scholarly journals Ectopic Thyroid Tissue in the Mediastinum Characterized by Histology and Functional Imaging with I-123 SPECT/CT

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Jed Hummel ◽  
Jason Wachsmann ◽  
Kelley Carrick ◽  
Orhan K. Oz ◽  
Dana Mathews ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Photon Emission ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Emission Computed Tomography ◽  
Tissue Mass ◽  
Ectopic Thyroid Tissue

Ectopic thyroid tissue is a rare entity and when discovered it is typically along the pathway of embryologic migration of the thyroid. We present a case of incidental finding of ectopic thyroid tissue within mediastinum in a 61-year-old female patient with a history of total thyroidectomy for thyroiditis and nodules. The patient presented to emergency room with cough and right chest pain and underwent a chest computed tomographic angiogram (CTA) to exclude pulmonary embolism as part of chest pain workup. One right paratracheal mediastinal soft tissue nodule was visualized on the images of CTA. This right paratracheal soft tissue mass was found to be ectopic benign thyroid tissue by histological analysis of the biopsied tissue samples. The function of this ectopic thyroid tissue was characterized by I-123 radioiodine uptake and single photon emission computed tomography/computed tomography (SPECT/CT) imaging. This case illustrates that ectopic thyroid tissue should be included for differential diagnosis of a hyperdense soft tissue mass located within mediastinum. I-123 SPECT/CT is useful for guiding tissue biopsy of ectopic thyroid tissue distant from orthotopic thyroid gland and functional and anatomic characterization of mediastinal ectopic thyroid tissue for surgical resection when it is medically necessary.

Lingual thyroid: diagnosis using a hybrid of single photon emission computed tomography and standard computed tomography

2013 ◽  
Vol 127 (4) ◽  
pp. 432-434 ◽  
Author(s):  
J Dolezal ◽  
J Vizda ◽  
J Horacek ◽  
S Spitalnikova
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Thyroid Tissue ◽  
Ectopic Thyroid ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Emission Computed ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

AbstractAim:To present a rare case of lingual thyroid detected using a hybrid of single photon emission computed tomography and standard computed tomography in a young woman with hypothyroidism.Materials and methods:A 29-year-old woman was screened for autoimmune thyroid disorders in early pregnancy, and found to have subclinical hypothyroidism. No thyroid tissue was found in the anterior neck upon ultrasonography, raising suspicions of an ectopic thyroid. The patient was treated with levothyroxine throughout the remainder of her pregnancy, and developed postpartum thyroiditis requiring an increase in levothyroxine dosage. Whole-body scintigraphy and zoomed static head and neck scintigraphy were performed. Abnormal 99mTc-pertechnetate uptake was observed in the oral region, whereas no uptake was found in the usual thyroid location. Hybrid imaging using single photon emission computed tomography and standard computed tomography was performed to improve three-dimensional representation of the area of increased activity.Results:The latter imaging modality detected ectopic thyroid tissue in the tongue.Conclusion:Whole body 99mTc-pertechnetate scintigraphy and a hybrid of single photon emission computed tomography and standard computed tomography are effective imaging modalities for the investigation of ectopic thyroid tissue. The latter modality is particularly recommended, as it allows more precise spatial visualisation of increased isotope uptake activity in the head and neck.

scholarly journals Image-Guided Biopsy for Relapsed Neuroblastoma: Focus on Safety, Adequacy for Genetic Sequencing, and Correlation of Tumor Cell Percent With Quantitative Lesion MIBG Uptake

2021 ◽  
pp. 275-285
Author(s):  
Andrew Samoyedny ◽  
Abhay Srinivasan ◽  
Lisa States ◽  
Yael P. Mosse ◽  
Emma Alai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Tumor Cell ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Mibg Uptake ◽  
Genetic Sequencing ◽  
Image Guided ◽  
Guided Biopsy

PURPOSE Many novel therapies for relapsed and refractory neuroblastoma require tumor tissue for genomic sequencing. We analyze our experience with image-guided biopsy in these patients, focusing on safety, yield, adequacy for next-generation sequencing (NGS), and correlation of tumor cell percent (TC%) with quantitative uptake on 123I-meta-iodobenzylguanidine (MIBG) single-photon emission computed tomography with computed tomography (SPECT/CT). MATERIALS AND METHODS An 11-year retrospective review of image-guided biopsy on 66 patients (30 female), with a median age of 8.7 years (range, 0.9-49 years), who underwent 95 biopsies (55 bone and 40 soft tissue) of relapsed or refractory neuroblastoma lesions was performed. RESULTS There were seven minor complications (7%) and one major complication (1%). Neuroblastoma was detected in 88% of MIBG- or fluorodeoxyglucose-avid foci. The overall NGS adequacy was 69% (64% in bone and 74% in soft tissue, P = .37). NGS adequacy within neuroblastoma-positive biopsies was 88% (82% bone and 96% soft tissue, P = .11). NGS-adequate biopsies had a greater mean TC% than inadequates (51% v 18%, P = .03). NGS-adequate biopsies had a higher mean number of needle passes (7.5 v 3.4, P = .0002). The mean tissue volume from NGS-adequate soft-tissue lesions was 0.16 cm3 ± 0.12. Lesion:liver and lesion:psoas MIBG uptake ratios correlated with TC% (r = 0.74, r = 0.72, and n = 14). Mean TC% in NGS-adequate samples was 51%, corresponding to a lesion:liver ratio of 2.9 and a lesion:psoas ratio of 9.0. Thirty percent of biopsies showed an actionable ALK mutation or other therapeutically relevant variant. CONCLUSION Image-guided biopsy for relapsed or refractory neuroblastoma was safe and likely to provide NGS data to guide therapy decisions. A lesion:liver MIBG uptake ratio of ≥ 3 or a lesion:psoas ratio of > 9 was associated with a TC% sufficient to deliver NGS results.

Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

Cardiology ◽  
2015 ◽  
Vol 133 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Mathias Sørgaard ◽  
Jesper James Linde ◽  
Klaus Fuglsang Kofoed ◽  
Jørgen Tobias Kühl ◽  
Henning Kelbæk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Stress Test ◽  
Photon Emission ◽  
Acute Onset ◽  
Emission Computed Tomography ◽  
Artery Disease

Objectives: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. We investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. Methods: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We compared the diagnostic accuracy of PTP and stress testing assessed by the area under the receiver operating characteristic curve (AUC) to identify significant CAD, defined as at least 1 coronary artery branch with >70% diameter stenosis identified by CCTA. Results: The diagnostic accuracy of PTP was significantly higher than the stress test (AUC 0.80 vs. 0.69; p = 0.009), but the diagnostic accuracy of the combination of PTP and a stress test did not significantly increase when compared to PTP alone (AUC 0.86 vs. 0.80; p = 0.06). Conclusions: PTP using the updated Diamond and Forrester Score is a very useful tool in risk-stratifying patients with acute-onset chest pain at a low-to-intermediate risk of having CAD. Adding a stress test to PTP does not appear to offer significant diagnostic benefit.

scholarly journals Primary accessory thyroid carcinoma with negative 99mTcO4− SPECT/CTimaging: a case report and literature review

2019 ◽  
Vol 47 (8) ◽  
pp. 3934-3939
Author(s):  
Yibo Ma ◽  
Feng Qian ◽  
Jianfeng Wang ◽  
Yanping Liu ◽  
Shuiqing Liu
Keyword(s):  
Computed Tomography ◽  
Thyroid Carcinoma ◽  
Single Photon ◽  
Thyroid Cartilage ◽  
Photon Emission ◽  
Thyroid Tissue ◽  
Punch Biopsy ◽  
Pathological Examination ◽  
Emission Computed Tomography ◽  
Accessory Thyroid

Introduction In contrast to orthotopic thyroid carcinoma, primary accessory thyroid carcinoma is very rare. We herein report a case involving primary accessory thyroid carcinoma in a patient with normal ultrasonography of the orthotopic thyroid and negative 99mTcO4− single-photon emission computed tomography (SPECT) scintigraphy. Case presentation: A computed tomography (CT) scan showed soft tissue nodules at the left anterior edge of the thyroid cartilage. To determine whether the mass was accessory thyroid tissue, 99mTcO4− SPECT/CT was performed, and the findings were negative. However, pathological examination after resection showed that mass was a primary accessory thyroid papillary carcinoma. The 1-year follow-up ultrasound showed no lesion at the orthotropic thyroid and neck incision sites. Conclusions This case suggests that negative 99mTcO4− SPECT/CT imaging may not completely exclude the possibility of thyroid carcinoma. A punch biopsy or postoperative pathological examination is necessary for the diagnosis.

scholarly journals Magnetic resonance imaging (MRI) versus single photon emission computed tomography (SPECT/CT) in painful total hip arthroplasty: a comparative multi-institutional analysis

2020 ◽  
Vol 93 (1105) ◽  
pp. 20190738 ◽  
Author(s):  
Henrik C. Bäcker ◽  
Isabelle Steurer-Dober ◽  
Martin Beck ◽  
Christoph A. Agten ◽  
Jens Decking ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Single Photon Emission Computed ◽  
Painful Hip ◽  
Hip Arthroplasties ◽  
Photon Emission Computed Tomography

Objective: To investigate the value of MRI in comparison to single photon emission computed tomography (SPECT)/CT in patients with painful hip arthroplasties. Methods: A prospective, multi-institutional study was performed. Therefore, 35 consecutive patients (21 female, 14 male, mean age 61.8 ± 13.3 years) with 37-painful hip arthroplasties were included. A hip surgeon noted the most likely diagnosis based on clinical examination and hip radiographs. Then, MRI and SPECT/CT of the painful hips were acquired. MRI and SPECT/CT were assessed for loosening, infection, fracture, tendon pathology and other abnormalities. Final diagnosis and therapy was established by the hip surgeon after integration of MRI and SPECT/CT results. The value of MRI and SPECT/CT for diagnosis was assessed with a 3-point scale (1 = unimportant, 2 = helpful, 3 = essential). Results: Loosening was observed in 13/37 arthroplasties (6 shaft only, 6 cup only, 1 combined). Sensitivity, specificity, positive predictive value and negative predictive value for loosening of MRI were 86%/88%/60%/100% and of SPECT/CT 93%/97%/90%/100%, respectively. MRI and SPECT/CT diagnosed infection correctly in two of three patients and fractures in two patients, which were missed by X-ray. MRI detected soft tissue abnormalities in 21 patients (6 bursitis, 14 tendon lesions, 1 pseudotumor), of which only 1 tendon abnormality was accurately detected with SPECT/CT. All 5 arthroplasties with polyethylene wear were correctly diagnosed clinically and with both imaging modalities. MRI and SPECT/CT were judged as not helpful in 0/0%, as helpful in 16%/49% and essential in 84%/51%. Conclusion: In patients with painful hip arthroplasty SPECT/CT is slightly superior to MR in the assessment of loosening. MRI is far superior in the detection of soft tissue, especially tendon pathologies. Advances in knowledge: To our knowledge this is the first prospective, multiinstitutional study which compares MRI with SPECT/CT in painful hip arthroplasties. We found that MRI is far superior in the detection of soft tissue pathologies, whereas SPECT/CT remains slightly superior regarding loosening.

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