ABSTRACT
Objective@#To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance.@*Methods@#Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model.@*Results@#Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck.@*Conclusions@#The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.
ABSTRACT
Objective To discuss the presentations, pathologic features, diagnosis and treatment of primary synovial sarcoma of the kidney. Methods One case of primary synovial sarcoma of the kidney was reported and the relevant literature was reviewed. A 55-year-old man was admitted with complaint of right abdomen and flank pain for 5 h. Computerized tomography revealed a 12.5 cm × 11.0 cm × 9. 0 cm mass located at the middle and lower pole of the right kidney. The patient was taken radical nephrectomy. Results The diagnosis of primary synovial sarcoma of the kidney in the patient was confirmed by postoperative pathology. Under microscope, tumor was typically mitotically active, monomorphic spindle cells growing in intersecting fascicles or in solid sheets with epithelial differentiation. In some areas a haemangiopericytoma-like pattern was found. Immunohistochemical staining showed that the tumor cells were positive for the markers Vimentin, CD99 and Bcl-2, but CK was negative. The patient died of local recurrence and multi-metastasis at 8 months after surgery. Conclusions Primary synovial sarcoma of the kidney is extremely rare with a high grade of malignancy,and its prognosis is poor. The diagnosis depends on pathological features, Immunohistochemical studies and RT-PCR detection. Radical resection combined with chemicaltherapy is considered to be the most reliable treatment so far.