• 대한두경부종양학회지
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• 제16권1호
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• pp.58-63
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• 2000

Objectives: To demonstrate effective diagnostic method and proper management of recurrent thyroid cancer through to compare treatment and surveillance of $I^{131}$ scanning detected recurrence and clinically detected recurrence. Material and Methods: We retrospectively analyzed clinical information about 46 patients who has recurrent thyroid cancer of 298 patients who have been primarily operated due to thyroid cancer in PMC at the over 10 years between 1986 and 1995. We examine incidence of recurrence due to pathologic types, site of recurrence, disease free interval, detection method of recurrence, and also treatment and progression of recurrence. A patients in which the clinical examination was entirely negative and the $I^{131}$ scan demonstrated either a new area of $I^{131}$ uptake or an increased area of concentration, compared to the previous scan, was designated as a recurrence detected by $I^{131}$ scan only. Recurrences that were obviously by physical examination or chest x-ray, etc were considered clinically detected recurrence, regardless of the the results of the thyroid scan. Results: Mean of disease tree interval(DFI) is 36months. When mean DFI of $I^{131}$ scan detected recurrence is 28months, whereas mean DFI of clinically detected recurrence is 47months. In statiscal analysis, p-value is 0.043 as significantly. In progression of recurrent patient, NED is 28case, AWD is Sease, DOD is 13case. Among the 13case, scan detected recurrence is lease of 20 patients(5%), whereas clinically detected recurrence is l2case of 26 patient(46%). In statiscal analysis, p-value is 0.003 as significantly. Conclusion: Early detection of the recurrent thyroid cancer by $I^{131}$ scanning leads to good progress compare with detection by clinical examination. NED: No Evidence of Disease AWD : Alive With Disease DOD : Dead Of Disease DOC: Dead of Other Cause

• Journal of Radiation Protection and Research
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• 제48권1호
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• pp.15-19
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• 2023

Background: Cone beam computed tomography (CBCT) is a specialized medical equipment and plays a significant role in the diagnosis of oral and maxillofacial diseases and abnormalities; however, it is attributed to risk of exposure of ionizing radiation. The aim of the study was to estimate and determine the amount of scattered radiation dose to the thyroid gland in dental CBCT during maxilla and mandible scan. Materials and Methods: The average scattered radiation dose for i-CAT 17-19 Platinum CBCT (Imaging Sciences International) was measured using a Multi-O-Meter (Unfors Instruments), placed at the patient's neck on the skin surface of the thyroid cartilage, with an exposure parameter of 120 kVp and 37.07 mAs. The surface entrance dose was noted using the Multi-O-Meter, which was placed at the time of the scan at the level of the thyroid gland on the anterior surface of the neck. Results and Discussion: The surface entrance dose to the thyroid from both jaws scans was 191.491±78.486 µGy for 0.25 mm voxel and 26.9 seconds, and 153.670±74.041 µGy from the mandible scan, whereas from the maxilla scan the surface entrance dose was 5.259±10.691 µGy. Conclusion: The surface entrance doses to the thyroid gland from imaging of both the jaws, and also from imaging of the maxilla and mandible alone were within the threshold limit. The surface entrance dose and effective dose in CBCT were dependent on the exposure parameters (kVp and mAs), scan length, and field of view. To further reduce the radiation dose, care should be taken in selecting an appropriate protocol as well as the provision of providing shielding to the thyroid gland.

• 대한방사선기술학회지:방사선기술과학
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• 제46권5호
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• pp.401-408
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• 2023

Thyroid uptake measurements can be subject to measurement errors due to the scoping and positioning of the thyroid gland. To compensate for these limitations, the clinical utility of the thyroid simultaneous counting method as an alternative to thyroid uptake measurement was analyzed and evaluated experimentally through quantitative analysis of images acquired after thyroid scanning. Experimental data were obtained using a Gamma camera (GE infinia), a thyroid uptake system (KOROID 1), and a thyroid neck phantom. Based on the thyroid uptake rate of 1-5% according to the protocol of thyroid scan test (^99mTcO₄ - , 370 MBq) in normal results, ^99mTcO₄ - was set in the range of 3.7-18.5 MBq (Matrix: 256×256, Scan time: 1 min, collimator: pin hole, phantom-collimator distances: 7 cm). The acquired images were corrected for the attenuation of isotopes due to the set-up time and half-life by applying the Auto Region of interest (ROI) drawing system, and the significance of the experimental results was evaluated by Multiple linear regression analysis (SPSS, ver. 22, IBM). The thyroid uptake rate showed a significant correlation between the dose and the measured counts when using the thyroid uptake system equipment. Meanwhile, the quantitative analysis counts of phantom images using Gamma camera also showed a significant correlation. Thus confirmed that the correlation between these two experiments was statistically significant (P<0.05). The simultaneous counting protocol, which indirectly measures thyroid uptake from thyroid scans, is likely to be clinically relevant if complemented by additional studies with different variables in patients with thyroid disease.

• Nuclear Medicine and Molecular Imaging
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• 제43권2호
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• pp.154-155
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• 2009

A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism.

• Nuclear Medicine and Molecular Imaging
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• 제40권1호
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• pp.51-52
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• 2006

A 39-year-old female patient who had undergone a total thyroidectomy for a papillary thyroid carcinoma underwent a whole body scan with I-131. The I-131 scan was performed 72 hours after administering 185 MBq (5 mCi) of an I-131 solution. The anterior image of the head, neck, and upper chest showed multiple areas of increased uptake in the mediastinal area considering of functional metastasis. However, radioactivity was not evident in the image taken after removing her clothes and muffler. The image obtained after placing the muffler on the pallet showed that the radioactivity was still present. It is well known that artifacts on an I-131 scan can be produced by styling hair sputum, drooling during sleep, chewing gum, and paper or a cloth handkerchief that is contaminated with the radioactive iodine from either perspiration or saliva. This activity might be mistaken for a functional metastasis. Therefore, it is essential that an image be obtained after removing the patient's clothes. In this study, artifacts due to a contaminated muffler on the I-131 scan were found. These mimicked a functional metastasis of the mediastinal area in a patient with a papillary thyroid carcinoma.

• 대한임상검사과학회지
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• 제45권3호
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• pp.108-113
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• 2013

The study compared the cytological features of papillary thyroid carcinoma (PTC) in liquid-based preparations (LBPs) and conventional Pap (CP) smears from fine needle aspiration (FNA), and assessed the feasibility of LBP using the Cell Scan $1500^{TM}$ processor on thyroid FNA samples. Thyroid FNA samples were obtained from 883 consecutive patients. Each sample was divided into two and used for LBPs and CP smears. All were screened independently in a double-blind manner. From the 883 cases, 95 cases were diagnosed as PTC in one or both types of preparation (10.8%). PTC was diagnosed via CP smears in 83 cases (87.4%) and via LBPs in 70 cases (73.7%). However, there were differences in categorization between the paired preparations: Twelve (12) PTCs were misinterpreted in CP smears and 25 PTCs in LBPs. There was a significant discrepancy in the rate of detection of the diagnostic features, with LBPs having a lower detection rate. One (1) case (1.2%) of CP smears and 16 cases (22.9%) of LBPs were categorized as unsatisfactory/nondiagnostic in a total of the 95 PTCs. To conclude, the detection rate of the diagnostic features of PTC is lower in Cell Scan 1500TM samples than in CP smears. However, there are some cases in which a diagnosis of PTC is made in LBPs, but not in CP smears. Therefore, definitive cancer diagnosis in thyroid FNA preparations is likely to result from agreement between direct smears and Cell Scan 1500TM preparations.

• 대한두경부종양학회지
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• 제16권2호
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• pp.206-211
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• 2000

Objectives: Any uptake of I-131 after total thyroidectomy means the remant thyroid tissue or distant metastasis of the thyroid cancer. However diffuse hepatic uptake of I-131 without abnormal uptake was showen in many cases on I-131 whole body scan. The aim of this study was to classify the liver uptake after I-131 scan and to evaluate the analysis of this finding. Materials and Methods: Between 1982 and 1998, 104 patients(l4 males, 90 females) with normal liver function underwent I-131 scan after total thyroidectomy. Prospectively we reviewed the films of the whole body scan and analysed the correlations between results of radioiodine uptake, pathologic diagnosis, prognostic factors, lymphatic metastasis, and thyroid function test. Result: Diffuse hepatic uptake was found in 44 of 104(42%) patients. 10 of 39(26%) patients on I-131 100mCi, and 34 of 63(54%) on I-131 150mCi showed hepatic uptake. 52 of 104(50%) patients was locally invasive thyroid cancer. The rate of the hepatic uptake was no significant differences with the thyroid hormone levels(T3, Free T4) and thyroglobulin between uptake group and non-uptake group. Conclusion: The rate of I-131 uptake was high in high-dose radioiodine treatment group. However, we can not find any correlation among the thyroid functions, the extent of metastasis or the extent of local invasion. We need further study to find out the causes of the hepatic uptake of I-131 after total thyroidectomy, besides liver metabolism of I-131 attached thyroid hormones.

• 대한핵의학회지
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• 제21권2호
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• pp.151-154
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• 1987

Total 114 patients were studied prospectively with radioiodine uptake (RAIU) and $^{99m}TcO_4^-$ thyroid scan to design a very simple, rapid and inexpensive method measuring the thyroid uptake on thyroid scan. After the RAIU was obtained at 24 hours after P.O. of $^{131}I$, Thyroid scan was performed at 20 minutes after LV. of $^{99m}TcO_4^-$ and the bilateral salivary glands were included in the scan field. Pinhole collimated and computer assisted gamma camera was used. Three regions of interest were set on each salivary gland and on the thyroid by automatic edge detection method. Mean counts per pixel were calculated for each ROI and the salivary-thyroid ratio (STR) was defined as; $$STR(%)=\frac{Mean\;counts\;per\;pixel\;of\;salivary\;glands\;(KC)}{Mean\;counts\;per\;pixel\;of\;thyroid\;gland\;(KC)}\times100$$ 114 cases consisted of 41 normal, 55 hyperthyroid and 18 hypothyroid patients and correlation between the STR and the RAID were evaluated in total and each group. The STR and the RAID showed reverse linear regression in 114 cases (r= -0.8, P=0) and closer correlation was shown in hyperthyroid group (r= -0_9, p=0). Mean STR in normal group was 47.6%. In predicting the RAID by STR, sensitivity and specificity were 88.3% and 64.9% in 114 cases and 95.3% and 83.3% in hyperthyroid group. It is recommended that the STR be used in place of the RAID giving same information at saving time, money and radiation exposure.

• 대한기관식도과학회지
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• 제17권1호
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• pp.50-52
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• 2011

Ectopic thyroid gland is a defined as thyroid tissue located in a site other than its usual pre-tracheal location. Ultrasound examination, CT scan, thyroid scan, and thyroid iodine uptake test are all valuable modalities for a differential diagnosis. Although most of cases are asymptomatic, treatment is indicated when there are symptoms related to progressive growth of mass. This article reports a ectopic thyroid cyst in the anterior neck that was similar to deep neck infection accompanied by acute airway obstruction.

• 대한핵의학회지
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• 제33권6호
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• pp.493-501
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• 1999

목적 : 분화된 갑상선암에서 암 절제술 및 방사성 옥소 치료 후 추적관찰 중 재발이나 전이병소를 찾기 위한 효과적인 검사 방법에 대한 자료를 제시하고자 T1-201 스캔, Tc-99m MIBI 스캔, I-131 스캔 검사의 결과를 비교하였다. 대상 및 방법: 분화된 갑상선암으로 진단되어 수술 및 방사성 옥소로 치료 후 추적관찰 중 국소 재발 또는 전이로 생각되어 한번이상의 방사성 옥소 재 치료를 시행한 20명(총 33예)의 환자를 대상하여 T1-201 스캔, Tc-99m MIBI 스캔, 진단적 및 치료적 I-131 스캔을 시행하여 각 스캔에서 결과를 후향적으로 분석하였다. 모든 환자에서 갑상선글로불린을 측정하였고 임상적, 방사선학적, 조직학적 검사로 암의 재발 및 전이를 확인하였다. 결과: 4가지 검사의 비교에서 병소를 발견할 수 있는 양성률은 Tc-99m MIBI 스캔, T1-201 스캔, 진단적 I-131 스캔, 치료적 I-131 스캔에서 각각 70% (19/27), 54% (15/28), 35% (17/48), 63% (30/48)였다. T1-201 스캔과 I-131 스캔을 같이 시행한 군(20 예, 28병소)에서는 병소의 양성률은 치료적 I-131 스캔, T1-201 스캔, 진단적 I-131 스캔 순으로 높았으나(71%, 54%, 36%), T1-201 스캔과 진단적 I-131 스캔간의 차이는 없었다(p>0.05). Tc-99m MIBI 스캔을 I-131 스캔과 같이 시행한 군(20예, 27병소)에 서는 Tc-99m MIBI, 치료적 I-131 스캔, 진단적 I-131 스캔의 순으로 높았고(70%, 52%, 33%), Tc-99m MIBI는 진단적 I-131 스캔보다 양성률이 유의하게 높았다(p<0.05). 결론: 분화된 갑상선암 환자의 치료 후 추적 관찰에서 국소 재발 및 전이 병소를 찾는데 Tc-99m MIBI 스캔은 진단적 I-131 스캔보다 우수하였다. 따라서 치료 전에 진단적 I-131 스캔을 시행하기보다는 갑상선 호르몬제를 중단하지 않은 상태에서 Tc-99m MIBI 스캔을 시행한 후 결과에 따라서 치료용량의 방사성 옥소를 투여하고 치료적 I-131 스캔을 하는 것이 효과적일 것으로 사료된다.