• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.493-501
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• 1999

Purpose: We conducted a comparative study to evaluate the diagnostic values of T1-201, Tc-99m MIBI and I-131 scans in the follow-up assessment after ablative I-131 therapy in differentiated thyroid cancer. Materials and Methods: The study population consisted of 20 patients who underwent surgical removal of thyroid cancer and ablative radioactive iodine therapy, and followed by one or mote times of I-131 retreatments (33 cases). In all patients, T1-201, 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. Results: Positive rates (PR) of Tc-99m MIBI, T1-201, 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 T1-201 and I-131 scans were in the order of therapeutic 131 scan 71%, T1-201 scan 54% and diagnostic I-131 scan 36%. There was no statistically significant difference between T1-201 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). Conclusion: 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. T1-201 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 patients.

• 대한두경부종양학회:학술대회논문집
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• 2004.11a
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• pp.265-265
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• 2004

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.356-364
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• 1997

To evaluate the clinical utility of Tc-99m MIBI scan in the detection of residual thyroid tissue or metastatic lesion in postoperative thyroid cancer patients, we compared Tc-99m MIBI scan with I-131 diagnostic and therapeutic scan in 30 postoperative well-differentiated thyroid cancer patients. Thyroglobulin levels of both on and off thyroid hormone medication and antithyroglobulin antibody were tested [Tg(on), Tg(off)]. Positive rates for I-131 diagnostic and Tc-99m MIBI scan were 81% and 68% respectively. Concordance between I-131 diagnostic and Tc-99m MIBI scan was observed in 15 cases; 12 positive and 3 negative respectively. Among the 6 cases with negative I-131 diagnostic scan and positive Tc-99m MIBI scan, 4 were Positive in the therapeutic I-131 scan We concluded that Tc-99m MIBI scan maybe a useful complementary modality to the currently established method of I-131 scan and serum thyroglobulin level in the detection of recurrent or metastatic thyroid cancer, especially in the case of negative I-131 diagnostic scan.

• 대한핵의학회:학술대회논문집
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• 2002.11a
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• pp.29.2-29.2
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• 2002

• Journal of radiological science and technology
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• v.39 no.4
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• pp.565-570
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• 2016

Radioactive iodine($^{131}I$) treatment reduces recurrence and increases survival in patients with differentiated thyroid cancer. However, it is important in terms of radiation safety management to measure the radiation dose rate generated from the patient because the radiation emitted from the patient may cause the exposure. Research methods, it measured radiation dose-rate according to the elapsed time from 1 m from the upper abdomen of the patient by intake of radioactive iodine. Directly comparing the changes over time, high dose rate sensitivity and efficiency is statistically significant, and higher chamber than GM counter(p<0.05). Low dose rate sensitivity and efficiency in the chamber had lower levels than gm counter, but not statistically significant(p>0.05). In this study confirmed the characteristics of calibrated ionization chamber and GM counter according to the radiation intensity during high-dose radioactive iodine therapy by measuring the accurate and rapid radiation dose rate to the patient explains, discharged patients will be reduced to worry about radiation hazard of family and others person.

• 대한핵의학회:학술대회논문집
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• 2003.11a
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• pp.10.2-10.2
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• 2003

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.346-355
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• 1997

To evaluate the utility of I-131, T1-201 scintigraphy, and serum thyroglobulin(Tg) in the follow-up of differentiated thyroid cancer, we compared retrospectively the data from 33 patients who underwent total or subtotal thyroidectomy. I-131 scintigraphy was performed after optimal endogenous TSH stimulation ($TSH>50{\mu}U/ml$). Total 41 cases of I-131 and T1-201 scintigraphy pairs were examined. Concomitant serum thyroglobulin levels were measured for 41 pairs of scan. Tg-off levels(that measured after discontinuation of the thyroid hormone) higher than 40ng/m1 were considered positive, and Tg-on levels(that measured during the thyroid hormone replacement) higher than 5ng/ml were considered positive. The concordance rates between I-131 therapeutic scintigraphy and T1-201 scintigraphy was 48% in the 38 case of total scan pairs(59% in the 17 cases of postoperative preablation group, and 38% in the 21 cases of postoperative postablation group). Of 17 studies before the I-131 ablation therapy(preablation group), 7 showed positive I-131 therapeutic scintigraphy despite of negative T1-201 scintigraphy. Among patients with negative I-131 therapeutic scintigraphy, no patients had abnormal T1-201 uptake. However, of 21 studies which were done after radioiodine therapy(postablation group) 6 had abnormal uptake on T1-201 scintigraphy which were not seen on I-131 therapeutic scintigraphy, and Tg-off levels also elevated in this 4 of 6 cases. As a result, I-131 therapeutic scintigraphy showed highest positive rate at postoperative preablation follow-up study in differentiated thyroid cancer patients. T1-201 scintigraphy may be useful in postablation studies, and the use of the combined modalities(T1-201 and Tg levels) provides a higher diagnostic yield.

• Korean Journal of Head & Neck Oncology
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• v.25 no.2
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• pp.132-137
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• 2009

Purpose : For the past 10 years, the incidence of thyroid cancer has been rapidly increased in female population showing current incidence of 12,000 new thyroid cancer patients annually in Korea. Though differentiated thyroid cancer is known to show favorable prognosis and excellent long-term survival from slow growth and late distant metastasis, we re-evaluated prognostic factors of recurrence and mortality following surgical procedures based on our cases. Material and Methods : 954 Patients of DTC surgically treated at Department of Surgery, Inje University Busan Paik Hospital between 1980 and 2004 were reviewed in the aspects of the surgical procedures, clinical staging, risk factors, recurrence and their outcome through median follow-up period of 10.5 years. Results : Recurrence in remnant thyroid, cervical nodes, and distant metastasis were observed in 84 paients(8.8%), and 31 patients were confirmed to be died of locoregional recurrence of cancer and distant metasasis. Regarding the risk factors to recurrence, tumor size, extrathyroidal extension, nodal metastasis, and capsular invasion were significant predictors(p<0.05). Local recurrence and distant metastasis had no statistical signiicance according to age, sex, pathology, surgery, and lymphovascular invasion. Overall 10-year survival rate was 92.4%, but low, intermediate, and high-risk patient showed 100%, 94.4%, and 70.5% respectively. Conclusion : The significant factors influencing local recurrence and distant metastasis were tumor size, extrathyroidal exension, LN metastasis, capsular invasion. In order to improve survival rate of high-risk group, appropriate and aggressive management should be recommended.

• Journal of Life Science
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• v.19 no.11
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• pp.1514-1521
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• 2009

To evaluate the feasibility of cathepsin-B levels in preoperatively screening patients with thyroid cancer, we assigned these patients to either the thyroid cancer group (n=32) or the nodular hyperplasia group (n=7). Five healthy volunteers served as controls (n=5). We quantified cathepsin-B expressions in cancerous lesions with follicular carcinoma and hyperplastic lesions with nodular hyperplasia, and compared the degrees to those of normal thyroid tissue, which was obtained from matched contralateral lobe. The activity of serum cathepsin B was significantly higher in patients with thyroid carcinoma ($284.87{\pm}79.32$, ${\times}10^{-2}\;mU$) and those with nodular hyperplasia ($255.45{\pm}95.68$, ${\times}10^{-2}\;mU$) than compared to normal control ($168.94{\pm}15.10$, ${\times}10^{-2}\;mU$) (p<0.05). Based on the results of immunoassay, the concentrations of cathepsin B in the thyroid cancer group ($15.50{\pm}7.86\;ng/ml$) and the nodular hyperplasia group ($17.64{\pm}7.49\;ng/ml$) were higher than those of the control group ($4.85{\pm}0.61\;ng/ml$). The degree of cathepsin-B mRNA expression was significantly higher in cancerous or hyperplastic lesions than normal thyroid tissues from matched contralateral lobe with follicular carcinoma or non-neoplastic thyroid disease. Our results indicate that the activity of serum cathepsin B is a useful indicator in screening patients with nodular hyperplasia or neoplastic thyroid disease and it may be involved in the abnormal proliferation of cells.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.129-136
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• 2009

Purpose: To determine optimal imaging time for diagnostic I-123 whole body scan in the follow-up of patients with differentiated thyroid cancer(DTC), we compared the image quality of 6- and 24-hour images of the same subjects. Materials and Methods: Four hundred ninety-eight patients(M:F = 55:443, Age $47.6{\pm}12.9$ years) with DTC who had undergone total thyroidectomy and I-131 ablation therapy underwent diagnostic whole body scanning 6 hour and 24 hour after oral ingestion of 185 MBq(5 mCi) of I-123. Serum thyroglobulin measurement and ultrasonography of the neck were performed at the time of imaging. In 40 patients underwent additional I-131 therapy, post-therapy I-131 images were obtained and compared with diagnostic I-123 images. Results: In 440 patients(88.4%), 6- and 24-hour diagnostic I-123 images were concordant, and 58 patients(11.6%) showed discordant findings. Among 58 discordant patients, 31 patients showed abnormal tracer uptake on only 6-hour image, which turned out false-positive findings in all cases. In 12 patients with positive findings on only 24-hour image, remnant thyroid tissue(4 patients) and cervical lymph node metastasis(3 patients) were presented. Among 40 patients underwent additional I-131 therapy, 6-hour and 24-hour images were discordant in 13 patients. All 5 patients with abnormal uptake on only 6-hour image revealed false-positive results, whereas most of 24-hour images were concordant with post-therapy I-131 images. Conclusion: I-123 imaging at 24-hour could reduce false-positive findings and improve diagnostic accuracy, compared with 6-hour image in the follow-up of patient with DTC.