• 대한핵의학회지
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• 제27권2호
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• pp.305-308
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• 1993

Metastatic thyroid carcinoma in bone shows characteristic expansile, trabeculated lysis on radio-gram. The ordinary scintigraphy manifests with a simple photopenic defect. We were able to portray trabeculation within photopenic defects. We present papillary thyroid carcinoma and follicular thyroid carcinoma, one each, pinhole bone scintigraphic findings of which are cold area with septated increased uptake at the iliae bone. These findings correspond very well with their X-ray pictures.

• 대한기관식도과학회지
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• 제6권1호
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• pp.16-20
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• 2000

The patient a 24-year-old male, was shown to have milliary shadows on chest radiographs from the age of 20. He was temporarily treated for pulmonary tuberculosis without success. He had left thyroid mass and lymph node metastases in neck CT scan which was taken after admission but fine needle aspiration result in scanty cellularity. He underwent total thyroidectomy with left modified radical neck dissection and right selective neck dissection under the impression of differentiated thyroid cancer with bilateral neck metastases. Then he underwent 131I ablation treatment and postoperative whole body 131I scintigraphy revealed diffuse intensive uptake in the bilateral lung fields, demonstrating that the pulmonary lesions were metastases of the thyroid cancer.

• 대한두경부종양학회지
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• 제10권2호
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• pp.91-101
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• 1994

Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.47-50
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• 2013

There has been an increase in the number of reports of atypical manifestations of Graves' disease (GD), such as jaundice, anemia, thrombocytopenia and leukopenia. Pancytopenia also rarely occurs in GD. In this paper, a case of pancytopenia with GD that was successfully treated with an anti-thyroid drug is reported. In this case, a 69-year-old woman showed pancytopenia with a normal peripheral blood smear, bone marrow aspiration smear and bone marrow biopsy. Her thyroid function test and thyroid scintigraphy confirmed her hyperthyroid status. Her laboratory abnormality and clinical condition improved after she was treated with an anti-thyroid drug. This is a rare case of pancytopenia associated with GD.

• 대한핵의학회지
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• 제35권3호
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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.

• 대한핵의학회지
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• 제30권4호
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• pp.516-523
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• 1996

목 적 : 신경내분비종양 진단에 대한 I-123 MIBG 스캔의 4시간 조기 영상과 SPECT 영상의 임상적 유용성을 평가하고자 시행하였다. 대상과 방법 : CT 또는 MRI를 시행하여 신경내분비종양이 의심되었던 21예를 대상으로 I-123 MIBG 스캔을 시행하였으며 4시간에 전신 평면 영상과 SPECT 영상을 얻고, 17예에서는 12-24시간 사이에 지연 평면 영상도 얻었다. 결 과 : 21예중 12예에서 신경내분비종양으로 확진되었고, 4시간 I-123 MIBG 스캔의 진단적 예민도는 75%, 특이도는 89%였다. SPECT 영상은 CT나 MRI와의 비교 분석에 용이하였다. 지연 영상은 일부 진양성을 소견을 보인 예에서 종양 대 배후 방사능의 비가 증가하여 병변 확인에 도움이 되었으나 4시간 평면 영상과 진단율에 차이는 없었다. 결 론 : I-123 MIBG 스캔은 4시간 조기 영상으로도 신경내분비종양의 진단에 유용했으며, SPECT 영상은 다른 진단매체와의 비교 분석이 용이하였고 향후 종양의 종류에 따라 더 많은 예의 연구가 필요할 것으로 생각하였다.

• 대한수의학회지
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• 제64권2호
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• pp.10.1-10.9
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• 2024

Hyperthyroidism, characterized by elevated thyroid hormone levels and thyroid gland hyperplasia or adenoma, is a prevalent endocrinopathy in older cats. Treatment options include antithyroid drugs, surgical thyroidectomy, and radioiodine therapy (RAIT), which is non-invasive treatment option that can achieve complete remission. However, efficacy and safety of RAIT in hyperthyroid cats have not been investigated in South Korea. This study includes 10 hyperthyroid cats with RAIT. Initial assessments comprised history, physical examination, blood analysis, and serum total T4 (tT4) concentration. Thyroid scintigraphy revealed hyperactivity and enlargement of thyroid gland at 24 hours before the RAIT. Radioiodine (RAI) was injected subcutaneously with 2 to 6 mCi, determined by the fixed dose or the scoring system based on severity of clinical signs, tT4 concentration, and thyroid size individually. After RAIT, the concentration of serum tT4 and liver enzymes were significantly decreased at discharge. However, no significant differences were noted in blood urea nitrogen, creatinine, symmetric dimethylarginine, hematocrits, and white blood cell counts pre- and post-treatment. Although 4 cats received RAI twice, clinical signs disappeared and tT4 levels decreased following the RAIT. All 10 cats achieved complete remission after 6 months without critical adverse effect. The safety and the effectiveness of RAIT was confirmed based on protocols reported other countries. Therefore, RAIT could be considered the treatment option and prevent adverse effects from medication or surgery. This preliminary study presents the first evaluation of RAIT for hyperthyroid cats using locally produced RAI in South Korea and provide valuable insight for clinicians and further studies.

• 대한핵의학회지
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• 제38권2호
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• pp.152-160
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• 2004

Radioiodide uptake in thyroid follicular epithelial cells, mediated by a plasma membrane transporter, sodium iodide symporter (NIS), provides a first step mechanism for thyroid cancer detection by radioiodide injection and effective radioiodide treatment for patients with invasive, recurrent, and/or metastatic thyroid cancers after total thyroidectomy. NIS gene transfer to tumor cells may significantly and specifically enhance internal radioactive accumulation of tumors following radioiodide administration, and result in better tumor control. NIS gene transfers have been successfully performed in a variety of tumor animal models by either plasmid-mediated transfection or virus (adenovirus or retrovirus)-mediated gene delivery. These animal models include nude mice xenografted with human melanoma, glioma, breast cancer or prostate cancer, rats with subcutaneous thyroid tumor implantation, as well as the rat intracranial glioma model. In these animal models, non-invasive imaging of in vivo tumors by gamma camera scintigraphy after radioiodide or technetium injection has been performed successfully, suggesting that the NIS can serve as an imaging reporter gene for gene therapy trials. In addition, the tumor killing effects of I-131, ReO4-188 and At-211 after NIS gene transfer have been demonstrated in in vitro clonogenic assays and in vivo radioiodide therapy studies, suggesting that NIS gene can also serve as a therapeutic agent when combined with radioiodide injection. Better NIS-mediated imaging and tumor treatment by radioiodide requires a more efficient and specific system of gene delivery with better retention of radioiodide in tumor. Results thus far are, however, promising, and suggest that NIS gene transfer followed by radioiodide treatment will allow non-invasive in vivo imaging to assess the outcome of gene therapy and provide a therapeutic strategy for a variety of human diseases.

• 대한핵의학회지
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• 제21권1호
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• pp.61-68
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• 1987

Investigation with $^{57}Co-Bleomycin$ in patients with the various cancers and in tumor bearing animals are descirbed. In the patients, $^{57}Co-Bleomycin$ appears to be one of the useful tumor-seeking radiopharmaceuticals, and worth applicable to clinical uses. Labelled yield of $^{57}Co-Bleo$ was about 97 % by thin layer chromatography. The pyrogen free tests were performed to meet U.S.P. critical ranges. In clinical studies with $^{57}Co-Bleo$, 4 cases out of 5 patients with lung cancer., 2 cases among 3 thyroid cancer patients, and all 3 hepatoma patients showed positive tumor scans. The patients with stomach cancer, and the esophageal cancer showed false negative scintigraphy. A case with pulmonary tuberculosis showed a positive scan while liver abscess showed a negative picture. The merits of $^{57}Co-Bleomycin$ scintigraphy seems to be its relatively high affinity to tumors and low radiation hazard in spite of long physical half life.

• 핵의학기술
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• 제18권1호
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• pp.104-109
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• 2014

핀홀 콜리메이터는 목적 장기 영상의 확대와 고 분해능을 필요로 하는 검사에 사용하며 주로 갑상선 검사와 전신 뼈 검사 시 정적검사에 이용되어 왔다. 현재 임상에 적용할 수 있는 핀홀 콜리메이터 초점 직경은 2 mm, 4 mm, 6 mm 및 8 mm의 4종류가 있지만 기존 핀홀 콜리메이터 검사는 모든 검사에 있어서 4 mm 직경의 초점만을 이용한 검사를 시행해 왔다. 본 연구에서는 실험을 통한 각각의 초점 직경별 성능을 비교 평가해보고 임상에 적용시킬 수 있도록 알아보고자 하였다. Gamma camera E.CAM을 이용하였으며 핀홀 콜리메이터와 2 mm, 4 mm, 6 mm, 8 mm의 4가지 초점을 준비하였다. 분해능 실험을 위해 capillary tube를 이용한 선 선원과 micro deluxe phantom을 사용하였으며 선 선원을 이용한 FWHM과 micro deluxe phantom을 이용한 육안 평가를 하였으며 두 가지의 분해능 실험 모두 인위적인 방법을 통한 핀홀 SPECT를 통해 영상을 획득하여 분석하였고 thyroid phantom을 이용하여 5분 시간 설정법과 230 kcounts 계수 설정법에 대한 영상비교와 각 초점별 시간 설정법에 대한 계수치와 계수 설정법에 대한 검사 소요시간을 비교하였으며 thyroid phantom을 만든 후의 일반영상과 24시간 후의 지연영상의 100 kcounts 계수를 획득 후 열소와 주변부의 $150mm^2$ ROI를 설정하여 SNR, uniformity, contrast값을 비교해 보았다. 선 선원을 이용한 FWHM 평가에서는 2 mm, 4 mm, 6 mm, 8 mm의 각 초점별로 2.2 mm FWHM, 3.2 mm FWHM, 5.4 mm FWHM, 7.5 mm FWHM의 FWHM이 측정되었고 micro deluxe phantom을 이용한 육안평가에서는 초점이 작아질수록 분해능이 점차 향상됨을 알 수 있었다. Thyroid phantom 5분 시간 설정법에 대한 계수치는 각 초점별로 27 kcounts, 96 kcounts, 228 kcounts, 410 kcounts가 획득되었으며 230 kcounts의 계수 설정법에 대한 검사 소요시간은 각 초점별로 39.7분, 11.5분, 5분, 2.7분이 소요되어 초점이 커질수록 감도가 향상 되었다. 일반영상과 지연영상의 SNR 평가에서는 2, 4, 6, 8 mm 각 초점별 값은 일반영상에서 6.55, 8.47, 6.2, 5.23으로 4 mm 초점에서 가장 높은 SNR값이 나타났으며 지연영상에서 5.25, 5.01, 5.38, 5.82로 8 mm 초점에서 가장 높은 SNR값이 나타났다. Uniformity 평가에서는 0.152, 0.118, 0.161, 0.19로 4 mm 초점에서 가장 낮은 uniformity값이 나타났으며 지연영상에서 0.19, 0.199, 0.185, 0.171로 8 mm 초점에서 가장 낮은 uniformity값이 나타났다. Contrast평가에서 일반영상은 1.31, 1.19, 1.15, 1.01로 2 mm 초점에서 가장 높은 contrast값이 나타났으며 지연영상은 1.09, 1.08, 1.04, 1로 2 mm 초점에서 가장 높은 contrast값이 나타났다. 본 연구는 핀홀 콜리메이터의 초점별 성능을 비교해 보고자 하였다. 감도와 분해능은 초점 크기에 따른 영향이 크다는 것을 알 수 있었다. 2 mm 초점은 고 분해능 영상을 획득할 수 있지만 낮은 감도로 인해 소동물형 검사나 환자의 방사능이 충분할 경우에 유용한 검사가 될 것이다. 6 mm, 8 mm 초점은 분해능 저하는 있지만 높은 감도로 인해 중증환자나 움직임이 많은 소아의 경우 유용하게 사용할 수 있으며 지연 영상 시 큰 초점의 높은 감도와 SNR, uniformity의 장점을 활용한다면 전신 뼈 검사 시 지연된 핀홀 정적검사에 고려해 볼 수 있다.