• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.7-12
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• 1989

The pain, swelling of salivary glands and dry mouth are not infrequent complication of the high dose radioiodine treatment in the patients with differentiated thyroid cancer. The purpose of this study was, by the dynamic salivary scintigraphy, to observe the change of the salivary function after the high dose $(150\sim200mci)$ radioiodine treatment. From May 1987 to April 1988, the dynamic salivary scintigraphy with 5mci of $^{99m}Tc-pertechnetate$ and gamma camera was performed before and 7 days after the radiolodine treatment in 7 patients with differentiated thyroid cancer. Just after the dynamic scintigraphy, the stimulation test with vitamin C solution of pH3.0 and poststirnulation scintigraphy were done, and the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were calculated for each gland. There was positive correlation between the radioactivity uptake index and excretion fraction after the stimulation. The salivary clearance after the stimulation was $18.96{\pm}8.95ml/min$ in the pretreatment state, and $14.37{\pm}7.7ml/min$ after the radioioine treatment. After the radioiodine treatment, the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were significantly reduced in the parotid glands, but only the excretion fraction was reduced in the submandibular glands. The more the pretreatment salivary clearance after the stimulation was, the % change after the treatment was smaller. Further studies on the relation between the radiation dose in the salivary glands and the change of their function, and the long-term observation for the recovery of function are expected.

• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.117-124
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• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.265-275
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• 2000

The thyroid gland is an interesting endocrine organ where a spectrum of tumors with different behavior arise. At one end of spectrum there is differentiated thyroid carcinoma (DTC) with excellent prognosis, whereas at the other end of the spectrum is anaplastic thyroid cancer which has universally poor outcome. Radioiodine (I-131) therapy has been in use for the treatment of thyroid diseases since 1946. It was introduced by Seidlin et al. 1) Although the use of I-131 has been vouge for a long time, its use in therapy for well differentiated thyroid cancer is still controversial 2). This is because, thyroid cancers (TC) are generally slow growing tumors, with low mortality and normal spans of survival. To record recurrence and mortality, long term follow up studies over a period of two to three decades are needed to establish definite conclusions on the acceptable mode of treatment The incidence of the disease being very low a large number of cases needed to establish a meaningful statistical data is lacking as most published reports feat with small series. Here again in the problem encountered are the differing protocols for treatment with I-131, the indications for treatment which may include or exclude ablation of residual thyroid tissue, cervical nodal and distal metastases. The dosage of I-131 used for ablation of residual thyroid tissue and metastatic disease also vary. The most reliable conclusion regarding I-131 treatment are obtained from studies reported on a large series of patients followed over a period of 2 decades or more from a single institute with a more or less unchanged protocol of management.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.237-246
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• 2016

This study is therefore aimed at measuring the surface dose rate and the spatial dose rate in and outside the radionuclide facility in order to ensure safety of the patients, radiation workers and family care-givers in their use of such equipment and to provide a basic framework for further research on radiation protection. The study was conducted at 4 restrooms in and outside the radionuclide facility of a general hospital in Incheon between May 1 and July 31, 2014. During the study period, the spatial contamination dose rate and the surface contamination dose rate before and after radiation use were measured at the 4 places-thyroid therapy room, PET center, gamma camera room, and outpatient department. According to the restroom use survey by hospitals, restrooms in the radionuclide facility were used not only by patients but also by family care-givers and some of radiation workers. The highest cumulative spatial radiation dose rate was 8.86 mSv/hr at camera room restroom, followed by 7.31 mSv/hr at radioactive iodine therapy room restroom, 2.29 mSv/hr at PET center restroom, and 0.26 mSv/hr at outpatient department restroom, respectively. The surface radiation dose rate measured before and after radiation use was the highest at toilets, which are in direct contact with patient's excretion, followed by the center and the entrance of restrooms. Unsealed radioactive sources used in nuclear medicine are relatively safe due to short half lives and low energy. A patient who received those radioactive sources, however, may become a mobile radioactive source and contaminate areas the patient contacts-camera room, sedation room, and restroom-through secretion and excretion. Therefore, patients administered radionuclides should be advised to drink sufficient amounts of water to efficiently minimize radiation exposure to others by reducing the biological half-life, and members of the public-family care-givers, pregnant women, and children-be as far away from the patients until the dose remains below the permitted dose limit.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.5
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• pp.394-400
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• 2008

Purpose: Quantitative comparison of transgene expression within stem cells between lentivirus and adenovirus-mediated delivery systems has not been reported. Here, we evaluated the human sodium iodide symporter (hNIS) gene expression in rat mesenchymal stem cell (rMSC) transduced by lentivirus or adenovirus, and compared the hNIS expression quantitatively between the two delivery systems. Materials and Methods: Lentiviral-mediated hNIS expressing rMSC (lenti-hNIS-rMSC) was constructed by cloning hNIS gene into pLenti6/UbC/V5-DEST (Invitrogen) to obtain pLenti-hNIS, transducing rMSC with the pLenti-hNIS, and selecting with blasticidin for 3 weeks. Recombinant adenovirus expressing hNIS gene (Rad-hNIS) was produced by homologous recombination and transduction efficiency of Rad-hNIS into rMSC evaluated by Rad-GFP was $19.1{\pm}4.7%$, $54.0{\pm}6.4%$, $85.7{\pm}8.7%$, and $98.4{\pm}1.3%$ at MOI 1, 5, 20, and 100, respectively. The hNIS expressions in lenti-hNIS-rMSC or adeno-hNIS-rMSC were assessed by immunocytochemistry, western blot, and 1-125 uptake. Results: Immunocytochemistry and western blot analyses revealed that hNIS expressions in lenti-hNIS-rMSC were greater than those in adeno-hNIS-rMSC at MOI 20 but lower than at MOI 50. However in vitro 1-125 uptake test demonstrated that iodide uptake in lenti-hNIS-rMSC ($29,704{\pm}6,659\; picomole/10^6\;cells$) was greater than that in adeno-hNIS-rMSC at MOI 100 ($6,168{\pm}2,134\;picomole/10^6\;cells$). Conclusion: Despite lower amount of expressed protein, hNIS function in rMSC was greater by lentivirus than by adenovirus mediated expression. Stem cell tracking using hNIS as a reporter gene should be conducted in consideration of relative vector efficiency for transgene expression.

• Journal of radiological science and technology
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• v.37 no.2
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• pp.143-150
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• 2014

This study was designated to investigate the bremsstrahlung and radiation dose by beta rays. Radiation attenuation from I-131 treatment ward was analyzed using radio protective apron. Shielding materials which is included lead or water were simulated in Monte Carlo Simulation then the spectrum on interaction was analyzed. The shielding materials were categorized according to the thickness. 0.25mm and 0.5mm thick lead and 0.1mm and 0.2mm thick water shielding materials were configured in Monte Carlo Simulation for this study. Only lead shielding method and water plus lead shielding method were carried. As a results, when 0.5mm thick lead shielding method was performed, the radiation dose was similar to the results with water plus lead shielding method. In case of using 0.25mm thick lead shielding, the shielding effect was somewhat less. However, that shielding method cause dose reduction of about 60% compare with non-shielding material.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.118-122
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• 1993

To evaluate the genotoxic effect of $^{131}I$, lymphocytes from 9 patients who underwent large dose (150 mCi) $^{131}I$ therapy after total thyroidectomy were studied for sister chromatid exchanges (SCE) before and after their first radioiodine treatments. Frequency of SCE (FSCE) was counted in chromosomes of 30 lymphocytes in each patients, and was expressed as numbers of SCE per cell. Numbers of leukocytes were also observed during $^{131}I$ therapy. Pretreatment FSCE ($4.2{\pm}0.7$) was not different from the control ($3.8{\pm}0.4$, p=0.17). However, the frequency was significantly elevated after $^{131}I$ administration (at the second day, $7.9{\pm}0.8$, p<0.001) and was diminished but still significantly elevated after a week (at 9th day, $6.4{\pm}0.6$, p<0.001). While counts of leukocytes in the peripheral blood showed no change (p> 0.05). In conclusion, chromatids of human lymphocytes were significantly damaged after $^{131}I$ treatment without any bone marrow supression. And the repair of SCE was not complete within one week.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.13-19
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• 2016

Background : The 2015 American thyroid association (ATA) guidelines greatly expanded section on risk stratification of thyroid cancer. Definition of "Low risk of recurrence" has expanded, by inclusion of small volume lymph node involvement, such as less than 5 lymph node metastases each smaller than 2mm in central compartment. Purpose : We evaluated the number of positive nodes, Positive node ratio (PNR), recurrence, and radioablation therapy. Also, evaluated the safety of omitting strategy of radioablation after total thyroidectomy with PTC, especially on low-PNR N1a patients compared with high-PNR N1a patients. Methods : Consecutive 147 N1a and 216 N0 patients who underwent total thyroidectomy with central neck dissection between 2003 and 2004 were enrolled. We divided 147 N1a patients into two groups, such as 96 high-PNR versus 51 low-PNR group according to 50% of PNR, and compared these two groups with N0 group. Results: 7.2% (26/363) recurrences were occurred, and 21/147 (14.3 %) recurrences were on N1a patients, and 5/216 (2.3 %) were on N0 patients. Of these 21 recurrences in N1a stage patients, 20 (95.2 %) recurrences were occurred in high-PNR N1a group and only 1 (4.8 %) recurrence was in low-PNR N1a group. The recurrence of low-PNR N1a group was significantly lower than high-PNR N1a group (Log-rank p value = 0.003), but significantly not different from N0 group (Log-rank p value = 0.889). Although this study was a retrospective non-randomized trial with small number of patients, the 10-year recurrence of omitting RAI in low-PNR N1a patients with less than 50% of PNR were shown to be comparable with 216 N0 low risk patients. Conclusion : Positive node ratio could be a useful predictor of recurrence and useful guidance postoperative management -rather than absolute number of positive node.

• Journal of Radiation Protection and Research
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• v.39 no.1
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• pp.38-45
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• 2014

This paper describes the results of assessment of radiological dose resulting from operation of the Daedeok nuclear facilities including the HANARO research reactor, which has been performed to assure whether or not to comply with the regulation standards of the radioactive effluents releases. Based on the meteorological data and the radiation source term, the maximum individual doses were evaluated from 2010 to 2012. The atmospheric dispersion and the deposition factors of gaseous effluents were calculated using the XOQDOQ computer code. ENDOS-G and ENDOS-L code systems were also used for maximum individual dose calculation from gaseous and liquid effluents, respectively. The results were compared with the regulation standards for the radioactive effluents presented by the Nuclear Safety and Security Commission (NSSC). The effective doses and the thyroid doses of the maximum individual were calculated at the maximum exposed point in the Daedeok site, and contributions of exposure pathways to the radiological doses resulting from gaseous and liquid radioactive effluents were evaluated at each facility of the Daedeok site. As a result, the maximum exposed age was analysed to be the child group, and the operation of HANARO research reactor had a major effect more than 90% on the individual doses. The main exposure pathways for gaseous radioactive effluent were from ingestion and inhalation. The effective doses and the thyroid doses were considerably influenced by tritium and iodine, respectively. The gaseous radioactive effluents contributed more than 90% on the total doses, whereas the contributions of the liquid radioactive effluents were relatively low. Consequently, the maximum individual dose due to radioactive effluents from the nuclear facilities within the Daedeok site were less than 3% of the regulation standard over 3 years; therefore, it can be concluded that radioactive effluents from the nuclear facilities were well managed, with the radiation-induced health detriment for residents around the site being negligible.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.3
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• pp.209-217
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• 2007

Purpose: Multidrug resistance (MDR) of the cancer cells related to mdr1 gene expression can be effectively treated by selective short hairpin RNA for mdr1 gene (shMDR). Sodium/iodide symporter (NIS) gene is well known to have both reporter and therapeutic gene characteristics. We have co-transfected both shMDR and NIS gene into colon cancer cells (HCT15 cell) expressing MDR and Tc-99m sestamibi and I-125 uptake were measured. In addition, cytotoxic effects of doxorubicin and I-131 therapy were also assessed after transfection. Material and Methods: At first, shMDR was transfected with liposome reagent into human embryonic kidney cells (HEK293) and HCT cells. shMDR transfection was confirmed by RT-PCR and western blot analysis. Adenovirus expressing NIS (Ad-NIS) gene and shMDR (Ad-shMDR) were co-transfected with Ad-NIS into HCT15 cells. Forty-eight hours after infection, inhibition of P-gycoprotein (Pgp) function by shMDR was analyzed by a change of Tc-99m sestamibi uptake and doxorubicin cytotoxicity, and functional activity of induced NIS gene expression was assessed with I-125 uptake assay. Results: In HEK293 cells transfected with shMDR, mdr1 mRNA and Pgp protein expressions were down regulated. HCT15 cells infected with 20 MOI of Ad-NIS was higher NIS protein expression than control cells. After transfection of 300 MOI of Ad-shMDR either with or without 10 MOI of Ad-NIS, uptake of Tc-99m sestamibi increased up to 1.5-fold than control cells. HCT15 cells infected with 10 MOI of Ad-NIS showed approximately 25-fold higher I-125 uptake than control cells. Cotransfection of Ad-shMDR and Ad-NIS resulted in enhanced cytotoxic by doxorubicin in HCT15 cells. I-131 treatment on HCT15 cells infected with 20 MOI of Ad-NIS revealed increased cytotoxic effect. Conclusion: Suppression of mdr1 gene expression, retention of Tc-99m sestamibi, enhanced doxorubicin cytotoxicity and increases in I-125 uptake were achieved in MDR expressing cancer cell by co-transfection of shMDR and NIS gene. Dual therapy with doxorubicin and radioiodine after cotransfection shMDR and NIS gene can be used to overcome MDR.