitochondrial disease (subacute necrotizing encephalomyelopathy of Leigh syndrome), v-stage chronic kidney disease of a diffuse mesangial sclerosis, as well as developmental disorders, and diagnosed with hyperthyroidism Graves-Basedow disease. Six weeks after starting the treatment with neo-carbimazole, the patient reported a serious case of agranulocytosis. This led to stopping the anti-thyroid drugs, and was treated successfully with 131 I ablation therapy. The relevance of the article is that Graves' disease is uncommon in the paediatric age range (especially in children younger than 6 years old), and developing complications due to a possible late diagnosis. Agranulocytosis as a potentially serious adverse effect following the use of anti-thyroid drugs, and the few reported cases of ablation therapy with 131 I at this age, makes this case unique. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  7. Estimation of parameters biokinetics from the resolution of a model compartment for I-131. Application to a patient with thyroid carcinoma hemodialysis

    International Nuclear Information System (INIS)

    Garcia, R.; Jimenez Feltstrom, D.; Luis dimon, F. J.; Sanchez Carmona, G.; Herrador Cordoba, M.

    2013-01-01

    This work aims to define a biokinetic model for the I-131, and solve it for different conditions of the patient or person affected (normal, with cancer of the thyroid or hyperthyroid). Solve the model in the case of a patient treated with I-131 for ablation of thyroid remnants with undergoing renal insufficiency and hemodialysis . Get the parameters Biokinetic this model for different situations. (Author)

  8. Remnant lipoproteins.

    Science.gov (United States)

    Varbo, Anette; Nordestgaard, Børge G

    2017-08-01

    To review recent advances in the field of remnant lipoproteins and remnant cholesterol with a focus on cardiovascular disease risk. In line with previous years' research, current observational, genetic, and mechanistic studies find remnant lipoproteins (defined in different ways) to be involved in atherosclerosis development and cardiovascular disease risk. High concentrations of remnant cholesterol could explain some of the residual risk of cardiovascular disease seen after LDL cholesterol lowering. This will be increasingly important as populations worldwide become more obese and more have diabetes, both of which elevate remnant cholesterol concentrations. Many smaller scale studies and post hoc analyses show that remnant cholesterol can be lowered by different types of drugs; however, results from large scale studies with the primary aim of reducing cardiovascular disease risk through lowering of remnant cholesterol in individuals with elevated concentrations are still missing, although some are under way. Remnant cholesterol is a risk factor for cardiovascular disease, and can be lowered by different types of drugs; however, large scale studies of cardiovascular disease risk reduction through remnant lipoprotein lowering are under way.

  9. The usefulness of 131I radioiodine to thyroid papillary carcinoma with extra thyroidal extension

    International Nuclear Information System (INIS)

    Shinohara, Shogo; Kikuchi, Masahiro; Naito, Yasushi; Fujiwara, Keizo; Hori, Shinya; Tona, Yosuke; Yamazaki, Hiroshi

    2009-01-01

    Extra thyroidal extension (ETE) of thyroid papillary carcinoma (PAC) is known as a risk factor of poor prognosis. The American Thyroid Association (ATA) Guideline recommends total thyroidectomy (TT) with radioiodine ablation for patients of PACs with ETE and we have been following this strategy for cases of PACs with ETE. In this paper, we retrospectively examined the patients of PACs with ETE in terms of the following two issues: Does 131 I total body scan ( 131 I-TBS) after TT enable us to detect subclinical distant metastases of PACs? and Can 131 I ablation eliminate microscopic remnants of PACs after TT? The subjects consisted of 68 patients who had PACs with ETE and underwent 131 I-TBS and/or 131 I ablation after TT in our hospital in the past 20 years. Tumor, nodes and metastasis (TNM) classifications of the patients were pT3:pT4=12:56, pN0:pN1a:pN1b=13:15:40, M0:M1=62:6. Twenty-two cases underwent only 131 I-TBS and 46 cases underwent 131 I-ablation. Fourteen cases diagnosed as M0 preoperatively had distant focus detected using 131 I-TBS. Including M1 cases, 20 out of 68 cases (29%) turned out to have clinical or subclinical distant lesions in our study. 131 I ablation eliminated thyroid bed in 18 out of 22 cases, and distant foci in 5 out of 13 cases. However, the distant lesions which had been apparent before operation (M1 cases) did not reach complete response (CR) by 131 I ablation. In 22 out of those 23 cases successfully treated with the ablation, serum-thyroglobulin level was almost undetected after therapy. The overall 10-year survival rate was 82% and the cause-specific survival rate was 91%. (author)

  10. Association of Xerostomia and Ultrasonographic Features of the Major Salivary Glands After Radioactive Iodine Ablation for Papillary Thyroid Carcinoma.

    Science.gov (United States)

    Soo Roh, Sang; Wook Kim, Dong; Jin Baek, Hye

    2016-11-01

    The objective of this study is to evaluate the association between xerostomia and sonographic features of the major salivary glands after patients undergo radioactive iodine ablation (RIA) for papillary thyroid carcinoma (PTC). The study included 256 consecutive patients who underwent total thyroidectomy, RIA, and neck ultrasound examinations. Changes in the ultrasound features of the parotid and submandibular glands after RIA were evaluated retrospectively by a single radiologist, on the basis of direct comparison of sonograms obtained before and after RIA. Clinical data, including the presence of xerostomia, were investigated retrospectively by the same radiologist via a review of the electronic medical records. For 111 of the 256 patients (43.4%), ultrasound examination revealed changes in the major salivary glands after RIA. The presence of xerostomia was undetermined in 85 of the 256 patients. Among the remaining 171 patients, the frequency of xerostomia was 36.8% (63/171). When patients with xerostomia were compared with those without xerostomia, no statistically significant differences in patient sex and age, the dose of RIA received, or the number of RIA sessions were noted (p > 0.05). Considering the changes in the ultrasound features of the major salivary glands after RIA, no statistically significant association was found between xerostomia and the number of involved major salivary glands or the presence of an involved submandibular gland (p > 0.05). In this study, ultrasound was unhelpful for evaluating xerostomia after RIA in patients with PTC.

  11. Comparison of thallium-201, Tc-99m MIBI and I-131 scan in the follow-up assessment after I-131 ablative therapy in differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Kwon, Jae Sung; Lee, Sung Keun; Kim, Doe Min; Park, Sae Jong; Jang, Kyong Sun; Kim, Eun Sil; Kim, Chong Soon

    1999-01-01

    We conducted a comparative study to evaluate the diagnostic values of Tl-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or more times of I-131 retreatment (33 cases). In all patients, Tl-201, Tc-99m MIBI, diagnostic and therapeutic I-131 scans were performed and the results were analyzed retrospectively. Also serum thyroglobulin levels were measured in all patients. The final diagnosis of recurrent or metastatic thyroid cancer was determined by clinical, biochemical, radiologic and/or biopsy findings. Positive rates (PR) of Tc-99m MIBI, Tl-201, diagnostic and therapeutic I-131 scans in detecting malignant thyroid tissue lesions were 70% (19/27), 54% (15/28), 35% (17/48) and 63% (30/48), respectively. The PR in the group of 20 cases (28 lesions) who underwent concomitant Tl-201 and I-131 scans were in the order of therapeutic 131 scan 71%, Tl-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between Tl-201 and diagnostic I-131 scans (p>0.05). In the group of 20 cases (27 lesions) who underwent concomitant Tc-99m MIBI and I-131 scans, the PR were in the order of Tc-99m MIBI scan 70%, I-131 therapeutic scan 52% and I-131 diagnostic scan 33%. The PR of Tc-99m MIBI was significantly higher than that of diagnostic I-131 scan (p<0.05). Tc-99m MIBI scan is superior to diagnostic I-131 scan in detecting recurrent or metastatic thyroid cancer following ablation therapy in patients with differentiated thyroid cancer. Tl-201 scan did not showed significantly higher positive rate than diagnostic I-131 scan. Instead of diagnostic I-131 scan before the I-131 retreatment, Tc-99m MIBI scan without discontinuing thyroid hormone replacement would be a prudent and effective approach in the management of these

  12. Thyroid Function after Subtotal Thyroidectomy in Patients with Graves' Hyperthyroidism

    NARCIS (Netherlands)

    Limonard, E. J.; Bisschop, P. H.; Fliers, E.; Nieveen van Dijkum, E. J.

    2012-01-01

    Background. Subtotal thyroidectomy is a surgical procedure, in which the surgeon leaves a small thyroid remnant in situ to preserve thyroid function, thereby preventing lifelong thyroid hormone supplementation therapy. Aim. To evaluate thyroid function after subtotal thyroidectomy for Graves'

  13. Iodine uptake patterns om post-ablation whole body scans are related to elevated serum thyroglobulin levels after radioactive iodine therapy in patients with papillary thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Geum Cheol; Song, Min Chul; Min, Jung Joon; Cho, Sang Geon; Kwon, Seong Young [Dept. of Nuclear Medicine, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Park, Ki Seong; Kang, Sae Ryung; Kim, Ja Hae; Song, Ho Chun [Dept. of Nuclear Medicine, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2016-12-15

    Serum thyroglobulin (Tg) level is frequently elevated shortly after radioactive iodine (RAI) ablation therapy. The authors studied the relationship between the elevation of serum Tg after RAI therapy and iodine uptake pattern on post-ablation whole body scans (RxWBSs) in patients with papillary thyroid carcinoma (PTC). The study subjects were patients with PTC that had undergone first RAI therapy with thyroid hormone withdrawal after total thyroidectomy. Patients with a high level of serum anti-Tg antibody (TgAb, ≥ 60 U/mL), possible regional or distant metastasis as determined by pre-ablation or post-ablation studies, and negative iodine uptake of the anterior neck on RxWBS were excluded. Serum Tg was checked twice, that is, 7 days after (post-ablation Tg) and on the day of RAI therapy (pre-ablation Tg). Ratio of pre-ablation Tg to post-ablation Tg (Tg ratio) was used to assess changes in serum Tg levels after RAI therapy. Patients were classified into two groups according to the presence of midline uptake above the thyroidectomy bed on RxWBS (negative (group 1) or positive (group 2) midline uptake). Variables were subjected to analysis to identify differences between the two groups. Two hundred and fifty patients were enrolled in this study; 101 in group 1 and 149 in group 2. Based on univariate analysis, post-ablation Tg (8.12 ± 11.05 vs. 34.12 ± 54.31; P < 0.001) and Tg ratio (7.81 ± 8.98 vs. 20.01 ± 19.84; P < 0.001) were significantly higher in group 2. On the other hand, gender, tumor (T) stage, lymph node (N) stage, size, multiplicity or bilaterality of primary tumor, dose of 131I, serum TgAb and thyroid-stimulating hormone (TSH) level (before or after RAI therapy) were not significantly different in the two groups. Variables with P values of < 0.25 by univariate analysis were subjected to multivariate analysis, which showed post-ablation Tg (OR 1.060, 95 % CI = 1.028–1.092; P < 0.001) and Tg ratio (OR 1.059, 95 % CI

  14. Association of Papillary Thyroid Carcinoma and Graves' Disease. Unexpected Development and Efficiency of Ablative Dose with Recombinant Human Thyrotropin (rhTSH)

    International Nuclear Information System (INIS)

    Pacenza, N.A.; Groppo, N.; Guibourg, H.C.

    2013-01-01

    athological uptake in middle and lower cervical region right and left lower neck. He was reoperated on 4 months after his initial S: R esection of epithelial proliferation with thyroid aspect in superior mediastinum region . Pathology: N ode with extensive infiltration of neoplastic proliferation of follicular variant of papillary carcinoma with areas of connective tissue infiltrated periganglionar of papillary thyroid cancer . Lab 40 days after the second surgery: TSH 2.3 μIU/mL, FT4 0.82 ng/dL, Tg 4.7 ng/mL. Neck and chest CT showed neither pathological lesions nor lymphadenopathy. I 131 uptake with 7.4 MBq was: 1st hour: 8 % and 24 hours: 12 %. Neck Scan: M ultiple areas of tracer fixation in the neck . No pathological signs on neck palpation. Ablative dose of 7.4 GBq of I 131 was performed to the patient, previously using rhTSH (two doses of 0.9 mg), reaching TSH >100 μIU/mL. Scan post ablative dose: I mportant focus on right paratracheal region. Neck MRI showed: Absence of thyroid gland. Rounded image of about 10 mm at right paratracheal level. The patient initiates suppressive therapy with levothyroxine (LT4). Six months after ablation therapy (without LT4): TSH >100 μIU/mL, Tg: 13.8 ng/mL, TGA: 431 IU/mL. Body Scan with 2 mCi: P athological focus of radioiodine behind the right sternoclavicular joint. New neck MRI: Image in right pretracheal region smaller than the previous study . The patient received 5.55 GBq of I 131 . The same radioiodine treatment was repeated 8 months later. At present, 4 years after the patient's initial surgery, he is in good general health, performing his normal activities, with TGA in sharp decline, negative I 131 body scan and without signs of persistent or recurrent disease. Conclusions: We report a case of follicular variant papillary TC associated with GD with concomitant development of hyperthyroidism, with positive TGA, in a 22-year-old obese man. Highlights: 1) The importance of initial US exploration in a patient with GD, 2

  15. Thyroid disease in the pediatric patient: emphasizing imaging with sonography

    International Nuclear Information System (INIS)

    Babcock, Diane S.

    2006-01-01

    Thyroid disease does occur in the pediatric patient, and imaging plays an important role in its evaluation. A review is presented of normal development of the thyroid gland, the technique and indications for thyroid sonography, and key imaging features of congenital thyroid disorders (ectopic or absent thyroid, infantile goiter, thyroglossal duct remnants), benign thyroid masses (follicular adenoma, degenerative nodules, colloid and thyroid cysts), malignant masses (follicular, papillary and medullary carcinoma) and diffuse thyroid disease (acute bacterial thyroiditis, Hashimoto's thyroiditis, Grave's disease). (orig.)

  16. Controversial Issues in Thyroid Cancer Management.

    Science.gov (United States)

    Tuttle, R Michael

    2018-04-13

    The lack of prospective randomized clinical trials for most management topics in differentiated thyroid cancer force us to make management recommendations based on retrospective observational data which is often incomplete, subject to selection bias, and conflicting. Therefore, it is not surprising that many aspects of thyroid cancer management remain controversial and not well defined. This review will examine the controversies surrounding three important topics in thyroid cancer management: (1) the option of thyroid lobectomy as initial therapy for thyroid cancer, (2) the proper use of preoperative neck imaging to optimize the completeness of the initial surgical procedure, and (3) the selective use RAI therapy as remnant ablation, adjuvant treatment or treatment of known persistent/recurrent disease. As thyroid cancer management moves toward a much more risk adapted approach to personalized management recommendations, clinicians and patients must balance the risks and benefits of the potential management options to arrive at a management plan that is optimized based on both patient preferences/values and the philosophy/experience of the local disease management team. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  17. 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

  18. Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease. A 3-month follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Korkusuz, H.; Happel, C.; Koch, D.A.; Gruenwald, F. [Frankfurt University Hospital (Germany). Dept. of Nuclear Medicine

    2016-01-15

    Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ± 7.9 ml (30.5 % ± 4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ± 4.8 % (p < 0.05) and hospitalization time by 30.9 % ± 19.9 % (p < 0.05). The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary.

  19. Optimization of the therapeutic dose of 131I for thyroid differentiated carcinoma

    International Nuclear Information System (INIS)

    Lima, Fabiana Farias de

    2002-09-01

    I-131 thyroid cancer therapy is based on the strategy of concentrating radioactive iodine in the thyroid tissue, to completetly eliminate thyroid tissue and functioning thyroid cancer metastases remaining after thyroidectomy. In Brazil, fixed activities of 131 I generally are given, sometimes either delivering insufficient activities to ablate all of the remnants, or unnecessarily high activities, with patients remaining in the hospital for some period of time. This investigation proposes a protocol of individualized planning of ablative doses, based on individual patients metabolisms and measured thyroid remnant masses. Simulated thyroid remnants were fabricated in various forms, volumes and activities, and optimum image acquisition parameters were determined using Single-Photon Emission Computed Tomography 9SPECT). Resultant images were evaluated, to determine the apparent volumes and the 131 I concentrations. I-131 metabolism was studied in 9 patients who had undergone thyroidectomies. Their thyroid remnant masses were determined applying the same parameters used in SPECT simulation studies, and the optimum activity for their therapy was calculated and compared to the established fixed activity of 3.7 GBq (100 mCi), which would have normally been assigned. Background subtraction using the method of percent maximum counts, using a value of 67.5%, combined with scatter correction (triple energy window method), was shown to be optimum for SPECT quantification of volumes between 3-10 ml. Errors in the method were below 9% for sources with regular geometries and around 11% for sources with irregular geometries. In the patient studies, it was observed that 78% of patients could have received reduced activities of 131 (from 0.8-3-2. GBq (20-87 nCi). In addition, 33% of these patients could have received low enough activities to have discharged from the hospital, using an individualized administration scheme. This could also have resulted in a dose reduction for many

  20. Biokinetic study of 131I following ablation dose administration

    International Nuclear Information System (INIS)

    Nascimento, A.C.H.; Lipsztein, J.L.; Lucena, E.A.; Dantas, B.M.; Rebelo, A.M.O.; Mello, R.C.

    2002-01-01

    Aim: The aim of this investigation is to study biokinetics from internally 131 I deposited for thyroid cancer patients during radioiodine therapy (2 to 3 days), after ablation dose administration (3.7 GBq). These data will help in the elaboration of a metabolic model, which will permit absorbed dose assessment for this specific case, since the biokinetic models for iodine available in scientific literature can not be applied to thyroidectomized patient's studies. Material and Methods: Four females patients, between 22 and 50 years old, without metastases, between 1.9 to 6% of remnant thyroid tissue uptake, agreed to contribute to this study. For the in vivo bioassay, periodical measurements were performed along internment time (2 to 3 days), just after Na 131 I dose administration (3.7 GBq). For this, we used the counting system for Nuclear Medicine model 13S002, IEN/CNEN- Brazil, which was adapted with lead filters, in order to allow the work with high rate counting. The measurements were performed in two geometries: thyroid region and thigh. Results: For each patient, we have done approximately 26 measurements for both geometries, starting at the first hour following dose administration until the release from hospital of patient. The results of counting rate (cps) were plotted against time (h). The measurements suggest a relation between remnant thyroid tissue uptake values and the time where counting rates start decreasing. In addition, it was observed a correlation between remnant thyroid tissue radioactive burdens and the circulating iodine through time. Conclusion: It is necessary to follow-up a greater number of patients aiming to confirm the observed correlations and with a greater number of measurements during the first 24 hours, in other to delimit the time range of increasing and decreasing counting rate

  1. The Role of STAT3 in Thyroid Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sosonkina, Nadiya; Starenki, Dmytro; Park, Jong-In, E-mail: jipark@mcw.edu [Department of Biochemistry, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226 (United States)

    2014-03-06

    Thyroid cancer is the most common endocrine malignancy and its global incidence rates are rapidly increasing. Although the mortality of thyroid cancer is relatively low, its rate of recurrence or persistence is relatively high, contributing to incurability and morbidity of the disease. Thyroid cancer is mainly treated by surgery and radioiodine remnant ablation, which is effective only for non-metastasized primary tumors. Therefore, better understanding of the molecular targets available in this tumor is necessary. Similarly to many other tumor types, oncogenic molecular alterations in thyroid epithelium include aberrant signal transduction of the mitogen-activated protein kinase, phosphatidylinositol 3-kinase/AKT (also known as protein kinase B), NF-κB, and WNT/β-catenin pathways. However, the role of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT3) pathway, a well-known mediator of tumorigenesis in different tumor types, is relatively less understood in thyroid cancer. Intriguingly, recent studies have demonstrated that, in thyroid cancer, the JAK/STAT3 pathway may function in the context of tumor suppression rather than promoting tumorigenesis. In this review, we provide an update of STAT3 function in thyroid cancer and discuss some of the evidences that support this hypothesis.

  2. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer

    Science.gov (United States)

    Alexander, Erik K.; Bible, Keith C.; Doherty, Gerard M.; Mandel, Susan J.; Nikiforov, Yuri E.; Pacini, Furio; Randolph, Gregory W.; Sawka, Anna M.; Schlumberger, Martin; Schuff, Kathryn G.; Sherman, Steven I.; Sosa, Julie Ann; Steward, David L.; Tuttle, R. Michael; Wartofsky, Leonard

    2016-01-01

    Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. Results: The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy

  3. Is {sup 131}I ablation necessary for patients with low-risk papillary thyroid carcinoma and slightly elevated stimulated thyroglobulin after thyroidectomy?

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    Rosario, Pedro Weslley; Mourao, Gabriela Franco, E-mail: pedrowsrosario@gmail.com [Santa Casa de Belo Horizonte, MG (Brazil). Instituto de Ensino e Pesquisa

    2016-02-15

    Objective: This prospective study evaluated the recurrence rate in low-risk patients with papillary thyroid cancer (PTC) who presented slightly elevated thyroglobulin (Tg) after thyroidectomy and who did not undergo ablation with {sup 131}I. Subjects and methods: The study included 53 low-risk patients (non aggressive histology; pT1b-3, cN0pNx, M0) with slightly elevated Tg after thyroidectomy (> 1 ng/mL, but ≤ 5 ng/mL after levothyroxine withdrawal or ≤ 2 ng/mL after recombinant human TSH). Results: The time of follow-up ranged from 36 to 96 months. Lymph node metastases were detected in only one patient (1.9%). Fifty-two patients continued to present negative neck ultrasound. None of these patients without apparent disease presented an increase in Tg. Conclusions: Low-risk patients with PTC who present slightly elevated Tg after thyroidectomy do not require ablation with {sup 131}I. (author)

  4. 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

  5. Thyroid cancer in lingual thyroid and thyroglossal duct cyst.

    Science.gov (United States)

    Sturniolo, Giacomo; Vermiglio, Francesco; Moleti, Mariacarla

    2017-01-01

    Ectopy is the most common embryogenetic defect of the thyroid gland, representing between 48 and 61% of all thyroid dysgeneses. Persistence of thyroid tissue in the context of a thyroglossal duct remnant and lingual thyroid tissue are the most common defects. Although most cases of ectopic thyroid are asymptomatic, any disease affecting the thyroid may potentially involve the ectopic tissue, including malignancies. The prevalence of differentiated thyroid carcinoma in lingual thyroid and thyroglossal duct cyst is around 1% of patients affected with the above thyroid ectopies. We here review the current literature concerning primary thyroid carcinomas originating from thyroid tissue on thyroglossal duct cysts and lingual thyroid. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. 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

  7. Quality of Life and Cost-Effectiveness Assessment of Radioiodine Ablation Strategies in Patients With Thyroid Cancer: Results From the Randomized Phase III ESTIMABL Trial.

    Science.gov (United States)

    Borget, Isabelle; Bonastre, Julia; Catargi, Bogdan; Déandréis, Désirée; Zerdoud, Slimane; Rusu, Daniela; Bardet, Stéphane; Leenhardt, Laurence; Bastie, Delphine; Schvartz, Claire; Vera, Pierre; Morel, Olivier; Benisvy, Daniele; Bournaud, Claire; Bonichon, Francoise; Kelly, Antony; Toubert, Marie-Elisabeth; Leboulleux, Sophie; Journeau, Florence; Benhamou, Ellen; Schlumberger, Martin

    2015-09-10

    In the ESTIMABL phase III trial, the thyroid ablation rate was equivalent for the two thyroid-stimulating hormone (TSH) stimulation methods (thyroid hormone withdrawal [THW] and recombinant human TSH [rhTSH]) and the two iodine-131 ((131)I) activities (1.1 or 3.7 GBq). The objectives of this article were to present health-related quality-of-life (HRQoL) results and a cost-effectiveness evaluation performed alongside this trial. HRQoL and utility were longitudinally assessed, from random assignment to the follow-up visit at 8 ± 2 months for the 752 patients with thyroid cancer, using the Short Form-36 and the EuroQoL-5D questionnaires, respectively. A cost-effectiveness analysis was performed from the societal perspective in the French context. Resource use (hospitalization for (131)I administration, rhTSH, sick leaves, and transportation) was collected prospectively. We used the net monetary benefit approach and computed cost-effectiveness acceptability curves for both TSH stimulation methods and (131)I activities. Sensitivity analyses of the costs of rhTSH were performed. At (131)I administration, THW caused a clinically significant deterioration of HRQoL, whereas HRQoL remained stable with rhTSH. This deterioration was transient with no difference 3 months later. rhTSH was more effective than THW in terms of quality-adjusted life-years (QALYs; +0.013 QALY/patient) but more expensive (+€474/patient). The probability that rhTSH would be cost effective at a €50,000/QALY threshold was 47% in France. The use of 1.1 GBq of (131)I instead of 3.7 GBq reduced per-patient costs by €955 (US$1,018) but with slightly decreased efficacy (-0.007 QALY/patient). rhTSH avoids the transient THW-induced deterioration of HRQoL but is unlikely to be cost effective at its current price. © 2015 by American Society of Clinical Oncology.

  8. Primary thyroid lymphoma: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo-Cheol; Han, Moon Hee E-mail: hanmh@radcom.snu.ac.kr; Kim, Keon Ha; Jae, Hwan Jun; Lee, Sang Hyun; Kim, Sam Soo; Kim, Kwang Hyun; Chang, Kee-Hyun

    2003-06-01

    Introduction: To evaluate the computed tomographic (CT) findings of primary thyroid lymphoma. Methods and material: The clinicopathological data and CT images of nine patients with primary thyroid lymphoma were retrospectively reviewed. The CT appearances were classified into three types: type 1, a solitary nodule surrounded by normal thyroid tissue; type 2, multiple nodules in the thyroid, and type 3, a homogeneously enlarged both thyroid glands with a reduced attenuation with or without peripheral thin hyperattenuating thyroid tissue. Results: All patients had a rapidly enlarging thyroid mass and coexistent Hashimoto's thyroiditis. One patient showed type 1 pattern, three type 2, and five type 3. Six patients had homogeneous tumor isoattenuating to surrounding muscles. The tumors had a strong tendency to compress normal remnant thyroid and the surrounding structure without invasion. Conclusion: Primary thyroid lymphoma should be included in the differential diagnosis when old female had a homogeneous thyroidal mass isoattenuating to muscles, which does not invade surrounding structures.

  9. Is Stimulated Thyroglobulin Necessary after Ablation in All Patients with Papillary Thyroid Carcinoma and Basal Thyroglobulin Detectable by a Second-Generation Assay?

    Directory of Open Access Journals (Sweden)

    Pedro Weslley Rosario

    2015-01-01

    Full Text Available Objective. To evaluate the percentage of elevated stimulated thyroglobulin (sTg and persistent or recurrent disease (PRD in patients with detectable basal Tg < 0.3 ng/mL. Methods. The sample consisted of 130 patients with papillary thyroid carcinoma (PTC who were at low risk of PRD and who had neck ultrasound (US without abnormalities, negative anti-Tg antibodies (TgAb, and detectable basal Tg < 0.3 ng/mL about 6 months after ablation. Results. sTg was <1 ng/mL in 88 patients (67.7%, between 1 and 2 ng/mL in 26 (20%, and ≥2 ng/mL in 16 (12.3%. Imaging methods revealed the absence of tumors in 16 patients with elevated sTg. During follow-up, Tg increased to 0.58 ng/mL in one patient and lymph node metastases were detected. Sixty-nine patients continued to have detectable Tg < 0.3 ng/mL and US revealed recurrence in only one patient. Sixty patients progressed to persistently undetectable Tg without apparent disease on US. Conclusions. In low-risk patients with PTC who have detectable basal Tg < 0.3 ng/mL after ablation, negative TgAb, and US, persistent disease is rare and eventual recurrences can be detected by basal Tg elevation and/or subsequent US assessments, with follow-up without sTg being an “alternative” to Tg stimulation.

  10. Long-term efficacy of ultrasound-guided low power microwave ablation for the treatment of primary papillary thyroid microcarcinoma: a 3-year follow-up study.

    Science.gov (United States)

    Teng, Dengke; Sui, Guoqing; Liu, Caimei; Wang, Yu; Xia, Yongxu; Wang, Hui

    2018-04-01

    To evaluate the safety and efficacy of ultrasound-guided low-power microwave ablation (MWA) for the treatment of papillary thyroid microcarcinoma (PTMC) with a 3-year follow-up. A total of 21 nodules diagnosed as PTMC from the 15 patients were performed with MWA at a power of 20 W. The images of the nodules were recorded by ultrasound before MWA and 1, 3, 6, 12 months after MWA, and every 6 months thereafter, respectively. The volumes of the nodules were compared before MWA and at each follow-up point after MWA. The volume reduction rate (VRR) of nodules was also calculated. The mean volume of the nodules was 134.3 ± 129.8 mm 3 initially (the range was 7.4-423.8 mm 3 ), which decreased significantly to 2.3 ± 10.5 mm 3 (the range was 0-48.1 mm 3 ) of the ablation area (P = 0.000) at the follow-up point of 36 months with a mean VRR as 98.78 ± 5.61% (the range was 74.28-100%). During the follow-up period (the range was 36-48 months), 20 of the 21 nodules were completely absorbed and no recurrent nodule was found. After a long-term follow-up of 3 years, the low power MWA showed a good safety and efficacy for the treatment of PTMC. In addition to surgery and active surveillance, MWA might be another alternative for patients with PTMC.

  11. Thyroid nodule

    International Nuclear Information System (INIS)

    McKenney, J.F.

    1975-01-01

    A palpable mass or nodule may represent any one of a large and diverse group of conditions that involve the thyroid. Whether the patient is euthyroid, hypothyroid, or hyperthyroid can be assessed, and the cause of hypofunction or hyperfunction can usually be determined. Scintiscanning provides important information on the anatomic structure of thyroid nodules. A hot nodule should be ablated by either radioiodine or surgery. A warm nodule usually responds to suppression therapy; if regression does not occur, the problem should be reevaluated. A cold nodule should be surgically excised, as microscopic study of such a lesion is mandatory

  12. [Clinical guideline for management of patients with low risk differentiated thyroid carcinoma].

    Science.gov (United States)

    Díez, Juan José; Oleaga, Amelia; Álvarez-Escolá, Cristina; Martín, Tomás; Galofré, Juan Carlos

    2015-01-01

    Incidence of thyroid cancer is increasing in Spain and worldwide. Overall thyroid cancer survival is very high, and stratification systems to reliably identify patients with worse prognosis have been developed. However, marked differences exist between the different specialists in clinical management of low-risk patients with thyroid carcinoma. Almost half of all papillary thyroid carcinomas are microcarcinomas, and 90% are tumors < 2 cm that have a particularly good prognosis. However, they are usually treated more aggressively than needed, despite the lack of adequate scientific support. Surgery remains the gold standard treatment for these tumors. However, lobectomy may be adequate in most patients, without the need for total thyroidectomy. Similarly, prophylactic lymph node dissection of the central compartment is not required in most cases. This more conservative approach prevents postoperative complications such as hypoparathyroidism or recurrent laryngeal nerve injury. Postoperative radioiodine remnant ablation and strict suppression of serum thyrotropin, although effective for the more aggressive forms of thyroid cancer, have not been shown to be beneficial for the treatment of low risk patients, and may impair their quality of life. This guideline provides recommendations from the task force on thyroid cancer of the Spanish Society of Endocrinology and Nutrition for adequate management of patients with low-risk thyroid cancer. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  13. Recurrence rates following I-131 therapy of differentiated thyroid carcinoma: results of meta-analysis

    International Nuclear Information System (INIS)

    Obaldo, J.M.

    1990-01-01

    To examine the efficacy of I-131 therapy in decreasing recurrence rates after surgery for differentiated thyroid carcinoma, a research tool called meta-analysis was used. Data were pooled from five published studies which evaluated recurrences following at least sub-total thyroidectomy with or without I-131 ablation of remnants. Of 1332 patients managed surgically only 202 (15%) developed recurrences compared to 36 of 339 (11%) treated with radioiodine. This difference was statistically significant at p<.05. When a separate analysis of only those studies which directly compared the two modes of management was conducted, recurrence rates for patients treated by surgery alone was higher at 18% (185 of 1034) compared with those who had subsequent I-131 therapy with a rate of 9% (27 of 297). This difference was again significant at p <.001. This meta-analysis strongly suggests that the use of I-131 for ablation of post-surgical thyroid remnants significantly reduces recurrence rates in patients with differentiated thyroid carcinoma. (Auth.). 34 refs., 1 tab.; 1 fig

  14. Use of recombinant human thyrotropin (rh TSH) as a method of preparation for radioiodine therapy in thyroid disorders; Utilisation de la thyreostimuline humaine recombinante dans la preparation au traitement par iode-131 des pathologies thyroidiennes

    Energy Technology Data Exchange (ETDEWEB)

    Taieb, D.; Guillet, B.A.; Tessonnier, L.; Mundler, O. [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, 13 - Marseille (France)

    2008-02-15

    The introduction of recombinant human TSH (rh TSH) as a method of preparation for radioiodine therapy of follicular-derived thyroid tumors (benign and malignant) is a significant medical advance. Rh TSH has been approved for use in remnants ablation after total thyroidectomy for carcinoma. There are other potential uses for rh TSH that have not yet been licensed. The use of rh TSH allows to reduce administrated doses in goiters through an increase of iodine uptake and a more homogeneous distribution of radioiodine in the gland. Rh TSH also improves thyroid cancer patients quality of life by avoiding hypothyroidism. (authors)

  15. Thyroid disease in the pediatric patient: emphasizing imaging with sonography

    Energy Technology Data Exchange (ETDEWEB)

    Babcock, Diane S. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2006-04-15

    Thyroid disease does occur in the pediatric patient, and imaging plays an important role in its evaluation. A review is presented of normal development of the thyroid gland, the technique and indications for thyroid sonography, and key imaging features of congenital thyroid disorders (ectopic or absent thyroid, infantile goiter, thyroglossal duct remnants), benign thyroid masses (follicular adenoma, degenerative nodules, colloid and thyroid cysts), malignant masses (follicular, papillary and medullary carcinoma) and diffuse thyroid disease (acute bacterial thyroiditis, Hashimoto's thyroiditis, Grave's disease). (orig.)

  16. Differentiated thyroid carcinoma referred for radioiodine therapy

    International Nuclear Information System (INIS)

    Al-Balawi, Ibrahim A.; Meir, Hadir M.; Yousef, Mohammad K.; Nayel, Hala A.; Al-Mobarak, Mohammad F.

    2001-01-01

    The current work was conducted to study the disease status and treatment results of patients with differentiated thyroid carcinoma referred for radioactive iodine therapy. Retrospective review of 78 patients with differentiated thyroid carcinoma referred for radioiodine therapy in the Nuclear Medicine Unit, King Abdulaziz Hospital and Oncology Center, Jeddah, Kingdom of Saudi Arabia. Analysis of the clinicopathologic characteristics, age correlation to different risk factors, treatment protocol and results were performed. Seventy seven percent were female and the female to male ratio was 3.5:1. The age of patients ranged between 13-63 years with a median age of 36 years. Cervical lymph node involvement was detected in 22 patients (25%). Papillary carcinoma was encountered in 78 patients (90%) and follicular carcinoma in 9 patients (10%). Analysis of the clinicopathologic characteristics showed no statistically significant difference between patients in the different age groups except for extrathyroid extension and lymph node involvement. Patients older than 45 years had a statistically significant lower incidence of nodal involvement and higher incidence of extra thyroid extension (P<0.02). In the current study we used a high dose method (Radioiodine-131 dose 75-100mCi) for thyroid remnant ablation after thyroidectomy (total or near total) in 67 patients. An Iodine 131 dose of 150 mCi was used in 12 patients with radioiodine-avid cervical lymph nodes and in 3 patients with gross residual tumor. In 4 patients with distant metastases an Iodine 131 dose of 200 mCi was used. For the whole study group the 5 year overall survival and disease-free survival was 96% and 88%. The current study, as with many other retrospective studies, concluded that despite the fact that differentiated thyroid carcinoma is among the most curable cancers, some patients are still at high risk for recurrent disease and associated mortality. (author)

  17. Absence of survival benefit of radioactive iodine (RAI) after thyroidectomy in low risk differentiated thyroid cancer (DTC) patients

    International Nuclear Information System (INIS)

    Schwartz, C.; Fieffe, S.; Pochart, J.M.; Bonnetain, F.; Gauthier, M.; Cueff, A.; Crevisy, E.; Dygai-Cochet, I.; Toubeau, M.

    2012-01-01

    After thyroidectomy, the goal of the first dose of radioactive iodine (RAI) is remnant ablation to facilitate the initial staging with the post-therapy scan and to facilitate the early detection of recurrences. The purpose of this study is to the survival benefit of RAI in low-risk thyroid cancer patients. Using Cancer thyroid registry of Marne Ardennes (1041 patients) and hospital data base of centre Leclerc (257 patients), we included all differentiated thyroid cancer (DTC) patients at low risk from 1975 to 2005. Median follow-up was 10.3 years, during which 19 recurrences, 61 other malignant diseases and 105 deaths were registered. 387 patients (30%) received no RAI and 911 had RAI (70%). If we confirmed that some clinical characteristics were associated with RAI intake, the study failed to demonstrate any survival benefit of RAI in low risk DTC patients

  18. Absence of survival benefit of radioactive iodine (RAI) after thyroidectomy in low risk differentiated thyroid cancer (DTC) patients

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, C.; Fieffe, S.; Pochart, J.M. [Endocrinology Nuclear Medicine, Institut Jean Godinot, Reims (France); Bonnetain, F.; Gauthier, M.; Cueff, A. [Statistics and Epidemiology, Centre Georges Francois Leclerc, Dijon (France); Crevisy, E.; Dygai-Cochet, I.; Toubeau, M. [Nuclear Medicine, Centre Georges Francois Leclerc, Dijon (France)

    2012-07-01

    After thyroidectomy, the goal of the first dose of radioactive iodine (RAI) is remnant ablation to facilitate the initial staging with the post-therapy scan and to facilitate the early detection of recurrences. The purpose of this study is to the survival benefit of RAI in low-risk thyroid cancer patients. Using Cancer thyroid registry of Marne Ardennes (1041 patients) and hospital data base of centre Leclerc (257 patients), we included all differentiated thyroid cancer (DTC) patients at low risk from 1975 to 2005. Median follow-up was 10.3 years, during which 19 recurrences, 61 other malignant diseases and 105 deaths were registered. 387 patients (30%) received no RAI and 911 had RAI (70%). If we confirmed that some clinical characteristics were associated with RAI intake, the study failed to demonstrate any survival benefit of RAI in low risk DTC patients

  19. The Treatment of Differentiated Thyroid Cancer in Children: Emphasis on Surgical Approach and Radioactive Iodine Therapy

    Science.gov (United States)

    Mazzaferri, Ernest L.; Verburg, Frederik A.; Reiners, Christoph; Luster, Markus; Breuer, Christopher K.; Dinauer, Catherine A.; Udelsman, Robert

    2011-01-01

    Pediatric thyroid cancer is a rare disease with an excellent prognosis. Compared with adults, epithelial-derived differentiated thyroid cancer (DTC), which includes papillary and follicular thyroid cancer, presents at more advanced stages in children and is associated with higher rates of recurrence. Because of its uncommon occurrence, randomized trials have not been applied to test best-care options in children. Even in adults that have a 10-fold or higher incidence of thyroid cancer than children, few prospective trials have been executed to compare treatment approaches. We recognize that treatment recommendations have changed over the past few decades and will continue to do so. Respecting the aggressiveness of pediatric thyroid cancer, high recurrence rates, and the problems associated with decades of long-term follow-up, a premium should be placed on treatments that minimize risk of recurrence and the adverse effects of treatments and facilitate follow-up. We recommend that total thyroidectomy and central compartment lymph node dissection is the surgical procedure of choice for children with DTC if it can be performed by a high-volume thyroid surgeon. We recommend radioactive iodine therapy for remnant ablation or residual disease for most children with DTC. We recommend long-term follow-up because disease can recur decades after initial diagnosis and therapy. Considering the complexity of DTC management and the potential complications associated with therapy, it is essential that pediatric DTC be managed by physicians with expertise in this area. PMID:21880704

  20. Iatrogenic hyperthyroidism does not promote weight loss or prevent ageing-related increases in body mass in thyroid cancer survivors.

    Science.gov (United States)

    Polotsky, Hanah N; Brokhin, Matvey; Omry, Gal; Polotsky, Alex J; Tuttle, R Michael

    2012-04-01

    Thyroid cancer survivors represent a unique population in which the potential long-term effects of brief periods of intentional thyroid hormone withdrawal and/or prolonged periods of iatrogenic hyperthyroidism on body weight and body mass were evaluated. The objectives of this study were to characterize body mass changes over several years in a cohort of thyroid cancer patients with iatrogenic hyperthyroidism and to compare these changes with the expected weight gain in age-matched healthy control populations. We also evaluated the possibility that the method of preparation [thyroid hormone withdrawal (THW) vs recombinant human TSH (rhTSH)] for radioactive iodine remnant ablation may be associated with differences in body mass at the time of the final follow-up. DESIGN/SETTING/PATIENTS/INTERVENTIONS: A retrospective review identified 153 patients with thyroid cancer who underwent total thyroidectomy at one major medical centre. Of the 153 patients, 143 also had radioactive iodine remnant ablation: 70 after THW and 73 after rhTSH. Change in weight and BMI at 1-2 and 3-5 years of follow-up points were examined. Annualized weight variation within the cohort was compared with age-matched population controls expressed in kilogram/year. Significant weight gain was noted for the full cohort after 3-5 years of follow-up as compared to baseline (76 ± 21 kg at baseline vs 79 ± 23 kg at 3-5 years of follow-up, P weight, respectively, which is similar or somewhat higher than previously published age-matched population controls (ranging from 0·23 to 0·34 kg/year). When expressed as per cent change and comparing the final weight to the pre-operative baseline, the rhTSH group experienced approximately a 1·7% increase in weight compared with the 3·9% increase seen with THW patients (P = 0·02). When expressed as kg/year change, the rhTSH cohort had 0·34 kg/year change compared with the 0·64 kg/year change seen in the thyroid hormone withdrawal patients (P = 0·02). In

  1. Percutaneous ethanol injection therapy of autonomous (toxic) thyroid nodules

    International Nuclear Information System (INIS)

    Dieter Erich Apitzsch, M. D.; Staedtische Paracelsusklinik

    2005-01-01

    In Europe, 9-10% of hyperfunctioning thyroid glands have toxic, autonomous thyroid nodules (ATN). Since 1994, in the Municipal hospital of Marl, Germany, 186 patients have performed percutaneous ethanol ablation of toxic thyroid nodules with very good or at least sufficient results. In this article, the ablation technique is described in detail and the costs of therapy of ATN are given.(authors)

  2. [Recurrent neck abscess due to a branchial cleft remnant].

    Science.gov (United States)

    Kruijff, Schelto; Mastboom, Walter J; Vriens, Menno R; Sidhu, Stan B; Delbridge, Leigh W

    2013-01-01

    Abscesses arising from a third or fourth branchial cleft remnant are uncommon clinical entities and are often not recognised in a timely manner. In a 33-year-old female patient with a recurrent abscess in the left side of her neck, the cause turned out to be a fistula in the third branchial cleft remnant. She was treated initially with antibiotics and prednisone without adequate results. When the abscess was finally surgically drained, she became very ill and was admitted to the ICU with sepsis and multiple organ failure. She was discharged from hospital after six weeks. Four months later, a third-branchial cleft remnant was found during pharyngoscopy, immediately after which the cleft remnant fistula was excised and an ipsilateral hemi-thyroidectomy was performed. In young patients with recurring peri-thyroidal abscesses, a branchial cleft remnant should be considered a causative factor; this could avoid high morbidity and a delay in the appropriate treatment.

  3. Remnant lipoproteins and atherosclerosis

    NARCIS (Netherlands)

    Twickler, Th. B.; Dallinga-Thie, G. M.; Chapman, M. J.; Cohn, J. S.

    2005-01-01

    A recently developed assay for quantification of remnant-like particle cholesterol has provided considerable evidence that reinforces the concept that elevated levels of plasma remnants are associated with increased cardiovascular disease in different populations and distinct patient groups. In this

  4. 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

  5. The effects of antithyroid drug treatment on thyroid hormone levels after 131I ablation for Graves' disease: a prospective randomized study

    International Nuclear Information System (INIS)

    Magalhaes, Patricia; Maciel, Lea

    2005-01-01

    Full text: The efficacy, safety and low cost of radioactive iodine ( 131 I) have made it the preferred definitive treatment in most patients with Graves' disease. The purposes of this study were: 1) Evaluate the acute changes in thyroid hormones (TH) levels before and after 131 I therapy in patients randomized to receive either antithyroid drug (ATD) pretreatment or no pretreatment, 2) Evaluate the effect of ATD pretreatment on the efficacy of 131 I therapy. 42 patients with clinical diagnosis of hyperthyroid Graves' disease were schedule to receive ablation therapy with 131 I: 24 were pretreated with methimazole (Group I) and 18 were not (Group II). ATD was stopped 5 days before 131 I therapy. Patients were monitorized clinically and biochemically with measurement of FT 3 , FT 4 and TSH on days -5, 0, 2, 6, 14, 30, 60, 120, 180, 360. Before 131 I treatment, comparing with baseline measurements, FT 4 levels after discontinuation of ATD have shown a mean increase of 61.8% (1.2 ± 0.6 to 1.8 ± 1.1 ng/dl, p=0.0006), while FT 3 levels increased 63.7% (3.2 ± 0.6 to 5.2 ± 2.2 pg/ml, p=0.0002). In this group, 131 I therapy resulted in a further increase in FT 4 levels on day 2 (p=0.0005) but not in T 3 levels. Conversely, the Group II patients experienced no further elevations in TH after 131 I therapy, which kept stable until day 30 th. After 60 days of treatment there was an important decrease in FT 4 concentrations for Group II patients, reaching similar values of the Group I levels but above the normal range. On the 120 th day, the TH levels were similar and at normal range in both groups. In the Group II, 12 patients (66.7%), 1 patient (5.6%) and 3 (16.7%) became hypothyroid, euthyroid or hyperthyroid, respectively. On the other hand, in the Group I, 7 patients (29.2%), 6 patients (25%) and 6 patients (25%) became hypothyroid, euthyroid or hyperthyroid, respectively. Conclusion: Pretreatment with methimazole before radioactive iodine therapy seems to interfere

  6. Decreased uptake after fractionated ablative doses of iodine-131

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Hurng-Sheng [Show Chwan Memorial Hospital, Department of Surgery, Changhua, Taiwan (Taiwan); Hseu, Huey-Herng [Taichung Veterans General Hospital, Department of Medical Education and Research, Taichung (Taiwan); Lin, Wan-Yu; Wang, Shyh-Jen [Taichung Veterans General Hospital, Department of Nuclear Medicine, Taichung, Taiwan (Taiwan); Liu, Yao-Chi [Department of Surgery, General Surgery, National Defense Medical Center, Taipe (Taiwan)

    2005-02-01

    In an attempt to obviate the necessity for hospitalisation, the ablative dose of {sup 131}I in the treatment of thyroid cancer is divided into two or three fractions at weekly intervals in some hospitals with no special bed for {sup 131}I treatment. Thyroid stunning has been observed in patients receiving a {sup 131}I dose between 74 and 370 MBq (2-10 mCi). However, the influence of {sup 131}I uptake after administration of a higher dose, such as 1,110-1,850 MBq of {sup 131}I, has never been reported. In this study, we evaluated the degree of reduction in {sup 131}I uptake after patients received 1,480 MBq of {sup 131}I and evaluated the clinical value of fractionated ablative doses of {sup 131}I. Thirty-five patients with functional thyroid cancer received a total of 4,440 MBq (120 mCi) of {sup 131}I which was divided into three fractions administered at weekly intervals. In all patients two {sup 131}I whole-body scans were performed. The first scan was performed directly prior to the second dose of {sup 131}I (7 days after the first administration of {sup 131}I), and the second scan was performed 7 days after the second administration of {sup 131}I and directly prior to the third administration. Regions of interest including the neck and lungs were drawn to calculate the uptake of {sup 131}I in the thyroid remnant and possible cervical lymph node and lung metastases. The mean uptake of {sup 131}I was 2.73% 7 days after the first administration, and decreased significantly to 0.26% 7 days after the second administration. The mean decrease was as high as 80.7%. The decrease in {sup 131}I uptake was significant in all patients except the two with lung metastases. In the two patients with lung metastases, no definite evidence of decreased uptake was noted; the uptake of {sup 131}I in the lung metastases even increased on the second {sup 131}I image in one of these patients. After administration of 1,480 MBq of {sup 131}I, the decreased uptake was significant in all

  7. The management of differentiated thyroid cancer in Europe in 1988

    International Nuclear Information System (INIS)

    Baldet, L.; Jaffiol, C.; Percheron, C.; Manderscheid, J.-C.; Coste-Seignovert, B.; Glinoer, D.

    1989-01-01

    In order to know how thyroid nodules and differentiated thyroid cancers are investigated and treated in 1988, an international inquiry was performed by mean of a questionnaire based on a well-defined case report of a 35-year-old female with a solitary small thyroid nodule. Clinicians were asked to indicate their diagnostic and therapeutic approaches to the reported case and to some variations. Analysis of the 157 responses from thyroid experts showed that three in vitro tests (sensitive-TSH, free T 4 and total T 4 ) and three in vivo tests ( 99m Tc or radioiodide scintiscan, fine needle aspiration and ultrasonography) were performed most frequently. In the case of a solid and cold nodule and in the absence of fine needle aspiration results, 19% of respondents advocated suppressive therapy and 81% surgery. In the same clinical case, but whom fine needle aspiration had been performed and cytology was benign, surgery was advocated by 24%, suppressive therapy by 48% and a regular follow-up without treatment by 28% of respondents. When surgery was performed and the diagnosis was a differentiated thyroid cancer, (near) total thyroidectomy was more frequently chosen than partial thyroidectomy in both papillary (60 and 40%, respectively, of respondents) and follicular (74 and 26%, respectively, of respondents) cancers; 80% of clinicians did not change their surgical technique in relation to histological type of the tumour. Total thyroidectomy was more often recommended in most of the clinical or anatomical variations compared with the basic case repot. Pre- og postoperative hormonal therapy was initiated with L-T 4 and TSH suppression was controlled by sensitive-TSH and thyroblobulin determinations. After total thyroidectomy, 131 I was used with similar modalities for papillary and follicular cancers to ablate a thyroid remnant. (author)

  8. Thyroid Diseases

    Science.gov (United States)

    ... beats. All of these activities are your body's metabolism. Thyroid problems include Goiter - enlargement of the thyroid gland Hyperthyroidism - when your thyroid gland makes more thyroid hormones ...

  9. Predictive value of pyramidal lobe, percentage thyroid uptake and age for ablation outcome after 15 mCi fixed dose of radioiodine-131 in Graves’ disease

    International Nuclear Information System (INIS)

    Zaman, Maseeh uz; Fatima, Nosheen; Zaman, Unaiza; Sajjad, Zafar; Zaman, Areeba; Tahseen, Rabia

    2015-01-01

    The purpose was to find out the efficacy of fixed 15 mCi radioactive iodine-131 (RAI) dose and predictive values of various factors for inducing hypothyroidism in Graves’ disease (GD). Retrospective study conducted from January 2012 till August 2014. Patients with GD who had a technetium-99m thyroid scan, thyroid antibodies, received fixed 15 mCi RAI and did follow endocrine clinics for at least 6 months were selected. RAI was considered successful if within 6 months of RAI therapy patients developed hypothyroidism. Of the 370 patients with GD who had RAI during study period, 210 (57%) qualified study criteria. Mean age of patients was 48 ± 15 years with female: male ratio of 69:31, positive thyroid antibodies in 61%, means thyroid uptake of 15.09 ± 11.23%, and presence of pyramidal lobe in 40% of total population. Hypothyroidism was achieved in 161 (77%) patients while 49 (23%) patients failed to achieve it (remained either hyperthyroid or euthyroid on antithyroid medication). Patients who became hypothyroid were significantly younger with higher proportion of presence of thyroid antibodies and pyramidal lobe and lower percentage thyroid uptake than those who failed. Multiple logistic regression analysis revealed that age (odds ratio; OR = 2.074), pyramidal lobe (OR = 3.317), thyroid antibodies (OR = 8.198), and percentage thyroid uptake (OR = 3.043) were found to be significant prognostic risk factors for post-RAI hypothyroidism. Gender was found to have nonsignificant association with the development of hypothyroidism. Receiver operating characteristic analysis revealed age <42 years and thyroid uptake <15% as threshold values for the development of post-RAI hypothyroidism. We conclude that fixed (15 mCi) RAI dose is highly effective in rendering hypothyroidism in patients with GD. Age (≤42 years), thyroid uptake (≤15%) and presence of pyramidal lobe are strong predictors of hypothyroidism and must be considered for selecting optimal RAI dose

  10. Therapy: a new nonsurgical therapy option for benign thyroid nodules?

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Despite the increasing implementation of iodization programs, benign nodular thyroid disease will remain a prevalent therapeutic concern for decades. recent research suggests that nonsurgical therapy, including radioactive iodine, radiofrequency thermal ablation and percutaneous laser ablation, m...

  11. Cervical Chondrocutaneous Branchial Remnants.

    Science.gov (United States)

    Klockars, Tuomas; Kajosaari, Lauri

    2017-03-01

      Cervical chondrocutaneous branchial remnants are rare malformations usually found in the lower neck. As high as 76% of patients have been reported to have associated anomalies. We review the literature and report a case series of seven patients with cervical cartilaginous remnants.   A retrospective case series of seven patients identified from the electronic hospital records.   Seven patients with cervical chondrocutaneous branchial remnants were identified (six boys and one girl). Only one of the patients had associated anomalies.   A review of the literature revealed no evidence for sinuses or cysts related to cervical chondrocutaneous branchial remnants. Operative treatment can be postponed to a suitable and safe age. There is marked variation in the reported prevalence of associated anomalies, ranging from 11% to 76%.

  12. Cost-effectiveness profile, organizational implications and patient preferences on the use of exogenous TSH therapy (Thyrogen® vs. THW in thyroid residue ablation in Italy

    Directory of Open Access Journals (Sweden)

    Gianluca De Danieli

    2016-10-01

    CONCLUSION: Thyrogen® represents a cost-effective option for patients with differentiated thyroid cancer who underwent total or near-total thyroidectomy in Italy. Our findings are consistent with other cost-utility analyses.

  13. Supporting Treatment Decisions in Patients with Differentiated Thyroid Carcinoma (DTC) under Radioiodine-131 Therapy: Role of Biological Dosimetry Assessment

    International Nuclear Information System (INIS)

    Fadel, A.M.; Chebel, G.M.; Di Giorgio, M.; Vallerga, M.B.; Taja, M.R.; Radl, A.; Bubniak, R.V.; Oneto, A.

    2010-01-01

    Radioiodine-131 therapy is applied in patients with differentiated thyroid carcinoma (DTC), within the therapeutic scheme following thyroidectomy, for the ablation of thyroid remnants and treatment of metastatic disease. Several approaches for the selection of a therapeutic dose were applied. The aim of this therapy is to achieve a lethal dose in the tumor tissue, without exceeding the dose of tolerance in healthy tissues (doses greater than 2 Gy in bone marrow could lead to myelotoxicity). In this work, the treatment protocol used incorporates the assessment by biological dosimetry (BD) for estimating doses to whole body and bone marrow, to tailor patient's treatment. Biological Dosimetry prospective studies conducted on samples from patients with cumulative activities, before and after each therapeutic administration, allows to evaluate DNA damage and repair capacity in peripheral blood lymphocytes. (authors)

  14. Comparison of therapeutic efficacy and clinical parameters between recombinant human thyroid stimulating hormone and thyroid hormone withdrawal in high-dose radioiodine treatment with differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Se Hun; Na, Chang Ju; Kim, Jeong Hun; Han, Yeon Hee; KIm, Hee Kwon; Jeong, Hwan Jeong; Sohn, Myung Hee; Lim, Seok Tae [Dept. of Nuclear Medicine, Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2015-06-15

    High-dose radioiodine treatment (HD-RIT) after injection of recombinant human thyroid stimulating hormone (rh-TSH) has become widely used. This study compared the therapeutic efficacy of HD-RIT and clinical parameters between rh-TSH supplement and thyroid hormone withdrawal (THW) after total thyroidectomy in patients with differentiated thyroid cancer. We retrospectively reviewed 266 patients (47 male and 219 female; age, 49.0 ± 10.9 years) with differentiated thyroid cancer detected from September 2011 to September 2012. Patients comprised THW (217, 81.6 %) and rh-TSH (49, 18.4 %). Inclusion criteria were: first HD-RIT; any TN stage; absence of distant metastasis. To evaluate the complete ablation of the remnant thyroid tissue or metastasis, we reviewed stimulated serum thyroglobulin (sTg), I-123 whole-body scan (RxWBS) on T4 off-state, and thyroid ultrasonography (US) or [F-18]-fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) 6–8 months after HD-RIT. We defined a complete ablation state when all three of the follow-up conditions were satisfied; <2.0 ng/ml of the sTg, I-123 RxWBS (−), and thyroid US or F-18 FDG PET/CT (−). If one of the three was positive, ablation was considered incomplete. We also compared various clinical biomarkers (body weight, body mass index, liver and kidney function) between THW and rh-TSH groups. The rates of complete ablation were 73.7 % (160/217) for the THW group and 73.5 % (36/49) for the rh-TSH group. There was no significant difference between the two groups (p = 0.970). The follow-up aspartate transaminase (p = 0.001) and alanine transaminase (p = 0.001) were significantly higher in the THW group. The renal function parameters of blood urea nitrogen (p = 0.001) and creatinine (p = 0.005) tended to increase in the THW group. The change of body weight was + Δ0.96 (±1.9) kg for the THW group and was decreased by -Δ1.39 (±1.5) kg for the rh-TSH group. The change

  15. Recombinant human TSH in differentiated thyroid cancer: a nuclear medicine perspective

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P. [CEA, DSV, I2BM, SHFJ, LMNRB, Orsay (France); Rubello, D. [Osped S Maria Misericordia, IRCCS, IOV, Dept Nucl Med, PET Ctr, I-45100 Rovigo (Italy); Hindie, E. [Hop St Louis, Dept Nucl Med, Paris (France)

    2008-07-01

    The use of recombinant human thyroid-stimulating hormone (rhTSH) in differentiated thyroid cancer (DTC) is widely discussed in the literature with regard to the diagnostic and therapeutic aspects of the management of DTC patients. However, some controversy about the appropriate indications, advantages and potential disadvantages of the use of rhTSH may still exist within the community of nuclear medicine physicians. In our opinion, the clinical benefits of rhTSH in avoiding hypothyroidism outweigh its somewhat lesser diagnostic accuracy. However, we disagree on designating rhTSH as the 'golden standard' to obtain TSH stimulation, as suggested by some authors. Thus, the first follow-up examination after ablation, which is determinant for patients' prognostic classification, can be either done under rhTSH stimulation or after hormone withdrawal. In our practice, and for higher risk patients, we still favour performing the initial follow-up after thyroid hormone withdrawal. rhTSH also shows the ability to enhance radioiodine concentration into thyroid cells. This characteristic is obviously of great interest among the nuclear medicine community. In clinical practice, it seems preferable to perform {sup 131}I treatment for metastatic disease during hypothyroidism. rhTSH may find its utility for the treatment of specific populations of patients, i.e. those in whom hormone withdrawal is medically contraindicated or in whom adequate endogenous TSH levels cannot be obtained due to reduced pituitary reserve or continued thyroxine production by metastatic tissue. In conclusion, rhTSH has demonstrated to be a reliable alternative to hypothyroidism for the stimulation of Tg in the follow-up of thyroid cancer patients. However, its use must be more carefully chosen in the therapeutic setting. Our feeling is that rhTSH should no tbe used for remnant ablation in high-risk patients and for the treatment of metastatic disease, except for specific populations of

  16. Recombinant human TSH in differentiated thyroid cancer: a nuclear medicine perspective

    International Nuclear Information System (INIS)

    Zanotti-Fregonara, P.; Rubello, D.; Hindie, E.

    2008-01-01

    The use of recombinant human thyroid-stimulating hormone (rhTSH) in differentiated thyroid cancer (DTC) is widely discussed in the literature with regard to the diagnostic and therapeutic aspects of the management of DTC patients. However, some controversy about the appropriate indications, advantages and potential disadvantages of the use of rhTSH may still exist within the community of nuclear medicine physicians. In our opinion, the clinical benefits of rhTSH in avoiding hypothyroidism outweigh its somewhat lesser diagnostic accuracy. However, we disagree on designating rhTSH as the 'golden standard' to obtain TSH stimulation, as suggested by some authors. Thus, the first follow-up examination after ablation, which is determinant for patients' prognostic classification, can be either done under rhTSH stimulation or after hormone withdrawal. In our practice, and for higher risk patients, we still favour performing the initial follow-up after thyroid hormone withdrawal. rhTSH also shows the ability to enhance radioiodine concentration into thyroid cells. This characteristic is obviously of great interest among the nuclear medicine community. In clinical practice, it seems preferable to perform 131 I treatment for metastatic disease during hypothyroidism. rhTSH may find its utility for the treatment of specific populations of patients, i.e. those in whom hormone withdrawal is medically contraindicated or in whom adequate endogenous TSH levels cannot be obtained due to reduced pituitary reserve or continued thyroxine production by metastatic tissue. In conclusion, rhTSH has demonstrated to be a reliable alternative to hypothyroidism for the stimulation of Tg in the follow-up of thyroid cancer patients. However, its use must be more carefully chosen in the therapeutic setting. Our feeling is that rhTSH should no tbe used for remnant ablation in high-risk patients and for the treatment of metastatic disease, except for specific populations of patients. (O.M.)

  17. Postpartum Thyroiditis

    Science.gov (United States)

    American Thyroid Association ® Postpartum Thyroiditis www.thyroid.org What is the thyroid gland? The thyroid gland is a butterfly-shaped endocrine gland that ... as they should. What are the symptoms of postpartum thyroiditis? Thyroiditis is a general term that refers ...

  18. Evolution of Supernova Remnants

    Science.gov (United States)

    Arbutina, B.

    2017-12-01

    This book, both a monograph and a graduate textbook, is based on my original research and partly on the materials prepared earlier for the 2007 and 2008 IARS Astrophysics Summer School in Istanbul, AstroMundus course 'Supernovae and Their Remnants' that was held for the first time in 2011 at the Department of Astronomy, Faculty of Mathematics, University of Belgrade, and a graduate course 'Evolution of Supernova Remnants' that I teach at the aforementioned university. The first part Supernovae (introduction, thermonuclear supernovae, core-collapse supernovae) provides introductory information and explains the classification and physics of supernova explosions, while the second part Supernova remnants (introduction, shock waves, cosmic rays and particle acceleration, magnetic fields, synchrotron radiation, hydrodynamic and radio evolution of supernova remnants), which is the field I work in, is more detailed in scope i.e. technical/mathematical. Special attention is paid to details of mathematical derivations that often cannot be found in original works or available literature. Therefore, I believe it can be useful to both, graduate students and researchers interested in the field.

  19. Radioiodine Treatment of Well-Differentiated thyroid cancer in children

    International Nuclear Information System (INIS)

    Barrenechea, E.

    2007-01-01

    responsiveness are evidence enough that these group of patients benefit with significant survival rate from radioiodine therapy. The belief that thyroid cancer in children is usually associated with low mortality and it being considered, as a benign disease, should be corrected because the course of the disease may not be so benign after all. Conclusion: WDTCA in children is rare but the biological behaviour differs from that of adults. Their course is sometimes aggressive and they may be recurrent. Total/near total thyroidectomy with I-131 ablation of remnant thyroid tissues and nodal or distal metastases if present, reduces mortality making RAI necessary. (author)

  20. Thyroid autoimmunity

    NARCIS (Netherlands)

    Wiersinga, Wilmar M.

    2014-01-01

    Autoimmune thyroid disease (AITD) is a multifactorial disease in which autoimmunity against thyroid antigens develops against a particular genetic background facilitated by exposure to environmental factors. Immunogenicity of the major thyroid antigens thyroid peroxidase, thyroglobulin (TG) and

  1. Iterative stimulation of endogenous TSH for ablation. Followup and/or treatment with I-131 in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

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

    2006-01-01

    In patients with differentiated thyroid carcinoma it is indispensable to raise the values of TSH to determine thyroglobulin and to effect the total tracking with radioiodine. Traditionally to raise the endogenous TSH it is necessary to suspend the opotherapy during a prolonged time with the consistent hypothyroidism. The objective of this work is to increase the endogenous TSH, shortening the time of abstinence of opotherapy [es

  2. Effect of a Low Iodine Diet vs. Restricted Iodine Diet on Postsurgical Preparation for Radioiodine Ablation Therapy in Thyroid Carcinoma Patients.

    Science.gov (United States)

    Lim, Chi Young; Kim, Jung-Yeon; Yoon, Mi-Jin; Chang, Hang Seok; Park, Cheong Soo; Chung, Woong Youn

    2015-07-01

    The radioiodine ablation therapy is required for patients who underwent a total thyroidectomy. Through a comparative review of a low iodine diet (LID) and a restricted iodine diet (RID), the study aims to suggest guidelines that are suitable for the conditions of Korea. The study was conducted with 101 patients. With 24-hour urine samples from the patients after a 2-week restricted diet and after a 4-week restricted diet, the amount of iodine in the urine was estimated. The consumed radioiodine amounts for 2 hours and 24 hours were calculated. This study was conducted with 47 LID patients and 54 RID patients. The amounts of iodine in urine, the 2-week case and 4-week case for each group showed no significant differences. The amounts of iodine in urine between the two groups were both included in the range of the criteria for radioiodine ablation therapy. Also, 2 hours and 24 hours radioiodine consumption measured after 4-week restrictive diet did not show statistical differences between two groups. A 2-week RID can be considered as a type of radioiodine ablation therapy after patients undergo a total thyroidectomy.

  3. Normalization of lymphocyte count after high ablative dose of I-131 in a patient with chronic lymphoid leukemia and secondary papillary carcinoma of the thyroid: case report

    International Nuclear Information System (INIS)

    Thom, Anneliese Rosmarie Gertrud Fischer; Hamerschlak, Nelson; Osawa, Akemi; Santos, Fabio Pires de Souza; Pasqualin, Denise da Cunha; Wagner, Jairo; Yamaga, Lilian Yuri Itaya; Cunha, Marcelo Livorsi da; Campos Neto, Guilherme de Carvalho; Funari, Marcelo Buarque de Gusmao; Teles, Veronica Goes

    2014-01-01

    The authors report the case of a 70-year-old male patient with chronic lymphoid leukemia who presented subsequently a papillary carcinoma of the thyroid with metastases to regional lymph nodes. The patient was treated with surgical thyroidectomy with regional and cervical lymph node excision and radioiodine therapy (I-131). The protocolar control scintigraphy 4 days after the radioactive dose showed I-131 uptake in both axillae and even in the inguinal regions. PET/CT showed faint FDG-F-18 uptake in one lymph node of the left axilla. An ultrasound guided fine needle biopsy of this lymph node identified by I-131 SPECT/CT and FDG-F-18 PET/CT revealed lymphoma cells and was negative for thyroid tissue and thyroglobulin content. The sequential blood counts done routinely after radiation treatment showed a marked fall until return to normal values of leucocytes and lymphocytes (absolute and relative), which were still normal in the last control 19 months after the radioiodine administration. Chest computed tomography showed a decrease in size of axillary and paraaortic lymph nodes. By immunohistochemistry, cells of the lymphoid B lineage decreased from 52% before radioiodine therapy to 5% after the procedure. The authors speculate about a possible sodium iodide symporter expression by the cells of this lymphoma, similar to some other non-thyroid tumors, such as breast cancer cells. (author)

  4. Thyroid Surgery

    Science.gov (United States)

    ... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroid Surgery Resources Thyroid Surgery Brochure PDF Thyroid Surgery FAQs PDF En Español Cirugia De La Tiroides El folleto de Cirugia De La Tiroides Search Thyroid ...

  5. Optimization of the therapeutic dose of {sup 131}I for thyroid differentiated carcinoma; Otimizacao da dose terapeutica com {sup 131}I para carcinoma diferenciado da tiroide

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Fabiana Farias de

    2002-09-01

    I-131 thyroid cancer therapy is based on the strategy of concentrating radioactive iodine in the thyroid tissue, to completetly eliminate thyroid tissue and functioning thyroid cancer metastases remaining after thyroidectomy. In Brazil, fixed activities of {sup 131} I generally are given, sometimes either delivering insufficient activities to ablate all of the remnants, or unnecessarily high activities, with patients remaining in the hospital for some period of time. This investigation proposes a protocol of individualized planning of ablative doses, based on individual patients metabolisms and measured thyroid remnant masses. Simulated thyroid remnants were fabricated in various forms, volumes and activities, and optimum image acquisition parameters were determined using Single-Photon Emission Computed Tomography 9SPECT). Resultant images were evaluated, to determine the apparent volumes and the {sup 131} I concentrations. I-131 metabolism was studied in 9 patients who had undergone thyroidectomies. Their thyroid remnant masses were determined applying the same parameters used in SPECT simulation studies, and the optimum activity for their therapy was calculated and compared to the established fixed activity of 3.7 GBq (100 mCi), which would have normally been assigned. Background subtraction using the method of percent maximum counts, using a value of 67.5%, combined with scatter correction (triple energy window method), was shown to be optimum for SPECT quantification of volumes between 3-10 ml. Errors in the method were below 9% for sources with regular geometries and around 11% for sources with irregular geometries. In the patient studies, it was observed that 78% of patients could have received reduced activities of {sup 131} (from 0.8-3-2. GBq (20-87 nCi). In addition, 33% of these patients could have received low enough activities to have discharged from the hospital, using an individualized administration scheme. This could also have resulted in a dose

  6. Simulation of Post-Thyroidectomy Treatment Alternatives for Triiodothyronine or Thyroxine Replacement in Pediatric Thyroid Cancer Patients

    Science.gov (United States)

    Ben-Shachar, Rotem; Huang, Stephen A.; DiStefano, Joseph J.

    2012-01-01

    Background As in adults, thyroidectomy in pediatric patients with differentiated thyroid cancer is often followed by 131I remnant ablation. A standard protocol is to give normalizing oral thyroxine (T4) or triiodothyronine (T3) after surgery and then withdraw it for 2 to 6 weeks. Thyroid remnants or metastases are treated most effectively when serum thyrotropin (TSH) is high, but prolonged withdrawals should be avoided to minimize hypothyroid morbidity. Methods A published feedback control system model of adult human thyroid hormone regulation was modified for children using pediatric T4 kinetic data. The child model was developed from data for patients ranging from 3 to 9 years old. We simulated a range of T4 and T3 replacement protocols for children, exploring alternative regimens for minimizing the withdrawal period, while maintaining normal or suppressed TSH during replacement. The results are presented with the intent of providing a quantitative basis to guide further studies of pediatric treatment options. Replacement was simulated for up to 3 weeks post-thyroidectomy, followed by various withdrawal periods. T4 vs. T3 replacement, remnant size, dose size, and dose frequency were tested for effects on the time for TSH to reach 25 mU/L (withdrawal period). Results For both T3 and T4 replacement, higher doses were associated with longer withdrawal periods. T3 replacement yielded shorter withdrawal periods than T4 replacement (up to 3.5 days versus 7–10 days). Higher than normal serum T3 concentrations were required to normalize or suppress TSH during T3 monotherapy, but not T4 monotherapy. Larger remnant sizes resulted in longer withdrawal periods if T4 replacement was used, but had little effect for T3 replacement. Conclusions T3 replacement yielded withdrawal periods about half those for T4 replacement. Higher than normal hormone levels under T3 monotherapy can be partially alleviated by more frequent, smaller doses (e.g., twice a day). LT4 may be the

  7. Low-Dose Radioactive Iodine Destroys Thyroid Tissue Left after Surgery

    Science.gov (United States)

    A low dose of radioactive iodine given after surgery for thyroid cancer destroyed (ablated) residual thyroid tissue as effectively as a higher dose, with fewer side effects and less exposure to radiation, according to two randomized controlled trials.

  8. Antenatal management of recurrent fetal goitrous hyperthyroidism associated with fetal cardiac failure in a pregnant woman with persistent high levels of thyroid-stimulating hormone receptor antibody after ablative therapy.

    Science.gov (United States)

    Matsumoto, Tadashi; Miyakoshi, Kei; Saisho, Yoshifumi; Ishii, Tomohiro; Ikenoue, Satoru; Kasuga, Yoshifumi; Kadohira, Ikuko; Sato, Seiji; Momotani, Naoko; Minegishi, Kazuhiro; Yoshimura, Yasunori

    2013-01-01

    High titer of maternal thyroid-stimulating hormone receptor antibody (TRAb) in patients with Graves' disease could cause fetal hyperthyroidism during pregnancy. Clinical features of fetal hyperthyroidism include tachycardia, goiter, growth restriction, advanced bone maturation, cardiomegaly, and fetal death. The recognition and treatment of fetal hyperthyroidism are believed to be important to optimize growth and intellectual development in affected fetuses. We herein report a case of fetal treatment in two successive siblings showing in utero hyperthyroid status in a woman with a history of ablative treatment for Graves' disease. The fetuses were considered in hyperthyroid status based on high levels of maternal TRAb, a goiter, and persistent tachycardia. In particular, cardiac failure was observed in the second fetus. With intrauterine treatment using potassium iodine and propylthiouracil, fetal cardiac function improved. A high level of TRAb was detected in the both neonates. To the best of our knowledge, this is the first report on the changes of fetal cardiac function in response to fetal treatment in two siblings showing in utero hyperthyroid status. This case report illustrates the impact of prenatal medication via the maternal circulation for fetal hyperthyroidism and cardiac failure.

  9. [Autoimmune diseases of the thyroid gland].

    Science.gov (United States)

    Allelein, S; Feldkamp, J; Schott, M

    2017-01-01

    Autoimmune diseases of the thyroid gland are considered to be the most frequent cause of thyroid gland disorders. Autoimmune thyroid diseases consist of two subgroups: autoimmune thyroiditis (AIT) and Graves' disease. The AIT is the most common human autoimmune disease. Infiltration of the thyroid gland with cytotoxic T‑cells can lead to an initial thyrotoxicosis und during the course to hypothyroidism due to destruction of the thyroid gland. Substitution with Levothyroxine is indicated for manifest hypothyroidism and subclinical hypothyroidism with increased thyroid antibodies with the intention of normalizing the serum thyroid stimulating hormone (TSH). Graves' disease is characterized by the appearance of stimulating TSH receptor antibodies leading to hyperthyroidism. Endocrine ophthalmopathy may also occur. Ablative therapy with radioiodine therapy or thyroidectomy is administered to patients with Graves' disease without remission after at least 1 year of antithyroid drug therapy.

  10. Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma.

    Science.gov (United States)

    Kim, Eui Young; Kim, Won Gu; Kim, Won Bae; Kim, Tae Yong; Kim, Jung Min; Ryu, Jin-Sook; Hong, Suck Joon; Gong, Gyungyub; Shong, Young Kee

    2009-10-01

    The effect of coexistent chronic lymphocytic thyroiditis (CLT) on prognosis in papillary thyroid carcinoma (PTC) patients remains controversial. We evaluated the influence of coexistent CLT on prognostic outcome and the association of coexistent CLT with clinicopathological parameters. A retrospective study with a median follow-up of 70 months. Patients with PTC who underwent total thyroidectomy followed by (131)I remnant ablation between 1995 and 2003 at Asan Medical Center, Seoul, Korea were enrolled. CLT was diagnosed histopathologically. Among 1441 patients, 214 (14.9%) had coexistent CLT. A greater female preponderance was noted in the patients with CLT compared with those without CLT (P CLT was smaller than that in patients without CLT (2.0 +/- 1.2 vs. 2.2 +/- 1.4 cm; P = 0.02). One hundred and fifty-one (12.3%) patients without CLT had recurrence, whereas 14 (7.1%) patients with CLT had recurrence during the follow-up period (P = 0.016). In patients with cervical lymph node metastases, those with coexistent CLT showed a significantly lower recurrence rate than those without CLT (P = 0.012). However, this association was lost on multivariate analysis adjusting for other clinicopathological predictors for recurrence. In this study, CLT was commonly associated with PTC and was associated with smaller size of the primary tumour at presentation. CLT was also associated with a reduced risk of recurrence during follow-up, although this was not significant after adjustment for other prognostic factors.

  11. Chronic thyroiditis (Hashimoto disease)

    Science.gov (United States)

    Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis; Chronic autoimmune thyroiditis; Lymphadenoid goiter - Hashimoto; Hypothyroidism - Hashimoto; Type 2 polyglandular autoimmune ...

  12. Use of 177Lu-dotatate in the treatment of iodine refractory thyroid carcinomas.

    Science.gov (United States)

    Oliván-Sasot, P; Falgás-Lacueva, M; García-Sánchez, J; Vera-Pinto, V; Olivas-Arroyo, C; Bello-Arques, P

    In a patient with a differentiated thyroid cancer the standard treatment protocol to be followed is surgery, ablation of thyroid remnants with 131 Iodine ( 131 I), and TSH suppression. However, the treatment with 131 I is not effective in some cases, and it no longer becomes a therapeutic option due to cell de-differentiation with loss of 131 I uptake. Systemic treatment can be used as other options, although patients are not always responsive; thus, the disease may progress and therapeutic options may run out. Endocrine tumours may express somatostatin receptors,and this characteristic has been used, not only for diagnosis, but also for their treatment through somatostatin analogue labelling with radioactive isotopes. This was the case of a patient suffering from iodine-refractory follicular thyroid carcinoma, with somatostatin receptors expression, treated with 177 Lu-DOTATATE, showing an excellent clinical and analytical response. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  13. PROGENITORS OF RECOMBINING SUPERNOVA REMNANTS

    Energy Technology Data Exchange (ETDEWEB)

    Moriya, Takashi J., E-mail: takashi.moriya@ipmu.jp [Kavli Institute for the Physics and Mathematics of the Universe, Todai Institutes for Advanced Study, University of Tokyo, Kashiwanoha 5-1-5, Kashiwa, Chiba 277-8583 (Japan)

    2012-05-01

    Usual supernova remnants have either ionizing plasma or plasma in collisional ionization equilibrium, i.e., the ionization temperature is lower than or equal to the electron temperature. However, the existence of recombining supernova remnants, i.e., supernova remnants with ionization temperature higher than the electron temperature, has been recently confirmed. One suggested way to have recombining plasma in a supernova remnant is to have a dense circumstellar medium at the time of the supernova explosion. If the circumstellar medium is dense enough, collisional ionization equilibrium can be established in the early stage of the evolution of the supernova remnant and subsequent adiabatic cooling, which occurs after the shock wave gets out of the dense circumstellar medium, makes the electron temperature lower than the ionization temperature. We study the circumstellar medium around several supernova progenitors and show which supernova progenitors can have a circumstellar medium dense enough to establish collisional ionization equilibrium soon after the explosion. We find that the circumstellar medium around red supergiants (especially massive ones) and the circumstellar medium dense enough to make Type IIn supernovae can establish collisional ionization equilibrium soon after the explosion and can evolve to become recombining supernova remnants. Wolf-Rayet stars and white dwarfs have the possibility to be recombining supernova remnants but the fraction is expected to be very small. As the occurrence rate of the explosions of red supergiants is much higher than that of Type IIn supernovae, the major progenitors of recombining supernova remnants are likely to be red supergiants.

  14. Cardiac ablation

    Directory of Open Access Journals (Sweden)

    Kelly Ratheal

    2016-01-01

    Full Text Available Cardiac ablation is a procedure that uses either radiofrequency or cryothermal energy to destroy cells in the heart to terminate and/or prevent arrhythmias. The indications for cardiac catheter ablation include refractory, symptomatic arrhythmias, with more specific guidelines for atrial fibrillation in particular. The ablation procedure itself involves mapping the arrhythmia and destruction of the aberrant pathway in an effort to permanently prevent the arrhythmia. There are many types of arrhythmias, and they require individualized approaches to ablation based on their innately different electrical pathways. Ablation of arrhythmias, such as Wolff-Parkinson-White syndrome, AV nodal reentrant tachycardia, and atrial-fibrillation, is discussed in this review. Ablation has a high success rate overall and minimal complication rates, leading to improved quality of life in many patients.

  15. Diagnostic 131I whole-body scintigraphy 1 year after thyroablative therapy in patients with differentiated thyroid cancer: correlation of results to the individual risk profile and long-term follow-up

    International Nuclear Information System (INIS)

    Berger, Frank; Friedrich, Ulla; Knesewitsch, Peter; Hahn, Klaus

    2011-01-01

    131 I whole-body scan (WBS) and serum thyroglobulin (TG) are important in detecting thyroid remnants or recurrent disease in patients with differentiated thyroid cancer. Usually, a diagnostic WBS is carried out 6 months after ablation to exclude residual disease. We retrospectively analysed results of a second routine diagnostic WBS and TG measurements at 1 year after thyroablation and correlated these to the risk profile of patients with long-term follow-up. A total of 197 patients were followed up after thyroidectomy and ablative 131 I therapy. Follow-up included clinical examination, radioiodine WBS and thyroid-stimulating hormone (TSH), free thyroxine and TG measurements at 3-6 months and 1 year after ablation. WBS (+) patients received a therapeutic activity of 131 I. The risk profile of patients was defined according to clinical results before the 1-year control. Clinical results at 1 year after ablation were analysed in correlation to the patient risk profile and long-term follow-up data (mean 7.2 years). One year after thyroablation, 95.8% of low-risk patients had no residual disease when diagnostic WBS was carried out using 370 MBq 131 I; 4.2% of low-risk patients had residual disease at this time point. In the high-risk group of this cohort, 54.5% were disease-free 1 year after ablation, but 45.5% demonstrated residual disease. After the 1-year control, 94% of all applied radioiodine therapies were executed in the high-risk group, compared with 6% in the low-risk group (p < 0.01). A second routine WBS 1 year after thyroablation is not indicated in low-risk patients. Risk stratification according to the early clinical course effectively identified patients with higher likelihood of persistent or recurrent disease in the long-term follow-up. (orig.)

  16. Ablative therapy with radioiodine in the postoperative management of differentiated thyroid carcinoma, a retrospective observational study of the justified indication of the therapy

    International Nuclear Information System (INIS)

    Soto Herrera, Esteban

    2013-01-01

    The validity of the indication of treatment with I131 as part of the management of differentiated thyroid cancer, was analyzed in patients older than 16 years attended in Hospital San Juan de Dios and Hospital Mexico, who received this therapy, during the years 2006-2009. The medical records of the selected patients were reviewed and registered in the SPSS statistical program. The following variables were obtained: name, file number, age, gender, type of cancer, maximum diameter of the tumor, presence of one of 2 or more tumor foci in the surgical piece, hospital of origin, value of T, N and M according to the TNM staging, MACIS scale score and staging according to the MACIS score. The most common differentiated carcinoma in the studied population was papillary carcinoma. A little less than half of the patients, had the criteria to receive radioiodine therapy according to that established by the ATA, same result when said population was subjected to European criteria Criteria to receive radioiodine dictated by the American school as the European one were fulfilled in the majority of patients with stage 2. Compliance with indication or non-indication of treatment was maintained without significant difference between papillary and follicular carcinomas [es

  17. First-Line Use of Vemurafenib to Enable Thyroidectomy and Radioactive Iodine Ablation for BRAF-Positive Metastatic Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Bao D. Dao MD

    2015-09-01

    Full Text Available Background. Patients with metastatic or radioactive iodine refractory papillary thyroid carcinoma (PTC have poor prognosis due to ineffective therapy for this condition beyond surgery and radioactive iodine (RAI or 131I. BRAF mutation occurs in more than 44% of PCT. Tyrosine kinase inhibitors, the most commonly used agents for these patients, have weak BRAF inhibition activity. BRAF inhibitors have demonstrated promising efficacy in relapsed metastatic PCT after standard treatment, though they are not currently approved for this indication. Case Presentation. We present the case of a 48-year-old Hispanic male who initially presented with columnar-cell variant subtype of PTC and positive BRAFV600E mutation. The patient had widespread bulky metastases to lungs, chest wall, brain, and bone. Discussion. Initial use of vemurafenib demonstrated a 42% cytoreduction of targeted pulmonary metastases and facilitated thyroidectomy and RAI treatment. The patient achieved a durable response over 21 months in the setting of widely metastatic disease. Conclusion. Vemurafenib may be effectively used for cytoreduction in patients with bulky metastatic PTC to bridge them to thyroidectomy and RAI treatment.

  18. Clinical significance of thyroglobulin autoantibodies enhancement in patients with differentiated thyroid cancer after thyroidectomy and radioiodine therapy

    Directory of Open Access Journals (Sweden)

    N V Severskaya

    2013-09-01

    Full Text Available Purpose: to evaluate the clinical utility of antithyroglobulin antibodies (TgAb as a tumor marker in patients with differentiated thyroid cancer (DTC after thyroidectomy and radioiodine ablation. Patients and methods. From 345 consecutive DTC patients after thyroidectomy and radioiodine ablation we select ed 148 patients with elevated TgAb level (with distant metastasis n = 93, without distant metastasis n = 55. Serum TgAb concentration was measured before radioiodine ablation and then every time before 131I treatment (RIT or diagnostic 131I whole body scanning (WBS. Results were compared with serum thyroglobulin (Tg concentration, neck echography, lung and bone roentgenography and 131I WBS findings. Results. TgAb level was elevated in 21% DTC patients before 131I ablation. The other 22% with initially normal TgAb displayed their rising during followup. In absence of distant metastasis TgAb declined after 1 st–2 nd cycle of RIT (an average 8.9 months after 131I ablation. Persistance or rising of TgAb in the longer term was associated with detectable thyroid remnant, residual tumor or metastatic lymph nodes. In case of negative TgAb status after sugery an increase of TgAb during first 3–6 months after ablation indicated mostly a response to the rise of Tg antigen secondary to 131I ablation. A rise TgAb in the longer term (after 3rd–5th cycles of RIT indicated to residual or recurrent disease in 86% cases. In patients with distant metastasis there were no correlation between change in TgAb concentration and clinical sta tus, including the rate of regression of metastatic disease. But in case of low or undetectable Tg and permanent high TgAb level only TgAb indicated the presence of disease. Conclusion: persistence or rising TgAb in longer term after 131I ablation can serve as surrogate tumor marker of per sistent or recurrent disease. It is critical to measure TgAb concentration, especially in patients with low or unde tectable Tg, because

  19. Diet low in iodine as well as goitrogens (LILGD) enhanced radioiodine (I-131) uptake in treatment of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Aaro, Erik; Gebre-Medhin, Mehari; Lindahl, Sten-AAke

    2005-01-01

    Full text: Low iodine diet (LID) is accepted as an adjuvant to post-thyroidectomy radioiodine therapy of differentiated thyroid cancer since it is held to enhance radioiodine uptake in thyroid remnants and thyroid cancer tissue. However, in the few clinical investigations performed only an indirect and weak evidence of a positive effect of the LID has been demonstrated. Also we had discouraging experience in the application of a strict LID using the same design as in the present study. We therefore decided to investigate the effect of a diet low in iodine as well as in goitrogens (LILGD). Methods: Six patients with differentiated thyroid cancer entered the study and they were their own control. After thyroid hormone withdrawal (TSH > 30 m U/L) and on regular diet a diagnostic whole body scan was performed 24 h after administration of 50 MBq (1,4 mCi) 123 I. The day following diagnostic scan the patients were put on LILGD for 4 days prior and two days after radioiodine therapy. In LILGD beverages, fruits and vegetables containing flavonoids, glucosinolates, cyanides and thiocyanates were avoided and spices and smoking prohibited. Therapeutic radioiodine was administered one week after diagnostic procedures and in the morning after over-night fasting with an activity range of 3,7-5,4 GBq (100 -150 mCi) 131 I. A 24-h therapeutic whole body scan and calculations of percentage uptake U(24) were performed. Diagnostic (basal) D U(24)% and subsequent therapeutic T U(24)% uptake were compared and expressed as therapeutic/diagnostic uptake ratios T/D U(24). Results: A significant increase in therapeutic versus diagnostic uptake T/D U(24) was observed (mean 2,53, median 2,30, range 1,40 - 4,46, p 131 I uptake in radio-ablation of normal and thyroid cancer tissue. (author)

  20. Effect of the hypo iodic diet in thyroid uptake. Its utility for 131I applications in differentiated thyroid carcinomas

    International Nuclear Information System (INIS)

    Brisoli, Jorge; Perinetti, Hector; Borremans, Carlos; Notti, Alberto

    2005-01-01

    Full text: To evaluate and to quantify the real profit of a hypo iodic diet before using a 131 I in DTC, are analyzed the values obtained in 213 patients in whom 364 controls were done with uptake tests before given the control, ablative and therapeutic 131 I doses. The patients were discriminated in 8 groups according as if they were treated with surgery, surgery and ablative or therapeutic 131 I, if surgery was realized by specialist or general surgeon. It also was considered if they had done or not the hypo iodic diet before the control. In those patients that were operated and checked by specialists in thyroid pathologies, it was verified a moderate increase in the uptake values (a little but more than 20% in patients that had done a previous diet). In the thyroidectomized group the average uptake in 88 patients with diet was 10.3%, and in 27 patients without diet 8.0%, with a difference of more than 22% in the formers. In patients with surgery that received complementary 131 I, the average uptake in 95 measurements was 1.1% with previous diet, and 0.8% in 11 patients that did not accomplish the diet, with a difference of 21% more uptake when hypo iodic diet was done. The results in patients with surgeries performed by a general surgeon (143 controls) were uncertain and in some cases illogical. These results are related with the surgery magnitude. Conclusion: The hypo iodic diet moderately increases (around more than 20%) the uptake values of the remnant tissue, postsurgery. The increase is proportional to the amount of tissue. The previous diet is considered necessary before an ablative, therapeutic dose, or in those cases that for clinical or complementary evidences (i.e: thyroglobulin) are supposed to be carriers of significant amounts of thyroid tissue. Because of the relative bother and the minimal difference found in patients well ablationed, it would not be necessary in those patients with low uptake in previous controls. Without having it as a goal

  1. Contemporary post surgical management of differentiated thyroid carcinoma.

    Science.gov (United States)

    Tala, H; Tuttle, R M

    2010-08-01

    Risk assessment is the cornerstone of contemporary management of thyroid cancer. Following thyroid surgery, an initial risk assessment of recurrence and disease-specific mortality is made using important intra-operative findings, histologic characteristics of the tumor, molecular profile of the tumor, post-operative serum thyroglobulin and any available cross-sectional imaging studies. This initial risk assessment is used to guide recommendations regarding the need for remnant ablation, external beam irradiation, systemic therapy, degree of TSH suppression, and follow-up disease detection strategy over the first 2 years after initial therapy. While this initial risk stratification provides valuable information, it is a static representation of the patient in the first few weeks post-operatively that does not change over time. Depending on how the patient responds to our initial therapies, the risk of recurrence and death may change significantly during follow-up. In order to account for differences in response to therapy in individual patients and to incorporate the impact of treatment on our initial risk estimates, we recommend a re-stratification of risk at the 2-year point of follow-up. This re-stratification provides an updated risk estimate that can be used to guide ongoing management recommendations including the frequency and intensity of follow-up, degree of ongoing TSH suppression, and need for additional therapies. Ongoing management recommendations must be tailored to realistic, evolving risk estimates that are actively updated during follow-up. By individualizing therapy on the basis of initial and ongoing risk assessments, we can maximize the beneficial effects of aggressive therapy in patients with thyroid cancer who are likely to benefit from it, while minimizing potential complications and side effects in low-risk patients destined to have a full healthy and productive life after minimal therapeutic intervention. Copyright (c) 2010 The Royal College

  2. Remnants of Lost Geology

    Science.gov (United States)

    2003-01-01

    [figure removed for brevity, see original site] In eastern Arabia Terra, remnants of a once vast layered terrain are evident as isolated buttes, mesas, and deeply-filled craters. The origin of the presumed sediments that created the layers is unknown, but those same sediments, now eroded, may be the source of the thick mantle of dust that covers much of Arabia Terra today.Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.Image information: VIS instrument. Latitude 20.5, Longitude 50 East (310 West). 19 meter/pixel resolution.

  3. Comparison of the cytogenetic effects of 131I in patients with differentiated thyroid cancer with and without prior treatment with rhTSH

    International Nuclear Information System (INIS)

    Valgode, Flavia Gomes Silva; Silva, Marcia Augusta da; Yoriyaz, Helio; Ribela, Maria Teresa de Carvalho Pinto; Bartolini, Paolo; Okazaki, Kayo; Gonzalez, Julia A.; Guimaraes, Maria Ines Calil Cury; Buchpiguel, Carlos Alberto

    2013-01-01

    The effects of internal irradiation caused by radiopharmaceuticals being utilized in nuclear medicine are very little studied at the cellular level. In this study, cytogenetic effects of 131 I thyroid remnant ablation were analyzed in lymphocytes of thyroidectomized differentiated thyroid cancer patients (DTC) through the chromosome aberration technique. The chromosome damages radioinduced in euthyroid patients submitted to rhTSH (Thyrogen) therapy (Group A) were compared to those induced in patients maintained in hypothyroid condition through levothyroxine withdrawal (L-T 4 ) (group B), before, 24h, one week and one month after radioiodine administration (4995 - 7030 MBq). In parallel, in vitro assays were carried out with lymphocytes of healthy donors for the construction of dose-response curves at different radioactive concentrations of 131 I (0.074 to 0.740 MBq/mL) for 24h, thus comparing chromosome damages in vivo and in vitro in order to estimate the absorbed dose through Monte Carlo program. Radioiodine therapy induced a higher total CA rate in hypothyroid compared with euthyroid patients, except 24h after administration of 131 I probably due to higher uptake induced by TSH, although without statistical significance (p > 0.05). The frequency of dicentrics obtained in lymphocytes of all patients 24h after treatment, was equivalent to that induced in vitro in the radioactive concentrations range of 0.07 to 0.50 MBq/mL, corresponding to an absorbed dose of up 1.0 Gy. The data obtained suggest that the use of rhTSH-aided thyroid remnant ablation is efficacy and secure for the patients with DTC. Cytogenetic analysis after one year are planned in order to evaluate late effects. (author)

  4. No evidence of chromosome damage in children and adolescents with differentiated thyroid carcinoma after receiving {sup 131}I radiometabolic therapy, as evaluated by micronucleus assay and microarray analysis

    Energy Technology Data Exchange (ETDEWEB)

    Federico, Giovanni; Fiore, Lisa; Massart, Francesco; Saggese, Giuseppe [Azienda Ospedaliero-Universitaria Pisana, Department of Pediatrics, Unit of Pediatric Endocrinology and Diabetes, Pisa (Italy); Boni, Giuseppe; Lazzeri, Patrizia; Mariani, Giuliano [Azienda Ospedaliero-Universitaria Pisana, Unit of Nuclear Medicine, Pisa (Italy); Fabiani, Barbara; Verola, Carmela; Scarpato, Roberto [University of Pisa, Department of Biology, Unit of Genetics, Mutagenesis and Environmental Epidemiology, Pisa (Italy); Traino, Claudio [Azienda Ospedaliero-Universitaria Pisana, Health Physics Service, Pisa (Italy)

    2008-11-15

    As {sup 131}I therapy, used to achieve ablation of thyroid gland remnant, can cause chromosome damage in cultured peripheral lymphocytes especially, we investigated whether administration of radioiodine may induce early genome damage in peripheral T lymphocytes of adolescents with differentiated thyroid carcinoma (DTC). We studied 11 patients, aged 14.8 {+-} 3.1 years, who assumed {sup 131}I (range: 1.11-4.44 GBq) to ablate thyroid remnant. A blood sample for micronucleus assay and for evaluating expression of some genes involved in the DNA repair or the apoptosis pathways was obtained from each patient 1 h before (T{sub 0}) and 24 (T{sub 1}) and 48 h (T{sub 2}) post-radioiodine administration. Compared to T{sub 0}, we did not find any difference in the number of micronucleated cells at both T{sub 1} and T{sub 2} in any subject. Nine out of 11 patients had altered expression levels in a majority of the DNA repair and apoptosis genes at T{sub 1}, which decreased at T{sub 2}. We demonstrated for the first time that peripheral cells of DTC children and adolescents who received {sup 131}I at a mean dosage of 3.50 {+-} 0.37 GBq did not show chromosome damage within 48 h from the end of radiometabolic therapy. This may be due to a prompt activation of the cell machinery that maintains the integrity of the genome to prevent harmful double-strand breaks from progressing to chromosome mutations, either by repairing the lesions or by eliminating the most seriously damaged cells via apoptosis. (orig.)

  5. Comparison of the cytogenetic effects of {sup 131}I in patients with differentiated thyroid cancer with and without prior treatment with rhTSH

    Energy Technology Data Exchange (ETDEWEB)

    Valgode, Flavia Gomes Silva; Silva, Marcia Augusta da; Yoriyaz, Helio; Ribela, Maria Teresa de Carvalho Pinto; Bartolini, Paolo; Okazaki, Kayo, E-mail: kokazaki@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Gonzalez, Julia A.; Guimaraes, Maria Ines Calil Cury; Buchpiguel, Carlos Alberto [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Centro de Medicina Nuclear

    2013-07-01

    The effects of internal irradiation caused by radiopharmaceuticals being utilized in nuclear medicine are very little studied at the cellular level. In this study, cytogenetic effects of {sup 131}I thyroid remnant ablation were analyzed in lymphocytes of thyroidectomized differentiated thyroid cancer patients (DTC) through the chromosome aberration technique. The chromosome damages radioinduced in euthyroid patients submitted to rhTSH (Thyrogen) therapy (Group A) were compared to those induced in patients maintained in hypothyroid condition through levothyroxine withdrawal (L-T{sub 4}) (group B), before, 24h, one week and one month after radioiodine administration (4995 - 7030 MBq). In parallel, in vitro assays were carried out with lymphocytes of healthy donors for the construction of dose-response curves at different radioactive concentrations of {sup 131}I (0.074 to 0.740 MBq/mL) for 24h, thus comparing chromosome damages in vivo and in vitro in order to estimate the absorbed dose through Monte Carlo program. Radioiodine therapy induced a higher total CA rate in hypothyroid compared with euthyroid patients, except 24h after administration of {sup 131}I probably due to higher uptake induced by TSH, although without statistical significance (p > 0.05). The frequency of dicentrics obtained in lymphocytes of all patients 24h after treatment, was equivalent to that induced in vitro in the radioactive concentrations range of 0.07 to 0.50 MBq/mL, corresponding to an absorbed dose of up 1.0 Gy. The data obtained suggest that the use of rhTSH-aided thyroid remnant ablation is efficacy and secure for the patients with DTC. Cytogenetic analysis after one year are planned in order to evaluate late effects. (author)

  6. Thyroid Disease

    Science.gov (United States)

    ... Institute. (2014). Thyroid Cancer . Bomeli, S.R., LeBeau, S.O., Ferris, R.L. (2010). Evalution of a Thyroid Nodule . ... Institute. (2014). Thyroid Cancer . Bomeli, S.R., LeBeau, S.O., Ferris, R.L. (2010). Evalution of a Thyroid Nodule . ...

  7. 131I therapy of thyroid cancer patients

    International Nuclear Information System (INIS)

    Reiners, C.; Farahati, J.

    1999-01-01

    Thyroid cancer is a rare malignancy with wide inter ethnic and geographic variations. In Germany thyroid carcinoma is the 13. most frequent malignancy (2.7 new cases yearly per 100,000 inhabitants). The overall temporal incidence is increasing slightly in recent years. The most common types of cancer are papillary (60-80%) and follicular cancers (10-20%). The relevant prognostic indicators are tumor stage and distant metastases. The mean survival rates in papillary thyroid cancer usually exceed 90%, whereas in follicular thyroid cancer they amount to approximately 80%. The standard treatment procedure in differentiated papillary and follicular thyroid cancer consists of total thyroidectomy followed by adjuvant ablative therapy with radioiodine. Only in papillary thyroid cancer stage pT 1 N 0 M 0 lobectomy alone is considered to be appropriate. In patients with locally invasive differentiated thyroid cancers stage pT 4 adjuvant percutaneous radiation therapy is a treatment option. Radioiodine therapy has to be performed under the stimulative influence of TSH. Usually TSH suppressive medication with Levothyroxine has to be withdrawn approximately 4 weeks prior to radioiodine therapy. In the future, exogenous stimulation by recombinant TSH may be used instead of thyroid hormone withdrawal. It has been proved by different studies that ablative radioiodine therapy reduces the frequency of recurrences and tumor spread in patients with thyroid cancer significantly. In patients with distant metastases, up to 50% of complete responses may be achieved with radioiodine treatment

  8. Scanning in Thyroid Cancer; Exploration des tumeurs de la thyroide; Ispol'zovanie radioizotopov pri issledovanii raka shchitovidnoj zhelezy; Exploracion de los tumores tiroideos

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Franz K [Radioisotope Centre, University of Southern California School of Medicine, Los Angeles, CA (United States)

    1959-07-01

    Scanning in thyroid cancer is of value in - 1. The preoperative diagnosis of a thyroid nodule; 2. The localization of thyroid cancer metastases; 3. The treatment of thyroidectomize d patients with metastases from thyroid cancer. The appearance of thyroid nodules on the scintigram is described. Some prelimi- nary results of the use of radiophosphoru s and external counting with a Geiger- Mueller tube of ''cold'' nodules are reported. Localization of thyroid cancer metastases with particular emphasis on the use of thyrotropic hormone is described. With this method three-fourths of all patients with metastatic thyroid cancer were found to have functioning metastases. The technique of ablation of normal thyroid remnants following total thyroidectomy and the treatment of metastases is discussed in detail. Scanning of metastases is the best method to follow the patient's progress. (author) [French] L'exploration des tumeurs de la thyroide presente un interet pour: 1. Le diagnostic preoperatoire des nodules de la thyroide; 2. La localisation des metastases du cancer de la thyroide; 3. Le traitement des personnes ayant subi l'ablation de la thyroide et atteintes de metastases du cancer de la thyroide. L'auteur decrit l'aspect des nodules de la thyroide sur le scintigramme. Il donne certains resultats preliminaires obtenus par l'emploi du radiophosphore et par comptage externe des nodules < froids > a l'aide d'un tube de Geiger-Mueller. L'auteur etudie aussi la localisation des metastases du cancer de la thyroide, en particulier par l'utilisation de l'hormone thyrotropique. L'emploi de cette methode a permis de constater que les trois quarts des malades atteints de cancer metastatique de la thyroide souffraient de metastases en activite. Apres avoir evoque la thyroidectomie totale et la methode d'ablation des fragments de thyroide restant normalement apres operation, l'auteur etudie en detail le traitement des metastases. L'exploration des metastases est la meilleure

  9. Ten years of experience with third and fourth branchial remnants.

    Science.gov (United States)

    Liberman, Moishe; Kay, Saundra; Emil, Sherif; Flageole, Hélène; Nguyen, Luong T; Tewfik, Ted L; Oudjhane, Kamal; Laberge, Jean-Martin

    2002-05-01

    Third and fourth branchial remnants may result in cysts and abscesses that are in close contact with the thyroid gland. These anomalies are rare and often present diagnostic and therapeutic challenges. The charts of patients diagnosed with a branchial anomaly between July 1991 and July 2001 at the Montreal Children's Hospital were reviewed. All cases of third and fourth branchial remnants or pyriform sinus fistulae were identified. Clinical presentation, imaging, treatment, and outcome were recorded. Eight patients with a third or fourth branchial anomaly were identified and ranged in age from birth to 13 years. All anomalies were left sided. Presenting symptoms consisted of an asymptomatic cervical mass (n = 1), an infected mass (n = 5), neonatal respiratory distress (n = 1), and 1 incidental cyst found on magnetic resonance imaging. Ultrasonography was useful in suggesting the diagnosis in 7 cases. Barium swallow was performed in 3 patients with 2 positive results. Pharyngoscopy results showed the internal opening in 2 of 7 patients. A portion of the thyroid gland was resected in 6 patients. One patient has not yet undergone a definitive procedure. There was 1 recurrence in a patient whose pathology did not confirm a branchial remnant. The diagnosis and management of pyriform sinus anomalies are challenging. Ultrasound scan, computed tomography scan, barium swallow, and pharyngoscopy are all useful. The portion of thyroid involved in the fistula must be excised en bloc with the inflammatory mass, and the tract should be ligated at the level of the pharynx to minimize recurrence. Copyright 2002, Elsevier Science (USA). All rights reserved.

  10. Relative value of thallium-201 and iodine-131 scans in the detection of recurrence or distant metastasis of well differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lin Jen-Der; Weng Hsiao-Fen; Lu Wen-Tsoung [Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital (Taiwan, Province of China); Kao Pan-Fu; Huang Miau-Ju [Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taiwan (Taiwan, Province of China)

    1998-07-01

    Radioactive iodine ({sup 131}I) has been found to be more sensitive and more specific than thallium-201 for the detection of distant metastases and thyroid remnants in the neck in cases of well-differentiated thyroid carcinoma. {sup 201}Tl has been deemed particularly useful in localizing metastases or recurrence in patients with a negative {sup 131}I scan and abnormal levels of serum thyroglobulin (Tg). This study aimed to: (1) determine the value of {sup 201}Tl imaging in localizing metastases or recurrence in patients with well-differentiated thyroid carcinoma, and (2) evaluate the false-positive and false-negative results of {sup 131}I and {sup 201}Tl scintigraphy. Sixty-two thyroid remnant ablated patients who underwent simultaneous postoperative {sup 201}Tl and {sup 131}I scans and and serum Tg determinations were evaluated. Fifty patients had papillary thyroid carcinomas and 12 had follicular thyroid carcinomas. {sup 201}Tl imaging was performed before the {sup 131}I studies. Of the 62 patients who underwent {sup 201}Tl imaging studies, 24 were found to have positive results, with local recurrence or distant metastases. Patients with positive results in the {sup 201}Tl imaging studies tended to be older, were mor often male, had higher Tg levels and had a higher recurrence rate. Of these 24 patients, ten had negative diagnostic or therapeutic {sup 131}I scans. Concurrently, serum Tg levels were less than 5 ng/ml in five of these ten patients. Three patients were deemed false positive by {sup 201}Tl scans; one had a parotid tumour, one a periodontal abscess and one lung metastasis. Among the 38 patients with negative {sup 201}Tl scans, 11 had positive findings on {sup 131}I scans. Three had distant metastases: two with lung metastases and one with bone metastases. Patients with false-positive results on {sup 131}I scans included those with biliary tract stones, ovarian cysts, and breast secretion. Of the 27 patients with negative {sup 201}Tl and {sup 131}I

  11. Relative value of thallium-201 and iodine-131 scans in the detection of recurrence or distant metastasis of well differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Lin Jen-Der; Weng Hsiao-Fen; Lu Wen-Tsoung; Kao Pan-Fu; Huang Miau-Ju

    1998-01-01

    Radioactive iodine ( 131 I) has been found to be more sensitive and more specific than thallium-201 for the detection of distant metastases and thyroid remnants in the neck in cases of well-differentiated thyroid carcinoma. 201 Tl has been deemed particularly useful in localizing metastases or recurrence in patients with a negative 131 I scan and abnormal levels of serum thyroglobulin (Tg). This study aimed to: (1) determine the value of 201 Tl imaging in localizing metastases or recurrence in patients with well-differentiated thyroid carcinoma, and (2) evaluate the false-positive and false-negative results of 131 I and 201 Tl scintigraphy. Sixty-two thyroid remnant ablated patients who underwent simultaneous postoperative 201 Tl and 131 I scans and and serum Tg determinations were evaluated. Fifty patients had papillary thyroid carcinomas and 12 had follicular thyroid carcinomas. 201 Tl imaging was performed before the 131 I studies. Of the 62 patients who underwent 201 Tl imaging studies, 24 were found to have positive results, with local recurrence or distant metastases. Patients with positive results in the 201 Tl imaging studies tended to be older, were mor often male, had higher Tg levels and had a higher recurrence rate. Of these 24 patients, ten had negative diagnostic or therapeutic 131 I scans. Concurrently, serum Tg levels were less than 5 ng/ml in five of these ten patients. Three patients were deemed false positive by 201 Tl scans; one had a parotid tumour, one a periodontal abscess and one lung metastasis. Among the 38 patients with negative 201 Tl scans, 11 had positive findings on 131 I scans. Three had distant metastases: two with lung metastases and one with bone metastases. Patients with false-positive results on 131 I scans included those with biliary tract stones, ovarian cysts, and breast secretion. Of the 27 patients with negative 201 Tl and 131 I scans, 15 had elevated serum Tg levels. Among these, local recurrence followed by lung

  12. Postprandial Hyperlipidemia and Remnant Lipoproteins.

    Science.gov (United States)

    Masuda, Daisaku; Yamashita, Shizuya

    2017-02-01

    Fasting hypertriglyceridemia is positively associated with the morbidity of coronary heart disease (CHD), and postprandial (non-fasting) hypertriglyceridemia is also correlated with the risk status for CHD, which is related to the increase in chylomicron (CM) remnant lipoproteins produced from the intestine. CM remnant particles, as well as oxidized low density lipoprotein (LDL) or very low density lipoprotein (VLDL) remnants, are highly atherogenic and act by enhancing systemic inflammation, platelet activation, coagulation, thrombus formation, and macrophage foam cell formation. The cholesterol levels of remnant lipoproteins significantly correlate with small, dense LDL; impaired glucose tolerance (IGT) and CHD prevalence. We have developed an assay of apolipoprotein (apo)B-48 levels to evaluate the accumulation of CM remnants. Fasting apoB-48 levels correlate with the morbidity of postprandial hypertriglyceridemia, obesity, type III hyperlipoproteinemia, the metabolic syndrome, hypothyroidism, chronic kidney disease, and IGT. Fasting apoB-48 levels also correlate with carotid intima-media thickening and CHD prevalence, and a high apoB-48 level is a significant predictor of CHD risk, independent of the fasting TG level. Diet interventions, such as dietary fibers, polyphenols, medium-chain fatty acids, diacylglycerol, and long-chain n-3 polyunsaturated fatty acids (PUFA), ameliorate postprandial hypertriglyceridemia, moreover, drugs for dyslipidemia (n-3 PUFA, statins, fibrates or ezetimibe) and diabetes concerning incretins (dipeptidyl-peptidase IV inhibitor or glucagon like peptide-1 analogue) may improve postprandial hypertriglyceridemia. Since the accumulation of CM remnants correlates to impaired lipid and glucose metabolism and atherosclerotic cardiovascular events, further studies are required to investigate the characteristics, physiological activities, and functions of CM remnants for the development of new interventions to reduce atherogenicity.

  13. Low- and high-dose radioiodine therapy for low-/intermediate-risk differentiated thyroid cancer. A preliminary clinical trial

    International Nuclear Information System (INIS)

    Qu Yuan; Huang Rui; Li Lin

    2017-01-01

    therapeutic response, respectively. The incidences of adverse reactions were 18% (12/66) and 39% (26/66) in the low-dose and high-dose groups, respectively, and this difference between the two groups was significant (P = 0.007). The result of thyroid remnant ablation and the response to therapy did not differ significantly between the two groups. The low-dose group had a lower incidence of adverse reactions than the high-dose group. N1b and pre-treatment-stimulated Tg were factors influencing the ablation result, whereas pre-treatment-stimulated Tg was a factor influencing the therapeutic response. Pre-treatment-stimulated Tg of 0.47 and 3.09 μg/L were identified as cutoff values for predicting the ablation result and therapeutic response, respectively. The study protocol was approved by the Clinical Trials and Biomedical Ethics Committee of our hospital and registered on the Chinese Clinical Trial Registry under the registration number ChiCTR-IOR-15006139. (author)

  14. Dosimetry for patients with differentiated thyroid cancer in therapy with {sup 131} (Nal) preceded by rec-hTSH and establishment of a correlation between absorbed dose and cytogenetic effects of radiation in humans

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, J.A.; Guimaraes, M.I.C.C.; Buchpiguel, C.A., E-mail: jgonzalez@usp.br [Universidade de Sao Paulo (CMN/InRad/HCFM/USP), SP (Brazil). Centro de Medicina Nuclear. Instituto de Radiologia. Hospital das Clinicas; Da Silva, M.A.; Okazaki, K.; Yoriyaz, H.; Bartolini, P., E-mail: masilva@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-11-01

    The objective of this study was to calculate the dosimetry for thyroid remnants and other organs of 22 patients with differentiated thyroid cancer and compare the dosimetric results with the genetic effects that may occur due the introduction of ionizing radiation in the human body. The patients were divided in two groups: group A included the patients that went through the interruption of the thyroid hormone reposition and group B included the ones that received the recombinant human Thyroid Stimulating Hormone (rec-hTSH). Blood samples were collected at predetermined intervals and analyzed with the conventional chromosomal aberrations technique. Patients collected their own urine during 24 hours after the administration of the radioiodine. For internal dosimetry calculations it is being used MlRD methodology and software MIRDOSE-3 and MlRDOSE-OLINDA. Preliminary results of the absorbed dose of 12 patients (6 from each group) show the normal pattern of this type of absorption in treatment of thyroid remnants ablation with a mean effective dose of 3 3.2 {+-} 6.4 mSv/MBq (group A) and 15.0 {+-} 4.5 mSv/MBq (group B). In the cytogenetic results for 5 patients (4 from group A and 1 from group B), the microscopic analysis showed the presence of various types of chromosomal aberrations. The dicentric chromosome was the most frequently found and is considered the most sensitive indicator of radiation damage. The correlation between the absorbed dose and the cytogenetic dosimetry appears to be in good agreement so far, since the doses are consistent with the genetic damage found. (author)

  15. Thyroid Function Tests

    Science.gov (United States)

    ... Home » Thyroid Function Tests Leer en Español Thyroid Function Tests FUNCTION HOW DOES THE THYROID GLAND FUNCTION? ... Cancer Thyroid Nodules in Children and Adolescents Thyroid Function Tests Resources Thyroid Function Tests Brochure PDF En ...

  16. Analysis of clinical factors for the determination of optimal serum level of thyrotropin after recombinant human thyroid-stimulating hormone administration

    International Nuclear Information System (INIS)

    Son, Seung Hyun; Lee, Sang Woo; Jung, Ji Hoon; Kim, Choon Young; Kim, Do Hoon; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jae Tae

    2015-01-01

    To determine the optimal levels of thyroid-stimulating hormone (TSH) levels after administration of recombinant human TSH (rhTSH) to patients with differentiated thyroid cancer (DTC), we have analyzed the clinical parameters that affected the degree of the increase in serum levels of TSH. We retrospectively analyzed 276 patients with differentiated thyroid cancer (DTC), post-thyroidectomy and remnant ablation. Pearson’s correlation coefficient test was used to evaluate the correlation between serum levels of TSH after rhTSH stimulation and various clinical factors, including age, sex, height, weight, body mass index (BMI), body surface area (BSA), serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate (GFR). Linear regression analysis was used to determine the predictors of the degree of increase in serum TSH level after rhTSH stimulation. After the rhTSH injections, all subjects achieved TSH levels of >30 μU/mL, with a mean of 203.8 ± 83.4 μU/mL. On univariate analysis, age (r = 0.255) and serum creatinine (r = 0.169) level were positive predictors for higher levels of serum TSH after rhTSH stimulation, while weight (r = –0.239), BMI (r = –0.223), BSA (r = –0.217), and estimated GFR (r = –0.199) were negative predictors. Multiple linear regression analysis revealed that serum creatinine was the most powerful independent predictor for serum levels of TSH, followed by age, BSA, and BMI. An increment in serum TSH after rhTSH stimulation was significantly affected by age, BSA, BMI, and creatinine, with creatinine being the most powerful predictor. By understanding the difference in the increased levels of TSH in various subjects, their dose of rhTSH can be adjusted during scheduling for radioiodine ablation, or during follow-up (recurrence surveillance) after surgery and ablation

  17. Analysis of clinical factors for the determination of optimal serum level of thyrotropin after recombinant human thyroid-stimulating hormone administration

    Energy Technology Data Exchange (ETDEWEB)

    Son, Seung Hyun; Lee, Sang Woo; Jung, Ji Hoon; Kim, Choon Young; Kim, Do Hoon; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jae Tae [Dept. of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, Daegu (Korea, Republic of)

    2015-12-15

    To determine the optimal levels of thyroid-stimulating hormone (TSH) levels after administration of recombinant human TSH (rhTSH) to patients with differentiated thyroid cancer (DTC), we have analyzed the clinical parameters that affected the degree of the increase in serum levels of TSH. We retrospectively analyzed 276 patients with differentiated thyroid cancer (DTC), post-thyroidectomy and remnant ablation. Pearson’s correlation coefficient test was used to evaluate the correlation between serum levels of TSH after rhTSH stimulation and various clinical factors, including age, sex, height, weight, body mass index (BMI), body surface area (BSA), serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate (GFR). Linear regression analysis was used to determine the predictors of the degree of increase in serum TSH level after rhTSH stimulation. After the rhTSH injections, all subjects achieved TSH levels of >30 μU/mL, with a mean of 203.8 ± 83.4 μU/mL. On univariate analysis, age (r = 0.255) and serum creatinine (r = 0.169) level were positive predictors for higher levels of serum TSH after rhTSH stimulation, while weight (r = –0.239), BMI (r = –0.223), BSA (r = –0.217), and estimated GFR (r = –0.199) were negative predictors. Multiple linear regression analysis revealed that serum creatinine was the most powerful independent predictor for serum levels of TSH, followed by age, BSA, and BMI. An increment in serum TSH after rhTSH stimulation was significantly affected by age, BSA, BMI, and creatinine, with creatinine being the most powerful predictor. By understanding the difference in the increased levels of TSH in various subjects, their dose of rhTSH can be adjusted during scheduling for radioiodine ablation, or during follow-up (recurrence surveillance) after surgery and ablation.

  18. Thyroid Cancer

    Science.gov (United States)

    ... body work normally. There are several types of cancer of the thyroid gland. You are at greater ... imaging tests, and a biopsy to diagnose thyroid cancer. Treatment depends on the type of cancer you ...

  19. Thyroid disease

    Energy Technology Data Exchange (ETDEWEB)

    Falk, S.

    1990-01-01

    Presenting a multidisciplinary approach to the diagnosis and treatment of thyroid disease, this volume provides a comprehensive picture of current thyroid medicine and surgery. The book integrates the perspectives of the many disciplines that deal with the clinical manifestations of thyroid disorders. Adding to the clinical usefulness of the book is the state-of-the-art coverage of many recent developments in thyroidology, including the use of highly sensitive two-site TSH immunoradionetric measurements to diagnose thyroid activity; thyroglobulin assays in thyroid cancer and other diseases; new diagnostic applications of MRI and CT; treatment with radionuclides and chemotherapy; new developments in thyroid immunology, pathology, and management of hyperthyroidism; suppressive treatment with thyroid hormone; and management of Graves' ophthalmopathy. The book also covers all aspects of thyroid surgery, including surgical treatment of hyperthyroidism; papillary, follicular, and other carcinomas; thyroidectomy; and prevention and management of complications.

  20. Thyroid disease

    International Nuclear Information System (INIS)

    Falk, S.

    1990-01-01

    Presenting a multidisciplinary approach to the diagnosis and treatment of thyroid disease, this volume provides a comprehensive picture of current thyroid medicine and surgery. The book integrates the perspectives of the many disciplines that deal with the clinical manifestations of thyroid disorders. Adding to the clinical usefulness of the book is the state-of-the-art coverage of many recent developments in thyroidology, including the use of highly sensitive two-site TSH immunoradionetric measurements to diagnose thyroid activity; thyroglobulin assays in thyroid cancer and other diseases; new diagnostic applications of MRI and CT; treatment with radionuclides and chemotherapy; new developments in thyroid immunology, pathology, and management of hyperthyroidism; suppressive treatment with thyroid hormone; and management of Graves' ophthalmopathy. The book also covers all aspects of thyroid surgery, including surgical treatment of hyperthyroidism; papillary, follicular, and other carcinomas; thyroidectomy; and prevention and management of complications

  1. Radioiodine (I-131) application in the management of differentiated thyroid cancer (DTC) audit

    International Nuclear Information System (INIS)

    Nanayakkara, D.

    2005-01-01

    metastases were detected in 16% (n=21). Of 52 patients with residual thyroid tissues, fourteen patients (30%) received residual ablation dose of 30 mCi of radioiodine. All 21 patients who exhibit abnormal WBS were referred to the cancer unit for high dose therapy. This study showed DTC is more common in young females than in males and Papillary carcinoma is the commonest histological type in Sri Lanka. Though the preferred surgical management is TT or NTT (92%) this study showed inadequacy of excision. In Sri Lanka we have very few experienced thyroid surgeons. Inadequate surgical excision could be due to inexperience and lack of facilities for surgical management in peripheral hospitals. Inadequate surgical excision will directly interfere with the long-term follow up of DTC. Presence of remnant thyroid tissues makes detection and treatment of nodal or distant metastases difficult. High TSH levels necessary to enhance tumor I 131 uptake and assessment of Tg levels, the most sensitive test for detection of recurrences cannot be achieved with a large thyroid remnants. This results indicative of low sensitivity of the WBS and serum Tg measurements in our set up. We have detected 16% of patients with distant metastases but the actual number may be higher than this figure. Monitoring with Tg is grossly inadequate. Serum Tg test is expensive in our set up prevent us using this facility. Approximately 2/3 of this study group were not received residual ablation partly due to unawareness, not enough radioiodine in the government hospitals and poor follow up in our set up. Management of DTC is still debatable. There is no agreement on extent of surgery, optimal time for WBS, residual ablation and long-term fallow up. Today highly effective method of treatment for DTC is the combination of thyroid surgery (TT/NTT) followed by RAI residual ablation and thyroxine suppression therapy. 30 mCi of radioiodine is the highest permissible activity for out patient treatment according to the

  2. Thyroid Tests

    Science.gov (United States)

    ... too low Hashimoto’s disease , of the most common cause of hypothyroidism thyroid nodules and thyroid cancer Your doctor will ... of hyperthyroidism—and Hashimoto’s disease —the most common cause of hypothyroidism. Thyroid antibodies are made when your immune system ...

  3. 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

  4. Management of hyperfunctioning single thyroid nodules in the era of minimally invasive thyroid surgery.

    Science.gov (United States)

    Tan, Charles; Sidhu, Stan; Sywak, Mark; Delbridge, Leigh

    2009-05-01

    Both surgical excision and radioiodine ablation are effective modalities in the management of hyperfunctioning thyroid nodules. Minimally invasive thyroid surgery (MITS) using the lateral mini-incision approach has previously been demonstrated to be a safe and effective technique for thyroid lobectomy. As such MITS may offer advantages as a surgical approach to hyperfunctioning thyroid nodules without the need for a long cervical incision or extensive dissection associated with formal open hemithyroidectomy. The aim of the present study was to assess the safety and efficacy of MITS for the treatment of hyperfunctioning thyroid nodules. This is a retrospective case study. Data were obtained from the University of Sydney Endocrine Surgical Unit Database from 2002 to 2007. There were 86 cases of hyperfunctioning thyroid nodules surgically removed during the study period, of which 10 (12%) were managed using the MITS approach. The ipsilateral recurrent laryngeal nerve was identified and preserved in all cases with no incidence of temporary or permanent nerve palsy. The external branch of the superior laryngeal nerve was visualized and preserved in eight cases (80%). There were no cases of postoperative bleeding. There was one clinically significant follicular thyroid carcinoma in the series (10%). In nine of 10 cases (90%) normalization of thyroid function followed surgery. MITS is a safe and effective procedure, achieving the benefits of a minimally invasive procedure with minimal morbidity. As such it now presents an attractive alternative to radioiodine ablation for the management of small hyperfunctioning thyroid nodules.

  5. Cytogenetic biodosimetry and dose-rate effect after radioiodine therapy for thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Khvostunov, Igor K. [Russian Ministry of Health Care, A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Obninsk, Kaluga Region (Russian Federation); Nagasaki University, Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki (Japan); Saenko, Vladimir A.; Yamashita, Shunichi [Nagasaki University, Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki (Japan); Krylov, Valeri; Rodichev, Andrei [Russian Ministry of Health Care, A.F. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Centre, Obninsk, Kaluga Region (Russian Federation)

    2017-08-15

    This study set out to investigate chromosomal damage in peripheral blood lymphocytes of thyroid cancer patients receiving {sup 131}I for thyroid remnant ablation or treatment of metastatic disease. The observed chromosomal damage was further converted to the estimates of whole-body dose to project the adverse side effects. Chromosomal aberration analysis was performed in 24 patients treated for the first time or after multiple courses. Blood samples were collected before treatment and 3 or 4 days after administration of 2-4 GBq of {sup 131}I. Both conventional cytogenetic and chromosome 2, 4 and 12 painting assays were used. To account for dose-rate effect, a dose-protraction factor was applied to calculate the whole-body dose. The mean dose was 0.62 Gy (95% CI: 0.44-0.77 Gy) in the subgroup of patients treated one time and 0.67 Gy (95% CI: 0.03-1.00 Gy) in re-treated patients. These dose estimates are about 1.7-fold higher than those disregarding the effect of exposure duration. In re-treated patients, the neglected dose-rate effect can result in underestimation of the cumulative whole-body dose by the factor ranging from 2.6 to 6.8. Elevated frequency of chromosomal aberrations observed in re-treated patients before radioiodine therapy allows estimation of a cumulative dose received from all previous treatments. (orig.)

  6. Thyroid cancer: experiences at Christian Medical College Hospital, Vellore

    International Nuclear Information System (INIS)

    Oomen, R.

    1999-01-01

    Since about last three decades, the management strategy for carcinoma of the thyroid at Christian Medical College (CMC) hospital includes surgery, radiotherapy and radioiodine therapy ( 131 I). The strategies of management of carcinoma of the thyroid at the institution evolved from surgery alone, surgery followed by external radiation, and surgery, post-operative 131 I with or without external radiation. 131 I ablation has emerged as an important modality in the routine management of carcinoma of the thyroid

  7. Einstein Observations of Galactic supernova remnants

    Science.gov (United States)

    Seward, Frederick D.

    1990-01-01

    This paper summarizes the observations of Galactic supernova remnants with the imaging detectors of the Einstein Observatory. X-ray surface brightness contours of 47 remnants are shown together with gray-scale pictures. Count rates for these remnants have been derived and are listed for the HRI, IPC, and MPC detectors.

  8. Chronic lymphocytic thyroiditis (CLT) has a positive prognostic value in papillary thyroid cancer (PTC) patients: the potential key role of Foxp3+ T lymphocytes.

    Science.gov (United States)

    Pilli, T; Toti, P; Occhini, R; Castagna, M G; Cantara, S; Caselli, M; Cardinale, S; Barbagli, L; Pacini, F

    2017-12-11

    An impact of chronic lymphocytic thyroiditis (CLT) on papillary thyroid cancer (PTC) outcome has long been advocated but it is still controversial. The aim of this study was to evaluate the prognostic value of CLT in a retrospective cohort of PTC patients and to characterize the lymphocytic subpopulations and infiltrate (LI). We assessed 375 PTC patients, aged 45.2 ± 16.4 years, and treated with thyroidectomy and radioiodine remnant ablation, with a mean follow-up of 6.28 ± 3.86 years. In a subgroup of patients (n = 81) tissue sections were reviewed for the presence of CLT or lymphocytes associated with tumor in absence of background thyroiditis (TAL); cytotoxic CD8+/regulatory Foxp3+ T lymphocyte (CD8+/Foxp3+) ratio was characterized by immunohistochemistry: a low ratio is suggestive of a less effective anti tumor immune response. Seventy-five/375 patients (20%) had a histological diagnosis of CLT and showed at the last follow-up a significantly better outcome compared to those with no CLT (cure rate: 91.8 versus 76.3%, p = 0.003). LI was characterized in 81 PTC patients (24 with CLT and 57 with TAL): the peri-tumoral CD8+/Foxp3+ ratio was lower in patients not cured at the final evaluation. Our data suggest that concurrent CLT has a protective effect on PTC outcome and that the imbalance between cytotoxic and regulatory T lymphocytes in the peri-tumoral TAL may affect the tumor-specific immune response favoring a more aggressive behavior of cancer.

  9. Local reactions to radioiodine in the treatment of thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Burmeister, L.A.; du Cret, R.P.; Mariash, C.N. (Univ. of Minnesota, Minneapolis (USA))

    1991-02-01

    The purpose of this study is to compare the rate of local complications resulting from radioiodine ablation of thyroid cancer in patients with a residual intact thyroid lobe to that in patients who had more extensive surgical treatment prior to radioiodine administration. We retrospectively studied 59 patients who had received 131I between 1979 and 1989. The patients were divided into two groups, depending on the extent of their previous surgical thyroid excision. Group 1 comprised 10 patients with a lobectomy or hemithyroidectomy before the ablative radioiodine dose, and Group 2 comprised 49 patients with more extensive thyroid excision (near-total or subtotal thyroidectomy) before the radioiodine treatment. Sixty percent of the 10 patients in Group 1 experienced some degree of neck pain or tenderness following radioiodine ablation of their residual thyroid. In one case, the local reaction was very severe and accompanied by the development of transient hyperthyroidism. There was only a 6% local complication rate in the patients who had undergone more extensive thyroid excision before ablative therapy (p less than 0.001), and none had a severe reaction. Patients with only unilateral surgical excision before radioiodine therapy have a higher rate of local complications than do patients treated with more extensive surgery prior to radioiodine ablation. If radioiodine is to be employed in such patients, they should be informed of this possible complication. Since evidence supports a dose effect in the pathogenesis of the complications, we recommend using a dose of less than 30 mCi for the initial ablation in these patients even though it may be necessary to repeat this dose to complete thyroid ablation.

  10. Local reactions to radioiodine in the treatment of thyroid cancer

    International Nuclear Information System (INIS)

    Burmeister, L.A.; du Cret, R.P.; Mariash, C.N.

    1991-01-01

    The purpose of this study is to compare the rate of local complications resulting from radioiodine ablation of thyroid cancer in patients with a residual intact thyroid lobe to that in patients who had more extensive surgical treatment prior to radioiodine administration. We retrospectively studied 59 patients who had received 131I between 1979 and 1989. The patients were divided into two groups, depending on the extent of their previous surgical thyroid excision. Group 1 comprised 10 patients with a lobectomy or hemithyroidectomy before the ablative radioiodine dose, and Group 2 comprised 49 patients with more extensive thyroid excision (near-total or subtotal thyroidectomy) before the radioiodine treatment. Sixty percent of the 10 patients in Group 1 experienced some degree of neck pain or tenderness following radioiodine ablation of their residual thyroid. In one case, the local reaction was very severe and accompanied by the development of transient hyperthyroidism. There was only a 6% local complication rate in the patients who had undergone more extensive thyroid excision before ablative therapy (p less than 0.001), and none had a severe reaction. Patients with only unilateral surgical excision before radioiodine therapy have a higher rate of local complications than do patients treated with more extensive surgery prior to radioiodine ablation. If radioiodine is to be employed in such patients, they should be informed of this possible complication. Since evidence supports a dose effect in the pathogenesis of the complications, we recommend using a dose of less than 30 mCi for the initial ablation in these patients even though it may be necessary to repeat this dose to complete thyroid ablation

  11. HI Absorption in Merger Remnants

    Science.gov (United States)

    Teng, Stacy H.; Veileux, Sylvain; Baker, Andrew J.

    2012-01-01

    It has been proposed that ultraluminous infrared galaxies (ULIRGs) pass through a luminous starburst phase, followed by a dust-enshrouded AGN phase, and finally evolve into optically bright "naked" quasars once they shed their gas/dust reservoirs through powerful wind events. We present the results of our recent 21- cm HI survey of 21 merger remnants with the Green Bank Telescope. These remnants were selected from the QUEST (Quasar/ULIRG Evolution Study) sample of ULIRGs and PG quasars; our targets are all bolometrically dominated by AGN and sample all phases of the proposed ULIRG -> IR-excess quasar -> optical quasar sequence. We explore whether there is an evolutionary connection between ULIRGs and quasars by looking for the occurrence of HI absorption tracing neutral gas outflows; our results will allow us to identify where along the sequence the majority of a merger's gas reservoir is expelled.

  12. [Painless thyroiditis].

    Science.gov (United States)

    Okamura, Ken; Fujikawa, Megumi; Bandai, Sachiko

    2006-12-01

    Painless thyroiditis is characterized by painless low-uptake thyrotoxicosis (thyrotoxicosis without hyperthyroidism). Destructive damage of the thyroid has been thought to be the mechanism for self-limited thyrotoxicosis. However, hydrolysis of thyroglobulin must be responsible for the release of excessive thyroid hormone. Low-uptake of iodine and excessive release of thyroid hormone suggest the uncoupling of hormone synthesis and hormone secretion in the thyroid gland. Suppressed serum TSH level, various cytokines or growth factors including TGFbeta1, and thyroglobulin itself may be responsible for the suppressed hormone synthesis. The mechanism for persistent hormone release despite suppressed hormone synthesis should be clarified. Quantitative TSH binding inhibitor immunoglobulin assay is helpful for the differential diagnosis of painless thyroiditis and Graves' hyperthyroidism.

  13. Molecular clouds near supernova remnants

    International Nuclear Information System (INIS)

    Wootten, H.A.

    1978-01-01

    The physical properties of molecular clouds near supernova remnants were investigated. Various properties of the structure and kinematics of these clouds are used to establish their physical association with well-known remmnants. An infrared survey of the most massive clouds revealed embedded objects, probably stars whose formation was induced by the supernova blast wave. In order to understand the relationship between these and other molecular clouds, a control group of clouds was also observed. Excitation models for dense regions of all the clouds are constructed to evaluate molecular abundances in these regions. Those clouds that have embedded stars have lower molecular abundances than the clouds that do not. A cloud near the W28 supernova remnant also has low abundances. Molecular abundances are used to measure an important parameter, the electron density, which is not directly observable. In some clouds extensive deuterium fractionation is observed which confirms electron density measurements in those clouds. Where large deuterium fractionation is observed, the ionization rate in the cloud interior can also be measured. The electron density and ionization rate in the cloud near W28 are higher than in most clouds. The molecular abundances and electron densities are functions of the chemical and dynamical state of evolution of the cloud. Those clouds with lowest abundances are probably the youngest clouds. As low-abundance clouds, some clouds near supernova remnants may have been recently swept from the local interstellar material. Supernova remnants provide sites for star formation in ambient clouds by compressing them, and they sweep new clouds from more diffuse local matter

  14. Carcinoma arising in thyroglossal remnants

    NARCIS (Netherlands)

    van Vuuren, P. A.; Balm, A. J.; Gregor, R. T.; Hilgers, F. J.; Loftus, B. M.; Delprat, C. C.; Rutgers, E. J.

    1994-01-01

    Three patients with a papillary carcinoma arising in a thyroglossal duct cyst are presented and the literature is reviewed. This rare malignancy is seen mostly in women between the ages of 20 and 50 years. The distribution of carcinoma subtypes differs from that of thyroid carcinomas and

  15. High prevalence of thyroid FDG uptake on PET study in patients with thyroid hormone replacement

    International Nuclear Information System (INIS)

    Yu, J.-Q.; Kumar, R.; Xiu, Y.; Dadparvar, S.; Kung, J.W.; Kunjunmen, B.D.; Feng, Q.; Alavi, A.; Zhuang, H.

    2004-01-01

    Thyroid uptake is commonly seen on whole-body FDG-PET images. One well-known cause for this uptake is hyperthyroidism. The purpose of this study was to determine whether hypothyroidism also affects FDG uptake by the thyroid gland. Hospital records of 2765 patients who had undergone whole-body FDG-PET imaging for malignancies were retrospectively reviewed. Among them, those who had thyroid cancer, history of thyroid ablation for hyperthyroidism, neck lymphoma, and other types of head and neck cancer or recent neck surgery were excluded from analysis. The prevalence and level of thyroid FDG uptake in the remaining 1939 patients was compared with the state of patients' thyroid function. There were 141 hypothyroid subjects and the rest (n=1798) were euthyroid. The prevalence of thyroid tissue uptake in euthyroid subjects was 2.34% (42 of 1798), while it was 22% (31 out of 141) in hypothyroid patients. This was statistically significant. Similarly, the prevalence of hypothyroidism in patients in patients showing thyroid uptake was 42.5% (31 of 73), while it was 5.9% (110 of 1866) in patients without thyroid uptake. This was again statistically significant (p<0.001). Based on this retrospective analysis it was concluded that the prevalence of increased thyroid FDG uptake is significantly higher in patients with hypothyroidism than those who are euthyroid. (author)

  16. Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy

    International Nuclear Information System (INIS)

    Biermann, M.; Pixberg, M.K.; Schober, O.; Schuck, A.; Willich, N.; Heinecke, A.; Koepke, W.; Schmid, K.W.; Dralle, H.

    2003-01-01

    Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pNO/1/xMO/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msds-studie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial's inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx). Advised by the trial's independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p 2 -test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity. (orig.) [de

  17. Flavonoids, Thyroid Iodide Uptake and Thyroid Cancer-A Review.

    Science.gov (United States)

    Gonçalves, Carlos F L; de Freitas, Mariana L; Ferreira, Andrea C F

    2017-06-12

    Thyroid cancer is the most common malignant tumor of the endocrine system and the incidence has been increasing in recent years. In a great part of the differentiated carcinomas, thyrocytes are capable of uptaking iodide. In these cases, the main therapeutic approach includes thyroidectomy followed by ablative therapy with radioiodine. However, in part of the patients, the capacity to concentrate iodide is lost due to down-regulation of the sodium-iodide symporter (NIS), the protein responsible for transporting iodide into the thyrocytes. Thus, therapy with radioiodide becomes ineffective, limiting therapeutic options and reducing the life expectancy of the patient. Excessive ingestion of some flavonoids has been associated with thyroid dysfunction and goiter. Nevertheless, studies have shown that some flavonoids can be beneficial for thyroid cancer, by reducing cell proliferation and increasing cell death, besides increasing NIS mRNA levels and iodide uptake. Recent data show that the flavonoids apingenin and rutin are capable of increasing NIS function and expression in vivo. Herein we review literature data regarding the effect of flavonoids on thyroid cancer, besides the effect of these compounds on the expression and function of the sodium-iodide symporter. We will also discuss the possibility of using flavonoids as adjuvants for therapy of thyroid cancer.

  18. Flavonoids, Thyroid Iodide Uptake and Thyroid Cancer—A Review

    Science.gov (United States)

    Gonçalves, Carlos F. L.; de Freitas, Mariana L.; Ferreira, Andrea C. F.

    2017-01-01

    Thyroid cancer is the most common malignant tumor of the endocrine system and the incidence has been increasing in recent years. In a great part of the differentiated carcinomas, thyrocytes are capable of uptaking iodide. In these cases, the main therapeutic approach includes thyroidectomy followed by ablative therapy with radioiodine. However, in part of the patients, the capacity to concentrate iodide is lost due to down-regulation of the sodium-iodide symporter (NIS), the protein responsible for transporting iodide into the thyrocytes. Thus, therapy with radioiodide becomes ineffective, limiting therapeutic options and reducing the life expectancy of the patient. Excessive ingestion of some flavonoids has been associated with thyroid dysfunction and goiter. Nevertheless, studies have shown that some flavonoids can be beneficial for thyroid cancer, by reducing cell proliferation and increasing cell death, besides increasing NIS mRNA levels and iodide uptake. Recent data show that the flavonoids apingenin and rutin are capable of increasing NIS function and expression in vivo. Herein we review literature data regarding the effect of flavonoids on thyroid cancer, besides the effect of these compounds on the expression and function of the sodium-iodide symporter. We will also discuss the possibility of using flavonoids as adjuvants for therapy of thyroid cancer. PMID:28604619

  19. Thyroid Problems

    Science.gov (United States)

    ... Home › Aging & Health A to Z › Thyroid Problems Font size A A A Print Share Glossary Basic ... enough thyroid hormone, usually of the thyroxine (T4) type of hormone. Your T4 levels can drop temporarily ...

  20. Thyroid diseases

    International Nuclear Information System (INIS)

    Noma, Koji

    1992-01-01

    This chapter reviews the correlation between thyroid disease, other than cancer, and radiation in the literature. Radiation-induced thyroid disturbance is discussed in the context of external and internal irradiation. External irradiation of 10 to 40 Gy may lower thyroid function several months or years later. Oral administration of I-131 is widely given to patients with Basedow's disease; it may also lower thyroid function with increasing radiation doses. When giving 70 Gy or more of I-131, hypothyroidism has been reported to occur in 20-30% and at least 10%. Thyroiditis induced with internal I-131 irradiation has also been reported, but no data is available concerning external irradiation-induced thyroiditis. The incidence of nodular goiter was found to be several ten times higher with external irradiation than internal irradiation. Thyroid disturbance is correlated with A-bomb survivors. A-bomb radiation can be divided into early radiation within one minute after A-bombing and the subsequent residual radiation. Nodular goiter was significantly more frequent in the exposed group than the non-exposed group; it increased with increasing radiation doses and younger age (20 years or less) at the time of exposure. The incidence of decrease in thyroid function was higher with increasing radiation doses. However, in the case of Nagasaki, the incidence of hypothyroidism was significantly higher in the low-dose exposed group, especially A-bomb survivors aged 10-39 at the time of exposure and women. (N.K.)

  1. [Thyroid nodule].

    Science.gov (United States)

    Clerc, Jérôme

    2005-01-31

    The thyroid nodule is a frequent, most often benign, chronic, multifocal and slowly progressive disease. The first line strategy is to diagnose cancerous nodules (thyroid nodules is controversial since the prognosis of thyroid cancer is excellent for lesions measuring less than 20 mm. Though imaging accuracy is quite limited in assessing the diagnosis of thyroid cancer, both ultrasounds (US) and thyroid scan are helpful to enhance nodular identification (>30%), to sort the nodules relevant for cytological sampling and to optimize the follow-up, the major source of health costs. Suspicious and non contributive FNAs must have a control FNA within 6 months. Nodules with a non suspicious FNA (>85%) require long term follow-up. This follow-up is mainly morphological. New or evolutive nodules, as assessed by palpation or US, will require iterative FNAs or should be considered for surgery. In patients with hyperfunctioning nodules on the scan (10 to 20%), a yearly evaluation of the TSH level is sufficient. These nodules account either for autonomously functioning ones, which slowly develop towards thyrotoxicosis, or for hyperplastic nodules frequently disclosing a lymphocytic thyroiditis. Morbidity due to thyroid autonomy is still underestimated especially in aging patients with TSH levels thyroid nodule is suggested.

  2. A misdiagnosed Riedel's thyroiditis successfully treated by thyroidectomy and tamoxifen.

    Science.gov (United States)

    Wang, Chih-Jung; Wu, Ta-Jen; Lee, Chung-Ta; Huang, Shih-Ming

    2012-12-01

    Riedel's thyroiditis, known as invasive fibrous thyroiditis, is a very rare form of chronic thyroiditis. It is hard to make the diagnosis without surgical biopsy. We present a case of Riedel's thyroiditis in a 52-year-old female with past history of Hashimoto's thyroiditis. She suffered from bilateral neck pain, which radiated to both lower jaws. The erythrocyte sedimentation rate was 125 mm/hour. Subacute thyroiditis superimposed on Hashimoto's thyroiditis was diagnosed and treated with steroid. However the response was poor and she had a history of severe peptic ulcer. To avoid inducing the peptic ulcer by steroid, she received bilateral subtotal thyroidectomy. During surgery, the thyroid had severe adhesion to surrounding soft tissue and the pathology showed Riedel's thyroiditis. The neck pain improved after thyroidectomy. Tamoxifen has been given for 8 months and the size of remnant thyroid decreased to 8 mm. We concluded that combined thyroidectomy and tamoxifen successfully cured a patient with Riedel's thyroiditis. Copyright © 2012. Published by Elsevier B.V.

  3. Postotic and preotic cranial neural crest cells differently contribute to thyroid development.

    Science.gov (United States)

    Maeda, Kazuhiro; Asai, Rieko; Maruyama, Kazuaki; Kurihara, Yukiko; Nakanishi, Toshio; Kurihara, Hiroki; Miyagawa-Tomita, Sachiko

    2016-01-01

    Thyroid development and formation vary among species, but in most species the thyroid morphogenesis consists of five stages: specification, budding, descent, bilobation and folliculogenesis. The detailed mechanisms of these stages have not been fully clarified. During early development, the cranial neural crest (CNC) contributes to the thyroid gland. The removal of the postotic CNC (corresponding to rhombomeres 6, 7 and 8, also known as the cardiac neural crest) results in abnormalities of the cardiovascular system, thymus, parathyroid glands, and thyroid gland. To investigate the influence of the CNC on thyroid bilobation process, we divided the CNC into two regions, the postotic CNC and the preotic CNC (from the mesencephalon to rhombomere 5) regions and examined. We found that preotic CNC-ablated embryos had a unilateral thyroid lobe, and confirmed the presence of a single lobe or the absence of lobes in postotic CNC-ablated chick embryos. The thyroid anlage in each region-ablated embryos was of a normal size at the descent stage, but at a later stage, the thyroid in preotic CNC-ablated embryos was of a normal size, conflicting with a previous report in which the thyroid was reduced in size in the postotic CNC-ablated embryos. The postotic CNC cells differentiated into connective tissues of the thyroid in quail-to-chick chimeras. In contrast, the preotic CNC cells did not differentiate into connective tissues of the thyroid. We found that preotic CNC cells encompassed the thyroid anlage from the specification stage to the descent stage. Finally, we found that endothelin-1 and endothelin type A receptor-knockout mice and bosentan (endothelin receptor antagonist)-treated chick embryos showed bilobation anomalies that included single-lobe formation. Therefore, not only the postotic CNC, but also the preotic CNC plays an important role in thyroid morphogenesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Radiofrequency Ablation of Lung Tumors

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Radiofrequency Ablation (RFA) / Microwave Ablation (MWA) of Lung Tumors ... and Microwave Ablation of Lung Tumors? What are Radiofrequency and Microwave Ablation of Lung Tumors? Radiofrequency ablation, ...

  5. Ultrasound diagnostics of thyroid diseases

    International Nuclear Information System (INIS)

    Kharchenko, Vladimir P.; Kotlyarov, Peter M.; Mogutov, Mikhail S.; Sencha, Alexander N.; Patrunov, Yury N.; Belyaev, Denis V.; Alexandrov, Yury K.

    2010-01-01

    This book is based on the authors' extensive practical experience in the use of modern ultrasound, and other radiological methods, in the diagnosis of thyroid diseases. The authors have analyzed more than 100,000 ultrasound examinations performed between 1995 and 2008 in patients with thyroid and parathyroid disease, as well as many thousands of diagnostic and therapeutic ultrasound-guided minimally invasive procedures. The opening chapters include discussion of current ultrasound techniques, pitfalls, and the specifics of ultrasound examination of the thyroid in children. Detailed attention is then devoted to findings in the normal thyroid and in the presence of diffuse and focal changes. Further chapters focus on such topics as ultrasound examination after thyroid surgery and ultrasound diagnosis of parathyroid disease, recurrent goiter, and neck masses. Ultrasound-guided minimally invasive techniques, such as fine-needle aspiration biopsy, percutaneous laser ablation, and ethanol and glucocorticoid injections, are considered in depth. This up-to-date and richly illustrated book will interest and assist specialists in ultrasound diagnostics, radiologists, endocrinologists, and neck surgeons. (orig.)

  6. Remnant cholesterol and ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G

    2014-01-01

    PURPOSE OF REVIEW: To review recent advances in the field of remnant cholesterol as a contributor to the development of ischemic heart disease (IHD). RECENT FINDINGS: Epidemiologic, mechanistic, and genetic studies all support a role for elevated remnant cholesterol (=cholesterol in triglyceride......-rich lipoproteins) as a contributor to the development of atherosclerosis and IHD. Observational studies show association between elevated remnant cholesterol and IHD, and mechanistic studies show remnant cholesterol accumulation in the arterial wall like LDL-cholesterol (LDL-C) accumulation. Furthermore, large...... genetic studies show evidence of remnant cholesterol as a causal risk factor for IHD independent of HDL-cholesterol levels. Genetic studies also show that elevated remnant cholesterol is associated with low-grade inflammation, whereas elevated LDL-C is not. There are several pharmacologic ways of lowering...

  7. Neutron Stars in Supernova Remnants and Beyond

    Science.gov (United States)

    Gvaramadze, V. V.

    We discuss a concept of off-centred cavity supernova explosion as applied to neutron star/supernova remnant associations and show how this concept could be used to preclude the anti-humane decapitating the Duck (G5.4-1.2 + G5.27-0.9) and dismembering the Swan (Cygnus Loop), as well as to search for a stellar remnant associated with the supernova remnant RCW86.

  8. Neutron Stars in Supernova Remnants and Beyond

    OpenAIRE

    Gvaramadze, V. V.

    2002-01-01

    We discuss a concept of off-centred cavity supernova explosion as applied to neutron star/supernova remnant associations and show how this concept could be used to preclude the anti-humane decapitating the Duck (G5.4-1.2 + G5.27-0.9) and dismembering the Swan (Cygnus Loop), as well as to search for a stellar remnant associated with the supernova remnant RCW86.

  9. 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)

  10. CLINICAL CONCEPTS ON THYROID EMERGENCIES

    Directory of Open Access Journals (Sweden)

    Alfredo ePontecorvi

    2014-07-01

    Full Text Available Objective. Thyroid-related emergencies are caused by overt dysfunction of the gland that are so severe that require admission to intensive care units frequently. Nonetheless, in the ICU setting, it is crucial to differentiate patients with non-thyroidal illness and alterations in thyroid function tests from those with intrinsic thyroid disease. This review presents and discusses the main etiopathogenetical and clinical aspects of hypothyroid coma (HC and thyrotoxic storm (TS, including therapeutic strategy flow-charts. Furthermore, a special chapter is dedicated to the approach to massive goiter, which represents a surgical thyroid emergency.Data source. We searched the electronic MEDLINE database to September 2013.Data selection and Data extraction. Reviews, original articles and case reports on myxedematous coma, hypothyroid coma, thyroid storm, thyrotoxic storm, massive goiter, huge goiter, prevalence, etiology, diagnosis, therapy, prognosis were selected.Data synthesis and conclusions. Severe excess or defect of thyroid hormone are rare conditions which jeopardize the life of patients in most cases. Both HC and TS are triggered by precipitating factors, which occur in patients with severe hypothyroidism or thyrotoxicosis, respectively. The pillars of HC therapy are: high dose l-thyroxine and/or tri-iodothyroinine; i.v. glucocorticoids; treatment of hydro-electrolyte imbalance (mainly, hyponatraemia; treatment of hypothermia; not rarely, endotracheal intubation and assisted mechanic ventilation are needed. Therapy of TS is based on beta-blockers, thyrostatics, and i.v. glucocorticoids; eventually, high-dose iodide compounds or lithium carbonate may be of benefit. Surgery represents the gold standard treatment in patients with euthyroid massive nodular goiter, although new techniques – e.g., percutaneous laser ablation - are helpful in subjects at high surgical risk or refusing operation.

  11. Thyroid effects

    International Nuclear Information System (INIS)

    Maxon, H.; Thomas, S.; Buncher, C.; Book, S.; Hertzberg, V.

    1985-01-01

    Risk coefficients for thyroid disorders have been developed for both 131 I and external x or gamma low-LET radiation. A linear, no-threshold model has been used for thyroid neoplasms. A linear, threshold model has been used for other thyroid disorders. Improvements since the Reactor Safety Study were made possible by relevant new animal and human data. Major changes are as follows. Animal data are used to supplement the human experience where necessary. A specific risk estimate model is used for thyroid neoplasms, which accounts for observed effects of gender and age at exposure on risk. For thyroid cancer, the basis of the risk coefficients is the experience of North Americans following x-irradiation for benign disease in childhood. This recognizes possible differences in susceptibility in people of different heritage. A minimum induction period for thyroid neoplasms following irradiation is used to define periods at risk. An upper bound risk coefficient for cancer induction following exposure to 131 I is based on human experience at relatively low dose exposures. While the overall lifetime risks of death due to thyroid cancer are consistent with projections by the ICRP, BEIR III, and UNSCEAR Reports, the current model permits greater flexibility in determining risk for population subgroups. 88 references, 8 tables

  12. Evaluation of radiation therapy for advanced well-differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Tatsuno, Ikuo; Tada, Akira; Choto, Shuichi; Takanaka, Tsuyoshi

    1987-01-01

    Eighty-two patients with advanced well-differentiated thyroid carcinoma were treated. Sixty-six patients survived for more than 10 years and 10-year-survival rate was 80.5 %. Multidisciplinary treatment, consisting of surgery, radioiodine, external irradiation and TSH suppression was studied. We emphasized that radioiodine treatment after thyroid-ectomy was unique and an ideal therapeutic model for locally advanced, distant metastatic and recurrent cases as far as radioiodine was accumulated on thyroid cancer tissue. External irradiation was sometimes effective for the remnant thyroid carcinoma and metastases. Occassionally, well-differentiated thyroid carcinoma showed good response to TSH suppression therapy using thyroid hormone. The significance of conversion of well-differentiated carcinoma of thyroid to anaplastic carcinoma was noticed. We recognized that radiation therapy was effective for advanced well-differentiated thyroid carcinoma in multidisciplinary treatment. (author)

  13. Evaluation of radiation therapy for advanced well-differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Tatsuno, Ikuo; Tada, Akira; Choto, Shuichi; Takanaka, Tsuyoshi

    1987-02-01

    Eighty-two patients with advanced well-differentiated thyroid carcinoma were treated. Sixty-six patients survived for more than 10 years and 10-year-survival rate was 80.5 %. Multidisciplinary treatment, consisting of surgery, radioiodine, external irradiation and TSH suppression was studied. We emphasized that radioiodine treatment after thyroid-ectomy was unique and an ideal therapeutic model for locally advanced, distant metastatic and recurrent cases as far as radioiodine was accumulated on thyroid cancer tissue. External irradiation was sometimes effective for the remnant thyroid carcinoma and metastases. Occassionally, well-differentiated thyroid carcinoma showed good response to TSH suppression therapy using thyroid hormone. The significance of conversion of well-differentiated carcinoma of thyroid to anaplastic carcinoma was noticed. We recognized that radiation therapy was effective for advanced well-differentiated thyroid carcinoma in multidisciplinary treatment.

  14. Early diagnostics and treatment of thyroid carcinoma

    International Nuclear Information System (INIS)

    Ismailov, S.I.; Nugmanova, L.B.; Nasirkhodjaev, Ya. B.

    2004-01-01

    Full text: Analysis of data of the oncological outpatient clinics of the Republic of Uzbekistan confirms our data obtained in the Institute of Endocrinology showing growth in iodine deficiency disorders. In the Republic of Uzbekistan, during period from 1983 to 1999, 6374 people were detected to have thyroid carcinoma. If in 1989, 1.95 cases of thyroid tumor accounted for 100000 population, in 1999 this index reached to 2.39. Moreover, among metropolitan population this was 4.6 cases in 1989, and 8.0 in 1999. Of the 4280 patients operated for different thyroid pathologies from 1989 to 1999 in the Institute of Endocrinology, 335 (7.9%) were diagnosed to have thyroid carcinoma. Clinical presentation was: multinodular goiter in 50.8%, nodular goiter in 37.3% and autoimmune thyroiditis in 4.2% of cases. The average age of patients operated for thyroid carcinoma was 42.8 years in 1989 and 32 years in 1999. Treatment of patients with thyroid carcinoma should be near total thyroidectomy with selective lymphadenectomy independent of morphologic form of the tumor. Our data showed that only surgical method of treatment was used in 7.4% of patients but in combination of radioiodine in 81.9% of patients. Radioiodine was used to destroy remnant thyroid tissue and iodine concentrating metastases. 131I treatment for destruction of thyroid remnants after measured from the front, back and lateral positions in radical operation was given by fractionation method with average total activity being 25 mCi to 75 mCi. Metastases into neck lymph nodes and mediastinum were treated with radioactivity ranging from 50 mCi to 100 mCi. Of the total patients of differentiated thyroid cancer treated from 1995-1999, 148 were alive on 01.01.2003 with five-year survival rate of 91.4%. Our results highlight that combined surgical and radioiodine treatment of thyroid carcinoma helps in preventing recurrence, metastasis and results in increasing the lifespan of patients. (author)

  15. Pellet ablation and ablation model development

    International Nuclear Information System (INIS)

    Houlberg, W.A.

    1989-01-01

    A broad survey of pellet ablation is given, based primarily on information presented at this meeting. The implications of various experimental observations for ablation theory are derived from qualitative arguments of the physics involved. The major elements of a more complete ablation theory are then outlined in terms of these observations. This is followed by a few suggestions on improving the connections between theory and experimental results through examination of ablation data. Although this is a rather aggressive undertaking for such a brief (and undoubtedly incomplete) assessment, some of the discussion may help us advance the understanding of pellet ablation. 17 refs

  16. Pregnancy and Thyroid Disease

    Science.gov (United States)

    ... People Who Were Treated with hGH Thyroid Disease & Pregnancy Thyroid disease is a group of disorders that ... prescribes. What role do thyroid hormones play in pregnancy? Thyroid hormones are crucial for normal development of ...

  17. Pediatric Thyroid Cancer

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric Thyroid Cancer Pediatric Thyroid Cancer Patient Health Information News media ... and neck issues, should be consulted. Types of thyroid cancer in children: Papillary : This form of thyroid cancer ...

  18. Thyroid cancer - medullary carcinoma

    Science.gov (United States)

    Thyroid - medullary carcinoma; Cancer - thyroid (medullary carcinoma); MTC; Thyroid nodule - medullary ... in children and adults. Unlike other types of thyroid cancer, MTC is less likely to be caused by ...

  19. Anaplastic thyroid cancer

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000352.htm Anaplastic thyroid cancer To use the sharing features on this page, ... of cancer of the thyroid gland. Causes Anaplastic thyroid cancer is an invasive type of thyroid cancer that ...

  20. Thyroid Nodules

    Science.gov (United States)

    ... your thyroid gland. The extra thyroxine can cause symptoms of hyperthyroidism such as: Unexplained weight loss Increased perspiration Tremor ... seek medical care if you develop signs and symptoms of hyperthyroidism, such as: Sudden weight loss even though your ...

  1. Thyroid Nodules

    Science.gov (United States)

    ... Peer Support Resources Diseases and Conditions Adrenal Disorders Osteoporosis and Bone Health Children and Teen Health Diabetes Heart Health Men's Health Rare Diseases Pituitary Disorders Thyroid Disorders Transgender Health Obesity and Weight Management Women's Health You and Your ...

  2. Dynamical study of merger remnants

    International Nuclear Information System (INIS)

    Lake, G.; Dressler, A.; ATandT Bell Labs., Murray Hill, NJ; Mount Wilson and Las Campanas Observatories, Pasadena, CA; Carnegie Institution of Washington, Washington, DC)

    1986-01-01

    The velocity dispersion of objects from the Arp and the Arp-Madore atlases that have characteristics of recently merged galaxies is measured. These data are used to test the hypothesis that the remnants become normal elliptical galaxies after the fireworks of recent star formation subside. Accurate velocity dispersions of objects dominated by Balmer lines in the blue were measured using the uncontaminated Ca triplet feature in the extreme red (8400-8700 A). No deviation from the velocity dispersion expected for elliptical galaxies of comparable luminosity, is found, e.g., these systems follow the usual L-sigma relation with no zero-point shift. For a few galaxies without Balmer contamination, stellar rotation velocities are determined. One slow, one moderate, and one fast rotator are found. 54 references

  3. Oral TRH stimulation of the thyroid in patients with thyroid carcinoma

    International Nuclear Information System (INIS)

    Eissner, D.; Hahn, K.; Grimm, W.

    1983-01-01

    In patients with differentiated thyroid carcinoma high serum TSH-levels enhance 131 J-uptake in thyroid remnant and/or metastases. An effective increase of TSH could be achieved by oral administration of thyrotropin releasing hormone (TRH) even after a short T 4 /T 3 -withdrawal period so that we recommend a TRH-stimulation in all patients before a diagnostic or therapeutic 131 J-application. Adverse reactions to TRH are infrequent and usually shorttimed so that-in contrast to TSH-stimulation - TRH can be given to outpatients without any risk. (orig.) [de

  4. Progenitor's Signatures in Type Ia Supernova Remnants

    NARCIS (Netherlands)

    Chiotellis, A.; Kosenko, D.; Schure, K.M.; Vink, J.

    2013-01-01

    The remnants of Type Ia supernovae (SNe Ia) can provide important clues about their progenitor histories. We discuss two well-observed supernova remnants (SNRs) that are believed to have resulted from SNe Ia, and use various tools to shed light on the possible progenitor histories. We find that

  5. [Thyroid hormones and cardiovascular system].

    Science.gov (United States)

    Límanová, Zdeňka; Jiskra, Jan

    Cardiovascular system is essentially affected by thyroid hormones by way of their genomic and non-genomic effects. Untreated overt thyroid dysfunction is associated with higher cardiovascular risk. Although it has been studied more than 3 decades, in subclinical thyroid dysfunction the negative effect on cardiovascular system is much more controversial. Large meta-analyses within last 10 years have shown that subclinical hyperthyroidism is associated with higher cardiovascular risk than subclinical hypothyroidism. Conversely, in patients of age > 85 years subclinical hypothyroidism was linked with lower mortality. Therefore, subclinical hyperthyroidism should be rather treated in the elderly while subclinical hypothyroidism in the younger patients and the older may be just followed. An important problem on the border of endocrinology and cardiology is amiodarone thyroid dysfunction. Effective and safe treatment is preconditioned by distinguishing of type 1 and type 2 amiodarone induced hyperthyroidism. The type 1 should be treated with methimazol, therapeutic response is prolonged, according to recent knowledge immediate discontinuation of amiodarone is not routinely recommended and patient should be usually prepared to total thyroidectomy, or rather rarely 131I radioiodine ablation may be used if there is appropriate accumulation. In the type 2 there is a promt therapeutic response on glucocorticoids (within 1-2 weeks) with permanent remission or development of hypothyroidism. If it is not used for life-threatening arrhytmias, amiodarone may be discontinuated earlier (after several weeks). Amiodarone induced hypothyroidism is treated with levothyroxine without amiodarone interruption.Key words: amiodarone induced thyroid dysfunction - atrial fibrillation - cardiovascular risk - heart failure - hyperthyroidism - hypothyroidism - thyroid stimulating hormone.

  6. Hydrodynamic evolution of neutron star merger remnants

    Science.gov (United States)

    Liu, Men-Quan; Zhang, Jie

    2017-11-01

    Based on the special relativistic hydrodynamic equations and updated cooling function, we investigate the long-term evolution of neutron stars merger (NSM) remnants by a one-dimensional hydrodynamic code. Three NSM models from one soft equation of state, SFHo, and two stiff equations of state, DD2 and TM1, are used to compare their influences on the hydrodynamic evolution of remnants. We present the luminosity, mass and radius of remnants, as well as the velocity, temperature and density of shocks. For a typical interstellar medium (ISM) density with solar metallicity, we find that the NSM remnant from the SFHo model makes much more changes to ISM in terms of velocity, density and temperature distributions, compared with the case of DD2 and TM1 models. The maximal luminosity of the NSM remnant from the SFHo model is 3.4 × 1038 erg s-1, which is several times larger than that from DD2 and TM1 models. The NSM remnant from the SFHo model can maintain high luminosity (>1038 erg s-1) for 2.29 × 104 yr. Furthermore, the density and temperature of remnants at the maximal luminosity are not sensitive to the power of the original remnant. For the ISM with the solar metallicity and nH = 1 cm- 3, the density of the first shock ∼10-23 g cm-3 and the temperature ∼3 × 105 K in the maximal luminosity phase; The temperature of the first shock decreases and there is a thin 'dense' shell with density ∼10-21 g cm-3 after the maximal luminosity. These characteristics may be helpful for future observations of NSM remnants.

  7. Silent Thyroiditis

    Science.gov (United States)

    Walker, Peter

    1984-01-01

    Silent or painless thyroiditis is a frequent cause of transient hyperthyroidism, which is characterized by recent onset of symptoms in a patient with a normal to modestly enlarged and firm thyroid gland. The hallmarks of the disease are the absence of thyroidal pain or tenderness and a markedly reduced radioiodine uptake. Histologically, the gland is characterized by an important lymphocytic infiltration, occasionally to the point of lymphoid follicle formation. However, other indices of an autoimmune cause are usually absent. The disease appears to have a predilection for the postpartum period. Relapses may occur with subsequent pregnancies. Otherwise, the course is usually benign and transient, requiring moderate doses of β-adrenergic blocking agents for symptomatic relief. No pathogenetic factors are known, but the disease may conceivably have an autoimmune basis, particularly in the postpartum patient. PMID:21278944

  8. Density and energy of supernova remnants

    Energy Technology Data Exchange (ETDEWEB)

    Canto, J [Manchester Univ. (UK). Dept. of Astronomy

    1977-12-01

    The effects of an interstellar magnetic field on the gas flow behind a strong shock front are considered. The ambient density and energy of supernova remnants are estimated from the intensity ratio of sulphur lines I(6717)/I(6731). It is found that, on average, the ambient density around galactic supernova remnants is 4 cm/sup -3/. The total energy appears to be the same for all supernova remnants (to within a factor = approximately 5). A mean value of 4 10/sup 51/ erg is found.

  9. Remnants of strong tidal interactions

    International Nuclear Information System (INIS)

    Mcglynn, T.A.

    1990-01-01

    This paper examines the properties of stellar systems that have recently undergone a strong tidal shock, i.e., a shock which removes a significant fraction of the particles in the system, and where the shocked system has a much smaller mass than the producer of the tidal field. N-body calculations of King models shocked in a variety of ways are performed, and the consequences of the shocks are investigated. The results confirm the prediction of Jaffe for shocked systems. Several models are also run where the tidal forces on the system are constant, simulating a circular orbit around a primary, and the development of tidal radii under these static conditions appears to be a mild process which does not dramatically affect material that is not stripped. The tidal radii are about twice as large as classical formulas would predict. Remnant density profiles are compared with a sample of elliptical galaxies, and the implications of the results for the development of stellar populations and galaxies are considered. 38 refs

  10. Thyroid stimulating hormone and subclinical thyroid dysfunction

    International Nuclear Information System (INIS)

    Guo Yongtie

    2008-01-01

    Subclinical thyroid dysfunction has mild clinical symptoms. It is nonspecific and not so noticeable. It performs only for thyroid stimulating hormone rise and decline. The value of early diagnosis and treatment of thyroid stimulating hormone in subclinical thyroid dysfunction were reviewed. (authors)

  11. [Autoimmune thyroiditis and thyroid cancer].

    Science.gov (United States)

    Krátký, Jan; Jiskra, Jan

    2015-10-01

    Association between autoimmune thyroiditis (CLT) and thyroid cancer remains not clear. Although both diseases often occur simultaneously in histological samples, it is not yet clear whether CLT can be regarded as a risk factor for thyroid malignancy. This review focus on the known epidemiological and molecular genetics links between both diseases. Most studies have shown a significant association between thyroid cancer and positive antibodies to thyroglobulin and histological evidence of CLT, as well. Both disorders share some risk factors (greater incidence in women, in areas with adequate supply of iodine and in patients after radiotherapy of the neck) and molecular genetics linkage. For example: RET/PTC rearrangements could be more often found in carcinomas associated with CLT, but this mutation could be found in benign lesions such as CLT, as well. CLT seems to be a positive prognostic factor in patients with differentiated thyroid cancer. It is associated with less invasive forms of tumor, lower occurrence of infiltrated lymphatic nodes and a lower risk of recurrence.

  12. Thyroid storm following radioactive iodine (RAI) therapy for pediatric graves disease.

    Science.gov (United States)

    Rohrs, Henry J; Silverstein, Janet H; Weinstein, David A; Amdur, Robert J; Haller, Michael J

    2014-01-01

    Female, 11 FINAL DIAGNOSIS: Thyroid storm Symptoms: Diarrhea • tachycardia • tachypnea • tremor • wheezing - Clinical Procedure: - Specialty: - Rare disease. A growing number of pediatric endocrinologists treat Graves disease with radioactive iodine (RAI) therapy due to the typically definitive nature of I-131 therapy. Given the published benefits and perceived low risks of RAI when compared to surgery or long-term anti-thyroid medication, the trend towards therapy with RAI is likely to continue. Nevertheless, RAI is not without significant risk. An 11-year-old girl with newly diagnosed Graves disease received RAI for definitive treatment of her hyperthyroidism. Within 24 hours of receiving I-131, she developed increasing sleepiness and eventually became unresponsive. Upon arrival at the emergency department she had a tonic-clonic seizure and was diagnosed with thyroid storm. Despite best efforts to manage her hyperthyroidism, she suffered a stroke of the left cerebral hemisphere that left her with persistent neurological deficits. Although thyroid storm after thyroid ablation is rare, the significant morbidity and potential mortality of pediatric thyroid storm warrant further studies to determine if children with markedly elevated thyroid hormone concentrations at diagnosis should receive prolonged pretreatment with anti-thyroid drugs. While such an approach may reduce the efficacy of I-131 ablation, it can also reduce and hopefully eliminate the risk of post-ablative thyroid storm.

  13. Dual thyroid ectopia

    International Nuclear Information System (INIS)

    Al-Akeely, Mohammed H.

    2003-01-01

    Ectopic thyroid gland is a rare embryological fault of thyroid development .Dual ectopic thyroid is more rare and only 8 cases have been reported in the literature. The author presents a case of dual ectopic thyroid in a 16 year old boy with an anterior red neck mass, which is gradually growing in size particularly in last 2 years. The initial diagnosis was thyroglossal duct cyst. Thyroid function test revealed elevated thyroid-stimulating hormone. Ultrasound of the neck did not show thyroid gland in its normal pre tracheal position. Thyroid scan (Technetium 99)revealed the diagnosis of dual thyroid ectopia(lingual and subhyoid). (author)

  14. [Non-autoimmune thyroiditis].

    Science.gov (United States)

    Rizzo, Leonardo F L; Mana, Daniela L; Bruno, Oscar D

    2014-01-01

    The term thyroiditis comprises a group of thyroid diseases characterized by the presence of inflammation, including autoimmune and non-autoimmune entities. It may manifest as an acute illness with severe thyroid pain (subacute thyroiditis and infectious thyroiditis), and conditions in which the inflammation is not clinically evident evolving without pain and presenting primarily thyroid dysfunction and/or goiter (drug-induced thyroiditis and Riedel thyroiditis). The aim of this review is to provide an updated approach on non-autoimmune thyroiditis and its clinical, diagnostic and therapeutic aspects.

  15. A Model of the Vela Supernova Remnant

    Science.gov (United States)

    Gvaramadze, Vasilii

    2000-10-01

    A model of the Vela supernova remnant (SNR) based on a cavity explosion of a supernova (SN) star is proposed. It is suggested that the general structure of the remnant is determined by the interaction of the SN blast wave with a massive shell created by the SN progenitor (15-20 M_solar) star. A possible origin of the nebula of hard X-ray emission detected around the Vela pulsar is discussed.

  16. Evolution of supernova remnants. III. Thermal waves

    International Nuclear Information System (INIS)

    Chevalier, R.A.

    1975-01-01

    The effect of heat conduction on the evolution of supernova remnants is investigated. A thermal wave, or electron conduction front, can travel more rapidly than a shock wave during the first thousand years of the remnant's evolution. A self-similar solution describing this phase has been found by Barenblatt. Numerical computations verify the solution and give the evolution past the thermal wave phase. While shell formation is not impeded, the interior density and temperature profiles are smoothed by the action of conduction

  17. Silent thyroiditis

    Science.gov (United States)

    ... to the touch Rapid heart rate Shaking hands (tremor) Tests that may be done include: Radioactive iodine uptake Thyroid hormones T3 and T4 TSH Treatment Treatment is based on symptoms. Medicines called beta-blockers may be used to relieve rapid heart rate ...

  18. Thyroid emergencies.

    Science.gov (United States)

    Klubo-Gwiezdzinska, Joanna; Wartofsky, Leonard

    2012-03-01

    This review presents current knowledge about the thyroid emergencies known as myxedema coma and thyrotoxic storm. Understanding the pathogenesis of these conditions, appropriate recognition of the clinical signs and symptoms, and their prompt and accurate diagnosis and treatment are crucial in optimizing survival. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Supernova Remnant in 3-D

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Click on the image for the movie For the first time, a multiwavelength three-dimensional reconstruction of a supernova remnant has been created. This stunning visualization of Cassiopeia A, or Cas A, the result of an explosion approximately 330 years ago, uses data from several telescopes: X-ray data from NASA's Chandra X-ray Observatory, infrared data from NASA's Spitzer Space Telescope and optical data from the National Optical Astronomy Observatory 4-meter telescope at Kitt Peak, Ariz., and the Michigan-Dartmouth-MIT 2.4-meter telescope, also at Kitt Peak. In this visualization, the green region is mostly iron observed in X-rays. The yellow region is a combination of argon and silicon seen in X-rays, optical, and infrared including jets of silicon plus outer debris seen in the optical. The red region is cold debris seen in the infrared. Finally, the blue reveals the outer blast wave, most prominently detected in X-rays. Most of the material shown in this visualization is debris from the explosion that has been heated by a shock moving inwards. The red material interior to the yellow/orange ring has not yet encountered the inward moving shock and so has not yet been heated. These unshocked debris were known to exist because they absorb background radio light, but they were only recently discovered in infrared emission with Spitzer. The blue region is composed of gas surrounding the explosion that was heated when it was struck by the outgoing blast wave, as clearly seen in Chandra images. To create this visualization, scientists took advantage of both a previously known phenomenon the Doppler effect and a new technology that bridges astronomy and medicine. When elements created inside a supernova, such as iron, silicon and argon, are heated they emit light at certain wavelengths. Material moving towards the observer will have shorter wavelengths and material moving away will have longer wavelengths. Since the amount

  20. Management of hyper and hypo thyroid conditions

    Energy Technology Data Exchange (ETDEWEB)

    Locke, W.

    1982-03-01

    In hyperthyroidism, the primary objective of therapy is to reduce secretion of thyroid hormone, which can be accomplished in various ways. The stimulus to hypersecretion can be removed in some causes of hyperthyroidism; in others, hormone synthesis and release can be inhibited by drugs such as thioamides, adrenergic blocking agents, or possibly lithium or glucocorticoids. Radioactive iodine is indicated for primary therapy of uncomplicated hyperthyroidism due to Graves' disease in persons over 30 years of age (myxedema may be a complication) and for treatment of autonomous thyroid adenoma in patients who are not suitable candidates for surgery. Surgical ablation is preferred for some causes of hyperthyroidism but may induce postoperative hypothyroidism. Hypothyroidism due to thyroid failure usually presents few therapeutic difficulties and can be managed simply by long-term hormone replacement. Before hormone replacement is prescribed for secondary or tertiary hypothyroidism, the other pituitary functions should be assessed.

  1. Management of hyper and hypo thyroid conditions

    International Nuclear Information System (INIS)

    Locke, W.

    1982-01-01

    In hyperthyroidism, the primary objective of therapy is to reduce secretion of thyroid hormone, which can be accomplished in various ways. The stimulus to hypersecretion can be removed in some causes of hyperthyroidism; in others, hormone synthesis and release can be inhibited by drugs such as thioamides, adrenergic blocking agents, or possibly lithium or glucocorticoids. Radioactive iodine is indicated for primary therapy of uncomplicated hyperthyroidism due to Graves' disease in persons over 30 years of age (myxedema may be a complication) and for treatment of autonomous thyroid adenoma in patients who are not suitable candidates for surgery. Surgical ablation is preferred for some causes of hyperthyroidism but may induce postoperative hypothyroidism. Hypothyroidism due to thyroid failure usually presents few therapeutic difficulties and can be managed simply by long-term hormone replacement. Before hormone replacement is prescribed for secondary or tertiary hypothyroidism, the other pituitary functions should be assessed

  2. Current status of fine needle aspiration for thyroid nodules.

    Science.gov (United States)

    Ogilvie, Jennifer B; Piatigorsky, Eli J; Clark, Orlo H

    2006-01-01

    considered for therapeutic thyroid lobectomy or radioiodine ablation as indicated without undergoing FNA biopsy.

  3. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... for a thyroid scan is 30 minutes or less. Thyroid Uptake You will be given radioactive iodine ( ... for each thyroid uptake is five minutes or less. top of page What will I experience during ...

  4. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... typically performed on people who have or had thyroid cancer. A physician may perform these imaging tests to: ... such as lumps (nodules) or inflammation determine whether thyroid cancer has spread beyond the thyroid gland evaluate changes ...

  5. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... scan and thyroid uptake provide information about the structure and function of the thyroid. The thyroid is ... computer, create pictures offering details on both the structure and function of organs and tissues in your ...

  6. MINIMALLY INVASIVE OPEN THYROIDECTOMY IN THYROID CANCER WITH COEXISTENT HASHIMOTO THYROIDITIS

    Directory of Open Access Journals (Sweden)

    Rumen Nenkov

    2013-06-01

    Full Text Available One of the minimally invasive thyroidectomy challenges is the application of this technique in the surgical treatment of thyroid cancer. The use of minimally invasive open approach in co-existence of thyroid cancer with Hashimoto thyroiditis is well known provocation to the skills of the surgeon working in the field of thyroid surgery.Aim: To report our results and to present the possibilities of minimally invasive open approach in the surgical treatment of thyroid carcinoma and coexistent Hashimoto thyroiditis. Patients and methods: For the period from 2008 to 2011, 641 patients were operated on in our clinic using minimally invasive open approach. In 32 of these patients presence of Hashimoto thyroiditis was found in combination with thyroid cancer. All patients were females, 26 to 46 years age. Patients were selected according to designed and accepted for our institution criteria. The procedures were performed using ultrasound (harmonic shears (Harmonic Focus® and Harmonic Ace®, Ethicon Endo-Surgery. The operative time, incidence, type and severity of complications, length of hospital stay, safety and reliability of the surgical procedure were analyzed. Results: The operative incision length in all cases was between 2.0-2.5 cm. In 27 patients papillary thyroid carcinoma and in 5 patients – follicular variant of the neoplasm were found. The tumor size ranged between 0.5 and 1.5 cm. In all patients total thyroidectomy using harmonic scalpel was performed. Lymph node metastases in the central neck compartment were not found in any of the cases. The rate, type and severity of complications did not exceed those for patients who underwent conventional thyroidectomy. All patients leaved the hospital in the first 24 postoperative hours. The follow-up did not reveal remnant thyroid tissue in thyroid gland bed or recurrence of the disease.Conclusions: Our results demonstrate the feasibility and reliability of minimally invasive open approach with

  7. Management of thyroid carcinoma with radioactive 131I

    International Nuclear Information System (INIS)

    Paryani, Shyam B.; Chobe, Rashmi J.; Scott, Walter; Wells, John; Johnson, Douglas; Kuruvilla, Anand; Schoeppel, Sonja; Deshmukh, Abhijit; Miller, Robert; Dajani, Lorraine; Montgomery, Charles Ted; Puestow, Eric; Purcell, John; Roura, Miguel; Sutton, David; Mallett, Ruth; Peer, Jan

    1996-01-01

    Purpose: To evaluate the role of radioactive 131 I in the management of patients with well differentiated carcinoma of the thyroid. Methods and Materials: Between 1965 and 1995, a total of 117 patients with well-differentiated carcinoma of the thyroid underwent either lobectomy or thyroidectomy followed by 100-150 mCi of 131 I. Results: With a median follow-up of 8 years, only four patients (3%) developed a recurrence of their disease. The 5-year actuarial survival was 97% with a 10-year survival of 91%. There were no severe side effects noted after 131 I therapy. Conclusions: Radioactive 131 I is a safe and effective procedure for the majority of patients with well-differentiated thyroid carcinoma. We currently recommend that all patients undergo a subtotal or total thyroidectomy followed by 131 I thyroid scanning approximately 4 weeks after surgery. If the thyroid scan shows no residual uptake and all disease is confined to the thyroid, we recommend following patients with annual thyroid scans and serum thyroglobulin levels. If there is any residual uptake detected in the neck or if the tumor extends beyond the thyroid, we recommend routine thyroid ablation of 100-150 mCi of radioactive 131 I

  8. A review on thyroid cancer during pregnancy: Multitasking is required

    Directory of Open Access Journals (Sweden)

    Hussein Khaled

    2016-07-01

    Full Text Available Thyroid cancer is the second most common cancer diagnosed during pregnancy after breast cancer. The goal of management is to control malignancy and prevent maternal and fetal complications as a result of maternal hypothyroidism. The role of female sex hormones as an etiologic factor was investigated, with no clear association. Pregnancy can cause an increase in size of a previously existed thyroid nodule through the structural similarity between TSH and BHCG, and the normally expressed estrogen receptors on thyroid gland cells. Effect of pregnancy on development and prognosis of differentiated thyroid malignancies (papillary and follicular has also been studied. The prognosis of thyroid cancer is not worse in patients diagnosed during pregnancy or those who got pregnant after curative treatment. Termination of pregnancy is not indicated at all, surgery can be delayed till after delivery except in rapidly growing aggressive tumors. While radioactive iodine ablation is absolutely contra-indicated, the new systemic therapies are not well studied during pregnancy. However, almost all these new agents are classified as FDA category C or D and are better to be avoided. The effect of pregnancy on other types of thyroid cancer (medullary and anaplastic thyroid tumors is not well studied because of very low incidence with pregnancy. The endocrinological management of thyroid cancer during pregnancy is of utmost importance. The hypothyroidism after total thyroidectomy can cause fetal hypothyroidism. Therefore, the management of thyroid cancer related to pregnancy needs a multidisciplinary team.

  9. Modelling the interaction of thermonuclear supernova remnants with circumstellar structures: the case of Tycho's supernova remnant

    NARCIS (Netherlands)

    Chiotellis, A.; Kosenko, D.; Schure, K.M.; Vink, J.; Kaastra, J.S.

    2013-01-01

    The well-established Type Ia remnant of Tycho's supernova (SN 1572) reveals discrepant ambient medium-density estimates based on either the measured dynamics or the X-ray emission properties. This discrepancy can potentially be solved by assuming that the supernova remnant (SNR) shock initially

  10. Thyroid carcinoma

    International Nuclear Information System (INIS)

    Lambertini, Roberto; Dalurzo, Liliana; Jaen, Ana del V.

    2008-01-01

    In this document the case of a 66-year old woman is presented, with record of multi nodular goiter of 5 year of evolution, which is derived to scan ultrasound office to make a puncture-aspiration with thin needle because of the growth of nodular thyroid injuries. The ultrasound scan examination made before the puncture determine multiple dominant nodules of hyperplasia aspect between 15 and 25 mm of diameter and a small nodule of 6 mm suspected proliferate process. Despite its size, it was decided to include small nodule in injuries to a biopsy. The cytological study reveals nodular hyperplasia with carcinoma in the small nodule of 6 mm. A thyroidectomy is practiced on the patient. The deferred histological study of the thyroid gland confirms the finding of multi-nodular goiter with a small focus of papillar carcinoma. The ganglions examined were negative in the deferred examination [es

  11. Thyroid gland removal

    Science.gov (United States)

    ... thyroidectomy; Thyroidectomy; Subtotal thyroidectomy; Thyroid cancer - thyroidectomy; Papillary cancer - thyroidectomy; Goiter - thyroidectomy; Thyroid nodules - ... Kaplan EL, Angelos P, James BC, Nagar S, Grogan RH. Surgery ...

  12. Detection of metastatic thyroid carcinoma through whole body counting

    International Nuclear Information System (INIS)

    Novenario, H.S.; Pascacio, F.M.; Cruz, Benjamin de la; Anden, A.B.

    Whole body counters are not only used in measuring radioactivity in the body for radiation protection purposes but also in the measurement of iron absorption, body potassium and cesium, chronic blood loss, and also in the determination of the effectiveness of surgery, thyroid hormone and radioactive iodine therapy in thyroid carcinoma. This report deals with our experience in the use of a shadow-shield whole body counter in the determination of I-131 uptake by metastatic lesions of cancer of thyroid after total thyroidectomy and ablation therapy with I-131. This study was undertaken jointly by the Department of Nuclear Medicine, Veterans Memorial Hospital and the Biomedical Research Division of the Philippine Atomic Energy Commission. Preliminary results indicate that the 22 patients who underwent whole body counting after total thyroidectomy I-131 ablation therapy, 9 patients had elevated percentage retention of I-131, 10 patients with normal values and 3 patients with rising values. Foci of I-131 concentration in those with elevated and rising percentage concentration values were seen in the thyroidal bed scintiscans, while the 10 patients with normal values had negative scintiscans. The results of our observations confirm the results obtained by other workers abroad. Our preliminary results indicate that with the use of whole body counters a sensitive method of assessing whether functioning metastatic lesion of cancer of the thyroid still exist after total thyroidectomy and I-131 ablation therapy can be provided. (author)

  13. Thyroid diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Scriba, P C; Boerner, W; Emrich, S; Gutekunst, R; Herrmann, J; Horn, K; Klett, M; Krueskemper, H L; Pfannenstiel, P; Pickardt, C R

    1985-03-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted.

  14. Thyroid diagnostics

    International Nuclear Information System (INIS)

    Scriba, P.C.; Boerner, W.; Emrich, S.; Gutekunst, R.; Herrmann, J.; Horn, K.; Klett, M.; Krueskemper, H.L.; Pfannenstiel, P.; Pickardt, C.R.; Reiners, C.; Reinwein, D.; Schleusener, H.

    1985-01-01

    None of the in-vitro and in-vivo methods listed permits on unambiguous diagnosis when applied alone, owing to the fact that similar or even identical findings are obtained for various individual parameters in different thyroid diseases. Further, especially the in-vitro tests are also subject to extrathyroidal effects which may mask the typical findings. The limited and varying specificity and sensitivity of the tests applied, as well as the falsification of results caused by the patients' idiosyncracies and the methodology, make it necessary to interpret and evaluate the in-vivo and in-vitro findings only if the clinical situation (anamnesis and physical examination) is known. For maximum diagnostic quality of the tests, the initial probability of the assumed type of thyroid disease must be increased (formulation of the clinical problem). The concepts of exclusion diagnosis and identification must be distinguished as well as the diagnosis of functional disturbances on the one hand and of thyroid diseases on the other. Both of this requires a qualified, specific and detailed anamnesis and examination procedure, and the clinical examination remains the obligatory basis of clinical diagnostics. In case of inexplicable discrepancies between the clinical manifestations and the findings obtained with specific methods, or between the findings obtained with a specific method, the patient should be referred to an expert institution, or the expert institution should be consulted. (orig./MG) [de

  15. 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.

  16. Black Thyroid Associated with Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Emad Kandil

    2010-01-01

    Full Text Available Objective. Black thyroid is a rare pigmented change seen almost exclusively in patients upon minocycline ingestion, and the process has previously been thought to be generally benign. There have been 61 reported cases of black thyroid. We are aware of 13 cases previously reported in association with thyroid carcinoma. This paper reports six patients with black thyroid pigmentation in association with thyroid carcinoma. Design. The medical records of six patients who were diagnosed with black thyroid syndrome, all of whom underwent thyroid surgery, were reviewed. Data on age, gender, race, preoperative fine needle aspiration biopsy (FNA, thyroid function levels, and pathology reports were collected. Main Outcome. The mean age was 60 years. There were 5 females, 4 of whom were African American. All patients were clinically and biochemically euthyroid. Black pigmentation was not diagnosed in preoperative FNA, and only one patient had a preoperative diagnosis of papillary thyroid carcinoma. The other patients underwent surgery and were found to have black pigmentation of the thyroid associated with carcinoma. Conclusions. FNA does not diagnose black thyroid, which is associated with thyroid carcinoma. Thyroid glands with black pigmentation deserve thorough pathologic examination, including several sections of each specimen.

  17. Association of Papillary Thyroid Carcinoma and Graves' Disease. Unexpected Development and Efficiency of Ablative Dose with Recombinant Human Thyrotropin (rhTSH); Asociación de carcinoma papilar de tiroides y enfermedad de Graves. Inesperada evolución y eficacia de la dosis ablativa con tirotrofina recombinante humana (rhTSH)

    Energy Technology Data Exchange (ETDEWEB)

    Pacenza, N. A.; Groppo, N. [Centro Médico “Enrique Tortosa”, Consultorio de Endocrinología, Buenos Aires (Argentina); Guibourg, H. C. [Sigma Imágenes Médicas S.A., Servicio de Medicina Nuclear, Buenos Aires (Argentina)

    2013-07-01

    with {sup 99m}Tc pertechnetate: {sup P}athological uptake in middle and lower cervical region right and left lower neck. He was reoperated on 4 months after his initial S: {sup R}esection of epithelial proliferation with thyroid aspect in superior mediastinum region{sup .} Pathology: {sup N}ode with extensive infiltration of neoplastic proliferation of follicular variant of papillary carcinoma with areas of connective tissue infiltrated periganglionar of papillary thyroid cancer{sup .} Lab 40 days after the second surgery: TSH 2.3 μIU/mL, FT4 0.82 ng/dL, Tg 4.7 ng/mL. Neck and chest CT showed neither pathological lesions nor lymphadenopathy. I{sup 131} uptake with 7.4 MBq was: 1st hour: 8 % and 24 hours: 12 %. Neck Scan: {sup M}ultiple areas of tracer fixation in the neck{sup .} No pathological signs on neck palpation. Ablative dose of 7.4 GBq of I{sup 131} was performed to the patient, previously using rhTSH (two doses of 0.9 mg), reaching TSH >100 μIU/mL. Scan post ablative dose: {sup I}mportant focus on right paratracheal region. Neck MRI showed: Absence of thyroid gland. Rounded image of about 10 mm at right paratracheal level. The patient initiates suppressive therapy with levothyroxine (LT4). Six months after ablation therapy (without LT4): TSH >100 μIU/mL, Tg: 13.8 ng/mL, TGA: 431 IU/mL. Body Scan with 2 mCi: {sup P}athological focus of radioiodine behind the right sternoclavicular joint. New neck MRI: Image in right pretracheal region smaller than the previous study{sup .} The patient received 5.55 GBq of I{sup 131}. The same radioiodine treatment was repeated 8 months later. At present, 4 years after the patient's initial surgery, he is in good general health, performing his normal activities, with TGA in sharp decline, negative I{sup 131}body scan and without signs of persistent or recurrent disease. Conclusions: We report a case of follicular variant papillary TC associated with GD with concomitant development of hyperthyroidism, with positive TGA, in a

  18. Autopsy of the Supernova Remnant Cassiopeia A

    Science.gov (United States)

    Milisavljevic, Dan; Fesen, Robert A.

    2014-01-01

    Three-dimensional kinematic reconstructions of optically emitting ejecta in the young Galactic supernova remnant Cassiopeia A (Cas A) are discussed. The reconstructions encompass the remnant's faint outlying ejecta knots, including the exceptionally high-velocity NE and SW streams of debris often referred to as `jets'. The bulk of Cas A's ejecta are arranged in several circular rings with diameters between approximately 30'' (0.5 pc) and 2' (2 pc). We suggest that similar large-scale ejecta rings may be a common phenomenon of young core-collapse remnants and may explain lumpy emission line profile substructure sometimes observed in spectra of extragalactic core-collapse supernovae years after explosion. A likely origin for these large ejecta rings is post-explosion input of energy from plumes of radioactive 56Ni-rich ejecta that rise, expand, and compress non-radioactive material to form bubble-like structures.

  19. Favourable course of disease after incomplete remission on {sup 131}I therapy in children with pulmonary metastases of papillary thyroid carcinoma: 10 years follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Biko, Johannes; Reiners, Christoph; Kreissl, Michael C.; Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Demidchik, Yuri [Thyroid Cancer Centre, Minsk (Belarus); Drozd, Valentina [International Belarussian-German Foundation, Minsk (Belarus)

    2011-04-15

    The aim of this study is to report on a collective of 20 children from Belarus who had developed papillary thyroid carcinoma with pulmonary metastases after the Chernobyl disaster. In all children fractionated radioiodine therapy (RIT) was ceased before achieving complete remission due to a lack of further effects of {sup 131}I therapy and an increased risk of pulmonary fibrosis. The 20 children (12 girls) were treated with {sup 131}I using 50 MBq/kg body weight for thyroid remnant ablation and 100 MBq/kg for further therapy in intervals of 5-12 months. After five to six courses and a cumulative activity of about 24 GBq {sup 131}I no further RIT was conducted; the median thyroglobulin (TG) was 56 {mu}g/l at this time. All patients were followed for at least 10 years after cessation of RIT using diagnostic whole-body scintigraphy, CT of the chest, lung function testing and stimulated TG measurements every 1-3 years. During follow-up after the last RIT a continuous decline of values for TG levels of {proportional_to}35% per year was observed between individual visits. The median Tg level at the time of cessation of {sup 131}I therapy was 56 {mu}g/l; however, at the last visit 16 of 20 patients had a TG level {<=}10 {mu}g/l (median 2.4 {mu}g/l). Neither on diagnostic radioiodine whole-body scan nor on CT was progression of lung metastases observed. No significant pulmonary fibrosis developed. In spite of incomplete remission of thyroid cancer at cessation of RIT, a continuing spontaneous decline of TG and clinically stable partial remissions were observed in this collective of children. Therefore, if RIT does not show further effects, the administration of further courses should be handled restrictively. (orig.)

  20. Simultaneous Papillary Carcinoma in Thyroglossal Duct Cyst and Thyroid

    Directory of Open Access Journals (Sweden)

    Gustavo Cancela e Penna

    2017-01-01

    Full Text Available Thyroglossal duct cyst (TDC is a cystic expansion of a remnant of the thyroglossal duct tract. Carcinomas in the TDC are extremely rare and are usually an incidental finding after the Sistrunk procedure. In this report, an unusual case of a 36-year-old woman with concurrent papillary thyroid carcinoma arising in the TDC and on the thyroid gland is presented, followed by a discussion of the controversies surrounding the possible origins of a papillary carcinoma in the TDC, as well as the current management options.

  1. Simultaneous branchial cleft and thyroid disorders may present a management challenge.

    Science.gov (United States)

    Harding, Jane L; Veivers, David; Sidhu, Stan B; Sywak, Mark S; Shun, Albert; Delbridge, Leigh W

    2005-09-01

    Cysts, sinuses or abscesses arising from second, third or fourth branchial cleft remnants may lie either within the body of, or in close proximity to the thyroid gland. Given their infrequent nature they may pose both diagnostic and management challenges for the treating surgeon when they occur in association with thyroid disorders. This is a case series. All patients with concomitant thyroid disorders and a branchial cleft anomaly treated in the University of Sydney Endocrine Surgical Unit in the 10-year period 1994-2003 comprised the study group. Patient demographics, clinical presentation, imaging, surgical management, definitive histology and outcomes were documented. Six patients were identified with an age range of 3-76 years and a male : female ratio of 1:5. Five branchial cleft anomalies were left sided, one was right sided. Two patients had second cleft anomalies, both of which were initially thought to represent metastatic lymph nodes in association with thyroid cancer. A further two patients had third cleft abnormalities presenting as suppurative thyroiditis. The final two patients had fourth cleft abnormalities causing intraoperative management problems. Branchial cleft remnants and anomalies are rare but may occur in association with thyroid disease. They may pose a diagnostic and management dilemma either preoperatively, when mistaken for metastatic thyroid cancer, or intraoperatively when mistaken for a thyroid nodule.

  2. Cosmic Ray Acceleration in Supernova Remnants

    International Nuclear Information System (INIS)

    O'C Drury, Luke

    2005-01-01

    This paper describes some recent developments in our understanding of cosmic ray acceleration in supernova remnant shocks. It is pointed out that while good agreement now exists as to steady nonlinear modifications to the shock structure, there is also growing evidence that the mesoscopic scales may not in fact be steady and that significant instabilities associated with magnetic field amplification may be a feature of strong collisionless plasma shocks. There is strong observational evidence for such magnetic field amplification, and it appears to solve a number of long-standing issues concerned with acceleration of cosmic rays in supernova remnants

  3. X-ray haloes around supernova remnants

    International Nuclear Information System (INIS)

    Morfill, G.E.; Aschenbach, B.

    1984-01-01

    Recent observations of the Cas-A supernova remnant have shown X-ray emissions not only from the interior, but also from a fainter 'halo' extending beyond what is normally regarded as the outer boundary, or shock front. The authors suggest that this may be due to the diffusion of energetic, charged particles out of the remnant giving rise to precursor structure of the type predicted by the theory of diffusive shock acceleration. If this is the case we are seeing thermal emission from ambient gas heated by compression and wave dissipation. (author)

  4. X-ray haloes around supernova remnants

    Energy Technology Data Exchange (ETDEWEB)

    Morfill, G.E.; Aschenbach, B. (Max-Planck-Institut fuer Physik und Astrophysik, Garching (Germany, F.R.). Inst. fuer Extraterrestrische Physik); Drury, L.O' C. (Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany, F.R.))

    1984-09-27

    Recent observations of the Cas-A supernova remnant have shown X-ray emissions not only from the interior, but also from a fainter 'halo' extending beyond what is normally regarded as the outer boundary, or shock front. The authors suggest that this may be due to the diffusion of energetic charged particles out of the remnant giving rise to precursor structure of the type predicted by the theory of diffusive shock acceleration. If this is the case we are seeing thermal emission from ambient gas heated by compression and wave dissipation.

  5. Pulmonary ablation: a primer.

    Science.gov (United States)

    Roberton, Benjamin J; Liu, David; Power, Mark; Wan, John M C; Stuart, Sam; Klass, Darren; Yee, John

    2014-05-01

    Percutaneous image-guided thermal ablation is safe and efficacious in achieving local control and improving outcome in the treatment of both early stage non-small-cell lung cancer and pulmonary metastatic disease, in which surgical treatment is precluded by comorbidity, poor cardiorespiratory reserve, or unfavorable disease distribution. Radiofrequency ablation is the most established technology, but new thermal ablation technologies such as microwave ablation and cryoablation may offer some advantages. The use of advanced techniques, such as induced pneumothorax and the popsicle stick technique, or combining thermal ablation with radiotherapy, widens the treatment options available to the multidisciplinary team. The intent of this article is to provide the reader with a practical knowledge base of pulmonary ablation by concentrating on indications, techniques, and follow-up. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  6. Thyroid disease: thyroid function tests and interpretation

    African Journals Online (AJOL)

    Diseases of the thyroid are among the most prevalent of medical conditions, especially in women, but the symptoms can be relatively nonspecific or mild. For this reason, clinicians have been placing increased reliance on the laboratory for assistance in the diagnosis of thyroid disorders. In the 1950s, only one thyroid.

  7. Recurrent Silent Thyroiditis as a Sequela of Postpartum Thyroiditis

    Science.gov (United States)

    Kim, Paul

    2014-01-01

    Thyroiditis encompasses a group of disorders characterized by thyroid inflammation. Though clinically indistinguishable from silent thyroiditis, postpartum thyroiditis occurs in women within 12 months after delivery. Recurrent postpartum thyroiditis in subsequent pregnancies is common, but recurrent silent thyroiditis is rare. We reported a case of patient with recurrent episodes of thyroiditis, unrelated to pregnancy, after an episode of postpartum thyroiditis. It is of interest that postpartum thyroiditis and silent thyroiditis could occur closely to each other; however, the link between these disorders is not well established. This report is to remind physicians of the possibility of recurrent silent thyroiditis in women with a history of postpartum thyroiditis. PMID:24987536

  8. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... information. The thyroid scan and thyroid uptake provide information about the structure and function of the thyroid. The thyroid is a gland in the neck that controls metabolism , a chemical process that regulates the rate at which the body ...

  9. Thyroid and Weight

    Science.gov (United States)

    ... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroid and Weight Resources Thyroid and Weight Brochure PDF En Español La Tiroides y el Peso El folleto de La Tiroides y el ...

  10. Laser ablation principles and applications

    CERN Document Server

    1994-01-01

    Laser Ablation provides a broad picture of the current understanding of laser ablation and its many applications, from the views of key contributors to the field. Discussed are in detail the electronic processes in laser ablation of semiconductors and insulators, the post-ionization of laser-desorbed biomolecules, Fourier-transform mass spectroscopy, the interaction of laser radiation with organic polymers, laser ablation and optical surface damage, laser desorption/ablation with laser detection, and laser ablation of superconducting thin films.

  11. [Thyroid emergencies : Thyroid storm and myxedema coma].

    Science.gov (United States)

    Spitzweg, C; Reincke, M; Gärtner, R

    2017-10-01

    Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction. The diagnosis is made based on clinical criteria only as thyroid hormone measurements do not differentiate between thyroid storm and uncomplicated hyperthyroidism. In addition to critical care measures therapy focusses on inhibition of thyroid hormone synthesis and secretion (antithyroid drugs, perchlorate, Lugol's solution, cholestyramine, thyroidectomy) as well as inhibition of thyroid hormone effects in the periphery (β-blocker, glucocorticoids).Cardinal symptoms of myxedema coma are hypothermia, decreased mental status, and hypoventilation with risk of pneumonia and hyponatremia. The diagnosis is also purely based on clinical criteria as measurements of thyroid hormone levels do not differ between uncomplicated severe hypothyroidism and myxedema coma. In addition to substitution of thyroid hormones and glucocorticoids, therapy focusses on critical care measures to treat hypoventilation and hypercapnia, correction of hyponatremia and hypothermia.Survival of both thyroid emergencies can only be optimized by early diagnosis based on clinical criteria and prompt initiation of multimodal therapy including supportive measures and treatment of the precipitating event.

  12. Thyroiditis: an integrated approach.

    Science.gov (United States)

    Sweeney, Lori B; Stewart, Christopher; Gaitonde, David Y

    2014-09-15

    Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.

  13. Primary thyroid lymphoma: a rare thyroid malignancy

    International Nuclear Information System (INIS)

    Mukhtar, R.; Khattak, R.; Mateen, A.

    2011-01-01

    Incidence of thyroidal masses is very high with predominance in females. Most of these masses are benign. Malignancy can be of thyroid or non-thyroid origin. Surgery is treatment of choice in the former but not in latter. Primary thyroid lymphoma (PTL) is a rare cause of thyroid malignancy of non-thyroid origin which is highly treatable without surgery but early diagnosis is important requisite to have better outcome. Fine needle aspiration cytology (FNAC) is an important tool in early diagnosis of PTL, which enables doctors to treat patient better without major surgery and its morbidity. Two cases of primary thyroid lymphoma are hereby presented. The patient diagnosed on FNAC had better outcome than the one who had major surgery. (author)

  14. Synchronous Parathyroid and Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Shi-Dou Lin

    2005-02-01

    Full Text Available Concomitant thyroid disease is not unusual among patients with primary hyperparathyroidism. However, the simultaneous occurrence of parathyroid and thyroid carcinoma is extremely rare. We report a 38-year-old man with primary hyperparathyroidism who presented with osteitis fibrosa cystica complicated with pathologic femoral neck fracture. Preoperative investigation for exclusion of multiple endocrine neoplasia did not find evidence of medullary thyroid carcinoma or pheochromocytoma, but imaging studies revealed the presence of nodules in the right lobe and a parathyroid lesion over the left inferior pole of the thyroid gland. Total thyroidectomy, left parathyroidectomy, and bipolar hemiarthroplasty of the left hip were then performed simultaneously. The resected specimens were pathologically identified as papillary thyroid carcinoma and parathyroid carcinoma, respectively. After the operation, 131I ablation therapy was administered at a dose of 120 mCi. Additional doses of 30 mCi were given yearly as serum thyroglobulin level became elevated. Serum calcium level remained normal during yearly follow-up. Although parathyroid carcinoma is an uncommon cause of parathyroid hormone-dependent hypercalcemia, it should nonetheless be given due consideration because its surgical approach differs from that of parathyroid adenoma. As the coexistence of parathyroid and non-medullary thyroid carcinoma has previously been reported, the possibility of both malignancies must also be considered in the setting of primary hyperparathyroidism with thyroid nodules. If confirmed with preoperative parathyroid scintigraphic and other laboratory studies, an optimal outcome may be achieved with complete resection of both tumors at the time of initial operation, followed by adjunctive therapy.

  15. The effect of radioactive iodine treatment in well differentiated thyroid carcinoma with lymphnode metastasis

    International Nuclear Information System (INIS)

    Liou, M. J.; Lin, J. D.; Chao, T. C.; Wen, H. F.; Ho, Y. S.

    1994-01-01

    Background: To exam the effect of radioactive iodine treatment for thyroid remnant ablation and/or distant metastasis. A total of 134 well-differentiated thyroid cancer patients with cervical lymphnode metastasis at the time of diagnosis were retrospectively reviewed at Chang Gung Medical Center in Taiwan from 1977 to 1995. Methods: Among them, 126 cases were papillary carcinomas and 8 cases were follicular carcinomas. The mean age was 37.0 ± 14.6 years old. After the operation, 127 (95 %) patients received 131 I treatment (mean dose: 146.6 ± 109.5 mCi, range 30 - 550 mCi) and long-term follow-up. The mean follow-up period is 5.9 ± 3.9 yrs. All patients were restage at the end of 1995. Clinical biochemical results were also analyzed. Results: Among 127 cases who received postoperative radioactive iodine treatment, the majority of cases (92.5 % in papillary ca. vs. 57.1 % in follicular ca.) improved to stage I, 11 (8.6 %) cases remained on the same disease and stages. 13 cases (10.2 %, 10 papillary and 3 follicular) deteriorated to stage III or IV. However, in the non-treatment group, only 33.3 % of papillary carcinoma patients improved to stage I and 16.7 % of the patients remained as stage II. There were 5 cases (3.7 %) of mortality. Two cases with stage IV papillary carcinomas died of metastatic or recurrent malignancy, and the other 2 cases with stage I or III papillary carcinomas died of tracheal cancer or valvular heart disease. One patient with stage IV follicular carcinoma died of cerebral vascular accident. Conclusions: Radioactive iodine ( 131 I) treatment plays a significant role in the management of well-differentiated thyroid carcinoma patients with cervical lymphnode metastasis. The effect of postoperative 131 I treatment on papillary carcinoma was better than that on follicular carcinoma. The optimal dosage and frequency of radioactive iodine treatment warrant further study. (author)

  16. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme

    Energy Technology Data Exchange (ETDEWEB)

    Gamper, Eva-Maria [Medical University Innsbruck, Department for Nuclear Medicine, Innsbruck (Austria); Medical University Innsbruck, Department for Psychiatry and Psychotherapy, Innsbruck (Austria); Wintner, Lisa M.; Holzner, Bernhard [Medical University Innsbruck, Department for Psychiatry and Psychotherapy, Innsbruck (Austria); Rodrigues, Margarida; Buxbaum, Sabine; Nilica, Bernhard; Virgolini, Irene [Medical University Innsbruck, Department for Nuclear Medicine, Innsbruck (Austria); Singer, Susanne [University of Mainz, Institute of Medical Biostatistics, Epidemiology, and Informatics, Mainz (Germany); Giesinger, Johannes M. [Netherlands Cancer Institute, Amsterdam (Netherlands)

    2015-07-15

    Health-related quality of life (HRQOL) in differentiated thyroid cancer (DTC) research has so far received little attention and available results are conflicting. We studied the HRQOL of radioiodine-naive DTC patients in comparison with the general population (GP), investigated the course of HRQOL up to 30 months after radioiodine remnant ablation (RAA) and sought to identify patient characteristics associated with HRQOL. We analysed data from routine HRQOL monitoring at a nuclear medicine department. Between 2005 and 2013, a total of 439 thyroid cancer patients (all histologies) completed the EORTC Quality of Life Questionnaire Core-30 (QLQ-C30) at least once during their treatment at the department. We compared patients' baseline HRQOL scores before RAA with scores from age-matched and sex-matched controls from the Austrian GP. We then determined the course of HRQOL over the 30 months after RAA and assessed the impact of the following clinical variables on HRQOL: method of thyroid-stimulating hormone (TSH) stimulation, histology (papillary vs. follicular) and disease stage. A total of 284 patients (mean age 48.3 years, SD 15.0 years; 71.6 % women; 80.7 % papillary type) with a baseline HRQOL assessment before RAA were available. We found clinically meaningful differences in the detriment in patients on almost all domains. These were largest for fatigue (23 points) and role functioning (25 points). Data from 241 patients (mean age 48.6 years, SD 15.9 years; 68.9 % women; 76.3 % papillary type) were included in the longitudinal analysis. Investigating the course of HRQOL, a significant improvement over time was found for role and emotional functioning, fatigue, pain, and dyspnoea. A range of HRQOL scores were improved in patients with exogenous TSH stimulation, but some scores both in patients with exogenous TSH stimulation and in those followed for 30 months, especially fatigue and role functioning, did not reach levels in the GP sample. Our results show that

  17. Parathyroid changes after high dose radioactive iodine in patients with thyroid cancer

    International Nuclear Information System (INIS)

    Guven, A.; Salman, S.; Boztepe, H.; Yarman, S.; Tanakol, R.; Azizlerli, H.; Alagol, F.

    2009-01-01

    The study aimed to investigate the effect of high dose radioactive iodine (RAI) on parathyroid function in patients with differentiated thyroid cancer. Nineteen patients (8 men/11 women, age 46.5±13.2 years) undergoing RAI for thyroid remnant ablation were enrolled in the study. The biochemical parameters related to parathyroid function [serum calcium (Ca), phosphate (P), creatinine (Cr), alkaline phosphatase (ALP), intact parathyroid hormone (iPTH), urinary Ca, cAMP concentrations and the maximum tubular capacity for phosphate per unit volume of glomerular filtrate (TmP/GFR)] were evaluated at baseline and at the 1st, 3rd, 6th and 12th months of RAI administration. SPSS 15.0 was used for statistical analysis. For all patients, thyroid-stimulating hormone levels were >30 U/ml at baseline and <0.1 U/ml at the following visits. Serum iPTH levels were decreased significantly at the 6th month and reached basal levels at the 12th month (baseline vs. 6th p=0.027, 1st vs. 6th p=0.011, 3rd vs. 6th p=0.047, 3rd vs. 12th p=0.014, 6th vs. 12th p=0.001). At the 6th month, P and TmP/GFR levels were higher (p=0.036, 0.017, respectively), and urinary cAMP measurements were lower (p=0.020) compared to those of the 1st month. No difference was detected concerning the other parameters. Serum Ca levels decreased below 2.1 mmol/l in several patients (n=5 at 1st month, n=4 at 3rd month, n=8 at 6th month and n=3 at 12th month) without clinical symptoms. The study indicated a transient decline in PTH levels at the 6th month following RAI therapy. Although this decrease did not cause symptoms in any of the present cases, this pattern might be important especially in individuals with diminished parathyroid background. (author)

  18. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme

    International Nuclear Information System (INIS)

    Gamper, Eva-Maria; Wintner, Lisa M.; Holzner, Bernhard; Rodrigues, Margarida; Buxbaum, Sabine; Nilica, Bernhard; Virgolini, Irene; Singer, Susanne; Giesinger, Johannes M.

    2015-01-01

    Health-related quality of life (HRQOL) in differentiated thyroid cancer (DTC) research has so far received little attention and available results are conflicting. We studied the HRQOL of radioiodine-naive DTC patients in comparison with the general population (GP), investigated the course of HRQOL up to 30 months after radioiodine remnant ablation (RAA) and sought to identify patient characteristics associated with HRQOL. We analysed data from routine HRQOL monitoring at a nuclear medicine department. Between 2005 and 2013, a total of 439 thyroid cancer patients (all histologies) completed the EORTC Quality of Life Questionnaire Core-30 (QLQ-C30) at least once during their treatment at the department. We compared patients' baseline HRQOL scores before RAA with scores from age-matched and sex-matched controls from the Austrian GP. We then determined the course of HRQOL over the 30 months after RAA and assessed the impact of the following clinical variables on HRQOL: method of thyroid-stimulating hormone (TSH) stimulation, histology (papillary vs. follicular) and disease stage. A total of 284 patients (mean age 48.3 years, SD 15.0 years; 71.6 % women; 80.7 % papillary type) with a baseline HRQOL assessment before RAA were available. We found clinically meaningful differences in the detriment in patients on almost all domains. These were largest for fatigue (23 points) and role functioning (25 points). Data from 241 patients (mean age 48.6 years, SD 15.9 years; 68.9 % women; 76.3 % papillary type) were included in the longitudinal analysis. Investigating the course of HRQOL, a significant improvement over time was found for role and emotional functioning, fatigue, pain, and dyspnoea. A range of HRQOL scores were improved in patients with exogenous TSH stimulation, but some scores both in patients with exogenous TSH stimulation and in those followed for 30 months, especially fatigue and role functioning, did not reach levels in the GP sample. Our results show that

  19. Particle acceleration and nonthermal radiation in supernova remnants

    International Nuclear Information System (INIS)

    Zirakashvili, Vladimir

    2013-01-01

    Cosmic ray acceleration and magnetic amplification in shell-type supernova remnants is shortly reviewed. The results on the modeling of broadband electromagnetic emission from supernova remnants are presented and compared with observations.

  20. GALACTIC AND EXTRAGALACTIC SUPERNOVA REMNANTS AS SITES OF PARTICLE ACCELERATION

    Directory of Open Access Journals (Sweden)

    Manami Sasaki

    2013-12-01

    Full Text Available Supernova remnants, owing to their strong shock waves, are likely sources of Galactic cosmic rays. Studies of supernova remnants in X-rays and gamma rays provide us with new insights into the acceleration of particles to high energies. This paper reviews the basic physics of supernova remnant shocks and associated particle acceleration and radiation processes. In addition, the study of supernova remnant populations in nearby galaxies and the implications for Galactic cosmic ray distribution are discussed.

  1. Recurrent Silent Thyroiditis as a Sequela of Postpartum Thyroiditis

    OpenAIRE

    Hanseree, Preaw; Salvador, Vincent Bryan; Sachmechi, Issac; Kim, Paul

    2014-01-01

    Thyroiditis encompasses a group of disorders characterized by thyroid inflammation. Though clinically indistinguishable from silent thyroiditis, postpartum thyroiditis occurs in women within 12 months after delivery. Recurrent postpartum thyroiditis in subsequent pregnancies is common, but recurrent silent thyroiditis is rare. We reported a case of patient with recurrent episodes of thyroiditis, unrelated to pregnancy, after an episode of postpartum thyroiditis. It is of interest that postpar...

  2. Treatment of thyroid follicular carcinoma.

    Science.gov (United States)

    Ríos, Antonio; Rodríguez, José M; Parrilla, Pascual

    2015-12-01

    Differentiated thyroid carcinoma includes 2 different tumor types, papillary (PC) and follicular carcinoma (FC), and although similar, their prognosis is different. FC is uncommon, and this has led to it often being analyzed together with PC, and therefore the true reality of this tumor is difficult to know. As a result, the diagnostic and therapeutic management and the prognostic factors in differentiated carcinoma are more predictive of PC than FC. In this review we analyze the current state of many of the therapeutic aspects of this pathology. The best surgical technique and the usefulness of associated lymphadenectomy is also analyzed. Regarding post-surgical ablation with 131I, the indications, doses and usefulness are discussed. For the remaining therapies we analyze the few indications for radiotherapy and chemotherapy, and of new drugs such as tyrosine kinase inhibitors. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. The follicular variant of papillary thyroid cancer and noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP).

    Science.gov (United States)

    Scharpf, Joseph; Kamani, Dipti; Sadow, Peter M; Randolph, Gregory W

    2017-01-01

    Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a new terminology proposed for encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC). Recently, thyroid cancer incidence has increased dramatically, without affecting related mortality rate. This increase is widely attributed to the intensified surveillance leading to a substantial increase in the diagnosis of small classic papillary thyroid cancers and EFVPTCs. Recent studies emphasize the indolent behavior of the EFVPTC. Recently, there has been a reclassification of EFVPTC as NIFTP, a benign entity. The financial and emotional burden of 'cancer' diagnosis and treatment can be significant. This review recapitulates the literature supporting the reclassification of EFVPTC as NIFTP, a benign entity, and reviews standardized diagnostic criteria for EFVPTC. The information highlighted in this review will affect surgical decision making and may promote the offering of hemithyroidectomy over a total thyroidectomy to some patients with 'indeterminate' cytopathological category; postoperative radioiodine ablation will not be required for NIFTP patients.

  4. Neutron Star/supernova Remnant Associations

    Science.gov (United States)

    Gvaramadze, V. V.

    We propose a new approach for studying the neutron star/supernova remnant associations, based on the idea that the (diffuse) supernova remnants (SNRs) can be products of an off-centred supernova (SN) explosion in a preexisting bubble created by the wind of a moving massive star. A cavity SN explosion of a moving star results in a considerable offset of the neutron star (NS) birth-place from the geometrical centre of the SNR. Therefore: a) the high transverse velocities inferred for a number of NSs (e.g. PSR B 1610-50, PSR B 1757-24, SGR 0525-66) through their association with SNRs can be reduced; b) the proper motion vector of a NS should not necessarily point away from the geometrical centre of the associated SNR. Taking into account of these two facts allow us to enlarge the circle of possible NS/SNR associations, and could significantly affect the results of previous studies of NS/SNR associations. The possibilities of our approach are illustrated with the example of the association between PSR B 1706-44 and SNR G 343.1-2.3. We show that this association could be real if both objects are the remnants of a SN exploded within a mushroom-like cavity (created by the SN progenitor wind breaking out of the parent molecular cloud and expanding into an intercloud medium of a much less density). We also show that the SN explosion sites in some middle-aged (shell-like) SNRs could be marked by (compact) nebulae of thermal X-ray emission. The possible detection of such nebulae within middle-aged SNRs could be used for the re-estimation of implied transverse velocities of known NSs or for the search of new stellar remnants possibly associated with these SNRs.

  5. Supernova remnants in the GC region

    Science.gov (United States)

    Asvarov, Abdul

    2016-07-01

    Along with the central Black hole the processes of active star formation play very important role in the energetics of the Galactic center region. The SNe and their remnants (SNRs) are the main ingredients of the processes of star formation. SNRs are also the sources of electromagnetic radiation of all wavelengths from the optical to hard gamma rays. In the presented work we consider the physics of supernova remnants evolving in extreme environmental conditions which are typical for the region of the Galactic center. Because of the high density and strong inhomogeneity of the surrounding medium these objects remain practically invisible at almost all wavelengths. We model evolution of SNR taking into account the pressure of the surrounding medium and the gravitational field of the matter (stars, compact clouds, dark matter) inside the remnant. As it is well established, considerable portion of the kinetic energy of the SNR can be converted into the cosmic ray particles by diffusive shock acceleration mechanism. Therefore the effect of particle acceleration is also included in the model (with the effectiveness of acceleration as a free parameter). Using the observed radiation fluxes at different wavelengths we attempt to obtain limits on the parameters of the model of the Galactic Center, namely, the frequency of star birth, the average density of the matter and radiation field, etc.

  6. THE FIRST FERMI LAT SUPERNOVA REMNANT CATALOG

    Energy Technology Data Exchange (ETDEWEB)

    Acero, F.; Ballet, J. [Laboratoire AIM, CEA-IRFU/CNRS/Université Paris Diderot, Service d’Astrophysique, CEA Saclay, F-91191 Gif sur Yvette (France); Ackermann, M.; Buehler, R. [Deutsches Elektronen Synchrotron DESY, D-15738 Zeuthen (Germany); Ajello, M. [Department of Physics and Astronomy, Clemson University, Kinard Lab of Physics, Clemson, SC 29634-0978 (United States); Baldini, L. [Università di Pisa and Istituto Nazionale di Fisica Nucleare, Sezione di Pisa I-56127 Pisa (Italy); Barbiellini, G. [Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, I-34127 Trieste (Italy); Bastieri, D.; Buson, S. [Istituto Nazionale di Fisica Nucleare, Sezione di Padova, I-35131 Padova (Italy); Bellazzini, R. [Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, I-56127 Pisa (Italy); Bissaldi, E. [Istituto Nazionale di Fisica Nucleare, Sezione di Bari, I-70126 Bari (Italy); Blandford, R. D.; Bloom, E. D.; Bottacini, E.; Caliandro, G. A.; Cameron, R. A. [W. W. Hansen Experimental Physics Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Department of Physics and SLAC National Accelerator Laboratory, Stanford University, Stanford, CA 94305 (United States); Bonino, R. [Istituto Nazionale di Fisica Nucleare, Sezione di Torino, I-10125 Torino (Italy); Brandt, T. J. [NASA Goddard Space Flight Center, Greenbelt, MD 20771 (United States); Bregeon, J. [Laboratoire Univers et Particules de Montpellier, Université Montpellier, CNRS/IN2P3, Montpellier (France); Bruel, P., E-mail: francesco.depalma@ba.infn.it, E-mail: t.j.brandt@nasa.gov, E-mail: john.w.hewitt@unf.edu [Laboratoire Leprince-Ringuet, École polytechnique, CNRS/IN2P3, Palaiseau (France); and others

    2016-05-01

    To uniformly determine the properties of supernova remnants (SNRs) at high energies, we have developed the first systematic survey at energies from 1 to 100 GeV using data from the Fermi Large Area Telescope (LAT). Based on the spatial overlap of sources detected at GeV energies with SNRs known from radio surveys, we classify 30 sources as likely GeV SNRs. We also report 14 marginal associations and 245 flux upper limits. A mock catalog in which the positions of known remnants are scrambled in Galactic longitude allows us to determine an upper limit of 22% on the number of GeV candidates falsely identified as SNRs. We have also developed a method to estimate spectral and spatial systematic errors arising from the diffuse interstellar emission model, a key component of all Galactic Fermi LAT analyses. By studying remnants uniformly in aggregate, we measure the GeV properties common to these objects and provide a crucial context for the detailed modeling of individual SNRs. Combining our GeV results with multiwavelength (MW) data, including radio, X-ray, and TeV, we demonstrate the need for improvements to previously sufficient, simple models describing the GeV and radio emission from these objects. We model the GeV and MW emission from SNRs in aggregate to constrain their maximal contribution to observed Galactic cosmic rays.

  7. Radio evolution of young supernova remnants

    International Nuclear Information System (INIS)

    Shirkey, R.C. Jr.

    1976-01-01

    A one dimensional spherically symmetric magnetohydrodynamic code was developed to describe the evolution of the dynamical and radio properties of young supernova remnants. The code contains subroutines which treat the development of Rayleigh-Taylor instabilities wherever they arise in the remnant. Under the assumption of quasi-stationary equilibrium (dynamical changes considered slow in comparison to the time it takes the instability to achieve equilibrium) determined that the velocity of the instability is W approximately (a lambda)/sup 1 / 2 /, where a is the Rayleigh-Taylor acceleration and lambda is the wavelength of the instability. Subsequent processing of the kinetic energy of expansion, through turbulence, resulted in an increase in temperature and magnetic field strength. The model was used to analyze instability effects of density inhomogeneities in the interstellar medium on magnetic field amplification. A model was constructed for Cassiopeia A which gave good agreement with the measured dynamics, radio structure, and secular flux density decrease for the remnant. In order to compare observation with theory a computer routine was written that convolves the surface brightness at the source. The resultant convolved surface brightness graph is in good agreement with Rosenberg's observed ''model profile;'' differences between the graphs can be attributed to the asymmetric expansion of Cassiopeia A

  8. Radiofrequency ablation in dermatology

    Directory of Open Access Journals (Sweden)

    Sachdeva Silonie

    2007-01-01

    Full Text Available Radiofreqeuency ablation is a versatile dermatosurgical procedure used for surgical management of skin lesions by using various forms of alternating current at an ultra high frequency. The major modalities in radiofrequency are electrosection, electrocoagulation, electrodessication and fulguration. The use of radiofrequency ablation in dermatosurgical practice has gained importance in recent years as it can be used to treat most of the skin lesions with ease in less time with clean surgical field due to adequate hemostasis and with minimal side effects and complications. This article focuses on the major tissue effects and factors influencing radiofrequency ablation and its application for various dermatological conditions.

  9. Anxiety and depression related to the hospitalization experience of patients receiving radioiodine ablation

    International Nuclear Information System (INIS)

    Koc, Z.; Karaboc, A.; Balci, T.; Kepenek, F.; Atmaca, M.

    2015-01-01

    Full text of publication follows. Objective: the hospital rooms for radioiodine ablation of differentiated thyroid carcinoma are designed according to radiation safety lows where patients have to remain isolated. The aim of the present study is to investigate depression and anxiety levels of the patients associated with hospitalization experience for radioiodine ablation. Methods: 30 patients (8 M, 22 F; mean: 45±13 years old) with differentiated thyroid carcinoma were included into study. After withdrawal of thyroid hormone replacement at least for 3 weeks, the patients were subject of the ablation treatment. After routine psychiatric examination Hamilton Anxiety and Depression scales were administered to the patients before and after complement of hospitalization for 1-3 days. Results: according to the statistical analysis there was not any significant difference between Hamilton depression and anxiety scores and state and trait anxiety scores of the patients before and after treatment (P>0.05). However, 18 patients had depression, with major depression of six, and 21 had high anxiety levels, according to Hamilton Depression and Anxiety Scales. Conclusion: Although the patients with differentiated thyroid carcinoma do not experience anxiety or depression related to the hospitalization itself for radioiodine ablation they might frequently have depression or anxiety just before the treatment. (authors)

  10. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... information about your thyroid’s size, shape, position and function that is often unattainable using other imaging procedures. ... thyroid uptake. It is a measurement of thyroid function, but does not involve imaging. Nuclear medicine is ...

  11. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... which are encased in metal and plastic and most often shaped like a box, attached to a ... will I experience during and after the procedure? Most thyroid scan and thyroid uptake procedures are painless. ...

  12. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... A thyroid scan is a type of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) is ... thyroid function, but does not involve imaging. Nuclear medicine is a branch of medical imaging that uses ...

  13. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... thyroid. The thyroid is a gland in the neck that controls metabolism , a chemical process that regulates ... examination table with your head tipped backward and neck extended. The gamma camera will then take a ...

  14. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Because nuclear medicine procedures are able to pinpoint molecular activity within the body, they offer the potential ... or imaging device that produces pictures and provides molecular information. The thyroid scan and thyroid uptake provide ...

  15. Stages of Thyroid Cancer

    Science.gov (United States)

    ... child or being exposed to radiation from an atomic bomb. The cancer may occur as soon as 5 years ... thyroid cancer, drugs may be given to prevent the body from making thyroid-stimulating hormone (TSH), a hormone that can ...

  16. Thyroid cancer - papillary carcinoma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000331.htm Thyroid cancer - papillary carcinoma To use the sharing features on ... the lower neck. Causes About 80% of all thyroid cancers diagnosed in the United States are the papillary ...

  17. Cabozantinib (thyroid cancer)

    Science.gov (United States)

    ... is used to treat a certain type of thyroid cancer that is getting worse and that has spread ... only gives information about cabozantinib capsules (Cometriq) for thyroid cancer. If you are using this medication for advanced ...

  18. Thyroid Hormone Treatment

    Science.gov (United States)

    ... THYROID HORMONES? Desiccated ( dried and powdered ) animal thyroid ( Armour ®), now mainly obtained from pigs, was the most ... hormone can increase the risk or heart rhythm problems and bone loss making the use of thyroxine ...

  19. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... RAIU) is also known as a thyroid uptake. It is a measurement of thyroid function, but does ... they offer the potential to identify disease in its earliest stages as well as a patient’s immediate ...

  20. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... of page What will I experience during and after the procedure? Most thyroid scan and thyroid uptake ... you otherwise, you may resume your normal activities after your nuclear medicine scan. If any special instructions ...

  1. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... known as a thyroid uptake. It is a measurement of thyroid function, but does not involve imaging. ... eating can affect the accuracy of the uptake measurement. Jewelry and other metallic accessories should be left ...

  2. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... imaging tests to: determine if the gland is working properly help diagnose problems with the thyroid gland, such as an overactive thyroid gland, a condition called hyperthyroidism , cancer or other growths assess the ...

  3. Sarcoidosis and Thyroid Autoimmunity

    Directory of Open Access Journals (Sweden)

    Piera Fazzi

    2017-08-01

    Full Text Available Most of the studies have shown a higher risk for subclinical and clinical hypothyroidism, antithyroid autoantibodies [overall antithyroid peroxidase antibodies (TPOAb], and in general, thyroid autoimmunity, overall in the female gender in patients with sarcoidosis (S. A significantly higher prevalence of clinical hypothyroidism and Graves’ disease was also described in female S patients with respect to controls. Gallium-67 (Ga-67 scyntigraphy in S patients, in the case of thyroid uptake, suggests the presence of aggressive autoimmune thyroiditis and hypothyroidism. For this reason, ultrasonography and thyroid function should be done in the case of Ga-67 thyroid uptake. In conclusion, thyroid function, TPOAb measurement, and ultrasonography should be done to assess the clinical profile in female S patients, and the ones at high risk (female individuals, with TPOAb positivity, and hypoechoic and small thyroid should have periodically thyroid function evaluations and suitable treatments.

  4. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Uptake? A thyroid scan is a type of nuclear medicine imaging. The radioactive iodine uptake test (RAIU) ... of thyroid function, but does not involve imaging. Nuclear medicine is a branch of medical imaging that ...

  5. Concomitant Graves' disease and Hashimoto's thyroiditis, presenting as primary hypothyroidism.

    LENUS (Irish Health Repository)

    Cronin, C C

    2012-02-03

    Hypothyroidism in patients with Graves\\' disease is usually the result of ablative treatment. We describe a 58 year old man with Graves\\' ophthalmopathy and pre-tibial myxoedema, who presented with spontaneous primary hypothyroidism. Circulating TSH receptor antibody activity was increased, while thyroid microsomal antibody was detectable in titres greater than one in one hundred thousand. It is likely that the TSH receptor antibody of Graves\\' disease was ineffective in stimulating hyperthyroidism because of concomitant thyroid destruction due to Hashimoto\\'s disease. Alternatively, primary hypothyroidism could have resulted from the effects of a circulating TSH receptor blocking antibody.

  6. Statins as a new therapeutic approach in dedifferentiated thyroid cancer?

    International Nuclear Information System (INIS)

    Hofmann, A.; John, P.; Sinzinger, H.; Staudenherz, A.; Schaffarich, M.P.

    2006-01-01

    Generally, primary differentiated tumours are removed surgically followed by adjuvant radioiodine treatment. The effect and outcome of radioiodine ablation depends on the uptake in the thyroid carcinoma cells. But, about one third of patients with local recurrent thyroid carcinomas or distant metastases do not respond to iodine treatment due to loss of differentiation. Prognosis was impaired if tumour cells are losing the capability for radioiodine uptake due to dedifferentiation. However, several trials have been attempted to induce re-differentiation of tumour cells in order to regain their potential for radioiodine uptake. (orig.)

  7. Metastatic Follicular Thyroid Carcinoma Secreting Thyroid Hormone and Radioiodine Avid without Stimulation: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Syed A. Abid

    2014-01-01

    Full Text Available Introduction. This is an extremely rare case of a patient with metastatic follicular thyroid cancer who continued to produce thyroid hormone and was iodine scan positive without stimulation after thyroidectomy and radioiodine (I-131 therapy. Patient Findings. A 76-year-old Caucasian male was diagnosed with metastatic follicular thyroid carcinoma on lung nodule biopsy. Total thyroidectomy was performed and he was ablated with 160 mCi of I-131 after recombinant human thyrotropin (rhTSH stimulation. Whole body scan (WBS after treatment showed uptake in bilateral lungs, right sacrum, and pelvis. The thyroglobulin decreased from 2,063 to 965 four months after treatment but rapidly increased to 2,506 eleven months after I-131. Thyroid stimulating hormone (TSH remained suppressed and free T4 remained elevated after I-131 therapy without thyroid hormone supplementation. He was treated with an additional 209 mCi with WBS findings positive in lung and pelvis. Despite I-131, new metastatic lesions were noted in the left thyroid bed and large destructive lesion to the first cervical vertebrae four months after the second I-131 dose. Conclusions. This case is exceptional because of its rarity and also due to the dissociation between tumor differentiation and aggressiveness. The metastatic lesions continued to secrete thyroid hormone and remained radioiodine avid with rapid progression after I-131 therapy.

  8. Ablative skin resurfacing.

    Science.gov (United States)

    Agrawal, Nidhi; Smith, Greg; Heffelfinger, Ryan

    2014-02-01

    Ablative laser resurfacing has evolved as a safe and effective treatment for skin rejuvenation. Although traditional lasers were associated with significant thermal damage and lengthy recovery, advances in laser technology have improved safety profiles and reduced social downtime. CO2 lasers remain the gold standard of treatment, and fractional ablative devices capable of achieving remarkable clinical improvement with fewer side effects and shorter recovery times have made it a more practical option for patients. Although ablative resurfacing has become safer, careful patient selection and choice of suitable laser parameters are essential to minimize complications and optimize outcomes. This article describes the current modalities used in ablative laser skin resurfacing and examines their efficacy, indications, and possible side effects. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Moldable cork ablation material

    Science.gov (United States)

    1977-01-01

    A successful thermal ablative material was manufactured. Moldable cork sheets were tested for density, tensile strength, tensile elongation, thermal conductivity, compression set, and specific heat. A moldable cork sheet, therefore, was established as a realistic product.

  10. Preoperative scintigraphic detection of lung metastases of a follicular thyroid carcinoma associated with hyperthyroidism

    International Nuclear Information System (INIS)

    Biyi, A.; Oufroukhi, Y.; Doudouh, A.; Baizri, H.; El Quatni, M.; Al Bouzidi, A.

    2009-01-01

    Preoperative accumulation of radioiodine in metastases of thyroid carcinoma and its association with hyperthyroidism are uncommon. We report a case of 58-year-old woman with follicular thyroid carcinoma revealed by thyrotoxicosis caused by a hot nodule, and bilateral pulmonary uptake of I-131 before total thyroidectomy. Despite four ablative doses of I-131, bone metastases were identified and the patient died 42 month after the initial diagnosis. (authors)

  11. [Thyroid and cardiovascular disorders].

    Science.gov (United States)

    Zyśko, Dorota; Gajek, Jacek

    2004-05-01

    In this study three problems concerning interactions between thyroid and cardiovascular system are discussed. Cardiac arrhythmias, congestive heart failure, pleural effusion, hyperlipidaemia, arterial hypertension may be consequences of thyroid disorders leading to inappropriate hormone secretion. During such illnesses as heart failure, myocardial infarction and in patients undergoing coronary artery bypass surgery profound changes may occur in thyroid hormone metabolism known as sick euthyroid syndrome. Treatment with amiodarone may lead to changes in thyroid tests results and to development of hypothyroidism or thyrotoxicosis.

  12. Thyroid Stimulating Hormone Receptor

    Directory of Open Access Journals (Sweden)

    Murat Tuncel

    2017-02-01

    Full Text Available Thyroid stimulating hormone receptor (TSHR plays a pivotal role in thyroid hormone metabolism. It is a major controller of thyroid cell function and growth. Mutations in TSHR may lead to several thyroid diseases, most commonly hyperthyroidism. Although its genetic and epigenetic alterations do not directly lead to carcinogenesis, it has a crucial role in tumor growth, which is initiated by several oncogenes. This article will provide a brief review of TSHR and related diseases.

  13. Value of the Serum Thyroglobulin Level Alteration at the First High Dose Radioiodine Treatment in Patients with Differentiated Thyroid Carcinoma

    International Nuclear Information System (INIS)

    Nam, Hyun Yeol; Kim, In Joo; Kim, Yong Ki; Kim, Seong Jang; Jun, Sung Min; Kim, Bum Soo

    2009-01-01

    The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P=0.03, the THW group; P=0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0≤5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients

  14. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... for a thyroid scan is 30 minutes or less. Thyroid Uptake You will be given radioactive iodine (I-123 or I-131) in liquid or capsule form to swallow. The thyroid uptake will begin several hours to 24 hours later. Often, two separate uptake ...

  15. Poorly Differentiated Thyroid Carcinoma.

    Science.gov (United States)

    Setia, Namrata; Barletta, Justine A

    2014-12-01

    Poorly differentiated thyroid carcinoma (PDTC) has been recognized for the past 30 years as an entity showing intermediate differentiation and clinical behavior between well-differentiated thyroid carcinomas (ie, papillary thyroid carcinoma and follicular thyroid carcinoma) and anaplastic thyroid carcinoma; however, there has been considerable controversy around the definition of PDTC. In this review, the evolution in the definition of PDTC, current diagnostic criteria, differential diagnoses, potentially helpful immunohistochemical studies, and molecular alterations are discussed with the aim of highlighting where the diagnosis of PDTC currently stands. Published by Elsevier Inc.

  16. Thyroid and the Heart

    Directory of Open Access Journals (Sweden)

    A Karas

    2009-09-01

    Full Text Available The cardiovascular signs and symptoms of thyroid disease are some of the most clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure and rhythm disturbances that result from thyroid dysfunction. In the present review will integrate what is known about the mechanisms of thyroid hormone action on the heart and the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure.

  17. Thyroid imaging in goiter

    International Nuclear Information System (INIS)

    Maier, R.

    1994-01-01

    Since Cassen und Taylor and Stewart introduced 131 iodine scans of the thyroid, these have become an integral part of the routine diagnostic procedures for thyroid disease. Today 131 I is no longer used due to its excessive radioactivity; 123 iodine or 99m technetium are now preferred. Pitfalls in the use of 99m Tc are that in some thyroid disorders, such as certain forms of thyroid carcinomas and chronic thyroiditis, a normal iodine trapping (but not organification) may occur. This mechanism can lead to false conclusions. (orig.) [de

  18. Supernova Remnants with Fermi Large Area Telescope

    Directory of Open Access Journals (Sweden)

    Caragiulo M.

    2017-01-01

    Full Text Available The Large Area Telescope (LAT, on-board the Fermi satellite, proved to be, after 8 years of data taking, an excellent instrument to detect and observe Supernova Remnants (SNRs in a range of energies running from few hundred MeV up to few hundred GeV. It provides essential information on physical processes that occur at the source, involving both accelerated leptons and hadrons, in order to understand the mechanisms responsible for the primary Cosmic Ray (CR acceleration. We show the latest results in the observation of Galactic SNRs by Fermi-LAT.

  19. Runaway companions of supernova remnants with Gaia

    Science.gov (United States)

    Boubert, Douglas; Fraser, Morgan; Evans, N. Wyn

    2018-04-01

    It is expected that most massive stars have companions and thus that some core-collapse supernovae should have a runaway companion. The precise astrometry and photometry provided by Gaia allows for the systematic discovery of these runaway companions. We combine a prior on the properties of runaway stars from binary evolution with data from TGAS and APASS to search for runaway stars within ten nearby supernova remnants. We strongly confirm the existing candidate HD 37424 in S147, propose the Be star BD+50 3188 to be associated with HB 21, and suggest tentative candidates for the Cygnus and Monoceros Loops.

  20. VHE Gamma-ray Supernova Remnants

    Energy Technology Data Exchange (ETDEWEB)

    Funk, Stefan; /KIPAC, Menlo Park

    2007-01-22

    Increasing observational evidence gathered especially in X-rays and {gamma}-rays during the course of the last few years support the notion that Supernova remnants (SNRs) are Galactic particle accelerators up to energies close to the ''knee'' in the energy spectrum of Cosmic rays. This review summarizes the current status of {gamma}-ray observations of SNRs. Shell-type as well as plerionic type SNRs are addressed and prospect for observations of these two source classes with the upcoming GLAST satellite in the energy regime above 100 MeV are given.

  1. On neutron star/supernova remnant associations

    OpenAIRE

    Gvaramadze, V. V.

    2000-01-01

    It is pointed out that a cavity supernova (SN) explosion of a moving massive star could result in a significant offset of the neutron star (NS) birth-place from the geometrical centre of the supernova remnant (SNR). Therefore: a) the high implied transverse velocities of a number of NSs (e.g. PSR B1610-50, PSR B1757-24, SGR0525-66) could be reduced; b) the proper motion vector of a NS should not necessarily point away from the geometrical centre of the associated SNR; c) the circle of possibl...

  2. Thyroglossal Duct Papillary Thyroid Carcinoma and Synchronous Lingual Thyroid Atypia

    Directory of Open Access Journals (Sweden)

    Timothy Yoo

    2016-01-01

    Full Text Available Thyroglossal duct and lingual thyroid ectopic lesions are exceedingly rare synchronous findings. Papillary thyroid carcinoma of these ectopic thyroid sites is well understood but still a rare finding. This case points to some management nuances in regard to ectopic thyroid screening with imaging and also shows the effectiveness of minimally invasive transoral robotic surgery for lingual thyroid.

  3. Thyroid dysfunction in pregnancy

    Directory of Open Access Journals (Sweden)

    El Baba KA

    2012-03-01

    Full Text Available Khalid A El Baba1, Sami T Azar21Department of Internal Medicine, Division of Endocrinology, Bahrain Specialist Hospital, Manama, Bahrain; 2Department of Internal Medicine, Division of Endocrinology, American University of Beirut-Medical Center, New York, NY, USAAbstract: Timely treatment of thyroid disease during pregnancy is important in preventing adverse maternal and fetal outcomes. Thyroid abnormalities are very often subclinical in nature and not easily recognized without specific screening programs. Even mild maternal thyroid hormone deficiency may lead to neurodevelopment complications in the fetus. The main diagnostic indicator of thyroid disease is the measurement of serum thyroid-stimulating hormone and free thyroxine levels. Availability of gestation-age-specific thyroid-stimulating hormone thresholds is an important aid in the accurate diagnosis and treatment of thyroid dysfunction. Pregnancy-specific free thyroxine thresholds not presently available are also required. Large-scale intervention trials are urgently needed to assess the efficacy of preconception or early pregnancy screening for thyroid disorders. Accurate interpretation of both antepartum and postpartum levels of thyroid hormones is important in preventing pregnancy-related complication secondary to thyroid dysfunction. This article sheds light on the best ways of management of thyroid dysfunction during pregnancy in order to prevent any possible maternal or fetal complication.Keywords: TSH, HCG, TBG

  4. 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

  5. Remnant cholesterol as a cause of ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Benn, Marianne; Nordestgaard, Børge G

    2014-01-01

    This review focuses on remnant cholesterol as a causal risk factor for ischemic heart disease (IHD), on its definition, measurement, atherogenicity, and levels in high risk patient groups; in addition, present and future pharmacological approaches to lowering remnant cholesterol levels...... are considered. Observational studies show association between elevated levels of remnant cholesterol and increased risk of cardiovascular disease, even when remnant cholesterol levels are defined, measured, or calculated in different ways. In-vitro and animal studies also support the contention that elevated...... levels of remnant cholesterol may cause atherosclerosis same way as elevated levels of low-density lipoprotein (LDL) cholesterol, by cholesterol accumulation in the arterial wall. Genetic studies of variants associated with elevated remnant cholesterol levels show that an increment of 1mmol/L (39mg...

  6. Are crab-type supernova remnants (plerions) short-lived

    International Nuclear Information System (INIS)

    Weiler, K.W.; Panagia, N.

    1978-01-01

    Arguments are given for a possible picture of the origin, maintenance, and lifetimes of the so-called Crab-like supernova remnants. It is suggested that these objects imply the existence of at least two distinct types of supernova events. A possible connection of the remnant types with the optically defined supernovae of Type I and Type II is discussed. Accepting that a pulsar is formed in at least some supernova events, the proposal is made that a rapidly rotating, rapidly slowing pulsar is necessary to create and maintain a Crab-like supernova remnant. Finally, arguments are presented that such a supernova remnant will be relatively short lived with respect to the more common shell-type of supernova remnant, perhaps surviving only 10000-20000 yr before fading into the Galactic background. The name of plerion is proposed for these filled-center supernova remnants and observational possiblities for confirming their nature are suggested. (orig.) [de

  7. Treatment and outcome of 32 patients with distant metastases of Hürthle cell thyroid carcinoma: a single-institution experience

    International Nuclear Information System (INIS)

    Besic, Nikola; Schwarzbartl-Pevec, Andreja; Vidergar-Kralj, Barbara; Crnic, Tea; Gazic, Barbara; Marolt Music, Maja

    2016-01-01

    It is generally believed that patients with Hürthle cell thyroid carcinoma (HCTC) have a poor prognosis. Furthermore, distant metastases represent the most frequent cause of thyroid cancer-related death of patients with HCTC. The aim of this study was to report the treatment and outcomes of patients with distant metastases. Altogether 108 patients were treated for HCTC from 1972 to 2011 in our tertiary center and 32 patients (19 females, 13 males; median age 64.5 years) had either initially proven metastatic disease (N = 12) or distant progression of HCTC after initial treatment (N = 20). Patients with metastases were followed for 1–226 (median 77) months. Data were collected on the patients’ gender and age, extent of their disease, morphologic characteristics, therapy, outcome, and survival rate. Statistical correlation between possible prognostic factors and cause-specific survival from time of detection of metastases was analyzed by univariate analysis and log-rank test. The most common were lung metastases, followed by bone, mediastinum, kidney, and liver in 24, 8, 2, 1, and 1 case, respectively. Total thyroidectomy, lobectomy, subtotal thyroidectomy and neck dissection were performed in 19, 10, 3, and 7 patients, respectively. Radioiodine (RAI) ablation of thyroid remnant was performed in 30 patients, while 20 of them had RAI therapy (median 4 times). RAI uptake in metastases was present in 16 patients and ranged from 0.05 % to 12 %. Chemotherapy was used in 13 patients and external beam radiotherapy in 19 patients. Locoregional control of disease was achieved in 19/21 (90 %) cases who succumbed due to HCTC. Estimated 10-year disease-specific survival for all patients was 60 %. 10-year disease-specific survival for patients with pulmonary metastases and other sites metastases was 60 % and 62 %, respectively. 10-year disease-specific survival for patients with single organ and multiple organ metastases was 52 %, and 100 %, respectively. Estimated median

  8. [Riedel thyroiditis: two cases report].

    Science.gov (United States)

    Zhou, Rongjin; Wang, Junguo

    2014-10-01

    Riedel thyroiditis is a benign disease, which is often self-limited. Examinations, such as CT and histologic diagnosis can distinguish it from malignant neoplasms and hashimoto's thyroiditis. Riedel thyroiditis is an uncommon form of chronic thyroiditis in which the thyroid gland is replaced by fibrous tissue. It can be cured by surgery and medicine.

  9. Increased Sclerostin Levels after Further Ablation of Remnant Estrogen by Aromatase Inhibitors

    Directory of Open Access Journals (Sweden)

    Wonjin Kim

    2015-03-01

    Full Text Available BackgroundSclerostin is a secreted Wnt inhibitor produced almost exclusively by osteocytes, which inhibits bone formation. Aromatase inhibitors (AIs, which reduce the conversion of steroids to estrogen, are used to treat endocrine-responsive breast cancer. As AIs lower estrogen levels, they increase bone turnover and lower bone mass. We analyzed changes in serum sclerostin levels in Korean women with breast cancer who were treated with an AI.MethodsWe included postmenopausal women with endocrine-responsive breast cancer (n=90; mean age, 57.7 years treated with an AI, and compared them to healthy premenopausal women (n=36; mean age, 28.0 years. The subjects were randomly assigned to take either 5 mg alendronate with 0.5 µg calcitriol (n=46, or placebo (n=44 for 6 months.ResultsPostmenopausal women with breast cancer had significantly higher sclerostin levels compared to those in premenopausal women (27.8±13.6 pmol/L vs. 23.1±4.8 pmol/L, P0.05.ConclusionSerum sclerostin levels increased with absolute deficiency of residual estrogens in postmenopausal women with endocrine-responsive breast cancer who underwent AI therapy with concurrent bone loss.

  10. Power Laser Ablation Symposia

    CERN Document Server

    Phipps, Claude

    2007-01-01

    Laser ablation describes the interaction of intense optical fields with matter, in which atoms are selectively driven off by thermal or nonthermal mechanisms. The field of laser ablation physics is advancing so rapidly that its principal results are seen only in specialized journals and conferences. This is the first book that combines the most recent results in this rapidly advancing field with authoritative treatment of laser ablation and its applications, including the physics of high-power laser-matter interaction. Many practical applications exist, ranging from inertial confinement fusion to propulsion of aerostats for pollution monitoring to laser ignition of hypersonic engines to laser cleaning nanoscale contaminants in high-volume computer hard drive manufacture to direct observation of the electronic or dissociative states in atoms and molecules, to studying the properties of materials during 200kbar shocks developed in 200fs. Selecting topics which are representative of such a broad field is difficu...

  11. 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

  12. Sericeous thyroglobulin and whole body thyroid scan in patients with differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Mendoza, G.; Cano, R.; Morales, R.; Huanca, M.; Postigo, J.; Farfan, J.

    1994-01-01

    Thyroid cancer is the most frequent malignant tumor among endocrine diseases. it has an incidence of 1,87 cases per hundred thousand habitants. Thyroglobulin is an iodo glycoprotein useful in the follow-up of patients with differentiated thyroid carcinoma. Total body scan is a well established method to localize distant functioning metastases. We report the concordance of this two methods in 22 patients attending to the Nuclear Medicine Center and proceeding from the Head and Neck Department of INEN, which had undergone total thyroidectomy, received a I-131 ablative dose, performed a total body scan and determined the thyroglobulin concentration fourteen were female patients and the same number were accounted as high risk patients. We conclude for the studied population, that an excellent correlation between thyroglobulin and scans was noted and that 6,5 ng/ml will be used as a cut-off point for the thyroglobulin determination. (authors). 40 refs., 5 tabs

  13. 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)

  14. Immune thrombocytopenia and autoimmune thyroid disease: a controversial overlap.

    Science.gov (United States)

    Marta, Guilherme Nader; de Campos, Fernando Peixoto Ferraz

    2015-01-01

    Immune thrombocytopenia (ITP) is an entity characterized by a platelet count of less than 100 × 10(9)/L in the absence of other causes of thrombocytopenia, such as viral infections, rheumatic diseases, or drugs. Grave's disease is also an autoimmune condition in which thrombocytopenia is often observed. Moreover, in the literature, many reports show a marked interference of the thyroid dysfunction (mainly hyperthyroidism) in the control of thrombocytopenia. Although this issue still remains debatable, the authors report the case of a young woman with a previous diagnosis of ITP with a brilliant initial response to corticotherapy. Some years after this diagnosis, the patient presented thyrotoxicosis due to Grave's disease and the thrombocytopenia relapsed, but this time there was no response to the glucocorticoids. Only after the radioiodine I-131 thyroid ablation the control of thrombocytopenia was achieved. The authors call attention to this overlap and for testing thyroid function in every patient with an unexpected negative response to corticotherapy.

  15. Find an Endocrinology - Thyroid Specialist

    Science.gov (United States)

    ... History Resource Center Patients Thyroid Information Find an Endocrinology – Thyroid Specialist Patient Support Links Clinical Thyroidology for ... Access Thyroid Online Access Clinical Thyroidology Online Video Endocrinology Donate Give Online Research Accomplishments Ridgway Legacy Fund ...

  16. Genetics Home Reference: Hashimoto thyroiditis

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions Hashimoto thyroiditis Hashimoto thyroiditis Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Hashimoto thyroiditis is a condition that affects the function of ...

  17. [Thyroid and pregnancy].

    Science.gov (United States)

    Iwen, K A; Lehnert, H

    2018-05-17

    During pregnancy thyroid hormones have profound effects on embryonal/fetal development and maternal health. Therefore, thyroid gland disorders should be immediately diagnosed and adequately treated. Pregnancy-specific physiological alterations during pregnancy cause changes in the reference interval for thyroid-stimulating hormone levels and trimester-specific thresholds must be taken into account. This article summarizes the most important diagnostic and therapeutic aspects before, during and after pregnancy. With reference to the period prior to pregnancy, the article discusses iodide supplementation, preconceptional examination of thyroid gland metabolism and the importance of thyroid gland functional disorders for fertility and fulfilling the desire to have children. With a view to the period during pregnancy, the effect of hypothyroxinemia, hypothyroidism, and hyperthyroidism as well as the effects of their treatment on the development of the child are explained. Finally, a description is given of what must be paid attention to in the breast-feeding period and in postpartum thyroiditis.

  18. Medical evaluations of ionizing radiation effects during I131 therapy in patients after thyroid carcinoma surgery

    International Nuclear Information System (INIS)

    Hermida, J.C.

    1996-01-01

    This study shows the para-clinical studies on a 39 years old patient who was operated on of a thyroid carcinoma and who, under the beirwaltes medical record (in use in our country), received in the post surgical stage, a Iodine-131 dose of about 2960 MBq (80 mCi) for ablation, having been noted subsequently her pregnancy condition. (author). 6 refs

  19. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Eschner, W.; Luster, M.; Reiners, C.; Schober, O.; Muenster Univ.

    2007-01-01

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for 131 I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative 131 I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC ≤1 cm 131 I ablation may be helpful in an individual constellation. Preparation for 131 I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for 131 I-therapy in patients with metastases, higher sensitivity of 131 I whole-body scan) are discussed. In most centers standard activities are used for 131 I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of 131 I should not exceed 1-10MBq, alternative tracers are 123 I or 124 I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

  20. Values of (99m)Tc-methoxyisobutylisonitrile imaging after first-time large-dose (131)I therapy in treating differentiated thyroid cancer.

    Science.gov (United States)

    Pan, Xiaomei; Duan, Dong; Zhu, Yuquan; Pang, Hua; Guan, Lili; Lv, Zhixiang

    2016-01-01

    The aim of this study is to investigate the use of (99m)Tc-methoxyisobutylisonitrile (MIBI) imaging for evaluating the treatment response of differentiated thyroid cancer (DTC) after the first administration of a high dose of (131)I. Patients with DTC who received (131)I therapy underwent (99m)Tc-MIBI imaging after successive increases in the therapeutic dose of (131)I, and the serum levels of thyroglobulin (Tg) were measured. A total of 191 patients were enrolled in the final analysis, including 65 metastases and/or thyroid remnant-positive patients (22 patients with metastases and 43 patients with thyroid remnants). The sensitivity of (99m)Tc-MIBI imaging for detecting positive cases and thyroid remnants was 56.9% and 39.5%, respectively, which was significantly lower than that of (131)I imaging (92.3% and 100%, respectively, PTc-MIBI imaging for detecting metastases was 90.9%, which was slightly higher than that of (131)I imaging (77.3%, P>0.05). The Tg levels in the positive group were significantly higher than that in the negative group (PTc-MIBI(+)/(131)I(-) group were significantly higher than that in the (131)I(+)/(99m)Tc-MIBI group (PTc-MIBI imaging was able to detect the existence of metastatic lesions in patients with DTC better, its assessment for the removal efficiency of thyroid remnants was unsatisfactory. The results of (99m)Tc-MIBI imaging showed good correlations with the Tg level.

  1. Pathophysiology of thyroid cancer

    International Nuclear Information System (INIS)

    Rajan, M.G.R.; Nadkarni, G.D.

    1999-01-01

    The main physiological function of the thyroid gland is to produce thyroid hormones. The primary physiological control over iodine transport, organification and hormone synthesis appears to be through thyroid stimulating hormone (TSH). Regulation of tumor cells, biochemical studies in experimental tumors, role of oxygen free radical and antioxidants, role of proteases in metastasis, influence of growth factors and influence of sex hormones and receptors are discussed

  2. Lingual Thyroid & its Management

    OpenAIRE

    Thiagarajan, Balasubramanian

    2017-01-01

    This e book discusses the topic Lingual thyroid. Lingual thyroid is a rare disorders seen only in 1 in 1 lakh population. This is actually a coincidental finding in most of the cases. This book discusses the embryological aspects of lingual thyroid, clinical features and the current management trends of the same. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  3. Urachal remnant carcinoma - a rare entity

    Directory of Open Access Journals (Sweden)

    Vanesha Naidu

    2013-06-01

    Full Text Available Primary malignancy of the urachal remnant is a rare neoplasm that accounts for less than 0.01% of all adult cancers, with an estimated annual incidence of 1:5 million. The tumour carries a grave prognosis that attests to its highly aggressive nature. Owing to its extra-peritoneal location, the tumour runs a relatively silent clinical course until late presentation, when most patients display extensive local invasion and metastatic spread. In this report, we highlight a case of primary malignancy of the urachus that on initial clinical evaluation masqueraded as a Sister Mary Joseph’s nodule. Characteristic imaging features, however, proved decisive in establishing the diagnosis of a urachal carcinoma.

  4. A Python Calculator for Supernova Remnant Evolution

    Science.gov (United States)

    Leahy, D. A.; Williams, J. E.

    2017-05-01

    A freely available Python code for modeling supernova remnant (SNR) evolution has been created. This software is intended for two purposes: to understand SNR evolution and to use in modeling observations of SNR for obtaining good estimates of SNR properties. It includes all phases for the standard path of evolution for spherically symmetric SNRs. In addition, alternate evolutionary models are available, including evolution in a cloudy ISM, the fractional energy-loss model, and evolution in a hot low-density ISM. The graphical interface takes in various parameters and produces outputs such as shock radius and velocity versus time, as well as SNR surface brightness profile and spectrum. Some interesting properties of SNR evolution are demonstrated using the program.

  5. THE DRESSMAKER, REMNANTS OF A LIFE

    DEFF Research Database (Denmark)

    Carpe Pérez, Inmaculada Concepción

    2015-01-01

    The Dressmaker, remnants of a life, is a visual representation of our research in animation ,at the Animated Learning Lab, as a means of reflection on the construction of the self and memories. Through the artistic production of motion pictures, an introspection is done in the author’s personal...... knowledge, which help us to reflect upon thoughts, feelings and actions (personal or external). Such experiences shape our personalities and whose emotional balance our happiness depends on. Memories are the left over product out of experiences, constituents of a reality. This is seen and created...... the psychology of the self. Animation, for it’s metaphorical power and playfulness: mix of reality and fantasy, results a very attractive and effective tool to explore different points of view and work the neuroplasticity, facilitator of the physical changes of our brain and our behavior, area of study...

  6. Exosat observations of the Kepler supernova remnant

    International Nuclear Information System (INIS)

    Smith, A.; Peacock, A.; Arnaud, M.; Ballet, J.; Rothenflug, R.

    1989-01-01

    The medium-energy experiment on board Exosat was used to measure the X-ray spectrum of the Kepler supernova remnant over the range 1.5-10 keV. An Fe emission line was clearly resolved with an energy of about 6.5 keV and equivalent width of about 1.8 keV. This was superposed on a continuum with a temperature of 5.0(+3.8, -1.9) keV. The medium-energy spectrum is shown to be consistent with a model in which the Kepler SNR is presently in a Sedov phase of evolution, the 5 keV continuum arises from the shocked interstellar/circumstellar medium, and thermal (but not ionization) equilibrium exists between electrons and ions behind the primary shock front. However, in this case, an overabundance of iron by more than 6 times cosmic is required. 28 refs

  7. On Neutron Star/Supernova Remnant Association

    Science.gov (United States)

    Gvaramadze, V. V.

    It is pointed out that a cavity supernova (SN) explosion of a moving massive star could result in a significant offset of the neutron star (NS) birth-place from the geometrical centre of the supernova remnant (SNR). Therefore: a) the high implied transverse velocities of a number of NSs (e.g. PSR B1610-50, PSR B1706-44, PSR B1757-24, SGR 0526-66) could be reduced; b) the proper motion vector of a NS should not necessarily point away from the geometrical centre of the associated SNR; c) the circle of possible NS/SNR associations could be enlarged. An observational test is discussed, which could provide a determination of the true birth-places of NSs associated with middle-aged SNRs, and thereby provide more reliable estimates of their transverse velocities.

  8. Carcinoma Showing Thymus-Like Differentiation (CASTLE of Thyroid: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Leong-Perng Chan

    2008-11-01

    Full Text Available Carcinoma showing thymus-like differentiation (CASTLE is a rare malignant neoplasm that occurs in the thyroid gland, or head and neck. This tumor arises from either ectopic thymus tissue or remnants of branchial pouches, which retain the potential to differentiate along the thymus line. Clinical presentation and imaging can be consistent with a malignant lesion such as thyroid cancer or thymic carcinoma. Immunohistochemical staining with CD5 can differentiate CASTLE from other malignant thyroid neoplasms. A 54-year-old male had initially presented with a painless, left neck mass for 3 months. He underwent left thyroid lobectomy via a median sternotomy approach. Carcinoma showing thymus-like differentiation was the final histopathologic diagnosis. After 36 months of follow-up, no evidence of recurrence was observed. A median sternotomy is an excellent approach for CASTLE with anterior mediastinum involvement. Complete resection is important to improve the long-term survival rate and the locoregional recurrence rate.

  9. Radioablative therapy with Iodine-131 on a patient with thyroid cancer and chronic renal failure in hemodialysis first experience in Peru

    International Nuclear Information System (INIS)

    Apaza Veliz, D. G.; Herrera Vera, R. D.; Cardenas Abarca, C. A.; Oporto Gonzales, C. A.; Aguilar Ramírez, C.; Urquizo Baldomero, R. M.; Vega Ramírez, J. L.

    2016-01-01

    The Iodine-131 (I-131) is a radioisotope used as a standard treatment for radioablation of thyroid remnants. Among thyroid cancer patients, the ones undergoing hemodialysis represent a specific group. The dose of I-131 is given orally to these patients, part of it is absorbed by the thyroid remnants and the rest of it, largely not incorporated, is excreted primarily by renal excretion. The use of a high dose of radioactivity in the process, and the inability of excretion, represents a high risk of exposure to the patient, medical staff and hemodialysis equipment. This work describes the procedure applied on the radioablation therapy for thyroid cancer while receiving hemodialysis, minimizing the risks for the patient and the staff involved. This clinical procedure will establish the dosimetric measures, a plan on radiation protection and a treatment protocol for this specific type of patients.

  10. Radioablative therapy with Iodine-131 on a patient with thyroid cancer and chronic renal failure in hemodialysis first experience in Peru

    Energy Technology Data Exchange (ETDEWEB)

    Apaza Veliz, D. G., E-mail: dgav02@gmail.com [Hospital Nacional Carlos Alberto Seguin Escobedo, Servicio de Medicina Nuclear, Arequipa, Perú, Universidad Nacional de San Agustín de Arequipa, Escuela de Física, Arequipa (Peru); Herrera Vera, R. D.; Cardenas Abarca, C. A.; Oporto Gonzales, C. A.; Aguilar Ramírez, C.; Urquizo Baldomero, R. M. [Hospital Nacional Carlos Alberto Seguin Escobedo, Servicio de Medicina Nuclear, Arequipa (Peru); Vega Ramírez, J. L. [Universidad Nacional de San Agustín de Arequipa, Escuela de Física, Arequipa (Peru)

    2016-07-07

    The Iodine-131 (I-131) is a radioisotope used as a standard treatment for radioablation of thyroid remnants. Among thyroid cancer patients, the ones undergoing hemodialysis represent a specific group. The dose of I-131 is given orally to these patients, part of it is absorbed by the thyroid remnants and the rest of it, largely not incorporated, is excreted primarily by renal excretion. The use of a high dose of radioactivity in the process, and the inability of excretion, represents a high risk of exposure to the patient, medical staff and hemodialysis equipment. This work describes the procedure applied on the radioablation therapy for thyroid cancer while receiving hemodialysis, minimizing the risks for the patient and the staff involved. This clinical procedure will establish the dosimetric measures, a plan on radiation protection and a treatment protocol for this specific type of patients.

  11. Radioablative therapy with Iodine-131 on a patient with thyroid cancer and chronic renal failure in hemodialysis first experience in Peru

    Science.gov (United States)

    Apaza Veliz, D. G.; Herrera Vera, R. D.; Cardenas Abarca, C. A.; Oporto Gonzales, C. A.; Aguilar Ramírez, C.; Vega Ramírez, J. L.; Urquizo Baldomero, R. M.

    2016-07-01

    The Iodine-131 (I-131) is a radioisotope used as a standard treatment for radioablation of thyroid remnants. Among thyroid cancer patients, the ones undergoing hemodialysis represent a specific group. The dose of I-131 is given orally to these patients, part of it is absorbed by the thyroid remnants and the rest of it, largely not incorporated, is excreted primarily by renal excretion. The use of a high dose of radioactivity in the process, and the inability of excretion, represents a high risk of exposure to the patient, medical staff and hemodialysis equipment. This work describes the procedure applied on the radioablation therapy for thyroid cancer while receiving hemodialysis, minimizing the risks for the patient and the staff involved. This clinical procedure will establish the dosimetric measures, a plan on radiation protection and a treatment protocol for this specific type of patients.

  12. Remnants of occipital vertebrae: proatlas segmentation abnormalities.

    Science.gov (United States)

    Menezes, Arnold H; Fenoy, Kathleen A

    2009-05-01

    Developmental remnants around the foramen magnum, or proatlas segmentation abnormalities, have been recorded in postmortem studies but very rarely in a clinical setting. Because of their rarity, the pathological anatomy has been misunderstood, and treatment has been fraught with failures. The objectives of this prospective study were to understand the correlative anatomy, pathology, and embryology and to recognize the clinical presentation and gain insights on the treatment and management. Our craniovertebral junction (CVJ) database started in 1977 and comprises 5200 cases. This prospective study has retrieval capabilities. Neurodiagnostic studies changed with the evolution of imaging. Seventy-two patients were recognized as having symptomatic proatlas segmentation abnormalities. Ventral bony masses from the clivus or medial occipital condyle occurred in 66% (44/72), lateral or anterolateral compressive masses in 37% (27 of 72 patients), and dorsal bony compression in 17% (12 of 72 patients). Hindbrain herniation was associated in 33%. The age at presentation was 3 to 23 years. Motor symptoms occurred in 72% (52 of 72 patients); palsies in Cranial Nerves IX, X, and XII in 33% (24 of 72 patients); and vertebrobasilar symptoms in 25% (18 of 72 patients). Trauma precipitated symptoms in 55% (40 of 72 patients). The best definition of the abnormality was demonstrated by 3-dimensional computed tomography combined with magnetic resonance imaging. Treatment was aimed at decompression of the pathology and stabilization. Remnants of the occipital vertebrae around the foramen magnum were recognized in 72 of 5200 CVJ cases (7.2%). Magnetic resonance imaging with 3-dimensional computed tomography of the CVJ provides the best definition and understanding of the lesions. Brainstem myelopathy and lower cranial nerve deficits are common clinical presentations in the first and second decades of life. Treatment is aimed at decompression of the pathology and CVJ stabilization.

  13. Benner's remnants: culture, tradition and everyday understanding.

    Science.gov (United States)

    Paley, John

    2002-06-01

    Benner's account of meaning and embodiment in nursing depends on a theory which she has never fully articulated, although she makes numerous allusions to it. Behind the background of shared meanings hovers something called 'culture', which provides each individual with meaning, determines what counts as real for her, and actively hands down interpretation-laden practices. This view is based, Benner claims, on the Heideggerian assumption that the meaning and organization of a culture precedes individual meaning-giving activity. I explore Benner's implicit view of culture, drawing on her published work over 15 years, and offer an appraisal of it. In doing so, I attempt to make sense of some rather strange remarks Benner has recently made about 'remnants' of Cartesian and Kantian thinking being found in the everyday understandings of people with asthma. The concept of culture is developed with reference to both Benner's own work and that of the anthropologist, Clifford Geertz, whose work she frequently cites. Having identified the principal tenets of what we might conveniently call the Benner-Geertz theory, I proceed to interrogate the theory, using the recent anthropological literature -- and, in particular, materialist attacks on the idea of culture as a system of meanings -- in order to cast doubt on it. I also review, very briefly, an alternative way of understanding 'culture', which is not vulnerable to the same criticisms. Benner's implicit theory of culture is revealed, somewhat ironically, as an inverted form of Cartesian dualism. Its intellectual provenance is not Heidegger, who appears to reject it, but the sort of American sociology associated with Talcott Parsons. As a corollary, it is suggested that Benner's 'remnants' analogy cannot be justified, and that the idea of Cartesian and Kantian concepts permeating Western culture, infecting both the providers and receivers of health care, is a myth.

  14. Supernova remnants and the origin of cosmic rays

    NARCIS (Netherlands)

    Vink, J.

    2014-01-01

    Supernova remnants have long been considered to be the dominant sources of Galactic cosmic rays. For a long time the prime evidence consisted of radio synchrotron radiation from supernova remnants, indicating the presence of electrons with energies of several GeV. However, in order to explain the

  15. Supernova Remnants as the Sources of Galactic Cosmic Rays

    NARCIS (Netherlands)

    Vink, J.

    2013-01-01

    The origin of cosmic rays holds still manymysteries hundred years after they were first discovered. Supernova remnants have for long been the most likely sources of Galactic cosmic rays. I discuss here some recent evidence that suggests that supernova remnants can indeed efficiently accelerate

  16. Relating Eye Activity Measures to Human Controller Remnant Characteristics

    NARCIS (Netherlands)

    Popovici, A; Zaal, P.M.T.; Pool, D.M.; Mulder, M.; Sawaragi, T

    2016-01-01

    This study attempts to partially explain the characteristics of the human perceptual remnant, following Levison’s representation of the remnant as an equivalent observation noise. Eye activity parameters are recorded using an eye tracker in two compensatory tracking tasks in which the visual

  17. Thyroid-stimulating hormone pituitary adenomas.

    Science.gov (United States)

    Clarke, Michelle J; Erickson, Dana; Castro, M Regina; Atkinson, John L D

    2008-07-01

    Thyroid-stimulating hormone (TSH)-secreting pituitary adenomas are rare, representing secreting or clinically silent TSH-immunostaining pituitary tumors among all pituitary adenomas followed at their institution between 1987 and 2003. Patient records, including clinical, imaging, and pathological and surgical characteristics were reviewed. Twenty-one patients (6 women and 15 men; mean age 46 years, range 26-73 years) were identified. Of these, 10 patients had a history of clinical hyperthyroidism, of whom 7 had undergone ablative thyroid procedures (thyroid surgery/(131)I ablation) prior to the diagnosis of pituitary adenoma. Ten patients had elevated TSH preoperatively. Seven patients presented with headache, and 8 presented with visual field defects. All patients underwent imaging, of which 19 were available for imaging review. Sixteen patients had macroadenomas. Of the 21 patients, 18 underwent transsphenoidal surgery at the authors' institution, 2 patients underwent transsphenoidal surgery at another facility, and 1 was treated medically. Patients with TSH-secreting tumors were defined as in remission after surgery if they had no residual adenoma on imaging and had biochemical evidence of hypo-or euthyroidism. Patients with TSH-immunostaining tumors were considered in remission if they had no residual tumor. Of these 18 patients, 9 (50%) were in remission following surgery. Seven patients had residual tumor; 2 of these patients underwent further transsphenoidal resection, 1 underwent a craniotomy, and 4 underwent postoperative radiation therapy (2 conventional radiation therapy, 1 Gamma Knife surgery, and 1 had both types of radiation treatment). Two patients had persistently elevated TSH levels despite the lack of evidence of residual tumor. On pathological analysis and immunostaining of the surgical specimen, 17 patients had samples that stained positively for TSH, 8 for alpha-subunit, 10 for growth hormone, 7 for prolactin, 2 for adrenocorticotrophic hormone

  18. Thyroid cancer around Chernobyl

    International Nuclear Information System (INIS)

    Beral, V.

    1997-01-01

    The author's presentation on thyroid cancer around Chernobyl will focus on four different things. First will be the time trends, or the pattern of thyroid cancer occurrence before and after the accident. It is now very well known that the increase in thyroid cancer in children in several areas has been unprecedented. Second, the author discusses thyroid cancer in general and patterns of thyroid cancer around the world before the Chernobyl accident, including differences by age and pathology. Third, the author presents relatively crude analyses of risk according to dose to the thyroid gland. And last, the author attempts to contrast the findings for thyroid cancer in relation to the internal radioiodine dose in Chernobyl studies with analyses of the effects of external dose on thyroid cancer incidence. The bottom line to be developed is similar to that presented by Elaine Ron with regard to effects of external dose on thyroid cancer. The similarities between the childhood finding from Chernobyl studies and external radiation studies appear more remarkable than the differences

  19. Carcinoma of the thyroid

    International Nuclear Information System (INIS)

    Botta Zunino, L.

    1992-01-01

    Reference is made to the diagnostic evaluation of thyroid nodule, reaffirming the concepts of algorithm study, sensitivity and specificity of diagnostic procedures and cost-effectiveness. Stressing once again the place of cytology and the concept of selecting patients for surgery, surgical tactics in front of the thyroid nodule and the need for probate multidisciplinary study and treatment of this pathology. Briefly discusses the most controversial treatment of differentiated thyroid carcinomas, the sine qua non of the pathologist in the operating room in thyroid surgery and the value of the quantification of nuclear DNA in the diagnosis and prognosis of these tumors (Author) [es

  20. Radionuclides in thyroid cancer

    International Nuclear Information System (INIS)

    Mahadev, V.

    1980-01-01

    The three main areas of application of radionuclides in thyroid disease will be reviewed. Firstly thyroid radionuclide imaging in thyroid swellings, in relationship to lumps in the neck and ectopic thyroid tissue such as retrosternal goitre, and lingual goitre will be described. Future developments in the field including tomographic scanning, using the coded aperture method, and fluorescent scans and ultrasound are reviewed. The second area of application is the assessment and evaluation of thyroid function and the therapy of Grave's Disease and Plummer's Disease using radioiodine. The importance of careful collection of the line of treatment, results of treatment locally and the follow-up of patients after radioiodine therapy will be described. The third area of application is in the diagnosis and therapy of thyroid cancer. Investigation of thyroid swelling, and the diagnosis of functioning metastases are reported. The therapeutic iodine scan as the sole evidence of functioning metastatic involvement is recorded. Histological thyroid cancer appears to be increasingly encountered in clinical practice and the plan of management in relation to choice of cases for therapeutic scanning is discussed with case reports. Lastly the role of whole body scanning in relationship to biochemical markers is compared. In the changing field of nuclear medicine radionuclide applications in thyroid disease have remained pre-eminent and this is an attempt to reassess its role in the light of newer developments and local experience in the Institute of Radiotherapy, Oncology and Nuclear Medicine. (author)

  1. Variants and pitfalls on radioiodine scans in pediatric patients with differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Mostafa, Mohamed; Vali, Reza; Chan, Jeffrey; Omarkhail, Yusuaf; Shammas, Amer [University of Toronto, Nuclear Medicine Division, Department of Medical Imaging, The Hospital for Sick Children, Toronto, Ontario (Canada)

    2016-10-15

    Potentially false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma can mimic functioning thyroid tissue and functioning thyroid carcinomatous tissue. Such false-positive findings comprise variants and pitfalls that can vary slightly in children as compared with adults. To determine the patterns and frequency of these potential false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma. We reviewed a total of 223 radioiodine scans from 53 pediatric patients (mean age 13.3 years, 37 girls) with differentiated thyroid carcinoma. Focal or regional activity that likely did not represent functioning thyroid tissue or functioning thyroid carcinomatous tissue were categorized as variants or pitfalls. The final diagnosis was confirmed by reviewing the concurrent and follow-up clinical data, correlative ultrasonography, CT scanning, serum thyroglobulin and antithyroglobulin antibody levels. We calculated the frequency of these variants and pitfalls from diagnostic and post-therapy radioiodine scans. The most common variant on the radioiodine scans was the thymic activity (24/223, 10.8%) followed by the cardiac activity (8/223, 3.6%). Salivary contamination and star artifact, caused by prominent thyroid remnant, were the most important observed pitfalls. Variants and pitfalls that mimic functioning thyroid tissue or functioning thyroid carcinomatous tissue on radioiodine scan in children with differentiated thyroid carcinoma are not infrequent, but they decrease in frequency on successive radioiodine scans. Potential false-positive findings can be minimized with proper knowledge of the common variants and pitfalls in children and correlation with clinical, laboratory and imaging data. (orig.)

  2. Preoperative scintigraphic detection of lung metastases of a follicular thyroid carcinoma associated with hyperthyroidism; Detection scintigraphique preoperatoire de metastases pulmonaires d'un carcinome vesiculaire de la thyroide associe a une hyperthyroidie

    Energy Technology Data Exchange (ETDEWEB)

    Biyi, A.; Oufroukhi, Y.; Doudouh, A. [Hopital Militaire d' Instruction Mohammed V, Rabat Instituts, Service de Medecine Nucleaire, Rabat (Morocco); Baizri, H.; El Quatni, M. [Hopital Militaire d' Instruction Mohammed V, Service d' Endocrinologie, Rabat (Morocco); Al Bouzidi, A. [Hopital Militaire d' Instruction Mohammed V, Service d' Anatomie Pathologique, Rabat (Morocco)

    2009-10-15

    Preoperative accumulation of radioiodine in metastases of thyroid carcinoma and its association with hyperthyroidism are uncommon. We report a case of 58-year-old woman with follicular thyroid carcinoma revealed by thyrotoxicosis caused by a hot nodule, and bilateral pulmonary uptake of I-131 before total thyroidectomy. Despite four ablative doses of I-131, bone metastases were identified and the patient died 42 month after the initial diagnosis. (authors)

  3. Radiation and thyroid cancer

    International Nuclear Information System (INIS)

    Lazo, Edward

    2014-01-01

    An International Workshop on Radiation and Thyroid Cancer took place on 21-23 February 2014 in Tokyo, Japan, to support the efforts of the Fukushima Prefecture and the Japanese government in enhancing public health measures following the Fukushima Daiichi nuclear power plant accident in March 2011. The workshop, which was designed to develop a state-of-the-art scientific understanding of thyroid cancer in children and of radiation-induced thyroid cancer (papillary carcinoma) in particular, was co-organised by the Japanese Ministry of the Environment (MOE), the Fukushima Medical University (FMU) and the OECD Nuclear Energy Agency (NEA). It brought together the world's top experts in the field, including medical doctors, epidemiologists and radiological risk assessment specialists from ten countries. Although rare, thyroid cancer occurs naturally, with the risk of developing a thyroid cancer increasing with age. Cases are usually identified when a thyroid carcinogenic nodule grows enough to be felt with a patient's fingers, at which point the patient visits a medical doctor to identify the nature of the growth. In many countries around the world, the incidence rate of naturally occurring thyroid cancer is on the order of less than 1 per year per 100 000 children (from ages 0 to 18). Statistically, this rate appears to be increasing in many countries, with young girls slightly more at risk than young boys. A second but very different means of detecting thyroid cancer cases is through thyroid ultrasound screening examinations on subjects who do not demonstrate any symptoms. Ultrasound screening is a more sensitive approach that can detect very small nodules (< 5 mm) and cysts (< 20 mm) which would not normally be perceived through simple palpitation. However, because thyroid ultrasound screening examinations are much more effective, the number of thyroid cancer cases per examination will normally be larger than the number per capita found through national cancer

  4. Remnant Cholesterol Elicits Arterial Wall Inflammation and a Multilevel Cellular Immune Response in Humans

    NARCIS (Netherlands)

    Bernelot Moens, Sophie J.; Verweij, Simone L.; Schnitzler, Johan G.; Stiekema, Lotte C. A.; Bos, Merijn; Langsted, Anne; Kuijk, Carlijn; Bekkering, Siroon; Voermans, Carlijn; Verberne, Hein J.; Nordestgaard, Børge G.; Stroes, Erik S. G.; Kroon, Jeffrey

    2017-01-01

    Mendelian randomization studies revealed a causal role for remnant cholesterol in cardiovascular disease. Remnant particles accumulate in the arterial wall, potentially propagating local and systemic inflammation. We evaluated the impact of remnant cholesterol on arterial wall inflammation,

  5. Does multifocal papillary micro-carcinoma require radioiodine ablation?

    International Nuclear Information System (INIS)

    Punda, A.; Markovic, V.; Eterovic, D.

    2015-01-01

    Full text of publication follows. Background: the thyroid carcinomas smaller than 1 cm (micro-carcinomas) comprise a significant fraction of papillary carcinomas. Excluding clinical micro-carcinomas, which present as metastatic disease, the micro-carcinomas diagnosed by ultrasound/FNAC or incidentally have very good prognosis. However, whether or not these papillary micro-carcinomas require post-surgical radioiodine ablation remains a matter of debate. Hypothesis: multi-focality is present in majority of clinical papillary micro-carcinomas and this characteristic can be used to identify the subset of non-clinical micro-carcinomas with greater malignant potential. Methods: the data on types of differentiated thyroid carcinomas diagnosed in the period 2008-2011 in the University Hospital Split were collected. Results: there were 359 patients with thyroid carcinoma, 329 (92%) of which had papillary carcinoma. About 61% (202/329) of papillary carcinomas were micro-carcinomas; most of them were diagnosed by ultrasound/FNAC (134/202= 66%), the rest were incidentalomas (48/202=24%) and clinical micro carcinomas (20/202=10%). Sixty percent (12/20) of patients with clinical micro-carcinoma and 23 patients with non-clinical micro-carcinoma (23/182=13%) had multifocal disease. Conclusion: multifocal disease is a frequent characteristic of clinical papillary thyroid micro-carcinomas, suggesting that multi-focality presents an early stage of non-clinical micro-carcinomas with more aggressive behaviour. Thus multifocal, but not uni-focal papillary micro-carcinomas may require radioiodine ablation. (authors)

  6. Thyroid hormone synthesis and anti-thyroid drugs

    Indian Academy of Sciences (India)

    The inhibition of thyroid hormone synthesis is required for the treatment of hyperthyroidism and this can be achieved by one or more anti-thyroid drugs. The most widely used anti-thyroid drug methimazole (MMI) inhibits the production of thyroid hormones by irreversibly inactivating the enzyme TPO. Our studies show that the ...

  7. American Thyroid Association

    Science.gov (United States)

    ... More October 20, 2017 0 American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors By ATA | 2017 ... Featured , News Releases | No Comments American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors October 19,… Read ...

  8. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... process that regulates the rate at which the body converts food to energy. top of page What are some common uses of the procedure? The thyroid scan is used to determine the size, shape and position of the thyroid gland. The ...

  9. Flavonoids and thyroid disease

    NARCIS (Netherlands)

    Heide, van der D.; Kastelijn, J.; Schroder-van der Elst, J.P.

    2003-01-01

    The most potent natural plant-derived compounds that can affect thyroid function, thyroid hormone secretion and availability to tissues is the group of flavonoids, i.e. plant pigments. They are present in our daily food, such as vegetables, fruits, grains, nuts, wine, and tea. Epidemiological

  10. Thyroid Disorders Overview

    Science.gov (United States)

    ... body breaks down food and either uses that energy immediately or stores it for the future. In other words, our thyroid hormones regulate our body's metabolism. Another gland, called the pituitary gland, actually controls how well the thyroid works. The pituitary gland ...

  11. Thyroid evaluation with radioassay

    International Nuclear Information System (INIS)

    Ashkar, F.S.

    1983-01-01

    Thyroid hormone is given therapeutically for the treatment of hypothyroidism and in goiterous conditions. When administered in full maintenance dosage, it interrupts the operation of the homeostatic mechanism that evokes excesses of thyrotropin (TSH) in response to various goiterogenic stimuli or impending thyroid failure, resulting in thyroid gland enlargement. All patients with treated thyroid cancer are maintained indefinitely on full replacement dosages of thyroid hormone to eliminate endogenous TSH and its trophic effect, thereby minimizing recurrence and growth of the tumor. A high-risk group of patients that were irradiated to the head and neck in childhood for various reasons are placed on thyroid hormone therapy prophylactically to turn off their endogenous TSH if they are found free of thyroid nodularity on initial evaluation. The adequacy of thyroid hormone therapy and the regularity of its intake can be ultimately evaluated by the thyrotropin releasing hormone (TRH) stimulation test, where no TSH response indicates adequate therapy and a normal TSH response suggests inadequate or irregular treatment

  12. Thyroid Disease (for Parents)

    Science.gov (United States)

    ... body fuels into the energy they need to work properly, these hormones are important in helping a child's body mature as it should. Thyroid hormones also directly affect how most organs function. So a thyroid that isn't operating properly can cause problems in many other parts of the body. ...

  13. Thyroid hormone replacement therapy

    NARCIS (Netherlands)

    Wiersinga, W. M.

    2001-01-01

    Thyroid hormone replacement has been used for more than 100 years in the treatment of hypothyroidism, and there is no doubt about its overall efficacy. Desiccated thyroid contains both thyroxine (T(4)) and triiodothyronine (T(3)); serum T(3) frequently rises to supranormal values in the absorption

  14. Thyroid and radiation

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Shunichi; Namba, Hiroyuki; Nagataki, Shigenobu (Nagasaki Univ. (Japan). School of Medicine)

    1993-11-01

    The topic 'Thyroid and Radiation' is both an old and new area to be solved by human beings. The thyroid is an organ that is usually susceptible to exposure to ionizing radiation, both by virtue of its ability to concentrate radioiodine (internal radiation) and by routine medical examination: Chest X-ray, Dental X-ray, X-irradiation of cervical lymph nodes etc. (external radiation). Iodine-131 is widely used for the therapy of Graves' disease and thyroid cancers, of which the disadvantage is radiation-induced hypothyroidism but not complications of thyroid tumor. The thyroid gland is comparatively radioresistant, however, the data obtained from Hiroshima, Nagasaki and Marshall islands indicates a high incidence of external radiation-induced thyroid tumors as well as hypothyroidism. The different biological effects of internal and external radiation remains to be further clarified. Interestingly, recent reports demonstrate the increased number of thyroid cancer in children around Chernobyl in Belarus. In this review, we would like to introduce the effect of radiation on the thyroid gland at the molecular, cellular and tissue levels. Furthermore the clinical usefulness of iodine-131, including the safety-control for radiation exposure will be discussed. (author) 50 refs.

  15. Radioimmunoassay of thyroid hormones

    International Nuclear Information System (INIS)

    Bartalena, L.; Mariotti, S.; Pinchera, A.

    1987-01-01

    For many years, methods based on iodine content determination have represented the only techniques available for the estimation of total thyroid hormone concentrations in serum. Subsequently, simple, sensitive, and specific radioligand assays for thyroid hormones have replaced these chemical methods. For the purpose of this chapter, iodometric techniques are only briefly summarized for their historical importance, whereas attention is focused on radioligand assays

  16. Thyroid function and obesity.

    Science.gov (United States)

    Laurberg, Peter; Knudsen, Nils; Andersen, Stig; Carlé, Allan; Pedersen, Inge Bülow; Karmisholt, Jesper

    2012-10-01

    Important interaction exists between thyroid function, weight control, and obesity. Several mechanisms seem to be involved, and in studies of groups of people the pattern of thyroid function tests depends on the balance of obesity and underlying thyroid disease in the cohort studied. Obese people with a normal thyroid gland tend to have activation of the hypothalamic-pituitary-thyroid axis with higher serum TSH and thyroid hormones in serum. On the other hand, small differences in thyroid function are associated with up to 5 kg difference in body weight. The weight loss after therapy of overt hypothyroidism is caused by excretion of water bound in tissues (myxoedema). Many patients treated for hyperthyroidism experience a gain of more weight than they lost during the active phase of the disease. The mechanism for this excessive weight gain has not been fully elucidated. New studies on the relation between L-T3 therapy and weight control are discussed. The interaction between weight control and therapy of thyroid disease is important to many patients and it should be studied in more detail.

  17. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Thyroid Scan and Uptake Thyroid scan and uptake uses ...

  18. 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)

  19. PREGNANCY AND THYROID

    Directory of Open Access Journals (Sweden)

    Simona Gaberšček

    2004-01-01

    Full Text Available Background. In conditions with appropriate iodine intake, thyroid gland adapts to changes during pregnancy without any consequences. Fetal need for thyroid hormones in the first trimester is directly connected with transplacental transport of thyroid hormones. Fetal synthesis of thyroid hormones depends on availability of iodine in the feto-placental unit. Hypo- and hyperthyroidism during pregnancy are risk factors for pregnant woman and for normal development of fetus and child.Conclusions. Pregnant women with appropriately treated thyroid diseases have the same outcome of pregnancy as healthy women, and neuroendocrinological development of children is not impaired. If the disease is unrecognized or untreated, complications of pregnancy and delivery occur more frequently. Therefore, timely recognition and treatment of the diseases with appropriate drugs during pregnancy and, also, after delivery is very important.

  20. High versus low radioiodine activity in patients with differentiated thyroid cancer - A meta-analysis

    International Nuclear Information System (INIS)

    Valachis, Antonis; Nearchou, Andreas

    2013-01-01

    Background: The purpose of the meta-analysis was to estimate the effectiveness and toxicity of low activity radioiodine ablation versus high activity in patients with differentiated thyroid cancer (DTC). Design: A systematic review and meta-analysis was performed by including all randomized trials of low activity versus high activity radioiodine ablation after thyroidectomy. Standard meta-analytic procedures were used to analyze the study outcomes. Results: Ten trials were considered eligible and were further analyzed. The pooled risk ratio (RR) of having a successful ablation for an activity of 1100 MBq versus 3700 MBq (seven trials, 1772 patients) was 0.94 (95% CI 0.85 - 1.04, p-value 0.21). The RR for successful ablation when only thyroid hormone withdrawal was used (five trials, 1116 patients) was 0.87 (95% CI 0.72 - 1.06, p-value 0.17) and it was comparable to RR when only recombinant-human TSH (rec-hTSH) (two trials, 812 patients) was used (1.00, 95% CI 0.93 - 1.07, p-value 0.92). Salivary dysfunction, nausea, and neck pain were significantly more frequent among patients with higher dose for ablation. Conclusion: Our meta-analysis provides some evidence from randomized trials that a lower activity of radioiodine ablation is as effective as higher dose after surgery in patients with DTC with lower toxicity

  1. High versus low radioiodine activity in patients with differentiated thyroid cancer - A meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Valachis, Antonis [Dept. of Oncology, Maelarsjukhuset., Eskilstuna (Sweden); Univ. of Uppsala,, (Sweden)], e-mail: Valachis@hotmail.com, Antonis.Valachis@akademiska.uu.se; Nearchou, Andreas [Dept, of Oncology, Maelarsjukhuset., Eskilstuna (Sweden); Univ. of Uppsala., Uppsala (Sweden)

    2013-08-15

    Background: The purpose of the meta-analysis was to estimate the effectiveness and toxicity of low activity radioiodine ablation versus high activity in patients with differentiated thyroid cancer (DTC). Design: A systematic review and meta-analysis was performed by including all randomized trials of low activity versus high activity radioiodine ablation after thyroidectomy. Standard meta-analytic procedures were used to analyze the study outcomes. Results: Ten trials were considered eligible and were further analyzed. The pooled risk ratio (RR) of having a successful ablation for an activity of 1100 MBq versus 3700 MBq (seven trials, 1772 patients) was 0.94 (95% CI 0.85 - 1.04, p-value 0.21). The RR for successful ablation when only thyroid hormone withdrawal was used (five trials, 1116 patients) was 0.87 (95% CI 0.72 - 1.06, p-value 0.17) and it was comparable to RR when only recombinant-human TSH (rec-hTSH) (two trials, 812 patients) was used (1.00, 95% CI 0.93 - 1.07, p-value 0.92). Salivary dysfunction, nausea, and neck pain were significantly more frequent among patients with higher dose for ablation. Conclusion: Our meta-analysis provides some evidence from randomized trials that a lower activity of radioiodine ablation is as effective as higher dose after surgery in patients with DTC with lower toxicity.

  2. Thyroid diseases and pregnancy

    Directory of Open Access Journals (Sweden)

    Marco Grandi

    2013-05-01

    Full Text Available BACKGROUND Thyroid diseases and diabetes mellitus are the most common endocrine diseases during pregnancy. Internal Medicine doctors could be involved in the management of pregnant women affected by thyroid diseases, in particular if an Endocrine Unit lacks in the hospital; it is mandatory that they have the skills to cope with these diseases. METHODS In this work authors describe the most common thyroid abnormalities that can occur during pregnancy: hypothyroidism (clinical and subclinical, hyperthyroidism (clinical and sub-clinical, autoimmune thyroiditis (in particular the so called post-partum thyroiditis, nodular diseases and cancer. They discuss moreover the peculiar pathophysiologic mechanisms by which these diseases appear, the diagnostic tools and the therapies, according to their own experience and the more recent international guidelines. RESULTS AND CONCLUSIONS It is important to evaluate thyroid function tests before and during pregnancy, at 16th and 28th gestational week; it is mandatory to cure also the “sub-clinical” hypothyroidism during pregnancy, when TSH level are higher than 5 μIU/mL; the optimal dose of levo-thyroxine during pregnancy is, average, 30-50% higher than that used before pregnancy; it is not correct to treat mild or sub-clinical hyperthyroidism; propylthyouracil is the best drug to treat hyperthyroidism during pregnancy; the post-partum thyroiditis is generally transient, so that a careful monitoring of thyroid function is advisable, in particular after 9-12 months of therapy; thyroid cancer, if discovered during pregnancy, generally has no negative effects on the outcome of the pregnancy; it would be better to treat surgically thyroid cancer during the last trimester of the pregnancy.

  3. Ablative thermal protection systems

    International Nuclear Information System (INIS)

    Vaniman, J.; Fisher, R.; Wojciechowski, C.; Dean, W.

    1983-01-01

    The procedures used to establish the TPS (thermal protection system) design of the SRB (solid rocket booster) element of the Space Shuttle vehicle are discussed. A final evaluation of the adequacy of this design will be made from data obtained from the first five Shuttle flights. Temperature sensors installed at selected locations on the SRB structure covered by the TPS give information as a function of time throughout the flight. Anomalies are to be investigated and computer design thermal models adjusted if required. In addition, the actual TPS ablator material loss is to be measured after each flight and compared with analytically determined losses. The analytical methods of predicting ablator performance are surveyed. 5 references

  4. Resistant thyrotoxicosis: A case of sarcoidosis of thyroid

    Directory of Open Access Journals (Sweden)

    Uday Yanamandra

    2013-01-01

    Full Text Available Autoimmune endocrinopathies and, less commonly, thyroid autoimmune disease have been reported in patients with sarcoidosis. Similarities exist in the pathogenesis of these two conditions. Concomitant sarcoidosis in the thyroid gland in patients with Graves′ disease may contribute to the resistance to antithyroid drugs and radioiodine therapy. We present the clinical, laboratory, imaging, and pathologic findings of a patient with Graves′ disease who was unresponsive to medical management. This 37-year-old man presented with thyrotoxicosis. Thyroid hormone assays and 99m Technitium findings were consistent with Graves′ disease. He was also found to have hilar lymphadenopathy. Patient failed to achieve remission with high doses of antithyroid drugs and 2 sessions of radioiodine ablative therapy.Histopathology of lymph nodesdisclosed noncaseating granulomas, consistent with sarcoidosis. Patient′s thyrotoxicosis subsided only following steroid administration. The histopathology of the thyroid gland on aspiration and the subsidence of symptoms with steroids reiterate the possibility of thyroid sarcoidosis. This diagnosis needs biopsy for confirmation, which our patient didn′t consent for.

  5. Thyroid Cancer—Patient Version

    Science.gov (United States)

    Thyroid cancer can be of four main types. Anaplastic thyroid cancer is hard to cure with current treatments, whereas papillary (the most common), follicular, and medullary thyroid cancer can usually be cured. Start here to find information on thyroid cancer treatment, screening, research, and statistics.

  6. Lesion size in relation to ablation site during radiofrequency ablation

    DEFF Research Database (Denmark)

    Petersen, H H; Chen, X; Pietersen, A

    1998-01-01

    This study was designed to investigate the effect of the convective cooling of the tip of the ablation electrode during temperature controlled radiofrequency ablation. In vivo two different application sites in the left ventricle of anaesthetised pigs were ablated and in vitro ablation was perfor......This study was designed to investigate the effect of the convective cooling of the tip of the ablation electrode during temperature controlled radiofrequency ablation. In vivo two different application sites in the left ventricle of anaesthetised pigs were ablated and in vitro ablation...... was performed during two different flow-velocities in a tissue bath, while electrode contact pressure and position were unchanged. Target temperature was 80 degrees C. Obtained tip temperature, power consumption and lesion dimensions were measured. In vivo lesion volume, depth and width were found significantly.......61 in vitro). We conclude that during temperature controlled radiofrequency ablation lesion size differs for septal and apical left ventricular applications. Differences in convective cooling might play an important role in this respect. This is supported by our in vitro experiments, where increased...

  7. Generation of Cosmic rays in Historical Supernova Remnants

    Directory of Open Access Journals (Sweden)

    Sinitsyna V.Y.

    2013-06-01

    Full Text Available We present the results of observations of two types of Galactic supernova remnants with the SHALON mirror Cherenkov telescope of Tien-Shan high-mountain Observatory: the shell-type supernova remnants Tycho, Cas A and IC 443; plerions Crab Nebula, 3c58(SN1181 and Geminga (probably plerion. The experimental data have confirmed the prediction of the theory about the hadronic generation mechanism of very high energy (800 GeV - 100 TeV gamma-rays in Tycho's supernova remnant. The data obtainedsuggest that the very high energy gamma-ray emission in the objects being discussedis different in origin.

  8. Revised Distances to 21 Supernova Remnants

    Science.gov (United States)

    Ranasinghe, S.; Leahy, D. A.

    2018-05-01

    We carry out a comprehensive study of H I 21 cm line observations and 13CO line observations of 21 supernova remnants (SNRs). The aim of the study is to search for H I absorption features to obtain kinematic distances in a consistent manner. The 21 SNRs are in the region of sky covered by the Very Large Array Galactic Plane Survey (H I 21 cm observations) and Galactic Ring Survey (13CO line observations). We obtain revised distances for 10 SNRs based on new evidence in the H I and 13CO observations. We revise distances for the other 11 SNRs based on an updated rotation curve and new error analysis. The mean change in distance for the 21 SNRs is ≃25%, i.e., a change of 1.5 kpc compared to a mean distance for the sample of 6.4 kpc. This has a significant impact on interpretation of the physical state of these SNRs. For example, using a Sedov model, age and explosion energy scale as the square of distance, and inferred ISM density scales as distance.

  9. Quantum remnants in the classical limit

    International Nuclear Information System (INIS)

    Kowalski, A.M.; Plastino, A.

    2016-01-01

    We analyze here the common features of two dynamical regimes: a quantum and a classical one. We deal with a well known semi-classic system in its route towards the classical limit, together with its purely classic counterpart. We wish to ascertain i) whether some quantum remnants can be found in the classical limit and ii) the details of the quantum-classic transition. The so-called mutual information is the appropriate quantifier for this task. Additionally, we study the Bandt–Pompe's symbolic patterns that characterize dynamical time series (representative of the semi-classical system under scrutiny) in their evolution towards the classical limit. - Highlights: • We investigate the classical limit (CL) of a well known semi classical model. • The study is made by reference to the Bandt Pompe symbolic approach. • The number and type of associated symbols changes as one proceeds towards the CL. • We ascertain which symbols pertaining to the quantum zone remain in the CL.

  10. Nonthermal Radiation from Supernova Remnant Shocks

    Directory of Open Access Journals (Sweden)

    Hyesung Kang

    2013-09-01

    Full Text Available Most of high energy cosmic rays (CRs are thought to be produced by diffusive shock acceleration (DSA at supernova remnants (SNRs within the Galaxy. Fortunately, nonthermal emissions from CR protons and electrons can provide direct observational evidence for such a model and place strong constraints on the complex nonlinear plasma processes in DSA theory. In this study we calculate the energy spectra of CR protons and electrons in Type Ia SNRs, using time-dependent DSA simulations that incorporate phenomenological models for some wave-particle interactions. We demonstrate that the timedependent evolution of the self-amplified magnetic fields, Alfvénic drift, and escape of the highest energy particles affect the energy spectra of accelerated protons and electrons, and so resulting nonthermal radiation spectrum. Especially, the spectral cutoffs in X-ray and γ-ray emission spectra are regulated by the evolution of the highest energy particles, which are injected at the early phase of SNRs. Thus detailed understandings of nonlinear wave-particle interactions and time-dependent DSA simulations of SNRs are crucial in testing the SNR hypothesis for the origin of Galactic cosmic rays.

  11. Radio emission from embryonic superluminous supernova remnants

    Science.gov (United States)

    Omand, Conor M. B.; Kashiyama, Kazumi; Murase, Kohta

    2018-02-01

    It has been widely argued that Type-I superluminous supernovae (SLSNe-I) are driven by powerful central engines with a long-lasting energy injection after the core-collapse of massive progenitors. One of the popular hypotheses is that the hidden engines are fast-rotating pulsars with a magnetic field of B ˜ 1013-1015 G. Murase, Kashiyama & Mészáros proposed that quasi-steady radio/submm emission from non-thermal electron-positron pairs in nascent pulsar wind nebulae can be used as a relevant counterpart of such pulsar-driven supernovae (SNe). In this work, focusing on the nascent SLSN-I remnants, we examine constraints that can be placed by radio emission. We show that the Atacama Large Millimeter/submillimetre Array can detect the radio nebula from SNe at DL ˜ 1 Gpc in a few years after the explosion, while the Jansky Very Large Array can also detect the counterpart in a few decades. The proposed radio follow-up observation could solve the parameter degeneracy in the pulsar-driven SN model for optical/UV light curves, and could also give us clues to young neutron star scenarios for SLSNe-I and fast radio bursts.

  12. Quantum remnants in the classical limit

    Energy Technology Data Exchange (ETDEWEB)

    Kowalski, A.M., E-mail: kowalski@fisica.unlp.edu.ar [Instituto de Física (IFLP-CCT-Conicet), Universidad Nacional de La Plata, C.C. 727, 1900 La Plata (Argentina); Comision de Investigaciones Científicas (CIC) (Argentina); Plastino, A., E-mail: plastino@fisica.unlp.edu.ar [Instituto de Física (IFLP-CCT-Conicet), Universidad Nacional de La Plata, C.C. 727, 1900 La Plata (Argentina); Argentina' s National Research Council (CONICET) (Argentina); SThAR, EPFL Innovation Park, Lausanne (Switzerland)

    2016-09-16

    We analyze here the common features of two dynamical regimes: a quantum and a classical one. We deal with a well known semi-classic system in its route towards the classical limit, together with its purely classic counterpart. We wish to ascertain i) whether some quantum remnants can be found in the classical limit and ii) the details of the quantum-classic transition. The so-called mutual information is the appropriate quantifier for this task. Additionally, we study the Bandt–Pompe's symbolic patterns that characterize dynamical time series (representative of the semi-classical system under scrutiny) in their evolution towards the classical limit. - Highlights: • We investigate the classical limit (CL) of a well known semi classical model. • The study is made by reference to the Bandt Pompe symbolic approach. • The number and type of associated symbols changes as one proceeds towards the CL. • We ascertain which symbols pertaining to the quantum zone remain in the CL.

  13. Predicting gravitational lensing by stellar remnants

    Science.gov (United States)

    Harding, Alexander J.; Stefano, R. Di; Lépine, S.; Urama, J.; Pham, D.; Baker, C.

    2018-03-01

    Gravitational lensing provides a means to measure mass that does not rely on detecting and analysing light from the lens itself. Compact objects are ideal gravitational lenses, because they have relatively large masses and are dim. In this paper, we describe the prospects for predicting lensing events generated by the local population of compact objects, consisting of 250 neutron stars, five black holes, and ≈35 000 white dwarfs. By focusing on a population of nearby compact objects with measured proper motions and known distances from us, we can measure their masses by studying the characteristics of any lensing event they generate. Here, we concentrate on shifts in the position of a background source due to lensing by a foreground compact object. With Hubble Space Telescope, JWST, and Gaia, measurable centroid shifts caused by lensing are relatively frequent occurrences. We find that 30-50 detectable events per decade are expected for white dwarfs. Because relatively few neutron stars and black holes have measured distances and proper motions, it is more difficult to compute realistic rates for them. However, we show that at least one isolated neutron star has likely produced detectable events during the past several decades. This work is particularly relevant to the upcoming data releases by the Gaia mission and also to data that will be collected by JWST. Monitoring predicted microlensing events will not only help to determine the masses of compact objects, but will also potentially discover dim companions to these stellar remnants, including orbiting exoplanets.

  14. Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism

    International Nuclear Information System (INIS)

    Harris, Jeffrey; Almarzouki, Hani; Barber, Brittany; Scrimger, Rufus; Romney, Jacques; O'Connell, Daniel; Urken, Mark; Seikaly, Hadi

    2016-01-01

    Purpose: The incidence of hypothyroidism after radiation therapy for head and neck cancer (HNC) has been found to be ≤53%. Medical treatment of hypothyroidism can be costly and difficult to titrate. The aim of the present study was to assess the feasibility of free thyroid transfer as a strategy for the prevention of radiation-induced damage to the thyroid gland during radiation therapy for HNC. Methods and Materials: A prospective feasibility study was performed involving 10 patients with a new diagnosis of advanced HNC undergoing ablative surgery, radial forearm free-tissue transfer reconstruction, and postoperative adjuvant radiation therapy. During the neck dissection, hemithyroid dissection was completed with preservation of the thyroid arterial and venous supply for implantation into the donor forearm site. All patients underwent a diagnostic thyroid technetium scan 6 weeks and 12 months postoperatively to examine the functional integrity of the transferred thyroid tissue. Results: Free thyroid transfer was executed in 9 of the 10 recruited patients with advanced HNC. The postoperative technetium scans demonstrated strong uptake of technetium at the forearm donor site at 6 weeks and 12 months for all 9 of the transplanted patients. Conclusions: The thyroid gland can be transferred as a microvascular free transfer with maintenance of function. This technique could represent a novel strategy for maintenance of thyroid function after head and neck irradiation.

  15. Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Jeffrey [Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta (Canada); Almarzouki, Hani [Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta (Canada); Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah (Saudi Arabia); Barber, Brittany, E-mail: brittanybarber0@gmail.com [Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta (Canada); Scrimger, Rufus [Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta (Canada); Romney, Jacques [Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta (Canada); O' Connell, Daniel [Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta (Canada); Urken, Mark [Institute for Head and Neck and Thyroid Cancers, Icahn School of Medicine, Mount Sinai Hospital, New York, New York (United States); Seikaly, Hadi [Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta (Canada)

    2016-09-01

    Purpose: The incidence of hypothyroidism after radiation therapy for head and neck cancer (HNC) has been found to be ≤53%. Medical treatment of hypothyroidism can be costly and difficult to titrate. The aim of the present study was to assess the feasibility of free thyroid transfer as a strategy for the prevention of radiation-induced damage to the thyroid gland during radiation therapy for HNC. Methods and Materials: A prospective feasibility study was performed involving 10 patients with a new diagnosis of advanced HNC undergoing ablative surgery, radial forearm free-tissue transfer reconstruction, and postoperative adjuvant radiation therapy. During the neck dissection, hemithyroid dissection was completed with preservation of the thyroid arterial and venous supply for implantation into the donor forearm site. All patients underwent a diagnostic thyroid technetium scan 6 weeks and 12 months postoperatively to examine the functional integrity of the transferred thyroid tissue. Results: Free thyroid transfer was executed in 9 of the 10 recruited patients with advanced HNC. The postoperative technetium scans demonstrated strong uptake of technetium at the forearm donor site at 6 weeks and 12 months for all 9 of the transplanted patients. Conclusions: The thyroid gland can be transferred as a microvascular free transfer with maintenance of function. This technique could represent a novel strategy for maintenance of thyroid function after head and neck irradiation.

  16. 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.

  17. WEST AFRICAN JOURNAL OF MEDICINE

    African Journals Online (AJOL)

    ABSTRACT. Recurrent thyroid cancer after remnant ablation is a known entity in follow up of differentiated thyroid cancer. It is however unusual for a stitch abscess to present as a recurrent thyroid cancer. We highlight the diagnostic dilemma of a stitch abscess masquerading as a recurrent thyroid cancer in a young female.

  18. Field enhancement induced laser ablation

    DEFF Research Database (Denmark)

    Fiutowski, Jacek; Maibohm, Christian; Kjelstrup-Hansen, Jakob

    Sub-diffraction spatially resolved, quantitative mapping of strongly localized field intensity enhancement on gold nanostructures via laser ablation of polymer thin films is reported. Illumination using a femtosecond laser scanning microscope excites surface plasmons in the nanostructures....... The accompanying field enhancement substantially lowers the ablation threshold of the polymer film and thus creates local ablation spots and corresponding topographic modifications of the polymer film. Such modifications are quantified straightforwardly via scanning electron and atomic force microscopy. Thickness...

  19. Ultrasound examination of the thyroid

    Energy Technology Data Exchange (ETDEWEB)

    Swaenepoel, L.; Demeester-Mirkine, N.; Sacre, R.; Jockheer, M.H.; van Geertruyden, J.

    1982-07-01

    Ultrasound examination of the thyroid offers an accurate morphological picture and the possibility of comparing objectively the size of lobes and lesions over long periods. Cysts and calcifications, mostly benign, are readily recognized. Neoplastic lesions in our series were all less reflective than normal thyroid tissue. But so were the majority of benign nodules. In hyperthyroidism, subacute thyroiditis and Hashimoto's thyroiditis, the thyroid tissue is much less echogenic than in the normal gland.

  20. Thyroid and thymic exeresis in surgery of hyperparathyroidism.

    Science.gov (United States)

    Diaconescu, Mr; Glod, M; Costea, I; Grigorovici, M; Diaconescu, S

    2014-01-01

    Owing to close anatomical and embryological connexions between the thyroid, parathyroids and thymus,manifold coexisting pathology can be identified during the surgery of hyperparathyroidism (Hp). In this retrospective study we report the incidence, clinical forms, histology and management of thyroid and thymic synchronous lesions encountered in as eries of 82 consecutive patients with various types of Hp operated on in the last three decades. Demography, clinical records, biochemical data, imaging procedures, pathology reports and surgical protocols were revised. Between 1984-2013, 82 cases of Hp, 20 primary and 62 renal (27 secondary and 35 tertiary), 57 women and 25 males (sex ratio: 2.3 1) of 15-72 (mean 46.5) years, under went surgery in our clinic. Concomitant thyroid exereses were performed in 32 patients (2 subtotal thyroidectomies, 12 lobectomies, 8 atypical resections and 10 diagnosis biopsies), foruni- or bilateral (multi)nodular goiters or different €œminutelesions. Pathology showed 11 colloid goiters, 3 follicular adenomas,5 nodular hyperplasias and 6 thyroiditis cases, 3 papillary microcarcinomas and 4 specimens with normal thyroid tissue.Excision of the fibrofatty retromanubrial tissue in total parathyroidectomies for renal Hp (19 cases) revealed one nonmyastenicthymoma, one thymic cyst and thymic remnants in 6 patients.Morbidity in these extended operations was not significantly increased, comparing to the parathyroid exploration alone. Meticulous pre- and intraoperative evaluation in all cases of Hp enables the actual shift from bilateral neck exploration to minimally invasive surgery,increasing however the potential risk of missing thyroid or thymic coexistent significant lesions. The surgeon dedicated to this pathology must be aware of the possibility of encountering such synchronous association and make generous efforts to wards their complete cure in a single operation. Celsius.

  1. Ectopic lingual thyroid

    International Nuclear Information System (INIS)

    Amani, Mohammed El Amine; Benabadji, Nadjia; Benzian, Zakaria; Amani, Souad

    2012-01-01

    Thyroid ectopy is characterized by the presence of thyroid tissue outside its normal position resulting from a defect of the thyroid diverticulum migration from the base of the tongue until its final pre-tracheal position. One case is presented in a 12-year-old girl patient who consults for a failure to thrive estimated at less than three standard deviations (SD). Bone age was estimated at 8 years late compared to chronological age. The hormonal assessment showed hypothyroidism with negative thyroid antibodies. Cervical ultrasound was revealed thyroid parenchyma pre-dominantly left in place while sweeping the area under chin showed a nodular formation of the base of the tongue. Thyroid scan with technetium 99 m showed a selective uptake of radiotracer in sublingual position. Cervical computed tomography revealed a posterior median sublingual mass spontaneously hyperdense and enhancing sharply after injection of contrast. Treatment with thyroxine allowed obtaining euthyroidism. This case asks us to be careful before aetiological diagnosis of hypothyroidism in children, because although this is rare, the presence of a thyroid parenchyma up to the cervical ultrasound does not eliminate the presence of ectopic tissue

  2. Radiofrequency ablation of pulmonary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Crocetti, Laura, E-mail: l.crocetti@med.unipi.i [Division of Diagnostic Imaging and Intervention, Department of Liver Transplants, Hepatology and Infectious Diseases, Pisa University School of Medicine (Italy); Lencioni, Riccardo [Division of Diagnostic Imaging and Intervention, Department of Liver Transplants, Hepatology and Infectious Diseases, Pisa University School of Medicine (Italy)

    2010-07-15

    The development of image-guided percutaneous techniques for local tumor ablation has been one of the major advances in the treatment of solid tumors. Among these methods, radiofrequency (RF) ablation is currently established as the primary ablative modality at most institutions. RF ablation is accepted as the best therapeutic choice for patients with early-stage hepatocellular carcinoma when liver transplantation or surgical resection are not suitable options and is considered as a viable alternate to surgery for inoperable patients with limited hepatic metastatic disease, especially from colorectal cancer. Recently, RF ablation has been demonstrated to be a safe and valuable treatment option for patients with unresectable or medically inoperable lung malignancies. Resection should remain the standard therapy for non-small cell lung cancer (NSCLC) but RF ablation may be better than conventional external-beam radiation for the treatment of the high-risk individual with NSCLC. Initial favourable outcomes encourage combining radiotherapy and RF ablation, especially for treating larger tumors. In the setting of colorectal cancer lung metastases, survival rates provided by RF ablation in selected patients, are substantially higher than those obtained with any chemotherapy regimens and provide indirect evidence that RF ablation therapy improves survival in patients with limited lung metastatic disease.

  3. [Is our approach to thyroid nodules and differentiated thyroid carcinoma in agreement with the American guideline and European consensus?].

    Science.gov (United States)

    Gómez Sáez, José Manuel

    2010-10-01

    The aim of this study was to assess the approaches of specialists in Spain to patients with thyroid nodules and differentiated thyroid carcinoma and to compare them with the American guideline and European consensus. We performed a cross-sectional study based on a questionnaire addressed to clinical endocrinologists specialized in thyroid cancer and specialists in nuclear medicine throughout Spain. A total of 177 questionnaires were completed, representing an overall response rate of 85%; 74% of responses were from endocrinologists and 24% from physicians active in nuclear medicine; 82% of respondents worked in third-level hospitals, 10% in second level hospitals and the remainder in private practice. Most used ultrasonography and cytology to assess thyroid nodules and collaborated with a group of surgeons expert in thyroid surgery. The majority preferred total or subtotal thyroidectomy in tumors with a diameter of 1 cm or more, and systematic lymph node dissection. Only 43 (24%) preferred prophylactic central lymph node dissection. Eighty-one respondents (45%) would still use whole body scan with ¹³¹I or ¹²³I before ¹³¹I ablation. Follow-up was based on cervical echography and thyroglobulin determination; however, 101 (57%) respondents continued to use diagnostic whole body scan in the follow-up. The approaches of the respondents were mainly in accordance with the guideline and consensus, although some variations were found, especially in the use of whole body scan with ¹³¹I before ablation and in follow-up. Copyright © 2010 SEEN. Published by Elsevier Espana. All rights reserved.

  4. Cystic duct remnant mucocele in a liver transplant recipient

    Energy Technology Data Exchange (ETDEWEB)

    Ahlawat, Sushil K. [Georgetown University Hospital, Department of Medicine, Division of Gastroenterology, Washington, DC (United States); University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ (United States); Fishbien, Thomas M. [Georgetown University Hospital, Department of Medicine, Division of Gastroenterology, Washington, DC (United States); Haddad, Nadim G. [Georgetown University Hospital, Department of Surgery, Division of Transplant Surgery, Washington, DC (United States)

    2008-08-15

    Cystic duct remnant mucocele is an extremely rare complication of liver transplantation in children. Surgical correction is usually required for cystic duct remnant mucocele when it causes biliary obstruction. We describe a 14-month-old liver transplant recipient who presented with biliary obstruction 1 month after orthotopic liver transplantation with an end-to-end choledochocholedocal biliary anastomosis for hepatoblastoma. US, CT and cholangiography findings were consistent with mucocele of the allograft cystic duct remnant. Surgery was not needed in our patient because the mucocele and biliary obstruction had resolved on repeat imaging most likely due to guidewire manipulation during cholangiography, resulting in opening of the cystic duct remnant orifice and drainage into the common duct. (orig.)

  5. Cystic duct remnant mucocele in a liver transplant recipient

    International Nuclear Information System (INIS)

    Ahlawat, Sushil K.; Fishbien, Thomas M.; Haddad, Nadim G.

    2008-01-01

    Cystic duct remnant mucocele is an extremely rare complication of liver transplantation in children. Surgical correction is usually required for cystic duct remnant mucocele when it causes biliary obstruction. We describe a 14-month-old liver transplant recipient who presented with biliary obstruction 1 month after orthotopic liver transplantation with an end-to-end choledochocholedocal biliary anastomosis for hepatoblastoma. US, CT and cholangiography findings were consistent with mucocele of the allograft cystic duct remnant. Surgery was not needed in our patient because the mucocele and biliary obstruction had resolved on repeat imaging most likely due to guidewire manipulation during cholangiography, resulting in opening of the cystic duct remnant orifice and drainage into the common duct. (orig.)

  6. Chemotherapy in thyroid carcinoma

    International Nuclear Information System (INIS)

    Samuel, A.M.; Shah, D.H.

    1999-01-01

    Chemotherapy alone, either as a single drug or a combination of drugs with or without external radiation (ER) is useful for treatment of locally advanced disease and non iodine concentrating metastasis in differentiated thyroid cancers (DTC). The reported response is not encouraging, but the absence of better alternatives leave no choice for the treatment of such cases. However, for treatment of anaplastic thyroid cancers (ANC), chemotherapy (CT) in combination with ER results in local control. In medullary thyroid cancers (MTC), the results obtained with multimodal treatment are encouraging

  7. Radioiodine (I-131) therapy in thyroid cancer differentiated type (abstract)

    International Nuclear Information System (INIS)

    Khan, M.S.

    1999-01-01

    Carcinoma thyroid is not an uncommon malignancy in Pakistan because of its location in iodine deficient terrain. Painless palpable (solitary) thyroid nodule is the common presentation in majority (>90%) of the patients and > 25% cold nodules in females turned malignant on biopsy whereas in males >75% of cold nodules turned malignant on historical examination. The disease is more common in females as compared to males (3:1) and in females pure papillary carcinoma is more common whereas in males mostly follicular or mixed tumors are seen. Radical surgery (thyroidectomy) is not a routine surgical treatment in our country. In teaching hospitals the routine surgical procedure is lobectomy and Isthmectomy, whereas in DHQ Hospitals less surgical procedures, e.g. tumorectomy or partial labectomy etc. are done. Therefore, in view of limited/partial surgical ablation, I-131 ablation is mandatory for better and longer survival. We have treated 118 patients of thyroid carcinoma (Differential type) at our centre (AEMC) with therapeutic dose of Radioactive iodine (I-131) during the last 13 years with encouraging results (Disease free survival). (author)

  8. Hydrodynamic Simulations of Kepler's Supernova Remnant

    Science.gov (United States)

    Sullivan, Jessica; Blondin, John; Borkowski, Kazik; Reynolds, Stephen

    2018-01-01

    Kepler’s supernova remnant contains unusual features that strongly suggest an origin in a single-degenerate Type Ia explosion, including anisotropic circumstellar medium (CSM), a strong brightness gradient, and spatially varying expansion proper motions. We present 3Dhydrodynamic simulations to test a picture in which Kepler's progenitor binary emitted a strong asymmetric wind, densest in the orbital plane, while the system moved at high velocity through the ISM. We simulate the creation of the presupernova environment as well as the supernova blast wave, using the VH-1 grid-based hydrodynamics code. We first modeled an anisotropic wind to create an asymmetric bowshock around the progenitor, then the blast wave from thesupernova. The final simulation places both previous model pieces onto a single grid and allows the blast wave to expand into the bowshock. Models were completed on a Yin-Yang grids with matching angular resolutions. By manipulating parameters that control the asymmetry of the system, we attempted to find conditions that recreated the current state of Kepler. We analyzed these models by comparing images of Kepler from the Chandra X-ray Observatory to line-of-sight projections from the model results. We also present comparisons of simulated expansion velocities with recent observations of X-ray proper motions from Chandra images. We were able to produce models that contained similar features to those seen in Kepler. We find the greatest resemblance to Kepler images with a presupernova wind with an equator-to-pole density contrast of 3 and a moderately disk-like CSM at a 5° angle between equatorial plane and system motion.

  9. Supernova Remnant Observations with Micro-X

    Science.gov (United States)

    Figueroa, Enectali

    Micro-X is a sounding rocket payload that combines an X-ray microcalorimeter with an imaging mirror to offer breakthrough science from high spectral resolution observations of extended X-ray sources. This payload has been in design and development for the last five years and is now completely built and undergoing integration; its first flight will be in November, 2012, as part of our current NASA award. This four-year follow-on proposal seeks funding for: (1) analysis of the first flight data, (2) the second flight and its data analysis, (3) development of payload upgrades and launch of the third flight, and (4) third flight data analysis. The scientific payload consists of a Transition Edge Sensor (TES) microcalorimeter array at the focus of a flight-proven conical imaging mirror. Micro-X capitalizes on three decades of NASA investment in the development of microcalorimeters and X-ray imaging optics. Micro-X offers a unique combination of bandpass, collecting area, and spectral and angular resolution. The spectral resolution goal across the 0.2 - 3.0 keV band is 2 - 4 eV Full-Width at Half Maximum (FWHM). The measured angular resolution of the mirror is 2.4 arcminute Half-Power Diameter (HPD). The effective area of the mirror, 300 square centimeters at 1 keV, is sufficient to provide observations of unprecedented quality of several astrophysical X-ray sources, even in a brief sounding rocket exposure of 300 sec. Our scientific program for this proposal will focus on supernova remnants (SNRs), whose spatial extent has made high-energy resolution observations with grating instruments extremely challenging. X-ray observations of SNRs with microcalorimeters will enable the study of the detailed atomic physics of the plasma; the determination of temperature, turbulence, and elemental abundances; and in conjunction with historical data, full three dimensional mapping of the kinematics of the remnant. These capabilities will open new avenues towards understanding the

  10. Bone metastases of differentiated thyroid cancer: the importance of early diagnosis and {sup 131}I therapy on prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P. [CEA, DSV, I2BM, SHFJ, UMNRC, Orsay (France); Rubello, D. [Santa Maria Misericordia Hosp, Rovigo (Italy); Hindie, E. [Hop StLouis, Paris (France)

    2008-07-01

    Complete text of publication follows: Distant metastases are found at diagnosis or during follow-up in 10%-15% of patients with differentiated thyroid cancer. Bone is the second most commonly involved site. Patients with bone metastases, whether isolated or associated with lung metastases, have a markedly poor prognosis. Ten-year survival rates range from 13% to 21%. Given such poor prognosis, the use of {sup 131}I therapy has been questioned. However, it might well be that poor prognosis of bone metastases can be overcome if {sup 131}I therapy is delivered at an early stage, when tumor burden is small, as previously demonstrated for pulmonary metastases. A review of a large series of patients showed that only rarely were bone metastases diagnosed at an early stage. Among 109 patients with bone metastases reported by Bernier et al., only 4 had both radioiodine uptake and a negative standard radiography examination. Similarly, Durante et al. reported that only 8 of 115 patients had negative radiography findings at presentation. Prognosis may improve if bone metastases are detected earlier. In a recent study, bone metastases were first detected by {sup 131}I scanning in 8 of 16 patients, when complementary radiologic studies were negative. Six of these patients showed an excellent response to {sup 131}I therapy. Today, the nuclear medicine community is well armed for this challenge toward earlier diagnosis. Postsurgery thyroid remnant ablation is more widely used. The {sup 131}I whole body scan associated with thyroid remnant ablation after thyroidectomy has a major role in early diagnosis of functioning distant metastases at a time when complementary imaging techniques (CT, MRI, bone scanning) are often still showing negative findings. Early diagnosis of specific {sup 131}I-avid bone foci will be improved with the advent and generalization of SPECT/CT. When early diagnosis is achieved, repeated {sup 131}I therapy can be effective by targeting not only visible

  11. Bone metastases of differentiated thyroid cancer: the importance of early diagnosis and 131I therapy on prognosis

    International Nuclear Information System (INIS)

    Zanotti-Fregonara, P.; Rubello, D.; Hindie, E.

    2008-01-01

    Complete text of publication follows: Distant metastases are found at diagnosis or during follow-up in 10%-15% of patients with differentiated thyroid cancer. Bone is the second most commonly involved site. Patients with bone metastases, whether isolated or associated with lung metastases, have a markedly poor prognosis. Ten-year survival rates range from 13% to 21%. Given such poor prognosis, the use of 131 I therapy has been questioned. However, it might well be that poor prognosis of bone metastases can be overcome if 131 I therapy is delivered at an early stage, when tumor burden is small, as previously demonstrated for pulmonary metastases. A review of a large series of patients showed that only rarely were bone metastases diagnosed at an early stage. Among 109 patients with bone metastases reported by Bernier et al., only 4 had both radioiodine uptake and a negative standard radiography examination. Similarly, Durante et al. reported that only 8 of 115 patients had negative radiography findings at presentation. Prognosis may improve if bone metastases are detected earlier. In a recent study, bone metastases were first detected by 131 I scanning in 8 of 16 patients, when complementary radiologic studies were negative. Six of these patients showed an excellent response to 131 I therapy. Today, the nuclear medicine community is well armed for this challenge toward earlier diagnosis. Postsurgery thyroid remnant ablation is more widely used. The 131 I whole body scan associated with thyroid remnant ablation after thyroidectomy has a major role in early diagnosis of functioning distant metastases at a time when complementary imaging techniques (CT, MRI, bone scanning) are often still showing negative findings. Early diagnosis of specific 131 I-avid bone foci will be improved with the advent and generalization of SPECT/CT. When early diagnosis is achieved, repeated 131 I therapy can be effective by targeting not only visible metastases but also those still too small

  12. [18F]FDG PET/CT outperforms [18F]FDG PET/MRI in differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Wenning, Christian; Weckesser, Matthias; Stegger, Lars; Burg, Matthias Christian; Allkemper, Thomas; Schaefers, Michael

    2016-01-01

    To evaluate the diagnostic potential of PET/MRI with [ 18 F]FDG in comparison to PET/CT in patients with differentiated thyroid cancer suspected or known to have dedifferentiated. The study included 31 thyroidectomized and remnant-ablated patients who underwent a scheduled [ 18 F]FDG PET/CT scan and were then enrolled for a PET/MRI scan of the neck and thorax. The datasets (PET/CT, PET/MRI) were rated regarding lesion count, conspicuity, diameter and characterization. Standardized uptake values were determined for all [ 18 F]FDG-positive lesions. Histology, cytology, and examinations before and after treatment served as the standards of reference. Of 26 patients with a dedifferentiated tumour burden, 25 were correctly identified by both [ 18 F]FDG PET/CT and PET/MRI. Detection rates by PET/CT and PET/MRI were 97 % (113 of 116 lesions) and 85 % (99 of 113 lesions) for malignant lesions, and 100 % (48 of 48 lesions) and 77 % (37 of 48 lesions) for benign lesions, respectively. Lesion conspicuity was higher on PET/CT for both malignant and benign pulmonary lesions and in the overall rating for malignant lesions (p < 0.001). There was a difference between PET/CT and PET/MRI in overall evaluation of malignant lesions (p < 0.01) and detection of pulmonary metastases (p < 0.001). Surgical evaluation revealed three malignant lesions missed by both modalities. PET/MRI additionally failed to detect 14 pulmonary metastases and 11 benign lesions. In patients with thyroid cancer and suspected or known dedifferentiation, [ 18 F]FDG PET/MRI was inferior to low-dose [ 18 F]FDG PET/CT for the assessment of pulmonary status. However, for the assessment of cervical status, [ 18 F]FDG PET/MRI was equal to contrast-enhanced neck [ 18 F]FDG PET/CT. Therefore, [ 18 F]FDG PET/MRI combined with a low-dose CT scan of the thorax may provide an imaging solution when high-quality imaging is needed and high-energy CT is undesirable or the use of a contrast agent is contraindicated. (orig.)

  13. Generation of thyroid follicular cells from pluripotent stem cells: Potential for regenerative medicine

    Directory of Open Access Journals (Sweden)

    Will eSewell

    2014-06-01

    Full Text Available Nearly 12 percent of the population in the United States will be afflicted with a thyroid related disorder during their lifetime. Common treatment approaches are tailored to the specific disorder and include surgery, radioactive iodine ablation, antithyroid drugs, thyroid hormone replacement, external beam radiation, and chemotherapy. Regenerative medicine endeavors to combat disease by replacing or regenerating damaged, diseased or dysfunctional body parts. A series of achievements in pluripotent stem cell research have transformed regenerative medicine in many ways by demonstrating repair of a number of body parts in mice, of which, the thyroid has now been inducted into this special group. Seminal work in pluripotent cells, namely embryonic stem cells and induced pluripotent stem cells, have made possible their path to becoming key tools and biological building blocks for cell-based regenerative medicine to combat the gamut of human diseases, including those affecting the thyroid.

  14. Aspergillus thyroiditis in a renal transplant recipient mimicking subacute thyroiditis.

    Science.gov (United States)

    Solak, Y; Atalay, H; Nar, A; Ozbek, O; Turkmen, K; Erekul, S; Turk, S

    2011-04-01

    Fungal pathogens are increasingly encountered after renal transplantation. Aspergillus causes significant morbidity and mortality in transplant patients. Fungal thyroiditis is a rare occurrence owing to unique features of the thyroid gland. Most cases are caused by Aspergillus species and have been described in immunocompromised patients. Presentation may be identical with that of subacute thyroiditis, in which hyperthyroidism features and painful thyroid are the prominent findings. Diagnosis can be ascertained by fine-needle aspiration of thyroid showing branching hyphae of Aspergillus. We describe a renal transplant patient who developed Aspergillus thyroiditis as part of a disseminated infection successfully treated with voriconazole. © 2010 John Wiley & Sons A/S.

  15. Thyroid gland disorder emergencies: thyroid storm and myxedema coma.

    Science.gov (United States)

    Hampton, Jessica

    2013-01-01

    Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema coma are endocrine emergencies resulting from thyroid hormone dysregulation, usually coupled with an acute illness as a precipitant. Careful assessment of risk and rapid action, once danger is identified, are essential for limiting morbidity and mortality related to thyroid storm and myxedema coma. This article reviews which patients are at risk, explains thyroid storm and myxedema coma, and describes pharmacological treatment and supportive cares.

  16. A comparison of physical and cytogenetic estimates of radiation dose in patients treated with iodine-131 for thyroid carcinoma

    International Nuclear Information System (INIS)

    Lloyd, D.C.; Purrott, R.J.; Dolphin, G.W.; Horton, P.W.; Halnan, K.E.; Scott, J.S.; Mair, G.

    1976-01-01

    Physical and cytogenetic estimates of the whole-body radiation doses have been compared in 11 patients receiving large doses of iodine-131 for the treatment of thyroid carcinoma. The physical estimate was based on the measurement of thyroid uptake, of the plasma activity variation, and of urinary activity. The cytogenetic estimate was obtained from the analysis of chromosome aberrations in peripheral blood lymphocytes. Good agreement between the estimates was observed in patients whose thyroid glands had previously be ablated by radioiodine. In patients who had varying degrees of thyroid function, there were considerable differences between the estimates with the cytogenetic value always being higher. It is suggested that these differences might be due in part to non-uniform irradiation of lymphocytes by local sources of activity in the thyroid and in the liver. (author)

  17. Dual-Phase 99MTc-MIBI Parathyroid Imaging Reveals Synchronous Parathyroid Adenoma and Papillary Thyroid Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Ming-Che Chang

    2008-10-01

    Full Text Available The possibility of a coincidental appearance of hyperparathyroidism and thyroid cancer is not often considered because of its low incidence. Here, we present a case of a 49-year-old woman with a parathyroid adenoma coexisting with two sites of papillary thyroid carcinoma. Dual-phase 99mTc-methoxyisobutylisonitrile (MIBI parathyroid imaging before the operation correctly visualized the site of the parathyroid adenoma. In addition, two papillary thyroid carcinomas showed faint uptake of 99mTc-MIBI on delayed image. Total thyroidectomy and parathyroidectomy of a solitary parathyroid adenoma were performed. The patient subsequently underwent radioiodine-131 ablation and was treated with T4 suppression. This case illustrates the need for clinical awareness of concomitant hyperparathyroidism and thyroid cancer. Dual-phase 99mTc-MIBI parathyroid imaging may be useful for detecting indolent thyroid cancer before it becomes a distinct disease.

  18. Thyroid Cancer—Health Professional Version

    Science.gov (United States)

    There are four types of thyroid cancer. These are papillary, follicular, medullary, and anaplastic thyroid cancer. Papillary is the most common type of thyroid cancer. Find evidence-based information on thyroid cancer treatment, screening, research, genetics, and statistics.

  19. Thyroid Disease in the Older Patient

    Science.gov (United States)

    ... treatment with radioactive iodine together. There is some controversy about what the normal level of TSH is ... VA 22041 thyroid@thyroid.org Contact Form Legal Privacy | Terms of Use AMERICAN THYROID ASSOCIATION ® , ATA ® , THYROID ® , ...

  20. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... camera heads are oriented at a 90 degree angle and placed over the patient's body. SPECT involves ... images of the thyroid gland from three different angles. You will need to remain still for brief ...

  1. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... intravenous injections, are usually painless medical tests that help physicians diagnose and evaluate medical conditions. These imaging ... to: determine if the gland is working properly help diagnose problems with the thyroid gland, such as ...

  2. Thyroid Disease and Teens

    Science.gov (United States)

    ... become enlarged and may result in a goiter. Hypothyroidism is usually easily diagnosed with a physical examination and blood tests, and treatment with thyroid hormone replacement pills can restore normal ...

  3. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... thyroid is a gland in the neck that controls metabolism , a chemical process that regulates the rate at which the body converts food to energy. top of page What are some common uses ...

  4. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Scan and Uptake Thyroid scan and uptake uses small amounts of radioactive materials called radiotracers, a special ... is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine ...

  5. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... that help physicians diagnose and evaluate medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or ... or had thyroid cancer. A physician may perform these imaging tests to: determine if the gland is ...

  6. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... Actual scanning time for each thyroid uptake is five minutes or less. top of page What will ... diagnostic procedures have been used for more than five decades, and there are no known long-term ...

  7. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... thyroid is a gland in the neck that controls metabolism , a chemical process that regulates the rate at which the body converts food to energy. top of page What are some common uses of the procedure? The ...

  8. Thyroid Diseases Tests

    Science.gov (United States)

    ... Gene Mutations Testing Cytomegalovirus (CMV) Tests D-dimer Dengue Fever Testing Des-gamma-carboxy prothrombin (DCP) DHEAS ... newborn blood screening programs since early detection and treatment can minimize long-term damage. Hashimoto thyroiditis : the ...

  9. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... radioactive iodine uptake test (RAIU) is also known as a thyroid uptake. It is a measurement of ... potential to identify disease in its earliest stages as well as a patient’s immediate response to therapeutic ...

  10. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... When radiotracer is taken by mouth, in either liquid or capsule form, it is typically swallowed up ... radioactive iodine (I-123 or I-131) in liquid or capsule form to swallow. The thyroid uptake ...

  11. MEDULLARY THYROID CARCINOMA

    Directory of Open Access Journals (Sweden)

    V. S. Medvedev

    2013-01-01

    Full Text Available Medullary thyroid carcinoma belongs to orphan diseases affecting a small part of the population. Multicenter trials are required to elaborate a diagnostic algorithm, to define treatment policy, and to predict an outcome.

  12. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... exam of any medications you are taking, including vitamins and herbal supplements. You should also inform them ... thyroid gland from three different angles. You will need to remain still for brief periods of time ...

  13. Thyroid Scan and Uptake

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    Full Text Available ... as an overactive thyroid gland, a condition called hyperthyroidism , cancer or other growths assess the nature of ... an x-ray or CT scan, surgeries or treatments using iodinated contrast material within the last two ...

  14. Thyroid Scan and Uptake

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    Full Text Available ... painless. However, during the thyroid scan, you may feel uncomfortable when lying completely still with your head ... When the radiotracer is given intravenously, you will feel a slight pin prick when the needle is ...

  15. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... a variety of diseases, including many types of cancers, heart disease, gastrointestinal, endocrine, neurological disorders and other ... performed on people who have or had thyroid cancer. A physician may perform these imaging tests to: ...

  16. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... energy. top of page What are some common uses of the procedure? The thyroid scan is used ... community, you can search the ACR-accredited facilities database . This website does not provide cost information. The ...

  17. Thyroid Scan and Uptake

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    Full Text Available ... as an overactive thyroid gland, a condition called hyperthyroidism , cancer or other growths assess the nature of ... abnormal was found, and should not be a cause of concern for you. If you had an ...

  18. Thyroid Scan and Uptake

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    Full Text Available ... regulates the rate at which the body converts food to energy. top of page What are some ... thyroid cancer. A physician may perform these imaging tests to: determine if the gland is working properly ...

  19. Thyroid Scan and Uptake

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    Full Text Available ... found, and should not be a cause of concern for you. If you had an intravenous line ... found, and should not be a cause of concern for you. Actual scanning time for each thyroid ...

  20. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... as an overactive thyroid gland, a condition called hyperthyroidism , cancer or other growths assess the nature of ... arm, but there are generally no other side effects. When swallowed, the radiotracer has little or no ...

  1. Thyroid Scan and Uptake

    Medline Plus

    Full Text Available ... is a gland in the neck that controls metabolism , a chemical process that regulates the rate at ... as an overactive thyroid gland, a condition called hyperthyroidism , cancer or other growths assess the nature of ...

  2. Thyroid Disorders (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body ... and released into the kid's bloodstream. Why Do Kids Get Thyroid Disease? In most cases, doctors and ...

  3. Thyroid Scan and Uptake

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    Full Text Available ... the gland following medication use, surgery, radiotherapy or chemotherapy top of page How should I prepare? You ... but is often performed on hospitalized patients as well. Thyroid Scan You will be positioned on an ...

  4. Thyroid and male reproduction

    Directory of Open Access Journals (Sweden)

    Anand Kumar

    2014-01-01

    Full Text Available Male reproduction is governed by the classical hypothalamo-hypophyseal testicular axis: Hypothalamic gonadotropin releasing hormone (GnRH, pituitary luteinizing hormone (LH and follicle stimulating hormone (FSH and the gonadal steroid, principally, testosterone. Thyroid hormones have been shown to exert a modulatory influence on this axis and consequently the sexual and spermatogenic function of man. This review will examine the modulatory influence of thyroid hormones on male reproduction.

  5. Papillary thyroid carcinoma

    DEFF Research Database (Denmark)

    Godballe, C; Asschenfeldt, P; Sørensen, J A

    1994-01-01

    The age influence on the prognosis of papillary thyroid carcinoma was analyzed in a group of 67 patients. A marked decline in cause-specific survival was found for patients older than 60 years of age at the time of diagnosis. In order to find a tumor-biological explanation of the prognostic...... invasion and distant metastases. The results indicate that 60 years of age the time of diagnosis may be the "prognostic break-point" for papillary thyroid carcinoma....

  6. Hashimoto's thyroiditis following Graves' disease.

    Science.gov (United States)

    Umar, Husaini; Muallima, Nur; Adam, John M F; Sanusi, Harsinen

    2010-01-01

    Both Graves' disease and chronic thyroiditis (Hashimoto's thyroiditis) are autoimmune diseases of thyroid gland. Graves' disease is caused by stimulation of TSH receptor located on the thyroid gland by an antibody, which is known as TSH receptor antibody (TRAb). Furthermore, this may lead to hyperplasia and hyperfunction of the thyroid gland. On the contrary, the cause of Hashimoto's thyroiditis is thought due to a TSH stimulation-blocking antibody (TSBAb) which blocks the action of TSH hormone and subsequently brings damage and atrophy to thyroid gland. Approximately 15-20% of patients with Graves' disease had been reported to have spontaneous hypothyroidism resulting from the chronic thyroiditis (Hashimoto's disease). Pathogenesis for chronic thyroiditis following anti-thyroid drug treatment in patients with Graves' disease remains unclear. It has been estimated that chronic thyroiditis or Hashimoto's disease, which occurs following the Graves' disease episode is due to extended immune response in Graves' disease. It includes the immune response to endogenous thyroid antigens, i.e. thyroid peroxidase and thyroglobulin, which may enhance lymphocyte infiltration and finally causes Hashimoto's thyroiditis. We report four cases of chronic thyroiditis (Hashimoto's disease) in patients who have been previously diagnosed with Graves' hyperthyroidism. In three cases, Hashimoto's thyroiditis occurs in 7 to 25 years after the treatment of Grave's disease; while the other case has it only after few months of Grave's disease treatment. The diagnosis of Hashimoto's disease (chronic thyroiditis) was based on clinical manifestation, high TSHs level, positive thyroid peroxidase antibody and thyroglobulin antibody, and supported by positive results of fine needle aspiration biopsy. Moreover, the result of histopathological test has also confirmed the diagnosis in two cases. All cases have been successfully treated by levothyroxine treatment.

  7. Radiofrequency ablation of osteoid osteoma

    NARCIS (Netherlands)

    Vanderschueren, Geert Maria Joris Michael

    2009-01-01

    The main purpose of this thesis was to evaluate the effectiveness and safety of CT-guided radiofrequency ablation for the treatment of spinal and non-spinal osteoid osteomas. Furthermore, the technical requirements needed for safe radiofrequency ablation and the clinical outcome after radiofrequency

  8. An unusual case of adult-onset multi-systemic Langerhans cell histiocytosis with perianal and incident thyroid involvement

    Directory of Open Access Journals (Sweden)

    Ozen Oz Gul

    2017-02-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography–computed tomography (PET/CT scan in the nineth month of follow-up. Current evaluation revealed euthyroid status, a hypoechoic solid lesion of 13 × 9 mm in size with irregular borders in the left thyroid lobe on thyroid USG and cytologic assessment of thyroid nodule. The patient was diagnosed with suspected, oncocytic lesion, Hashimoto thyroiditis or LCH. The patient underwent total thyroidectomy and pathological assessment confirmed the diagnosis of Langerhans cell histiocytosis. Assessments in the sixth month of postoperative follow-up revealed euthyroid status with no thyroid tissue remnants or pathological lymph node on thyroid USG. In view of the multifocal lesions indicating multi-system disease, a systemic chemotherapy protocol with combination of prednisone (PRED and vinblastine (VBL has been planned by the hematology department.

  9. [Subclinical thyroid diseases].

    Science.gov (United States)

    Zamrazil, V

    2007-01-01

    Subclinical thyroids disease (STD) is recently defined term in clinical thyroidology, which includes mainly functional disorders. Basic diagnostic signs are: normal values of thyroid hormones (fT4, fT3) and elevated TSH level (subclinical hypothyroidism) or suppresed TSH level (subclinical hyperthyroidism). In a category of STD may be included subclinical autoimunne thyroiditis (elevated level of thyroid antigens antibodies and/or hypoechogenity in sonographic screen, increased volume of the thyroid without clinical symptoms and/or autoimminity) and microscopic lesions of papillary thyroid carcinoma. Subclinical hypothyroidism may be dangerous for tendency to development of manifest hypothyroidism and for risk of disorders of lipid profile and development of atherosclerosis and its organ complication (esp. myocardial infarction). Subclinical hyperthyroidism is a risk factor of cardiac arythmias and probably can increase a risk of cardiovascular mortality) as well for osteoporosis (esp. in peri- and post-climacteric women), and last but not least for degenerative diseases of brain (?). Indication of treatment of STD is a matter of controversies. Recomendations of experts, varied from "no therapy, monitoring only" to "treat always". Treatment of risk groups (esp. pregnant women) is probably nowadays a most rationale recommendations since results of sofisticated prospective studies will be available.

  10. Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3); Verfahrensanweisung zur Radioiodtherapie (RIT) beim differenzierten Schilddruesenkarzinom (Version 3)

    Energy Technology Data Exchange (ETDEWEB)

    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); Nuklearmedizinsiche 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; Gruenwald, F. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Frankfurt Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Lassmann, M. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Deutsche Gesellschaft fuer Medizinische Physik (DGMP) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Allgemeines Krankenhaus St. Georg, Hamburg (Germany); Luster, M.; Reiners, C. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Moser, E. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Radiologische Universitaetsklinik Freiburg (Germany); Schober, O. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    The procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for {sup 131}I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative {sup 131}I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC {<=}1 cm {sup 131}I ablation may be helpful in an individual constellation. Preparation for {sup 131}I ablation requires low iodine diet for two weeks and TSH stimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lowerblood activity) and the advantages of endogenous TSH stimulation (necessary for {sup 131}I-therapy in patients with metastases, higher sensitivity of {sup 131}I whole-body scan) are discussed. In most centers standard activities are used for {sup 131}I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of {sup 131}I should not exceed 1-10MBq, alternative tracers are {sup 123}I or {sup 124}I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene. (orig.)

  11. [Radiofrequency ablation of hepatocellular carcinoma].

    Science.gov (United States)

    Widmann, Gerlig; Schullian, Peter; Bale, Reto

    2013-03-01

    Percutaneous radiofrequency ablation (RFA) is well established in the treatment of hepatocellular carcinoma (HCC). Due to its curative potential, it is the method of choice for non resectable BCLC (Barcelona Liver Clinic) 0 and A. RFA challenges surgical resection for small HCC and is the method of choice in bridging for transplantation and recurrence after resection or transplantation. The technical feasibility of RFA depends on the size and location of the HCC and the availability of ablation techniques (one needle techniques, multi-needle techniques). More recently, stereotactic multi-needle techniques with 3D trajectory planning and guided needle placement substantially improve the spectrum of treatable lesions including large volume tumors. Treatment success depends on the realization of ablations with large intentional margins of tumor free tissue (A0 ablation in analogy to R0 resection), which has to be documented by fusion of post- with pre-ablation images, and confirmed during follow-up imaging.

  12. SUPERNOVA REMNANT PROGENITOR MASSES IN M31

    Energy Technology Data Exchange (ETDEWEB)

    Jennings, Zachary G.; Williams, Benjamin F.; Dalcanton, Julianne J.; Gilbert, Karoline M.; Fouesneau, Morgan; Weisz, Daniel R. [Department of Astronomy, University of Washington Seattle, Box 351580, WA 98195 (United States); Murphy, Jeremiah W. [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States); Dolphin, Andrew E., E-mail: zachjenn@uw.edu, E-mail: adolphin@raytheon.com [Raytheon, 1151 East Hermans Road, Tucson, AZ 85706 (United States)

    2012-12-10

    Using Hubble Space Telescope photometry, we age-date 59 supernova remnants (SNRs) in the spiral galaxy M31 and use these ages to estimate zero-age main-sequence masses (M{sub ZAMS}) for their progenitors. To accomplish this, we create color-magnitude diagrams (CMDs) and employ CMD fitting to measure the recent star formation history of the regions surrounding cataloged SNR sites. We identify any young coeval population that likely produced the progenitor star, then assign an age and uncertainty to that population. Application of stellar evolution models allows us to infer the M{sub ZAMS} from this age. Because our technique is not contingent on identification or precise location of the progenitor star, it can be applied to the location of any known SNRs. We identify significant young star formation around 53 of the 59 SNRs and assign progenitor masses to these, representing a factor of {approx}2 increase over currently measured progenitor masses. We consider the remaining six SNRs as either probable Type Ia candidates or the result of core-collapse progenitors that have escaped their birth sites. In general, the distribution of recovered progenitor masses is bottom-heavy, showing a paucity of the most massive stars. If we assume a single power-law distribution, dN/dM{proportional_to}M{sup {alpha}}, then we find a distribution that is steeper than a Salpeter initial mass function (IMF) ({alpha} = -2.35). In particular, we find values of {alpha} outside the range -2.7 {>=} {alpha} {>=} -4.4 to be inconsistent with our measured distribution at 95% confidence. If instead we assume a distribution that follows a Salpeter IMF up to some maximum mass, then we find that values of M{sub Max} > 26 are inconsistent with the measured distribution at 95% confidence. In either scenario, the data suggest that some fraction of massive stars may not explode. The result is preliminary and requires more SNRs and further analysis. In addition, we use our distribution to estimate a

  13. 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.

  14. Laboratory Simulations of Micrometeoroid Ablation

    Science.gov (United States)

    Thomas, Evan Williamson

    Each day, several tons of meteoric material enters Earth's atmosphere, the majority of which consist of small dust particles (micrometeoroids) that completely ablate at high altitudes. The dust input has been suggested to play a role in a variety of phenomena including: layers of metal atoms and ions, nucleation of noctilucent clouds, effects on stratospheric aerosols and ozone chemistry, and the fertilization of the ocean with bio-available iron. Furthermore, a correct understanding of the dust input to the Earth provides constraints on inner solar system dust models. Various methods are used to measure the dust input to the Earth including satellite detectors, radar, lidar, rocket-borne detectors, ice core and deep-sea sediment analysis. However, the best way to interpret each of these measurements is uncertain, which leads to large uncertainties in the total dust input. To better understand the ablation process, and thereby reduce uncertainties in micrometeoroid ablation measurements, a facility has been developed to simulate the ablation of micrometeoroids in laboratory conditions. An electrostatic dust accelerator is used to accelerate iron particles to relevant meteoric velocities (10-70 km/s). The particles are then introduced into a chamber pressurized with a target gas, and they partially or completely ablate over a short distance. An array of diagnostics then measure, with timing and spatial resolution, the charge and light that is generated in the ablation process. In this thesis, we present results from the newly developed ablation facility. The ionization coefficient, an important parameter for interpreting meteor radar measurements, is measured for various target gases. Furthermore, experimental ablation measurements are compared to predictions from commonly used ablation models. In light of these measurements, implications to the broader context of meteor ablation are discussed.

  15. Complex structure of the supernova remnant HB 3

    Science.gov (United States)

    Leahy, D. A.; Venkatesan, D.; Long, K. S.; Naranan, S.

    1985-01-01

    HB 3 is an old, large (84 pc diameter) supernova remnant associated with the W3 H II region/molecular cloud complex. Observations of the imaging proportional counter (IPC) onboard the Einstein X-ray astronomy satellite have been reprocessed to yield a contour map of X-ray brightness and spectra of various regions of this remnant. The measured IPC flux is 2.4 x 10 to the -11th ergs per sq cm per s, giving a 0.2-4 keV luminosity of 1.6 x 10 to the 35th ergs/s for a column densityof 6 x 10 to the 21st per sq cm. The measured X-ray temperatures reveal a decrease from center to limb of the remnant of 1-0.3 keV. HB 3 is in the late adiabatic blast-wave phase of evolution, 30,000 to 50,000 yr old and with an initial blast energy of 3 x 10 to the 50th ergs. The X-ray map is compared with available radio and optical images. In X-rays, HB 3 has two components - a diffuse emission inside the 84 pc radio remnant and a ring of emission at the center of 30 pc in diameter. The diffuse emission is similar to that from other supernova remnants which are moderately obscured (column density, nH approximately 10 to the 22nd per sq cm). Three possibilities for the origin of the ring are explored: (1) a second supernova remnant, (2) a shocked shell in the interstellar medium surrounding HB 3, and (3) reverse-shock heated ejecta. There is no hot neutron star within the remnant.

  16. The thyroid nodule. Thyrotropin and peripheral thyroid hormones

    International Nuclear Information System (INIS)

    Zimny, M.

    2008-01-01

    Thyrotropin, free triodothyronine and thyroxine represent the standard serological parameters for the diagnostic work-up of the thyroid but only a minority of thyroid nodules present with subclinical or overt thyroid disorders. Besides a review of the regulation and principle of function of thyroid hormones as well as the effects of subclinical or overt hyperthyroidism, the significant role of these parameters beyond the assessment of hyperthyroidism in thyroid nodules is discussed. There is evidence that the level of thyrotropin within the normal range is predictive for the relevance of autonomous functioning nodules and the risk of malignancy of non-functioning thyroid nodules. Furthermore, the ratio of triodothyronine and thyroxine indicates the etiology of hyperthyroidism. Thyrotropin represents the main parameter to determine the adequate dose of thyroid hormone therapy of thyroid nodules. (orig.)

  17. [Iodine 131 joint radio frequency ablation treatment for child with hyperthyroidism goiter: one case report].

    Science.gov (United States)

    Chen, Yonghua; Liang, Li; Fang, Yanlan; Wang, Chunlin; Li, Linfa; Jiang, Tian'an