• 제목/요약/키워드: Post-therapy scan

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Comparison of Diagnostic and Post-therapy Radioiodine Scan in Well-Differentiated Thyroid Cancer and the Clinical Outcome (갑상선암 환자에서 방사성옥소 진단스캔과 치료 후 스캔의 비교 및 임상경과)

  • Lee, Seok-Mo;Bae, Sang-Kyun;Yum, Ha-Yong
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.22-29
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    • 2000
  • Purpose: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. Materials and Methods: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of $3.7{\sim}9.3$ GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. Results: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. Conclusion: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.

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Case study of application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance (골반 불균형에 의한 편측체중지지 요통환자의 골반도수교정 적용사례)

  • Kim, Han-Il;Kim, Sang-Su;Kim, Gee-Sun;Park, Ji-Whan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.72-78
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    • 2009
  • Purpose: to recognized that influence of decrease low back pain, change pelvic structure and balance control on unilateral weight bearing after application on pelvic manipulation which low back pain patient in unilateral weight bearing due to pelvic imbalance. Methods: The patient with low back pain in unilateral weight bearing due to pelvic imbalance was 39year female. one subject received intervention of pelvic manipulation on sidelying position and reaching exercise on sitting position which during 2 weak at the 3 time per a weak, each 30 minutes. outcomes measured were Facia l Action Coding System(FACS), Radiograph(Lumbar-Spine Anteroposterior AP.), Pressure Scan. Results: The results of this study were summarized below : 1. FACS score were Pre: min.4 - max.6 and Post: min.2 - max.4. 2. Radiograph measured Ilium width were Pre: Lt.14cm, Rt.12.7cm and Post: Lt.13.4cm, Rt.13cm which discrepancy of Ilium height were Pre: 1cm and Post: 0.2cm. 3. Pressure scan measured Pre: Lt. 36.8%, Rt.40.2% and Post: Lt.41.3%, Rt.36.2%. Conclusion: Pelvic manipulation applied a patient with low back pain in unilateral weight bearing due to pelvic imbalance suggest that can decrease low back pain, change pelvic structure and balance control on unilateral weight bearing.

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Management of Recurrent Thyroid Carcinoma with Negative Diagnostic Radioiodine Whole-Body Scan (진단적 방사성옥소 전신스캔이 음성인 갑상선 재발암의 진료)

  • Chung, June-Key
    • 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.

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Usefulness of 3-Dimensional Body Surface Scanning in the Evaluation of Patients with Pectus Carinatum

  • Song, Seung Hwan;Kim, Chong Hoon;Moon, Duk Hwan;Lee, Sungsoo
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.301-305
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    • 2020
  • Background: Radiographic modalities have been commonly used to evaluate pectus carinatum (PC), and compressive orthotic bracing is the most widely accepted treatment method. The aim of this study was to determine the efficacy of 3-dimensional (3D) body surface scanning as an alternative modality for the evaluation of PC. Methods: The medical records of 63 patients with PC who were treated with compressive orthotic bracing therapy between July 2017 and February 2019 were retrospectively analyzed. Using both 2-view chest radiography (posteroanterior and lateral view) and 3D body scanning, the height of maximal protrusion of the chest wall was measured both before and after 2 weeks of bracing therapy. The difference between the pre- and post-treatment measurements was calculated for both modalities, and these differences were compared and analyzed. Results: Based on the comparison between the pre- and post-treatment radiographs, bracing therapy produced favorable outcomes in all patients (p<0.001). The measurements obtained via 3D scanning were strongly correlated with those obtained via chest radiography (r=0.60). Conclusion: Based on the findings of this study, 3D body surface scanning appears to be an effective, radiation-free, and simple method for the post-treatment follow-up evaluation of PC, and thus can be considered an alternative to radiography.

Kicking a Ball on Balance and Upper Limb Function in Chronic Stroke

  • Jeoungah Ahn;Joong Hwi Kim
    • The Journal of Korean Physical Therapy
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    • v.34 no.6
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    • pp.292-297
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    • 2022
  • Purpose: This study describes the effects of kicking a ball training on balance and upper limb function in chronic hemiplegia. Methods: Thirty chronic stroke patients were randomly selected; Kicking a ball (n=10), Treadmill gait (n=10), Stepping on the ground group (n=10). The Short Physical Performance Battery (SPPB) for balance and Foot Scan for weight distribution. Upper limb function was measured by the Manal Function Test (MFT). This treatment was performed five times a week for a total of 4 weeks. Results: Kicking group was significantly increased in SPPB (p<0.05) and MFT (p<0.05) between pretest vs post test and pretest vs follow-up. Conclusion: Kicking a ball was effective for improving weight acceptance on the paretic leg, balance and upper limb function. However, In terms of balance, the core stabilization that affected the upper extremity function was not evaluated. Thus, additional research may help determine correlation between core stability and upper limb function to improve balance.

Complex Regional Pain Syndrome on Post-Stroke Patients with Korean Medicine: A Case Series of Three Patients (뇌졸중 후 발병한 복합부위 통증증후군 환자의 한방치료로 호전된 치험 3례 보고)

  • Byun, Sung-Bum;Yun, Jong-Min;Moon, Byung-Soon
    • The Journal of Internal Korean Medicine
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    • v.35 no.4
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    • pp.573-584
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    • 2014
  • Objectives: This study was performed to evaluate the efficacy of Korean Medicine on post-stroke patients with upper limb pain due to complex regional pain syndrome diagnosed by three-phase bone scan, digital infrared thermal imaging, and International Association for the Study of Pain diagnostic criteria Methods: To evaluate the effectiveness of the treatments, visual analogue scale, medical research council grade, Brunnstrom stage of motor recovery, modified Ashworth scale, and Korean modified Barthel index were used. Results: After Korean medical treatments like acupuncture, herb medication, bee-venom therapy and rehabilitation therapy for 4 weeks, upper limb pain was considerably less and function of upper limbs was improved. Conclusions: Korean medical treatments have some good effects on post-stroke patients with complex regional pain syndrome.

False-positive I-131 Uptake in Meningioma (갑상선암 환자에서 관찰된 뇌수막종의 위양성 옥소 섭취)

  • Jeong, Shin-Young;Seo, Ji-Hyoung;Bae, Jin-Ho;Hwang, Jeong-Hyun;Ahn, Byeong-Cheol;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.272-273
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    • 2004
  • We experienced a case with meningioma showing false positive I-131 uptake. A 55-years old female patient underwent high dose (150 mCi) radioactive iodine therapy to ablate remnant tissue after total thyroidectomy for papillary thyroid cancer. in addition to intense tracer uptake in thyroid bed, there was mild but focal abnormal uptake in left frontal lobe of the brain on post-therapy I-131 whole body scan. Subsequent brain MR imaging showed single mass lesion in left frontal lobe and the mass was resected under the impression of brain metastasis of thyroid carcinoma. Pathologic report confirmed meningioma from the surgical specimen.

Optimal Imaging Time for Diagnostic I-123 Whole Body Scan in the Follow-up of Patients with Differentiated Thyroid Cancer: Comparison between 6- and 24-Hour Images of the Same Subjects (분화 갑상선 암의 추적 관찰에서 진단적 I-123 전신 스캔의 최적 영상 시점: 동일 환자에서 6시간과 24시간 영상의 비교)

  • Lee, Hong-Je;Lee, Sang-Woo;Song, Bong-Il;Kang, Sung-Min;Seo, Ji-Hyoung;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • 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.

The Effect of Arm Swing on Gait in Post-Stroke Hemiparesis (팔 흔들기가 뇌졸중으로 인한 편마비 환자의 보행에 미치는 영향)

  • Kim, Jin-Seop;Kwon, Oh-Hyoun
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.1
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    • pp.95-101
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    • 2012
  • Purpose : The purpose of this study was to investigate the variations in gait parameters according to arm swing use in post stroke hemiparesis. Methods : Sixteen patients participated in this study and walked at self-selected speeds on a Rs-scan systems. The were randomly assigned conditions: self-selected arm swing, constraint arm swing, emphasis arm swing. Results : In the comparison of parameters in each trial, both affected step length, non affected step length, affected stride length, non affected stride length, affected single support time, and non affected single support time were significantly increased and double support time was significantly decrease in emphasis arm swing when compared with both self-selected arm swing and constraint arm swing(p<.05). However, Asymmetrical ratio was significantly increased in both emphasis arm swing and self-selected arm swing when compared constraint arm swing(p<.05). Conclusion : Therefore, In this study, gait rehabilitation of patients with hemiplegia depending on what you need to apply the arm swing is considered.

Initial experience with intra-articular 188Re-tin colloid as a "radiation synovectomy" agent in various joints

  • Shinto, Ajit S;Indira, VU;Kamaleshwaran, KK;Banka, Vinay Kumar;Aswathy, KK;Thirumalaisamy, SG;Rajamani, V;Mallia, Madhav;Banerjee, Sharmila
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.1 no.2
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    • pp.109-117
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    • 2015
  • Radiation synovectomy has been proposed as a promising palliative therapy for recurrent joint effusions for the last two or three decades. Ionizing radiations emitted by intrarticularly administered radiolabelled colloids. The aim of this study was to assess the effectiveness of radiation synovectomy (RSV) using $^{188}Re$-tin colloid in the treatment of recurrent joint effusions and chronic synovitis of knee joints. Three phase bone scan was acquired for the concerned joint prior to radiosynovectomy. $^{188}Re$-tin colloid was prepared as per the reported protocol. 9 patients, diagnosed with rheumatoid arthritis and suffering from chronic resistant synovitis of the knee, ankle or elbow joints were administered the radiopharmaceuticals, checked for radiochemical purity >95% by intraarticular route. A whole body scan was acquired 2 h post-radiosynovectomy. In all the 9 treatments, no leakage to non-target organs was visible in the whole body scan. Static scans of the joint revealed complete retention of $^{188}Re$-tin colloid in the joints post administration of the agent. Clinically all patients exhibited a complete or partial response. RSV with $^{188}Re$-tin colloid was safe and effective in patients with chronic synovitis of rheumatoid origin.