scholarly journals Clinical Significance of Extra-Thyroid99mTc-Pertechnetate Uptake Before Initial Radioiodine Therapy For Differentiated Thyroid Carcinoma

2021 ◽  
Author(s):  
bin long ◽  
lifang yao ◽  
shoucong chen ◽  
jin shui ◽  
xuemei ye ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Clinical Significance ◽  
Clinical Features ◽  
Uptake Rate ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Iodine Uptake ◽  
99Mtc Pertechnetate ◽  
Uptake Rates ◽  
Technetium Uptake

Abstract Background: Over the last few decades, extra-thyroid 99mTc-pertechnetate uptake has rarely been reported. The clinical characteristics of extra-thyroid 99mTc-pertechnetate uptake were retrospectively analysed to explore the effect of the phenomenon on RAI therapy for DTC and its clinical significance. Methods: In this study, we retrospectively analysed 4930 RAI-treated DTC patients who had undergone 99mTc-pertechnetate scanning. Thirty-eight cases with extra-thyroid 99mTc-pertechnetate uptake were selected. The clinical features, location, location count and extra-thyroid 99mTc-pertechnetate uptake distribution were analysed, combined with the uptake rate, stimulated thyroglobulin (sTg) level, post-therapy whole-body scan and curative effect. Results: The results showed that sixty-five extra-thyroid 99mTc-pertechnetate foci were detected in 38 patients. The proportions of patients with abnormal uptake in the lymph nodes, lungs and bones were 68.4%, 10.5% and 10.5%, respectively. The corresponding uptake rates were 0.2%, 0.2% and 0.8%. The uptake rate was significantly lower in the lymph nodes than in the bones (Z = -2.722, p = 0.019). The uptake rate and sTg were positively correlated (r = 0.36, p = 0.027). 131I uptake was found in 36 cases at the technetium uptake site, and the number of iodine uptake foci was significantly higher than that of 99mTc-pertechnetate uptake foci. The sTg value and pathological staging significantly differed between the excellent and nonexcellent response groups (Z = 2.947, p = 0.003 and Z = 2.348, p = 0.019, respectively). Conclude: Extra-thyroid 99mTc-pertechnetate uptake mostly indicated metastases with specific clinical features, which may have prognostic value for the judgment of iodine uptake function and the RAI therapy plan.

scholarly journals Clinical significance of extra-thyroid 99mTc-pertechnetate uptake before initial radioiodine therapy for differentiated thyroid carcinoma

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110126
Author(s):  
Bin Long ◽  
Li-Fang Yao ◽  
Shou-Cong Chen ◽  
Jin Shui ◽  
Xue-Mei Ye ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Clinical Significance ◽  
Clinical Features ◽  
Uptake Rate ◽  
Radioactive Iodine ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Iodine Uptake ◽  
Uptake Rates ◽  
Post Therapy

Objective To analyse the clinical characteristics of extra-thyroid 99mTc-pertechnetate uptake in order to explore the effect of the phenomenon on radioactive iodine (RAI) therapy for differentiated thyroid carcinoma (DTC) and its clinical significance. Methods This study retrospectively selected patients with DTC and extra-thyroid 99mTc-pertechnetate uptake. The clinical features, location, location count and extra-thyroid 99mTc-pertechnetate uptake distribution were analysed, combined with the uptake rate, stimulated thyroglobulin (sTg) level, post-therapy whole-body scan and curative effect. Results A total of 38 patients were enrolled in the study and 65 extra-thyroid 99mTc-pertechnetate foci were detected. Thirty-four patients showed abnormal 99mTc-pertechnetate uptake in the lymph nodes (26 of 38; 68.4%), lungs (four of 38; 10.5%) and bones (four of 38; 10.5%). The corresponding uptake rates were 0.2%, 0.2% and 0.8%, respectively. The uptake rate and sTg were significantly positively correlated ( r = 0.36). 131I uptake was found in 36 patients at the 99mTc-pertechnetate uptake site. The number of iodine uptake foci was significantly higher than that of 99mTc-pertechnetate uptake foci. The sTg value and pathological staging significantly differed between the excellent and nonexcellent response groups (Z = –2.947 and Z = –2.348, respectively). Conclusion Extra-thyroid 99mTc-pertechnetate uptake mostly indicated metastases with specific clinical features, which may have prognostic value for the judgment of iodine uptake function and the RAI therapy plan.

scholarly journals Focal Bronchiectasis Causing Abnormal Pulmonary Radioiodine Uptake in a Patient with Well-Differentiated Papillary Thyroid Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Ash Gargya ◽  
Elizabeth Chua
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Radioactive Iodine ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Iodine Uptake ◽  
Papillary Thyroid ◽  
Radioiodine Uptake ◽  
Well Differentiated ◽  
Radioactive Iodine Uptake

Background. False-positive pulmonary radioactive iodine uptake in the followup of differentiated thyroid carcinoma has been reported in patients with certain respiratory conditions.Patient Findings. We describe a case of well-differentiated papillary thyroid carcinoma treated by total thyroidectomy and radioiodine ablation therapy. Postablation radioiodine whole body scan and subsequent diagnostic radioiodine whole body scans have shown persistent uptake in the left hemithorax despite an undetectable stimulated serum thyroglobulin in the absence of interfering thyroglobulin antibodies. Contrast-enhanced chest computed tomography has confirmed that the abnormal pulmonary radioiodine uptake correlates with focal bronchiectasis.Summary. Bronchiectasis can cause abnormal chest radioactive iodine uptake in the followup of differentiated thyroid carcinoma.Conclusions. Recognition of potential false-positive chest radioactive iodine uptake, simulating pulmonary metastases, is needed to avoid unnecessary exposure to further radiation from repeated therapeutic doses of radioactive iodine.

scholarly journals P705 Is chest wall deformity a serious issue? A rare case of TGFBR1 mutation in the paediatric population

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
L Abood ◽  
S Padmanabhan
Keyword(s):  
Chest Wall ◽  
Clinical Significance ◽  
Clinical Features ◽  
Aortic Root ◽  
Missense Variant ◽  
Paediatric Population ◽  
Ascending Aorta ◽  
Whole Body ◽  
Chest Wall Deformity ◽  
Aortic Root Dilatation

Abstract INTRODUCTION Mutations in the genes encoding transforming growth factor β receptors 1 and 2 (TGFBR1 and TGFBR2) have recently been found in association with a continuum of clinical features. Mild association – a presentation similar to that of Marfan"s syndrome. Severe association – a complex phenotype in which aortic dissection or rupture commonly occurs in childhood and at aortic diameters, that ordinarily would not be predictive of these events. Classified as the Loeys–Dietz syndrome. Is chest wall asymmetry a serious issue? A study of 71 patients with Loeys-Dietz – 9% died from aneurysm rupture or dissection with aortic diameters of less than 4.5cm and as early as 6 months of age. Genetic variants of unknown clinical significance - how should they be managed? CASE History 3-year old girl seen in general paediatric clinic with 5 months history of worsening chest wall deformity. Examination Asymmetrical pectus deformity. Spinal asymmetry and soft systolic murmur at the lower left sternal edge. INVESTIGATION Chest x-ray: Grossly enlarged and distorted cardiac/mediastinal silhouette. Echocardiogram Massive ascending aortic root dilatation (5.5cm) with significant aortic regurgitation. MRI whole body angiogram Massively dilated aortic root and ascending aorta to the proximal arch, hugely tortuous and ectatic cerebral vessels, diffuse marked dural ectasia, asymmetrical pectus deformity and a diaphragmatic morgagni hernia in the lower right hemi thorax. Genetic analysis Heterozygous missense variant of unknown clinical significance in exon 3 of TGFBR1 gene. The first heterozygous missense variant of its kind in the paediatric population for which its clinical significance remains unknown. TREATMENT As risk of dissection, a Bentall procedure was performed. Family screening - Father has a dilated proximal ascending aorta. LEARNING POINTS Chest wall deformity should prompt clinicians to expedite investigations for aortic root dilatation/aneurysm and connective tissue disorders. The continuum of clinical features of these genetic associations emphasises the importance of early recognition of the phenotype, prophylactic intervention and meticulous surveillance of the distal aorta and vascular tree for optimal management. A genetic variant of uncertain significance (VUS) should not be used in clinical decision making. Efforts to resolve the classification of the variant as pathogenic or benign should be undertaken with good working relationships with clinical geneticists. A VUS is difficult for patients and parents to understand and may also cause psychological distress. The importance of careful clinical and molecular characterisation to identify patients and families at risk cannot be overemphasised. This allows the use of a structured approach to intervention, informed counselling regarding the risk of recurrence, concerns related to pregnancy, and guidelines for clinical management. Abstract P705 Figure. Case Photography and Imaging

scholarly journals Capability of Catfish (Clarias gariepinus) to Accumulate Hg2+ From Water

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Heny Suseno
Keyword(s):  
Kinetic Model ◽  
Uptake Rate ◽  
Clarias Gariepinus ◽  
Elimination Rate ◽  
Aquatic Organisms ◽  
Whole Body ◽  
Clear Correlation ◽  
Half Time ◽  
Uptake Rates ◽  
Simple Kinetic Model

Mercury is hazardous contaminant that can be accumulated by aquatic organisms such as fishes, mussels etc. Catfish is one of source of animal protein but it also can accumulate Hg<sup>2+</sup> from water that used in aquaculture. Due to less information about capability of catfish to accumulate Hg<sup>2+</sup>, therefore we studied bioaccumulation of Hg<sup>2+</sup> that used biokinetic approach (aqueous uptake-rate, and elimination-rate).  Nuclear application technique was applied in this study by using radiotracer of <sup>203</sup>Hg.  A simple kinetic model was then constructed to predict the bioaccumulation capability of   by catfish. The result of experiments were shown that the uptake rate of difference Hg<sup>2+</sup> concentration were 79.90 to 101.22 ml.g<sup>-1</sup>.d<sup>-1</sup>. Strong correlation between uptake rates with increasing Hg<sup>2+</sup>concentration. In addition, the elimination rates were range 0.080 – 0.081 day<sup>-1</sup>. The biology half time (t<sub>1/2b</sub>) of Hg<sup>2+</sup> in whole body catfish were 8.50 – 8.63 days.  However<em>, </em><em>no clear correlation</em><em> </em> between elimination rate with increasing concentration of Hg<sup>2+</sup>. The calculation of Bio Concentration Factor (BCF) shown catfish have capability to accumulated Hg maximum 1242.69 time than its concentration in water

scholarly journals Diagnostic Algorithm for Metastatic Lymph Nodes of Differentiated Thyroid Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1338
Author(s):  
Sae Rom Chung ◽  
Jung Hwan Baek ◽  
Young Jun Choi ◽  
Tae-Yon Sung ◽  
Dong Eun Song ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Diagnostic Algorithm ◽  
Needle Aspiration ◽  
Differentiated Thyroid Carcinoma ◽  
Ultrasound Guided ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Malignancy Rate ◽  
Needle Aspiration Cytology ◽  
Ultrasound Features

We aimed to evaluate appropriate strategies for interpreting fine-needle aspiration cytology (FNAC) and thyroglobulin concentrations obtained through aspiration (FNA-Tg) results based on the sonographic features of lymph nodes (LNs). Consecutive patients who underwent ultrasound-guided FNAC and FNA-Tg for metastatic LNs from differentiated thyroid carcinomas (DTCs) from January 2014 to December 2018 were reviewed retrospectively. LNs were categorized sonographically as suspicious, indeterminate, or benign. The optimal FNA-Tg cutoff for metastatic LNs was evaluated preoperatively, after lobectomy, and after total thyroidectomy. The diagnostic performances of FNA-Tg, FNAC, and their combination were analyzed based on the sonographic features of LNs. The malignancy rates of LNs were analyzed based on the sonographic features, FNAC, and FNA-Tg results. Of the 1543 LNs analyzed, 528 were benign, whereas 1015 were malignant. FNA-Tg increased the sensitivity and accuracy of FNAC for LNs. The malignancy rate of LNs found to be malignant by FNAC or elevated FNA-Tg ranged from 82% to 100%, regardless of the sonographic features. The malignancy rate of LNs with indeterminate or benign FNAC findings and low FNA-Tg were stratified according to their sonographic features. We propose a diagnostic algorithm, based on combined FNAC, FNA-Tg, and ultrasound features of LNs, for diagnosing metastatic LNs of DTCs.

scholarly journals Radioiodine in Differentiated Thyroid Carcinoma: Do We Need Diagnostic Pre-Ablation Iodine-123 Scintigraphy to Optimize Treatment?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 553
Author(s):  
Elizabeth de Koster ◽  
Taban Sulaiman ◽  
Jaap Hamming ◽  
Abbey Schepers ◽  
Marieke Snel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Treatment Success ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Thyroid Remnant ◽  
Node Metastasis ◽  
Unsuccessful Treatment

Changing insights regarding radioiodine (I-131) administration in differentiated thyroid carcinoma (DTC) stir up discussions on the utility of pre-ablation diagnostic scintigraphy (DxWBS). Our retrospective study qualitatively and semi-quantitatively assessed posttherapy I-131 whole-body scintigraphy (TxWBS) data for thyroid remnant size and metastasis. Findings were associated with initial treatment success after nine months, as well as clinical, histopathological, and surgical parameters. Possible management changes were addressed. A thyroid remnant was reported in 89 of 97 (92%) patients, suspicion of lymph node metastasis in 26 (27%) and distant metastasis in 6 (6%). Surgery with oncological intent and surgery by two dedicated thyroid surgeons were independently associated with a smaller remnant. Surgery at a community hospital, aggressive tumor histopathology, histopathological lymph node metastasis (pN1) and suspicion of new lymph node metastasis on TxWBS were independently associated with an unsuccessful treatment. Thyroid remnant size was unrelated to treatment success. All 13 pN1 patients with suspected in situ lymph node metastases on TxWBS had an unsuccessful treatment, opposite 19/31 (61%) pN1 patients without (p = 0.009). Pre-ablative knowledge of these TxWBS findings had likely influenced management in 48 (50%) patients. Additional pre-ablative diagnostics could optimize patient-tailored I-131 administration. DxWBS should be considered, especially in patients with pN1 stage or suspected in situ lymph node metastasis. Dependent on local surgical expertise, DxWBS is not recommended to evaluate thyroid remnant size.

scholarly journals A Rare Case of Sensory Neuropathy Associated with Transitional Cell Carcinoma of the Bladder

2020 ◽  
Vol 13 (3) ◽  
pp. 1397-1401
Author(s):  
Sujitha Ketineni ◽  
Sreenath Kodali ◽  
Sasikanth Gorantla
Keyword(s):  
Lymph Nodes ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Rare Case ◽  
Transitional Cell ◽  
Sensory Neuropathy ◽  
Endobronchial Ultrasound ◽  
Whole Body ◽  
Initial Symptoms ◽  
Carcinoma Of The Bladder

Malignancies can trigger an autoimmune response against the nervous system and manifest as paraneoplastic neurological syndromes (PNS). Initial symptoms of PNS may develop up to 5 years prior to the diagnosis of the underlying malignancy. We report a rare case of PNS associated with transitional cell carcinoma of the bladder in a 70-year-old male with a 6-month history of rapidly progressive symmetric sensory neuropathy. Peripheral neuropathy serological workup was unremarkable. A paraneoplastic neuropathy panel revealed anti-Hu autoantibodies. Further evaluation with a whole-body PET scan could not identify the primary malignancy, but it showed hypermetabolic hilar lymph nodes. An endobronchial ultrasound biopsy of the hilar lymph nodes was negative for cancer. The patient developed painless hematuria 2.5 years after the onset of the sensory neuropathy. Cystoscopy with biopsy revealed non-muscle-invasive transitional cell carcinoma of the bladder. Progression of the sensory neuropathy stopped after tumor resection. This case highlights the importance of a diligent and systematic approach to diagnose PNS. A relentless search is often required to detect PNS-associated occult malignancies.

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