Radioiondine therapy for Graves hyperthyroidism with large goiter: feasibility, efficacy and safety / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the feasibility, efficacy and safety of radioiondine therapy in the treatment of Graves hyperthyroidism with large goiter.</p><p><b>METHODS</b>A total of 128 patients with Graves; hyperthyroidism with large goiter (thyroid weight>70 g) as the study group were treated with radioiondine, using 318 concurrent patients with Graves disease with a smaller goiter (thyroid weight<70 g) as the control group. The cure rate following a single-session treatment, the total cure rate and the incidence of hypothyroidism were compared between the two groups.</p><p><b>RESULTS</b>In the large goiter group, the total cure rate was 95.3%, and the cure rate following a single-session treatment was 46.9%, with the incidence of hypothyroidism of 4.7%, as compared with 90.9%, 65.7%, and 9.1% in the control group, respectively. A significant difference was noted in the cure rate following a single-session treatment (P=0.000), but not in the total cure rate or the incidence of early-onset hypothyroidism (P=0.115) between the two groups. No tracheal compression, laryngeal edema, or hyperthyroidism crisis occurred in the large goiter group after the treatment.</p><p><b>CONCLUSION</b>Radioiondine is safe and effective for treatment of Graves hyperthyroidism with large goiter, and results in a total cure rate and incidence of early-onset hypothyroidism similar to those in patients with goiters of a smaller size.</p>

Value of (18)F-FDG dual head coincidence imaging in predicting the efficacy of radioiodine therapy for papillary thyroid carcinoma with cervical lymph node metastasis / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of (18)F-FDG dual head coincidence imaging in the prediction of the efficacy of radioiodine therapy in patients with cervical lymph node (LN) metastasis of papillary thyroid carcinoma (PTC).</p><p><b>METHODS</b>Thirty-six patients undergoing thyroidectomy and radioiodine ablation of the residual normal thyroid tissue received (18)F-FDG dual head coincidence imaging and then therapeutic (131)I-whole body imaging ((131)I-WBI) in the same week. According to those imaging results, the patients were divided into group I with positive results of both imaging examinations and group II with positive results by (131)I-WBI but negative results by(18)F-FDG dual head coincidence imaging. All the patients were followed up for 6 months.</p><p><b>RESULTS</b>In group I (14 patients), a total of 49 lesions were diagnosed as cervical LN metastases, and the total sensitivity differed significantly between (18)F-FDG dual head coincidence imaging and (131)I- WBI (67.3% vs 89.8%, P=0.027). In both groups, the total sensitivity of (18)F-FDG dual head coincidence imaging and (131)I-WBI showed a significant difference (26.0% vs 94.5%, P<0.001). The target and non-target ratio (T/NT) was identified as one of the factors affecting the radioiodine efficacy (P<0.001). In group II (22 patients), 76 lesions were diagnosed as cervical LN metastases. The effective rates of groups I and II were 35.7% and 81.8%, respectively, showing a significant difference between them (P=0.011).</p><p><b>CONCLUSION</b>(131)I-WBI is more sensitive than (18)F-FDG dual head coincidence imaging in detecting cervical LN metastasis in patients with PTC. Patients with cervical LN metastases who have positive results in both (131)I-WBI and (18)F-FDG dual head coincidence imaging tend to have a poorer response to the therapy than the patients with negative results in (18)F-FDG dual head coincidence imaging. The T/NT of the cervical LN metastases in (18)F-FDG dual head coincidence imaging is associated with the efficacy of radioiodine therapy.</p>

Value of additional skull lateral static imaging in whole-body bone imaging for skull bone invasion evaluation in nasopharyngeal carcinoma patients: comparison with CT / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of the additional skull lateral static imaging in whole-body bone imaging (WBI) vs CT for evaluation of skull base invasion in patients with nasopharyngeal carcinoma.</p><p><b>METHODS</b>A total of 405 patients with pathologically confirmed NPC underwent WBI with additional static imaging of the left and right skull as well as CT examination of the nasopharynx and skull base within one week before the radiotherapy.</p><p><b>RESULTS</b>The concordance rates between WBI and CT for positive and negative diagnosis were 29.48% and 76.05% in these cases, respectively, with the total concordance rate of 81.23%. The concordance rates between skull lateral static imaging with visual judgment and CT examination for positive and negative diagnosis were 67.95% and 74.07%, respectively, showing a total concordance rate of 87.16%. Skull lateral static imaging with semi-quantitative analysis and CT examination showed concordance rates for positive and negative diagnosis of 75.64% and 74.07%, respectively, with a total rate of 88.64%. In 27 patients with negative diagnosis by CT but a positive one in skull lateral static imaging with semi-quantitative analysis, 9 had a positive diagnosis by magnetic resonance imaging.</p><p><b>CONCLUSIONS</b>Skull lateral static imaging can be of value in the diagnosis of skull base invasion in NPC patients and may serve as an effective means for screening skull base invasion in NPC.</p>