Risk factors for anaplastic thyroid cancer.

Background. Anaplastic thyroid cancer (ATC) is a form of thyroid cancer with very poor prognosis, but is fortunately quite rare. Its aetiology is unknown and not well researched. Aim. The aim of this study was to identify potential risk factors for ATC. Material and Method. Case-control study of 126 ATC patients (77 females and 49 males) and 252 controls individually matched by gender, age, and place of abode. In statistical analysis we used a Cox regression model. Results. Univariate logistic regression showed that the risk factors for ATC are low education level, type B blood group, goitre, other nonthyroid malignancies, diabetes, late menarche, and an early first pregnancy. Multivariate logistic regression analysis showed that independent risk factors for ATC are low education level (OR = 1.42, 95% CI = 1.09-1.86), type B blood group (OR = 2.41, 95% CI = 1.03-5.66), and goitre (OR = 25-33, 95% CI = 5.66-126.65). Conclusion. Independent risk factors for ATC are: low education level, type B blood group, and goitre.

Surgical anatomy of the pyramidal lobe and its significance in thyroid surgery.

AIM: The purpose of this prospective study was to highlight some new findings about anatomical and morphological variations of the thyroid pyramidal lobe and to emphasise the necessity and importance of exploration of the visceral compartment of the neck and resection of this structure in primary thyroid operations. METHOD: We analysed 100 consecutive primary thyroid operations with additional pathological examination of the specimens. RESULTS: A pyramidal lobe was found in 61% of the cases. The lobe of Lalouette was found more often in women (61.96%) than in men (50%) and more often (67.3%) in patients less than 50 years old than in those older than 50 (54.2%). The lobe branched off more frequently from the midline (49.18%) than from other parts of the isthmus; its length ranged from 8 - 40 mm, with a median length of 20.13 mm. In diffuse thyroid diseases, the lobes were always pathologically involved and significantly longer. CONCLUSION: Since the pyramidal lobe is a normal component of the thyroid gland, of varying position and size, with pathological changes in benign and malignant diseases, it should always be examined during thyroid surgery and mandatorily removed in total and subtotal thyroidectomies.

[Solitary hyperfunctioning thyroid gland carcinomas]. / Unifokale hyperfunktionelle Karzinome der Schilddrüse.

BACKGROUND: Thyroid gland carcinomas usually appear as afunctional and hypofunctional lesions on thyroid scintigrams, but some rare cases of thyroid carcinoma with scintigraphic hyperfunctional lesions have also been reported. The aim of our retrospective study was to elucidate the frequency of carcinomas in patients operated for solitary hyperfunctional thyroid nodules and to represent their demographic and clinical features. PATIENTS AND METHODS: During one decade (1997/2006), 308 patients were operated for solitary hyperfunctional thyroid nodules in the Centre for Endocrine Surgery in Belgrade. RESULTS: Malignancy was revealed in 9 cases (about 3 %) by histopathological examination. In 6 cases papillary microcarcinomas were found adjacent to dominant hyperfunctional adenomas, while in 3 cases (about 1 %) real hyperfunctional carcinomas were confirmed. Follicular carcinoma was diagnosed in 2 cases and papillary carcinoma in one. All 3 patients were preoperatively hyperthyroid. In both patients with follicular carcinoma we performed lobectomies. In the third case we carried out a total thyroidectomy considering the intraoperative frozen section finding of a papillary carcinoma. CONCLUSIONS: According to our results the frequency of solitary hyperfunctioning thyroid carcinomas is about 1 %, so that the possibility that a hyperfunctional nodule is malignant should be considered in the treatment of such lesions.

Comparison of doses calculated by the Monte Carlo method and measured by LiF TLD in the buildup region for a 60Co photon beam.

This work studied the percent depth doses of (60)Co photon beams in the buildup region of a plastic phantom by LiF TLD measurements and by Monte Carlo calculations. An agreement within +/-1.5% was found between PDDs measured by TLD and calculated by the Monte Carlo method with the TLD in a plastic phantom. The dose in the plastic phantom was scored in voxels, with thickness scaled by physical and electron density. PDDs calculated by electron density scaling showed a better match with PDD(TLD)(MC); the difference is within +/-1.5% in the buildup region for square and rectangular field sizes.

Some cosmic radiation dose measurements aboard flights connecting Zagreb Airport.

When primary particles from space, mainly protons, enter the atmosphere, they produce interactions with air nuclei, and cosmic-ray showers are induced. The radiation field at aircraft altitude is complex, with different types of particles, mainly photons, electrons, positrons and neutrons, with a large energy range. The non-neutron component of cosmic radiation dose aboard A320 and ATR40 aircraft was measured with TLD-100 (LiF:Mg,Ti) detectors and the Mini 6100 semiconductor dosimeter; the neutron dose was measured with the neutron dosimeter consisted of LR-115 track detector and boron foil BN-1 or 10B converter. The estimated occupational effective dose for the aircraft crew (A320) working 500 h per year was 1.64 mSv. Another experiment was performed at the flights Zagreb-Paris-Buenos Aires and reversely, when one measured non-neutron cosmic radiation dose; for 26.7 h of flight, the MINI 6100 dosimeter gave an average dose rate of 2.3 microSv/h and the TLD dosimeter registered the dose equivalent of 75 microSv or the average dose rate of 2.7 microSv/h; the neutron dosimeter gave the dose rate of 2.4 microSv/h. In the same month, February 2005, a traveling to Japan (24-h-flight: Zagreb-Frankfurt-Tokyo and reversely) and the TLD-100 measurement showed the average dose rate of 2.4microSv/h; the neutron dosimeter gave the dose rate of 2.5 microSv/h. Comparing dose rates of the non-neutron component (low LET) and the neutron one (high LET) of the radiation field at the aircraft flight level, we could conclude that the neutron component carried about 50% of the total dose, that was near other known data.

Harmonization of individual dosimetry quality control within metrology system of a small country.

A programme of harmonization of individual dosimetry quality control organized in the framework of a distributed metrology system is presented as seen from the experiences gained in Slovenia. As a part of the programme intercomparison of dosimetry services was organized and basic characteristics of dosimetry systems compared. Results are discussed with suggestions for further improvements of quality assurance.

Intercomparison of dosimetry systems based on CaF2:Mn TL detectors.

The responses of readings by the TL dosimetry system MR200 TL developed in-house and used at JSI and the TOLEDO TL system used at RBI are compared. Ten measurements at different doses ranging from 0.01 mSv to 5 Sv were carried out. A set of 36 dosemeters with three pellets of CaF2:Mn were irradiated in radiation fields of 137Cs and 60Co. Analysis of the measured results shows that at doses below 0.1 Sv, readers' outputs do not differ >5% from each other. At doses >1 Sv, the results obtained by the MR200 reader must be corrected with a known factor. Finally, the reproducibility of the results from the MR200 was tested.

Energy dependence of new thermoluminescent detectors in terms of HP(10) values.

The aim of this work was to determine energy dependence characteristics in terms of values of the personal dose equivalent, HP(10). The following types of thermoluminescent detectors (TLDs) were investigated: (a) two new types based on lithium borate, Li2B4O7:Cu,In and Li2B4O7:Cu,In,Ag; (b) two types based on the highly sensitive material LiF:Mg,Cu,P, TLD-700H and GR 200A; (c) two well-known types of LiF:Mg,Ti detector, TLD-100 and TLD-700 and (d) highly sensitive Al2O3:C detectors. TLDs previously calibrated with 137Cs gamma rays were simultaneously irradiated with X ray beams in the range of mean energies between 33 and 116 keV. The irradiations were performed with detectors in polymethyl methacrylate (PMMA) holders placed on a 30 cm x 30 cm x 15 cm water phantom with PMMA walls (ISO phantom). Measured energy responses were compared with calculated data for HP(10) values. The results confirmed the satisfactory tissue equivalent characteristics of all investigated TLDs except Al2O3:C, which (due to its large energy dependence) is suitable for personal dosimetry only with an appropriate filter.

Efficacy of breast shielding during CT of the head.

In light of increasing frequency of CT examinations in the past decades, the aims of this prospective study were to investigate scatter radiation breast exposure in head CT and its dependence upon body constitution, and to assess the efficacy of lead shielding as a means of breast dose reduction. In 49 women referred to head CT for objective medical reasons one breast was covered with lead apron during CT scanning. Radiation doses were measured by use of thermoluminescent dosimeters, at skin of both breasts and over the apron. The doses were then compared as well as correlated to body mass index and meatus acusticus externus-to-dosimeter distance, respectively. Average exposure at the skin of the unshielded breast was 0.28 mGy (range 0.15-0.41 mGy), compared with 0.13 mGy (range 0.05-0.29 mGy) at the shielded breast. The doses showed a mean reduction by 57% due to lead shielding. At least half of breast exposure was imparted to the breast from outside, whereas the remainder results from internal scatter. The higher the body mass index, the higher the percentage of internal scatter in total breast dose. Although the level of scatter radiation to the breast is generally low during head CT examination, the use of lead cover enables recognizable further reduction of the exposure, and is recommended as a feasible and effective procedure of breast protection during CT of the head.

Main dosimetric characteristics of some tissue-equivalent TL detectors.

The aim of this work was to determine important dosimetric characteristics of several types of the most interesting tissue-equivalent thermoluminescent detectors (TLDs). Special attention was given to the determination of energy dependence for medium and low energy X rays. The following types of TLDs were investigated: (a) two new types based on lithium borate: Li2B4O7:Cu,In and Li,B4O7:Cu,In,Ag; (b) two types of the recently developed highly sensitive LiF:Mg,Cu,P material: TLD-700H and GR 200A and (c) two well known types of LiF:Mg,Ti detectors: TLD-100 and TLD-700. In order to determine their photon energy response characteristics, TLDs previously calibrated with 137Cs gamma rays were simultaneously irradiated with X ray beams in the range of effective energies between 33 and 116 keV. Measured energy responses (relative to air), normalised to those to 137Cs photons were compared with calculated data. Although the deviations of the measured data from the 'theoretical' predictions are different for all the investigated TLDs, there is no large difference in 'tissue-equivalency' between them.

Application of the alkaline comet assay in biodosimetry: assessment of in vivo DNA damage in human peripheral leukocytes after a gamma radiation incident.

The alkaline comet assay was employed in the assessment of DNA damage in leukocytes of a worker incidently exposed to gamma radiation (221 mSv, 60Co source). The comet tail lengths and tail moments were studied. By using the alkaline comet assay immediately after accidental exposure a high level of DNA damage was recorded. The highest levels of DNA damage were recorded one day and one week after the radiation incident. Later on, a decrease in both comet parameters was observed. Although the level of DNA damage was diminished during a one year period, it was still elevated compared to normal values recorded in leukocytes of a healthy, unexposed person. The results obtained indicate that the alkaline comet assay is a rapid and sensitive microdosimetric technique and is suitable for in vivo human biomonitoring, especially in cases of incidental exposure to ionising radiation.

Biological monitoring of three 60Co radiation incident victims.

Radiation-induced structural chromosomal aberrations were the only adverse effects found in three workers overexposed to 60Co gamma-radiation. Chromosomal analyses were performed on the 5th and 75th days after exposure. Hematologic follow-up was carried out on the 5th, 12th, 16th, and 75th days after exposure. Hematologic findings did not differ over time in any of the three exposed workers. In two workers, we found dicentric chromosomes, which are conventional indicators for exposure to ionizing radiation.