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1.
J Endocrinol Invest ; 44(3): 541-545, 2021 Mar.
Article in English | MEDLINE | ID: mdl-32583373

ABSTRACT

PURPOSE: To assess the success rate of first dose radioiodine for treatment of hyperthyroidism in children and adolescent. METHODS: This is a retrospective data analysis of children and adolescent with hyperthyroidism who received radioiodine (RAI) therapy from January 2013 to December 2017. Age, gender, family history of hyperthyroidism, duration of anti-thyriod drugs (ATDs) treatment, rapid turnover status, 2 h and 24 h I-131 radioiodine uptake (RAIU), thyroid volume, and treatment dose were also analyzed. The goal of RAI therapy was to achieve hypothyroidism within 3-6 months after treatment. Treatment result was evaluated at 6 months after treatment and divided into 2 groups: treatment success (hypothyroid and euthyroid) and treatment failure (hyperthyroid). The same parameters were compared between both groups. RESULTS: 32 hyperthyroid patients, 26 female with mean age at treatment of 13.84 ± 1.83 years. All patients had prior treatment with ATDs, with a median treatment duration of 32.5 months (range 2-108). The median estimated thyroid gland size was 24.62 g, range 9.29-72.8. RAI doses ranged from 4.1 to 29.9 mCi (median dose = 7.54 mCi). Significant difference in 24-h I-131 uptake and RI status was demonstrated. Successful treatment rate after single dose of therapeutic I-131 was 65.63%. CONCLUSION: With the I-131 dose of 220 µCi/g of thyroid tissue, successful treatment rate after single dose of therapeutic I-131 was 65.63%. RAI therapy with I-131 dose of 250-400 µCi/g of thyroid tissue might be suitable in patients with medical failure from ATDs. Possible role of RI as the predictor for RAI therapy failure are needed to investigate in both adult and children clinical settings.


Subject(s)
Hyperthyroidism/radiotherapy , Iodine Radioisotopes/therapeutic use , Adolescent , Child , Female , Follow-Up Studies , Humans , Male , Retrospective Studies , Treatment Outcome
2.
Exp Clin Endocrinol Diabetes ; 115(10): 694-6, 2007 Nov.
Article in English | MEDLINE | ID: mdl-18058606

ABSTRACT

Hurthle cell carcinoma (HCC) of the thyroid is an uncommon and relatively rare differentiated thyroid neoplasm. To our knowledge, no reported case of adrenal metastases with abdominal carcinomatosis secondary to HCC of the thyroid has been demonstrated by F-18 FDG PET/CT imaging. One report of adrenal uptake on I-131 whole-body scan with HCC exists. In this case report, we describe a patient with HCC who had a left adrenal metastasis with abdominal carcinomatosis that was discovered using F-18 FDG PET/CT imaging.


Subject(s)
Abdominal Neoplasms/diagnostic imaging , Adenoma, Oxyphilic/diagnostic imaging , Adrenal Gland Neoplasms/diagnostic imaging , Carcinoma/diagnostic imaging , Positron-Emission Tomography , Thyroid Neoplasms/diagnostic imaging , Abdominal Neoplasms/secondary , Adrenal Gland Neoplasms/secondary , Aged , Carcinoma/secondary , Female , Humans , Neoplasm Metastasis , Radiography
3.
Singapore Med J ; 48(12): 1125-30, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18043841

ABSTRACT

INTRODUCTION: Variceal haemorrhage is a potentially life-threatening complication in cirrhotic patients. Identification of patients at high risk for bleeding is particularly important. The aim of this study was to determine the clinical usefulness of per-rectal portal scintigraphy (PPS) in the evaluation of the severity of portal hypertension in cirrhotic patients, in terms of correlation between cirrhosis and the parameters of hepatic functional reserve, and identifying the difference of the portal shunt index (PSI) of the bleeding oesophageal variceal (BEV) patients and non-BEV patients. METHODS: Portal circulations in 67 patients with cirrhosis and oesophageal varices were evaluated by Tc-99m pertechnetate PPS. Tc-99m pertechnetate (550 MBq) was instilled into the upper rectum, and dynamic images of upper abdomen were taken. Radioactivity curves for the liver and the heart were generated sequentially. Through the analysis of these curves, the PSI was determined. RESULTS: The results, expressed as PSI, were: 11.4 +/- 98.4 percent (mean 66.8) in all 67 cirrhotic patients, 56.4 +/- 27.1 percent in cirrhotic patients without history of BEV, and 74.9 +/- 13.6 percent in cirrhotic patients with history of BEV. The PSI was significantly lower in cirrhotic patients without BEV than those with BEV (p-value equals 0.001). The PSI calculated with this method was correlated with the serum albumin, the serum bilirubin, the prothrombin time, and the Child-Turcotte-Pugh score. CONCLUSION: Tc-99m pertechnetate PPS has clinical usefulness as a noninvasive method of choice for quantitatively evaluating the severity of portal hypertension in cirrhotic patients.


Subject(s)
Hypertension, Portal/diagnostic imaging , Liver Cirrhosis/diagnostic imaging , Sodium Pertechnetate Tc 99m , Administration, Rectal , Adult , Cohort Studies , Female , Humans , Hypertension, Portal/physiopathology , Hypertension, Portal/surgery , Liver Cirrhosis/physiopathology , Liver Cirrhosis/surgery , Liver Function Tests , Male , Middle Aged , Portasystemic Shunt, Surgical/methods , Probability , Radionuclide Imaging , Radiopharmaceuticals , Risk Assessment , Sensitivity and Specificity , Severity of Illness Index
6.
Singapore Med J ; 46(12): 688-92, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16308641

ABSTRACT

INTRODUCTION: To analyse and determine the clinical value of lymphoscintigraphy for sentinel lymph node (SLN) localisation in woman undergoing surgery for breast cancer, and evaluate the predictive value of SLN versus axillary lymph node (ALN) status in these patients. METHODS: Preoperative breast lymphoscintigraphy was performed in 35 female patients with breast cancer and clinically-negative ALNs. The mean age was 52.8 years (age range 38 to 73 years). The lymphoscintigraphy was performed using 74 MBq of Tc-99m nanocolloid subdermal injection over the tumour. The SLN location was marked on the skin. All patients underwent standard modified radical mastectomy with axillary lymph node dissection (ALND). A comparison of SLN and ALN histopathological results was completed in order to define the means by which the SLN biopsy was able to reflect the final status of ALNs. RESULTS: In 20/35 (57.1 percent) cases, SLNs were visualised in 20-minute dynamic imaging. In 12 patients, SLNs were seen after delayed imaging and/or by repositioning the patient. Overall, the estimated SLN identification rate was 91.4 percent. Of 32 patients in whom SLNs were localised by lymphoscintigraphy, nine were positive for metastatic tumours and the rest were negative for tumour involvement. In four of these nine patients, SLN was the only node that contained metastatic tumour cells while in five patients, an additional concomitant ALN metastasis was detected. In four patients, SLN was negative on frozen section, but skip ALN metastases were noted. Of three patients in which SLNs were not localised by lymphoscintigraphy, two had positive ALNs for tumour cells and the remaining one was negative for tumour involvement. CONCLUSION: We concluded that SLN localisation using lymphoscintigraphy is an accurate minimally-invasive procedure for staging breast cancer patients with clinically-negative ALNs, and can substantially reduce the morbidity and costs of surgical treatment by avoiding unnecessary ALND in the majority of patients.


Subject(s)
Breast Neoplasms/diagnostic imaging , Lymph Nodes/diagnostic imaging , Neoplasm Staging/methods , Sentinel Lymph Node Biopsy/methods , Adult , Aged , Axilla , Breast Neoplasms/surgery , Female , Gamma Cameras , Humans , Lymph Nodes/surgery , Lymphatic Metastasis/diagnostic imaging , Middle Aged , Radionuclide Imaging , Technetium
7.
Singapore Med J ; 45(1): 43-7, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14976582

ABSTRACT

A 63-year-old woman was found to have pathological fracture of the right lower tibia through a brown tumour, hypercalcemia, and a soft tissue mass at the lower pole of the right lobe of thyroid gland. US scan of the neck showed a well-circumscribed heterogeneously-hypoechoic mass with displacement of the right lobe of thyroid gland. Diagnosis of parathyroid adenoma was confirmed on histopathological examination of the excised specimen. The cause and clinical manifestations of primary hyperparathyroidism are discussed. Imaging methods of parathyroid gland are presented.


Subject(s)
Adenoma/diagnostic imaging , Adenoma/surgery , Hypercalcemia/surgery , Parathyroid Glands/surgery , Parathyroid Neoplasms/diagnostic imaging , Parathyroid Neoplasms/surgery , Female , Humans , Hypercalcemia/diagnostic imaging , Middle Aged , Parathyroid Glands/diagnostic imaging , Ultrasonography
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