• Title/Summary/Keyword: thyroid imaging

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Bilateral Extraocular Muscle Metastasis of Nasal Rhabdomyosarcoma Mimicking a Thyroid Associated Orbitopathy: A Case Report (갑상선 안병증으로 오인된 비강 내 횡문근육종의 양쪽 외안근 전이: 증례 보고)

  • Shin, Jin-Ho;Lee, Jeong-Hyun;Lim, Hyun-Kyung;Lee, Ha-Young;Park, Jee-Won;Baek, Hye-Jin;Choi, Young-Jun;Ahn, Jin-He;Baek, Jung-Hwan
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.2
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    • pp.176-180
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    • 2011
  • Metastases to the orbit usually affect the intraorbital fat and bone than the extraocular muscles. Metastasis to the extracoular muscles commonly occurs unilaterally, and diffuse enlargement of the bilateral extraocular muscles due to metastasis is extremely rare. In this report, we will describe a case of diffuse metastasis to the bilateral extraocular muscles from nasal rhabdomyosarcoma masquerading as thyroid associated orbitopathy. We will also discuss about the MR imaging findings helpful for differential diagnosis from thyroid associated orbitopathy.

Conventional Ultrasonography and Real Time Ultrasound Elastography in the Differential Diagnosis of Degenerating Cystic Thyroid Nodules Mimicking Malignancy and Papillary Thyroid Carcinomas

  • Wu, Hong-Xun;Zhang, Bing-Jie;Wang, Jun;Zhu, Bei-Lin;Zang, Ya-Ping;Cao, Yue-Long
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.935-940
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    • 2013
  • Background: To evaluate the diagnostic utility of conventional ultrasonography and real time ultrasound elastography in differentiating degenerating cystic thyroid nodules mimicking malignancy from papillary thyroid carcinoma. Methods: We retrospectively analyzed conventional ultrasonographic and elastographic characteristics of 19 degenerating cystic thyroid nodules mimicking malignancy in 19 patients, with 30 surgically confirmed PTCs as controls. Based on size, the nodules had been grouped into less than 10mm (group A) and greater than 10 mm (group B). We evaluated conventional parameters and elasticity pattern. Color-scaled elastograms were graded as to stiffness of nodules using an elasticity pattern from I (soft) to IV (stiff). Results: Degenerating cystic thyroid nodules were similar to PTCs in conventional ultrasonographic findings, but the former frequently showed oval to round in shape (group A, 69.2% vs 18.8%, P=0.017; group B, 66.7% vs 7.14%, P=0.017) and punctuate hyperechoic foci (group A, 61.5% vs 0, P<0.001; group B, 50% vs 0, P<0.001). On real time ultrasound elastography, 7 of 13 degenerating cystic thyroid nodules in group A were pattern I, 5 were pattern II, 1 was pattern III. One degenerating cystic thyroid nodule in group B was pattern II, 5 were pattern III. The area under the curve for elastography was 0.98 in group A (sensitivity 92.3%, specificity 100%, P = 0.002), and 0.88 in group B (sensitivity 16.7%, specificity 100%, P = 0.014). Conclusions: As a dependable imaging technique, elastography helps increase the performance in differential diagnosis of degenerating cystic thyroid nodule and malignancy.

The Usefulness of Al Face Block Fabrication for Reducing Exposure Dose of Thyroid Glands in Mammography (유방촬영 시 갑상샘의 피폭선량 경감을 위한 Al Face Block 제작 및 유용성에 관한 연구)

  • Hong, Eun-Ae;Lee, In-Ja
    • Journal of radiological science and technology
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    • v.36 no.1
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    • pp.11-17
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    • 2013
  • Currently, there are many studies being conducted around the world to reduce exposure dose to radiation for patients to receive medical treatments in a safe environment. We developed and fabricated of this shield that the patients are protected from the radiation and are need of safety control during breast imaging. In this study, for breast imaging, GE Senography 2000D were used and set at SID 65cm, 28kVp, and 63mAs. The measuring instrument was Fluke's Victoreen 6000-529. And we performed Face Block on with 30 patients. The chamber on the actual thyroid glands to take CC and MLO and measure the dosage before and after wearing the Face Block. For the results, after wearing the Face Block, exposure was decreased by 53.8%-100% and 65.8% in average in CC View and by 50%-100% and 60.7% in average in MLO View. The development of the Face Block that practically decreased the exposure dose of thyroid glands, crystalline eyes during breast imaging and reduced the patients' anxiety during breast imaging. The Face Block is expected to improve patients' satisfaction and contribute to reducing patients' exposure dose, but more efforts should be made to reduce exposure dose to medical radiation.

Development of Decision Tree Software and Protein Profiling using Surface Enhanced laser Desorption/lonization - Time of Flight - Mass Spectrometry (SELDI-TOF-MS) in Papillary Thyroid Cancer (의사결정트리 프로그램 개발 및 갑상선유두암에서 질량분석법을 이용한 단백질 패턴 분석)

  • Yoon, Joon-Kee;Lee, Jun;An, Young-Sil;Park, Bok-Nam;Yoon, Seok-Nam
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.299-308
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    • 2007
  • Purpose: The aim of this study was to develop a bioinformatics software and to test it in serum samples of papillary thyroid cancer using mass spectrometry (SELDI-TOF-MS). Materials and Methods: Development of 'Protein analysis' software performing decision tree analysis was done by customizing C4.5. Sixty-one serum samples from 27 papillary thyroid cancer, 17 autoimmune thyroiditis, 17 controls were applied to 2 types of protein chips, CM10 (weak cation exchange) and IMAC3 (metal binding - Cu). Mass spectrometry was performed to reveal the protein expression profiles. Decision trees were generated using 'Protein analysis' software, and automatically detected biomarker candidates. Validation analysis was performed for CM10 chip by random sampling. Results: Decision tree software, which can perform training and validation from profiling data, was developed. For CM10 and IMAC3 chips, 23 of 113 and 8 of 41 protein peaks were significantly different among 3 groups (p<0.05), respectively. Decision tree correctly classified 3 groups with an error rate of 3.3% for CM10 and 2.0% for IMAC3, and 4 and 7 biomarker candidates were detected respectively. In 2 group comparisons, all cancer samples were correctly discriminated from non-cancer samples (error rate = 0%) for CM10 by single node and for IMAC3 by multiple nodes. Validation results from 5 test sets revealed SELDI-TOF-MS and decision tree correctly differentiated cancers from non-cancers (54/55, 98%), while predictability was moderate in 3 group classification (36/55, 65%). Conclusion: Our in-house software was able to successfully build decision trees and detect biomarker candidates, therefore it could be useful for biomarker discovery and clinical follow up of papillary thyroid cancer.

Psychotic Symptoms of Hashimoto's Encephalopathy: A Diagnostic Challenge

  • Savarimuthu, Monisha K;Tsheringla, Sherab;Mammen, Priya
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.1
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    • pp.42-44
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    • 2019
  • Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

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.

Effectiveness of Ultrasonographic Screening for Thyroid Cancer: Round-table Conference in the National Evidence-based Healthcare Collaborating Agency (NECA) in conjunction with the Korean Thyroid Association

  • Shin, Sangjin;Park, Sae Eun;Kim, Soo Young;Hyun, Min Kyung;Kim, Sun Wook;Kwon, Jin Won;Kim, Yeol;Kim, Won Bae;Na, Dong Gyu;Park, Hyun-Ah;Sheen, Seung Soo;Yi, Ka Hee;Chang, Hang-Seok;Cho, Jung Jin;Chung, Jae Hoon
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.5107-5110
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    • 2014
  • Background: The incidence rate of thyroid cancer has been increasing worldwide in recent years, and it is also the most prevalent cancer when it comes to the number of patients among Korean women. With it, ultrasonographic screening test has also become very common. However, there is still controversy over the performance of this screening test. Therefore, the National Evidence-based Healthcare Collaborating Agency (NECA) organized a Round-table Conference on the issues regarding ultrasonographic screening for thyroid cancer in Korea. The objective of the conference was mainly about delivering worthwhile information reflecting social value for the current situation, which was based on evidence surrounding thyroid cancer screening that relevant experts investigated and agreed on. The significance of this Round-table Conference lies in the fact that we reviewed the current evidence, and we were able to discuss the social value and future direction for ultrasonographic screening in Korea.

Sonographic Diagnosis of Cervical Lymph Node Metastasis in Patients with Thyroid Cancer and Comparison of European and Korean Guidelines for Stratifying the Risk of Malignant Lymph Node

  • Sae Rom Chung;Jung Hwan Baek;Yun Hwa Rho;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1102-1111
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    • 2022
  • Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.