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Objective To evaluate the role of (99)Tc(m)-MDP SPECT/CT bone fusion imaging in diagnosis and treatment strategy establishment of patients with bone metastatic malignancy.Methods Retrospective study was carried out on 66 patients (55 patients with primary malignant tumors,11 patients with primary benign bone disease) chosen from 117 patients who had undergone whole body bone scintigraphy and SPECT/CT fusion imaging examination.Comparison was carried out on diagnostic efficacy for bone metastases and changes of treatment between SPECT/CT fusion imaging and other anatomical imaging (CT and/or MR).Cases excluded are extensive bone metastases and no final diagnosis of patients.Results For diagnosis of patient with bone metastasis and bone metastasis lesion,the sensitivity of SPECT/CT fusion imaging was (90.62％,93.88％),specificity (79.41％,89.47％) and accuracy (84.84％,90.97％),while sensitivity of simple anatomical imaging was (59.38％,51.02％),specificity (94.11％,94.73％) and accuracy (77.27％,79.86％),with a significant difference (P ＜ 0.05).SPECT/CT fusion imaging changed 30.31％ (20/66) the patient's treatment plan,while 16.67％ (11/66) for simple anatomical imaging,with a significant difference (P ＜ 0.05).Conclusions SPECT/CT fusion imaging could increase the accuracy of diagnosis of bone metastases and have an important role in establishing the treatment strategy.
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Objective To analyze the pregnancy outcomes and effect on fertility in women with Graves' disease after 131I therapy and the health status of their newborns.Methods From year 2009 to 2012,a total of 102 female patients with Graves' disease,who were pregnant during propylthiouracil (PTU)/L-thyroxine (euthyrox) maintenance treatment,were retrospectively recruited.The subjects were divided into 131I therapy group (n=57) and non-131I therapy group (n=45).The time interval between 131I (non-131I) therapy and getting pregnant were at least 6 months.They were followed for their pregnancy outcomes.During the pregnancy period,recorded parameters included serum thyroid biochemistry,dose of PTU/euthyrox,health conditions of the newborns and termination of pregnancy.Medication compliance,delivery mode,baby gender and body weight between the 2 groups were compared byx2 test,Mann-Whitney u test,Fisher exact test and two-sample t test.Results Ninety-seven patients had normal labor.In 131I therapy group and non-131I therapy group,15 vs 22 patients were treated by PTU,31 vs 18 by euthyrox and 11 vs 5 without any medication during pregnancy (x2=5.69,P＞0.05).The medical compliance (PTU and euthyrox: u=163.50,233.50,both P＞0.05) was similar between the 2 groups.The delivery mode (natural labor/cesarean: 36/19 vs 28/14,x2 =0.016),baby gender (male/female: 32/23 vs 18/24,x2 =2.239) and body weight ((3.18t0.47) vs (3.07±4.17) kg,t=1.154) were also similar between the 2 groups (all P＞0.05).Condusion Women of reproductive age with Graves' disease were found to have normal pregnancy after 131I therapy,on the condition that their thyroid function could be reasonably controlled and maintained by the proper medication before and during pregnancy.
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Objective To evaluate the effects of 131I treatment for Graves hyperthyroidism patients with leucopenia and the alteration of WBC levels after treatment.Methods A total of 257 Graves hyperthyroidism cases were retrospectively studied after 131I treatment.Based on baseline WBC count,119 cases with WBC count ＜4.0 × 109/L before 131I treatment were diagnosed with leucopenia and 138 cases had normal WBC.There were no significant differences in age,weight of thyroid,131I uptake rate in 24 h,dose of 131I and course of the disease between the two groups (all t ＜ 0.972,all P ＞ 0.05).WBC,lymphocyte,neutrophil and platelet counts were recorded before and 1,3,6 and 12 months after 131I therapy.The therapeutic effects were graded as clinical cure,improvement,invalidation and hypothyroidism.Statistical analyses,including independent samples t test,x2 test and one-way analysis of variance,were performed using SPSS 13.0.Results The WBC levels in the leucopenia group were (3.49 ± 0.43) × 109/L,(4.06 ±0.98) × 109/L,(4.20 ±1.04) × 109/L,(4.37 ±0.93) × 109/L and (4.88 ± 1.20) × 109/L before 131I treatment and 1,3,6,12 months after 131I treatment,respectively; while,those in the normal WBC group were (5.70 ± 1.08) × 109/L,(5.50 ± 1.14) × 109/L,(5.74 ±0.99) × 109/L,(5.95 ± 1.14) × 109/L and (6.07 ± 1.17) × 109/L,respectively.There was no statistically significant difference of WBC levels before and 1 month after 131 I treatment (t =1.662,P ＞ 0.05) in the normal WBC group,but WBC levels at those timepoints were significantly different in the leucopenia group (t =3.816,P ＜ 0.05).In the leucopenia group,there was no significant change of lymphocytes before and after 131I treatment,while the average neutrophil count showed an increasing trend during the 1,3,6 and 12 months after 131I treatment (F =40.583,t:1.468-11.264,all P ＜ 0.05).The average platelet counts at 6 and 12 months after 131I treatment were (187.80 ± 36.03) × 109/L and (206.88 ± 26.04) × 109/L respectively,which were higher than that before 131I treatment (F =9.735,t =2.604,4.892,all P ＜0.05).In the normal WBC group,there were no statistical differences of WBC changes before and after 131I treatment except for a lower lymphocyte count at 1 month after 131I treatment than that at baseline ((1.79 ± 0.37) × 109/L vs (1.99 ±0.63) × 109/L;F =12.868,t =3.284,both P ＜ 0.05).The treatment effects of the two groups were not significantly different (x2 =0.739,P ＞ 0.05).Conclusions 131I treatment presents similar therapeutic effects on Graves hyperthyroidism patients with leucopenia and those with normal WBC levels.WBC levels in patients with leucopenia may recover to baseline during the post-treatment follow-up.Thus 131I treatment is a safe and effective method for Graves hyperthyroidism patients with leucopenia.