• Title/Summary/Keyword: thyroid imaging

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A Study of Radiation Dose Evaluation and Optimization Methods for Intra Oral Dental X-ray in Pediatric Patient (소아 구내촬영 시 방사선량 평가 및 최적화 방안에 대한 연구)

  • Lee, Hyun-Yong;Cho, Yong-In
    • Journal of radiological science and technology
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    • v.44 no.3
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    • pp.195-203
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    • 2021
  • Although intra oral dental x-ray is a lower dose than other radiological examinations, pediatric patients are known to have a higher risk of radiation damage than adults. For this reason, pediatric dental x-ray requires management of dose evaluation and imaging conditions during the examination. In this study, the dose calculation program ALARA-Dental(child/adult) was used to evaluate the organ dose and effective dose exposed to each examination site during intra oral imaging of children during dental radiographic examination, and dose analysis according to the imaging conditions was performed. As a result, the highest organ dose distribution was shown at 0.044 ~ 0.097 mGy in all are as of the mucous membrane of oral cavity except for the maxillary incisors and canines. Also, in the case of the thyroid gland, the maxillary canine and maxillary premolar examination showed 0.027 and 0.020 mGy, respectively, and the dose distribution was 15.4% to 70.0% higher than that of the mandibular examination. As for the effective dose calculated during intra oral imaging, the maxillary anterior and canine examinations showed the highest effective doses of 0.005 and 0.004 mSv, respectively, and the maxillary area examination showed a higher dose distribution on average than the mandible.

An Elimination of False-Positive I-131 Sites in Esophagus for Thyroid Carcinoma; Using Water with Vitamin C Dissolved (갑상선암의 방사성옥소 치료 후 전신 스캔에서 비타민C 용액을 이용한 식도의 위양성 병소 제거에 대한 고찰)

  • Lee, Seung-Jae;Park, Hoon-Hee;Ahn, Sa-Ron;Cho, Seok-Won;Choi, Young-Sook;Cho, Arther;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.49-56
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    • 2008
  • Purpose: Whole body imaging with radioiodine can detect functioning metastases. Non-physiologic I-131 uptake detected on images usually is interpreted as suggesting functioning thyroid metastases. However, extra-thyroidal I-131 accumulation does not always imply thyroid cancer metastases and has been reported in many circumstances. In order to avoid unnecessary therapeutic interventions it is important to distinguish false-positive sites of I-131 localization. We study here to remove false-positive sites around esophagus region on I-131 whole body imaging in patients who were administrated thyroidectomy. Materials and Methods: From April to August in 2007, we had the patients who had visited our department after they received thyroidectomy due to thyroid cancer. They were given I-131, and performed radioiodine body scan after 41 to 50 hours. Patients were whole-body-scanned for the speed of 8 cm per minute. After that, we took anterior and posterior static images around the patients' neck measured by 300 thousand counts per image. We selected 44 patients who had hot spots around neck region, we divided the patients into two groups. One group was given 0.5 L of water and the other group was given 0.5 L of water with 1 g of Vitamin C dissolved. The patients were asked to drink the fluid for one minute in sitting position and after that, we measured 300 kilo counts per image again. We compared prior anterior, posterior static images with anterior, posterior images after the patients had water or water that Vitamin C resolved. Results: In using water, both observer 1 and 2 interpreted 6 patients were washed out. In the water with Vitamin C resolved, observer 1 and 2 interpreted 9 and 8 patients were washed out. Observer 1 and 2 interpreted 6 and 5 patients had 'indeterminate' when they used water. Both observer 1 and 2 interpreted 6 patients had 'indeterminate' when they used water with Vitamin C resolved. When they used water, observer 1 interpreted 10 patients had 'unchanged' and observer 2 interpreted 11 patients had 'unchanged'. Differently, when they used water with vitamin C resolved, observer1 had 8 patients having 'unchanged'and observer 2 had 9. Conclusion: As a result, by making patients drink 0.5 liter of water which has vitamin C resolved helped getting rid of false-positive sites in esophagus. Therefore, based on this study, we believe that drinking water with vitamin C dissolved is very in terms of reducing false-positive hot spot around the esophagus for the iodine-131 whole body scan.

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Identification of the Nonrecurrent Laryngeal Nerve during Thyroid Surgery: Variations, Associated Vascular Malformation, Adequate Surgical Technique (갑상선 수술시 발견된 비회귀성 후두신경; 유형, 동반 혈관 이상, 신경 손상 예방에 대한 고찰)

  • Lee Jan-Dee;Yun Ji-Sup;Lim Chi-Young;Nam Kee-Hyun;Chang Hang-Seok;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.3-7
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    • 2006
  • Purpose: The nonrecurrent laryngeal nerve(NRLN) is a rare anomaly that is associated with the developmentally aberrant subclavian artery. Although rare on the right side and exceptional on the left, an aberrant nonrecurrent pathway for RLN represents a major surgical risk. Three course variations of right NRLN can be distinguished: descending(type I) , horizontal(type II), ascending(type III). This study is performed to characterize the variations of NRLN, associated vascular anomaly, and proper surgical methods for preventing nerve damage. Materials and Methods: Between January 1998 and March 2006 3,381 thyroidectomy were performed at our institution, and during these operations a nonrecurrent laryngeal nerve was observed in 13 cases (0.38%). There were 1 men and 12 women with a median age of 48 years(range 28-57). All of them are identified on the right side. Results: In all cases, there were no clinical symptoms observed preoperatively. The nerve anomaly was diagnosed preoperatively in only one case. There were type I variations of right RLN in 2 cases and type II variations in 11 cases. The retroesophageal aberrant right subcalvian artery; no innominate(brachiocephalic) artery was found and the right common carotic artery was arising directly from the aortic arch, was seen in 12 cases. A vocal cord palaysis caused by NRLN damage during operation was observed in one patient(7.6%) , where the nerve was close to the superior thyroid artery. No other complications were noted. Conclusion: It can be possible to predict NRLN from signs associated with the vascular anomaly; clinical symptoms or imaging studies. When an vascular anomaly is not detected preoperatively, overlooking possibility of NRLN may lead to severe operative morbidity. Hence, It is most important to identify all the thyroid structures carefully during thyroid surgery and to be aware of the possibility of anatomic variations of RLN.

Ultrasonographic Features of Medullary Thyroid Carcinoma: Do they Correlate with Pre- and Post-Operative Calcitonin Levels?

  • Cho, Kyung Eun;Gweon, Hye Mi;Park, Ah Young;Yoo, Mi Ri;Kim, Jeong-Ah;Youk, Ji Hyun;Park, Young Mi;Son, Eun Ju
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3357-3362
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    • 2016
  • Purpose: To correlate ultrasonographic (US) features of medullary thyroid carcinoma (MTC) with preoperative and post-operative calcitonin levels. Materials and Methods: A total of 130 thyroid nodules diagnosed as MTC were evaluated. Two radiologists retrospectively evaluated preoperative US features according to size, shape, margin, echogenicity, type of calcification, and lymph node status. Postoperative clinical and imaging follow-up (mean duration $31.9 {\pm} 22.5$ months) was performed for detection of tumor recurrence. US features, presence of LN metastasis, and tumor recurrence were compared between MTC nodules with and without elevated preoperative calcitonin (>100 pg/mL). Those with normalized and non-normalized postoperative calcitonin levels groups were also compared. Results: Common US features of MTCs were solid internal content (90.8%), irregular shape (44.6%), circumscribed margin (46.2%), and hypoechogenicity (56.2%). Comparing MTC nodules with and without elevated preoperative calcitonin levels, the size and shape of MTC nodule and lymph node metastasis showed statistical significance (p<0.05). Postoperative calcitonin normalization correlated with US features of tumor size (p=0.002), margin (p=0.034), shape ($p{\leq}0.001$), and presence of calcification (p=0.046). Tumor recurrence and LN metastasis were more prevalent in patients without normalization of postoperative calcitonin than in those with normalization (p=0.001). Conclusions: Serum calcitonin measurement is helpful for early diagnosis and predicting prognosis. Postoperative calcitonin measurement is also important for postoperative US follow up, especially in cases with larger nodule size, presence of calcification, irregular shape, and irregular margin.

The Clinical Role of $^{99m}Tc$-(V)-DMSA Imaging in Patients with Head and Neck Cancer (두경부 종양에서 $^{99m}Tc$-(V)-DMSA 영상술의 진단적 유용성)

  • Bae, Sun-Kun;Lee, Jae-Tae;Park, June-Sik;Park, In-Kyu;Hyun, Dong-Woo;Lee, Young-Hak;Kim, Jeong-Gyun;Ahn, Byeong-Cheal;Choi, Ji-Yong;Sohn, Sang-Gyun;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.526-532
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    • 1995
  • Introduction : $^{99m}Tc$-(V)-DMSA is a tumor seeking agent that has been used to image medullary carcinoma of thyroid, soft tissue sarcoma and lung cancer. This study was designed to assess the clinical role of $^{99m}Tc$-(V)-DMSA in the diagnosis of head and neck cancers. We has evaluated the diagnostic efficacy of planar and SPECT imaging using $^{99m}Tc$-(V)-DMSA. Patients and Method : Sixty-eight patients with head and neck mass were included in this study. All subjects were diagnosed by biopsy or surgery. Planar and SPECT images were obtained at 2 or 3 hour after intravenous injection of 740 MBq(20 mCi) $^{99m}Tc$-(V)-DMSA. Seventeen patients also underwent SPECT in aging using dual head camera. Result : The diagnostic sensitivity of $^{99m}Tc$-(V)-DMSA planar and SPECT imaging was 65% and 90%, and specificity was 80% and 66%, respectively. The sensitivity of planar imaging in squamous cell carcinoma was similar to overall sensitivity Six metastatic lesion were first diagnosed by scintigraphy. But benign lesions such as Kikuchi syndrome, tuberculous lymphadenitis also revealed increased uptake. Conclusion : $^{99m}Tc$-(V)-DMSA imaging seems to be a promising method in the evaluation of patients with head and neck mass. We recommend SPECT imaging to delineate anatomic localization of the lesion.

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Synthesis and in vitro evaluation of 99mTc-labeled tetraiodothyroacetic acid for tumor angiogenesis imaging

  • Kim, Hyunjung;Koo, Hyun-Jung;Choe, Yearn Seong
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.6 no.1
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    • pp.3-9
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    • 2020
  • Tetraiodothyroacetic acid (tetrac) is a derivative of thyroid hormone T4 and causes anti-angiogenesis by blocking T4 binding to integrin αvβ3. In this study, we synthesized [99mTc]Tc-Cys-Asp-Gly(CDG)-tetrac and evaluated it in vitro as a tumor angiogenesis imaging ligand. The CDG was conjugated to tetrac as a chelator for technetium-99m labeling. The cold vial containing CDG-tetrac, sodium glucoheptonate, and reducing agent was completed under nitrogen-filled atmospheric glove bag. [99mTc]Tc-CDG-tetrac was synthesized in quantitative yield by heating the cold vial with [99mTc]TcO4- at 100℃ for 30 min. In vitro serum stability of [99mTc]Tc-CDG-tetrac was measured by incubating the radioligand in 50% fetal bovine serum at 37℃ and analyzing the incubation mixture by radio-TLC, which showed high stability over 6 h (≥ 98%). Cell binding study was carried out by incubating [99mTc]Tc-CDG-tetrac with human umbilical vein endothelial (HUVE) cells at 37℃ for 6 h. The cell binding of the radioligand increased from 100% at 0.5 h to 293.7% at 6 h in a time-dependent manner. For blocking study, the cells were incubated with the radioligand in the presence of either tetrac (20 μM) or cRGDyK (20 μM) at 37℃ for 4 h. The results demonstrated that the cell binding of the radioligand was inhibited by tetrac (19.1%) or cRGDyK (35.6%), indicating specific binding of the radioligand to integrin αvβ3. Thus, this study suggests that [99mTc]Tc-CDG-tetrac may be a potential radioligand for tumor angiogenesis imaging.

Metastatic adenocarcinoma of the mandible

  • Hwang Eui-Hwan;Hwang Ji-Young;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.34 no.4
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    • pp.219-223
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    • 2004
  • Metastases to the jawbones are found predominantly in the mandible and are rare in relation to the overall spectrum of oral malignancy. Analysis of the literature shows that the most frequent primary sites are the breast, lung, kidney, thyroid, and prostate. Adenocarcinoma of the mandible, whether primary or metastatic, are usually difficult to diagnose clinically. We report a case illustrating the clinical, radiographic, and histologic findings of a metastatic lung adenocarcinoma of the anterior mandible in a 58-year-old male.

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Multiple brown tumors of the jaws in primary hyperparathyroidism (원발성 부갑상선항진증에 의한 악골의 다발성 갈색종양)

  • Kim, Kyoung-A;Koh, Kwang-Joon
    • Imaging Science in Dentistry
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    • v.40 no.3
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    • pp.149-153
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    • 2010
  • Brown tumor is usually diagnosed at the terminal stage of hyperparathyroidism. Diagnosis of this tumor is confirmed by endocrinologic investigations along with clinical and radiographic examination. Radiographical differential diagnosis of this tumor includes central giant cell granuloma, aneurysmal bone cyst, metastatic tumor, multiple myeloma, and Paget disease. This report presents a rare case of multiple brown tumors occurring at the maxilla and mandible, which was initially misdiagnosed as central giant cell granuloma. Plain radiographs demonstrated multiple well-defined multilocular radiolucency. CT images showed soft tissue mass with low attenuated lesions, perforation of the lingual cortical plate, and a heterogeneous mass at the right thyroid lobe. These findings were consistent with parathyroid adenoma. The patient had hypercalcemia, hypophosphatemia, and elevated alkaline phosphatase level. Surgical excision of the tumor was performed. No recurrence was observed during a 28-month follow-up.

Thyroid adenocarcinoma in a Maltese dog

  • Chung, Dai-Jung;Chang, Hwa-Seok;Choi, Jun-Chul;Kang, Eun-Hee;Lee, Jae-Hoon;Yang, Woo-Jong;Kim, Dae-Hyoun;Jung, Wook-Hyon;Choi, Chi-Bong;Sur, Jung-Hyang;Eom, Ki-Dong;Kim, Hwi-Yool
    • Proceedings of the Korean Society of Veterinary Clinics Conference
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    • 2006.11a
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    • pp.128-128
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    • 2006
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Radioimmunotherapy (I): Development of Radioimmunoconjugates (방사면역치료(I): 방사면역접합체 개발)

  • Choi, Tae-Hyun;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.66-73
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    • 2006
  • Monoclonal antibodies are designed to bind specifically to certain antigen, give therapeutic effect to the target and to be produced in large scale with homogeneity. The monoclonal antibodies conjugated with radionuclide can deliver therapeutic irradiation to the target, and showed successful results in certain malignancies, which is known as radioimmunotherapy. The target-to-background ratio depends on the antigen expression in the target and normal tissues, which is related to the therapeutic efficacy and toxicity in radioimmunotherapy. For the solid tumor beta-ray energy should be high, but lower beta energy is better for the hematological malignancies. I-l31 is widely used in thyroid cancer with low cost and high availability. Labeling monoclonal antibody with I-131 is relatively simple and reproducible. Some preclinical data for the I-131 labeled monoclonal antibodies including acute toxicity and efficacy are available from already published literatures in KIRAMS, physician sponsored clinical trial protocols using Rituximab, KFDA approved anti-CD20 chimeric monoclonal antibody and I-131 were approved by KFDA and currently are ongoing.