Long-term follow-up of differentiated thyroid carcinoma in children and adolescents.

Objectives The aims were to analyze the clinical features, response to treatment, prognostic factors and long-term follow-up of children and adolescents with differentiated thyroid carcinoma (DTC). Methods Eighty patients with DTC were studied retrospectively. All underwent total or near-total thyroidectomy, and in 75 cases, ablative iodine therapy was recommended. Patients were assessed periodically by tests for serum thyroglobulin levels and whole-body iodine scans. Age, gender, initial clinical presentation, histology, tumor stage, postoperative complications, radioiodine treatment protocol, treatment response, thyroglobulin (Tg), recurrence and long-term disease progression were evaluated. Results Seventy patients completed >2 years of follow-up (23 males, 47 females; median age: 14 years; range: 3-18 years). Sixty-two patients showed papillary DTC and eight, follicular DTC. Sixty-five percent presented nodal metastasis and 16%, pulmonary metastasis at diagnosis. Six months after first radioiodine treatment, 36.2% of patients were free of disease. Seven recurrences were documented. At the end of follow-up, overall survival was 100%, and 87.2% of patients were in complete remission. Nine patients had persistent disease. We found a significant association between stage 4 and persistent disease. Hundred percent of patients with negative Tg values at 6 months posttreatment were documented free of disease at the end of the follow-up. The analysis of disease-free survival based on radioiodine treatment protocols used showed no statistically significant differences. Conclusions DTC in children and adolescents is frequently associated with presence of advanced disease at diagnosis. Despite this, complete remission was documented after treatment in most cases, with a good prognosis in the long-term follow-up. Negative posttreatment thyroglobulin and stage 4 at diagnosis were significant prognostic variables.

Normal myocardial perfusion SPECT database for the Spanish population.

INTRODUCTION AND OBJECTIVES: The aims of this study were to create a Spanish database of normal myocardial perfusion SPECT (single-photon emission computed tomography) data, termed the normal Spanish database, and to compare it with a database of normal data from the North American population. METHODS: We selected 104 healthy volunteers (45 female, mean age 42+/-14 years) who underwent SPECT during stress and at rest. The findings were analyzed using the 4DM-SPECT commercial software package. The resulting normal Spanish database for males and females was compared with the North American population database (from 70 men and 60 women) provided with the 4DM-SPECT software. RESULTS: In the Spanish database, the highest percentage uptake during both stress and rest was observed in medial-lateral region and the lowest, in the basal-septal region. The percentage uptake in the anterior-medial region was significantly lower in women than men, while uptake in the inferior, medial-septal and apical regions was lower in men than women. Data values in the Spanish database were significantly lower for the majority of heart regions than those in the database with the 4DM-SPECT software. CONCLUSIONS: A Spanish database of normal myocardial perfusion SPECT data was created and included separate data for men and women. Significant differences were observed between this database and a commercial North American database that is commonly used in semiquantitative studies.

Base de datos de normalidad de la SPECT de perfusión miocárdica en la población española / Normal myocardial perfusion SPECT database for the spanish population

Introducción y objetivos. El objetivo de este estudio ha sido crear una base de datos española (BDE) de normalidad de la SPECT ( single photon emission computed tomography) de perfusión miocárdica y compararla con una base de datos de normalidad de población norteamericana. Métodos. Se seleccionó a 104 voluntarios sanos (45 mujeres, media de edad, 42 ± 14 años) a los que se practicó una SPECT de estrés y reposo, procesándose los estudios en el programa comercial 4DM-SPECT. La BDE de normalidad generada para varones y mujeres se comparó con la base de datos de la población norteamericana (70 varones y 60 mujeres) que proporciona el programa 4DM-SPECT. Resultados. En la BDE el mayor porcentaje de captación correspondió a la región lateral-medial, y el menor, a la región septal-basal, tanto en estrés como en reposo. En las mujeres el porcentaje de captación de la región anterior-medial fue significativamente más bajo que en los varones, mientras que en éstos se observó una menor captación en las regiones inferiores, septal medial y apical con respecto a las mujeres. Los valores de la BDE fueron significativamente más bajos que los de la 4DMSPECT en la mayoría de las regiones. Conclusiones. Se ha creado una base de datos de normalidad española para mujeres y varones por separado de la SPECT de perfusión miocárdica, y se ha observado que hay diferencias significativas con una base de datos comercial de origen norteamericano que suele utilizarse en estudios semicuantitativos (AU)

Introduction and objectives. The aims of this study were to create a Spanish database of normal myocardial perfusion SPECT (single-photon emission computed tomography) data, termed the normal Spanish database, and to compare it with a database of normal data from the North American population. Methods. We selected 104 healthy volunteers (45 female, mean age 42±14 years) who underwent SPECT during stress and at rest. The findings were analyzed using the 4DM-SPECT commercial software package. The resulting normal Spanish database for males and females was compared with the North American population database (from 70 men and 60 women) provided with the 4DM-SPECT software. Results. In the Spanish database, the highest percentage uptake during both stress and rest was observed in medial-lateral region and the lowest, in the basal-septal region. The percentage uptake in the anterior-medial region was significantly lower in women than men, while uptake in the inferior, medial-septal and apical regions was lower in men than women. Data values in the Spanish database were significantly lower for the majority of heart regions than those in the database with the 4DM-SPECT software. Conclusions. A Spanish database of normal myocardial perfusion SPECT data was created and included separate data for men and women. Significant differences were observed between this database and a commercial North American database that is commonly used in semiquantitative studies (AU)